A Phase 1 interventional study of Cetuximab + Irinotecan and Cetuximab + Irinotecan in Cancer and Refractory Solid Tumor, sponsored by Eli Lilly and Company. Completed at 9 sites in United States. Open to participants aged 1 Year to 18 Years. Per ClinicalTrials.gov, last updated 2015-12-24.
Sponsored by Eli Lilly and Company · Phase 1, Interventional, and Diagnostic
The purpose of this clinical research study is to establish the maximum tolerated dose and recommended Phase II dose of Erbitux™ in combination with Irinotecan in pediatric and adolescent patients with refractory solid tumors.
9,365 studies on the registry are indexed under Neoplasms; 2,489 are open to participants now.
This study's enrollment of 48 is close to the median of 50 across 7,253 interventional studies indexed under Neoplasms.
Browse Neoplasms studies →Eli Lilly and Company is the lead sponsor of 2,048 studies on the registry; 140 are open to participants now.
Of its 521 completed or terminated interventional studies of FDA-regulated products, 341 (65%) have results posted.
Counted across the registry records on this site, refreshed daily.
Exclusion Criteria:
1-12 years old
Drug: Cetuximab + Irinotecan
13-18 years old
Drug: Cetuximab + Irinotecan
Intravenous (IV) cetuximab 75 - 250 mg/m2 depending on dose escalation for MTD, weekly; irinotecan was administered at a dose of 16 or 20 mg/m2 or per dose escalation, administered x5 days x2 weeks, separated by 2 days off, every 21 days.
Intravenous (IV) cetuximab 75 - 250 mg/m2 depending on dose escalation for MTD, weekly; irinotecan was administered at a dose of 20 mg/m2 or per dose escalation, administered x5 days x2 weeks, separated by 2 days off, every 21 days.
Maximum Tolerated Dose (MTD) and Recommended Phase 2 Dose (RPIID) of Cetuximab in Combination With Irinotecan
MTD of cetuximab intravenous (IV) weekly + irinotecan IV x5 days x2 weeks (in a 3-week cycle) and RPIID of cetuximab IV weekly, as measured by dose-limiting toxicities (see outcome measure 2)
Time frame: Continuous assessment of safety throughout the entire study period and determination of doe-limiting toxicities during and at the end of Cycle 1.
Number of Participants With a Dose-Limiting Toxicity
Dose-limiting toxicities (DLTs)=serious drug side effects preventing further dose escalation. If 1 of the first 3 subjects developed a DLT during cycle 1 up to 3 additional subjects were enrolled at that dose level. The maximum dose level at which DLTs occurred in fewer than 2 out of 3 to 6 subjects was defined as the Maximum Tolerated Dose (MTD).
Time frame: Prior to each 21-day cycle until dose-limiting toxicities
Maximum Plasma Concentration (Cmax)
The single dose pharmacokinetics (PK) of cetuximab was administered with an intravenous dose of irinotecan 16 to 20 mg/m2; Cmax was evaluated based on concentration-time profile.
Time frame: up to 168 hours after the start of the cetuximab infusion during the first 21-day cycle of the study
Area Under the Curve, Extrapolated to Infinity (AUC[INF])
The single dose PK of cetuximab was administered with an intravenous dose of irinotecan 16 to 20 mg/m2; AUC(INF) was evaluated based on concentration-time profile.
Time frame: up to 168 hours after the start of the cetuximab infusion during the first 21-day cycle of the study
Terminal Half-Life (T-Half)
The single dose PK of cetuximab was administered with an intravenous dose of irinotecan 16 to 20 mg/m2; T-half was evaluated based on concentration-time profile.
Time frame: up to 168 hours after the start of the cetuximab infusion during the first 21-day cycle of the study
Clearance Corrected for Body Surface Area (CL/BSA)
The single dose PK of cetuximab was administered with an intravenous dose of irinotecan 16 to 20 mg/m2; CL/BSA was evaluated based on concentration-time profile.
Time frame: up to 168 hours after the start of the cetuximab infusion during the first 21-day cycle of the study
Volume of Distribution at Steady State Corrected for Body Surface Area (VSS/BSA)
The single dose PK of cetuximab was administered with an intravenous dose of irinotecan 16 to 20 mg/m2; VSS/BSA was evaluated based on concentration-time profile.
Time frame: up to 168 hours after the start of the cetuximab infusion during the first 21-day cycle of the study
Tumor Response
Non-central nervous system (CNS) tumors evaluated using Response Evaluation Criteria In Solid Tumors (RECIST), criteria to define when cancer patients improve ("respond"), stay the same ("stable"), or worsen ("progression"). CNS tumors evaluated based on measurements by investigator, dependence on corticosteroids, and neurologic exam.
Time frame: Every other 21-day cycle
Human Anti-cetuximab Antibody (HACA) Response
In order to be considered positive for anti-cetuximab a sample had to: 1) be evaluable (i.e., have a pre and at least one post-treatment timepoint), 2) have an anti-cetuximab value \> 7 ng/mL and 3) have a post-treatment sample at least twice the pre-treatment level.
Time frame: Blood was drawn immediately prior to cetuximab infusions, on a 21-day cycle
Number of Deaths, Serious Adverse Events (SAEs), and Adverse Events (AEs)
Toxicity assessments performed at least weekly from the 1st dose of study drug until at least 30 days after the final dose of study drug and thereafter every 4 weeks until all study-related toxicities resolved, returned to baseline, or were deemed irreversible, whichever was longer. Grade 3=severe AE; grade 4=disabling or life threatening.
Time frame: Weekly throughout the study and every 4 weeks thereafter
Grade 3-4 Laboratory Abnormalities - Leukopenia
Blood samples were collected at selected times (pretreatment visit, prior to each treatment cycle, weekly, and at the end of treatment) for clinical laboratory evaluations. Grade 3= Severe AE; Grade 4=Life-threatening or disabling AE
Time frame: pretreatment visit, prior to each treatment cycle, weekly, and at the end of treatment
Grade 3-4 Laboratory Abnormalities - Neutropenia
Blood samples were collected at selected times (pretreatment visit, prior to each treatment cycle, weekly, and at the end of treatment) for clinical laboratory evaluations. Grade 3= Severe and undesirable AE; Grade 4=Life-threatening or disabling AE
Time frame: pretreatment visit, prior to each treatment cycle, weekly, and at the end of treatment
Grade 3-4 Laboratory Abnormalities - Thrombocytopenia
Blood samples collected at selected times (pretreatment visit, prior to each treatment cycle, weekly, and at the end of treatment) for clinical laboratory evaluations. Grade 3= Severe AE; Grade 4=Life-threatening or disabling AE
Time frame: pretreatment visit, prior to each treatment cycle, weekly, and at the end of treatment
Grade 3/4 Laboratory Abnormalities - Hypomagnesemia
Blood samples were collected at selected times (pretreatment visit, prior to each treatment cycle, weekly, and at the end of treatment) for clinical laboratory evaluations. Grade 3= Severe AE; Grade 4=Life-threatening or disabling AE
Time frame: pretreatment visit, prior to each treatment cycle, weekly, and at the end of treatment
| Milestone | 1- to 12-years-old | 13- to 18-years-old |
|---|---|---|
| Started | 27 | 19 |
| Completed | 0 | 0 |
| Not completed | 27 | 19 |
| Withdrew: Deterioration without progression | 2 | 0 |
| Withdrew: Disease progression/relapse | 20 | 15 |
| Withdrew: Study closure | 1 | 0 |
| Withdrew: Study drug toxicity | 1 | 3 |
| Withdrew: Withdrawal by subject | 3 | 1 |
Dose-limiting toxicities (DLTs)=serious drug side effects preventing further dose escalation. If 1 of the first 3 subjects developed a DLT during cycle 1 up to 3 additional subjects were enrolled at that dose level. The maximum dose level at which DLTs occurred in fewer than 2 out of 3 to 6 subjects was defined as the Maximum Tolerated Dose (MTD).
| Participants | Group A: 75/20 | Group A: 150/20 | Group A 150/16 | Group A: 250/16 | Group B: 75/20 | Group B: 150/20 | Group B: 250/20 |
|---|---|---|---|---|---|---|---|
| Subjects with a dose-limiting toxicity | 1 | 2 | 0 | 0 | 1 | 0 | 1 |
| Subjects with no dose-limiting toxicity | 5 | 4 | 3 | 12 | 7 | 4 | 6 |
The single dose pharmacokinetics (PK) of cetuximab was administered with an intravenous dose of irinotecan 16 to 20 mg/m2; Cmax was evaluated based on concentration-time profile.
| µg/mL | Group A: 75 | Group A :150 | Group A: 250 | Group B: 75 | Group B: 150 | Group B: 250 |
|---|---|---|---|---|---|---|
| Maximum Plasma Concentration (Cmax) | 50.5 ± 16.7 | 112.9 ± 24.7 | 163.7 ± 31.1 | 53.4 ± 21.7 | 83.1 ± 13.2 | 148.5 ± 28.1 |
The single dose PK of cetuximab was administered with an intravenous dose of irinotecan 16 to 20 mg/m2; AUC(INF) was evaluated based on concentration-time profile.
| µg•h/mL | Group A: 75 | Group A :150 | Group A: 250 | Group B: 75 | Group B: 150 | Group B: 250 |
|---|---|---|---|---|---|---|
| Area Under the Curve, Extrapolated to Infinity (AUC[INF]) | 1598.3 ± 863.32 | 8871.2 ± 1861.1 | 17706.0 ± 6384.5 | 1925.2 ± 460.6 | 7027.3 ± 239.5 | 13410.4 ± 5484.5 |
The single dose PK of cetuximab was administered with an intravenous dose of irinotecan 16 to 20 mg/m2; T-half was evaluated based on concentration-time profile.
| hours | Group A: 75 | Group A :150 | Group A: 250 | Group B: 75 | Group B: 150 | Group B: 250 |
|---|---|---|---|---|---|---|
| Terminal Half-Life (T-Half) | 31.0 ± 13.9 | 75.2 ± 18.7 | 110.3 ± 43.1 | 37.9 ± 6.3 | 61.1 ± 10.5 | 81.9 ± 20.4 |
The single dose PK of cetuximab was administered with an intravenous dose of irinotecan 16 to 20 mg/m2; CL/BSA was evaluated based on concentration-time profile.
| L/h/m2 | Group A: 75 | Group A :150 | Group A: 250 | Group B: 75 | Group B: 150 | Group B: 250 |
|---|---|---|---|---|---|---|
| Clearance Corrected for Body Surface Area (CL/BSA) | 0.057 ± 0.041 | 0.017 ± 0.004 | 0.015 ± 0.005 | 0.040 ± 0.010 | 0.021 ± 0.001 | 0.020 ± 0.009 |
The single dose PK of cetuximab was administered with an intravenous dose of irinotecan 16 to 20 mg/m2; VSS/BSA was evaluated based on concentration-time profile.
| L/m2 | Group A: 75 | Group A: 150 | Group A: 250 | Group B: 75 | Group B: 150 | Group B: 250 |
|---|---|---|---|---|---|---|
| Volume of Distribution at Steady State Corrected for Body Surface Area (VSS/BSA) | 2.081 ± 0.666 | 1.860 ± 0.564 | 2.157 ± 0.362 | 2.138 ± 0.453 | 1.887 ± 0.262 | 2.179 ± 0.250 |
Non-central nervous system (CNS) tumors evaluated using Response Evaluation Criteria In Solid Tumors (RECIST), criteria to define when cancer patients improve ("respond"), stay the same ("stable"), or worsen ("progression"). CNS tumors evaluated based on measurements by investigator, dependence on corticosteroids, and neurologic exam.
| Participants | CNS Primary Tumor | Non-CNS Primary Tumor |
|---|---|---|
| Partial Response | 2 | 0 |
| Stable Disease | 10 | 8 |
| Progressive Disease | 10 | 11 |
| Not Assessable/Unable to Determine | 4 | 1 |
In order to be considered positive for anti-cetuximab a sample had to: 1) be evaluable (i.e., have a pre and at least one post-treatment timepoint), 2) have an anti-cetuximab value \> 7 ng/mL and 3) have a post-treatment sample at least twice the pre-treatment level.
| Participants | Number of Participants |
|---|---|
| Evaluable Participants | 27 |
| Unevaluable Participants | 15 |
| Participants with positive HACA level | 1 |
Toxicity assessments performed at least weekly from the 1st dose of study drug until at least 30 days after the final dose of study drug and thereafter every 4 weeks until all study-related toxicities resolved, returned to baseline, or were deemed irreversible, whichever was longer. Grade 3=severe AE; grade 4=disabling or life threatening.
| Participants | Group A: 75/20 | Group A: 150/20 | Group A 150/16 | Group A: 250/16 | Group B: 75/20 | Group B: 150/20 | Group B: 250/20 |
|---|---|---|---|---|---|---|---|
| Deaths (total) | 0 | 5 | 2 | 5 | 3 | 1 | 1 |
| Deaths within 30 days of last dose | 0 | 2 | 0 | 3 | 0 | 0 | 1 |
| SAEs | 2 | 4 | 0 | 6 | 5 | 3 | 4 |
| AEs leading to discontinuation of study treatment | 0 | 1 | 0 | 0 | 2 | 1 | 0 |
| Grade 3-4 AEs | 4 | 4 | 2 | 5 | 7 | 4 | 4 |
MTD of cetuximab intravenous (IV) weekly + irinotecan IV x5 days x2 weeks (in a 3-week cycle) and RPIID of cetuximab IV weekly, as measured by dose-limiting toxicities (see outcome measure 2)
| mg/m2 | Group A (Ages 1-12 Years) | Group B (Ages 13-18 Years) |
|---|---|---|
| MTD cetuximab (in combination w/ irinotecan) | 250 | 250 |
| MTD irinotecan (in combination w/ cetuximab) | 16 | 20 |
| RPIID cetuximab (in combination with irinotecan) | 250 | 250 |
| RPIID irinotecan (in combination with cetuximab) | 16 | 20 |
Blood samples were collected at selected times (pretreatment visit, prior to each treatment cycle, weekly, and at the end of treatment) for clinical laboratory evaluations. Grade 3= Severe AE; Grade 4=Life-threatening or disabling AE
| Participants | Group A 75/20 | Group A 150/16 | Group A 150/20 | Group A 250/16 | Group B 75/20 | Group B 150/20 | Group B 250/20 |
|---|---|---|---|---|---|---|---|
| Grade 3-4 Laboratory Abnormalities - Leukopenia | 3 | 0 | 3 | 4 | 2 | 2 | 4 |
Blood samples were collected at selected times (pretreatment visit, prior to each treatment cycle, weekly, and at the end of treatment) for clinical laboratory evaluations. Grade 3= Severe and undesirable AE; Grade 4=Life-threatening or disabling AE
| Participants | Group A 75/20 | Group A 150/16 | Group A 150/20 | Group A 250/16 | Group B 75/20 | Group B 150/20 | Group B 250/20 |
|---|---|---|---|---|---|---|---|
| Grade 3-4 Laboratory Abnormalities - Neutropenia | 3 | 0 | 3 | 3 | 3 | 1 | 4 |
Blood samples collected at selected times (pretreatment visit, prior to each treatment cycle, weekly, and at the end of treatment) for clinical laboratory evaluations. Grade 3= Severe AE; Grade 4=Life-threatening or disabling AE
| Participants | Group A 75/20 | Group A 150/16 | Group A 150/20 | Group A 250/16 | Group B 75/20 | Group B 150/20 | Group B 250/20 |
|---|---|---|---|---|---|---|---|
| Grade 3-4 Laboratory Abnormalities - Thrombocytopenia | 1 | 0 | 3 | 2 | 0 | 0 | 4 |
Blood samples were collected at selected times (pretreatment visit, prior to each treatment cycle, weekly, and at the end of treatment) for clinical laboratory evaluations. Grade 3= Severe AE; Grade 4=Life-threatening or disabling AE
| Participants | Group A 75/20 | Group A 150/16 | Group A 150/20 | Group A 250/16 | Group B 75/20 | Group B 150/20 | Group B 250/20 |
|---|---|---|---|---|---|---|---|
| Grade 3/4 Laboratory Abnormalities - Hypomagnesemia | — | — | — | 1 | — | — | — |
Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| 01 75 mg/m2 CET + 20 mg/m2 IRI | — | 7/14 (50%) | 14/14 (100%) |
| 02 150 mg/m2 CET + 20 mg/m2 IRI | — | 7/10 (70%) | 8/10 (80%) |
| 03 150 mg/m2 CET + 16 mg/m2 IRI | — | 0/3 (0%) | 3/3 (100%) |
| 04 250 mg/m2 CET + 16 mg/m2 IRI | — | 6/12 (50%) | 12/12 (100%) |
| 05 250 mg/m2 CET + 20 mg/m2 IRI | — | 4/7 (57.1%) | 7/7 (100%) |
| Event | 01 75 mg/m2 CET + 20 mg/m2 IRI | 02 150 mg/m2 CET + 20 mg/m2 IRI | 03 150 mg/m2 CET + 16 mg/m2 IRI | 04 250 mg/m2 CET + 16 mg/m2 IRI | 05 250 mg/m2 CET + 20 mg/m2 IRI |
|---|---|---|---|---|---|
| MALIGNANT NEOPLASM PROGRESSIONNeoplasms benign, malignant and unspecified (incl cysts and polyps) | 0/14 | 0/10 | 0/3 | 0/12 | 3/7 |
| PYREXIAGeneral disorders | 2/14 | 3/10 | 0/3 | 1/12 | 0/7 |
| NAUSEAGastrointestinal disorders | 1/14 | 3/10 | 0/3 | 0/12 | 1/7 |
| VOMITINGGastrointestinal disorders | 3/14 | 2/10 | 0/3 | 1/12 | 1/7 |
| DIARRHOEAGastrointestinal disorders | 2/14 | 2/10 | 0/3 | 1/12 | 1/7 |
| CHILLSGeneral disorders | 0/14 | 2/10 | 0/3 | 0/12 | 0/7 |
| DEHYDRATIONMetabolism and nutrition disorders | 2/14 | 1/10 | 0/3 | 2/12 | 0/7 |
| HYPOMAGNESAEMIAMetabolism and nutrition disorders | 0/14 | 0/10 | 0/3 | 0/12 | 1/7 |
| NEUTROPHIL COUNTInvestigations | 0/14 | 0/10 | 0/3 | 0/12 | 1/7 |
| CRANIAL NEUROPATHYNervous system disorders | 0/14 | 0/10 | 0/3 | 0/12 | 1/7 |
| Event | 01 75 mg/m2 CET + 20 mg/m2 IRI | 02 150 mg/m2 CET + 20 mg/m2 IRI | 03 150 mg/m2 CET + 16 mg/m2 IRI | 04 250 mg/m2 CET + 16 mg/m2 IRI | 05 250 mg/m2 CET + 20 mg/m2 IRI |
|---|---|---|---|---|---|
| NAUSEAGastrointestinal disorders | 11/14 | 5/10 | 0/3 | 7/12 | 6/7 |
| VOMITINGGastrointestinal disorders | 11/14 | 5/10 | 1/3 | 9/12 | 6/7 |
| DIARRHOEAGastrointestinal disorders | 11/14 | 7/10 | 2/3 | 10/12 | 6/7 |
| ABDOMINAL PAINGastrointestinal disorders | 7/14 | 5/10 | 1/3 | 9/12 | 2/7 |
| RASHSkin and subcutaneous tissue disorders | 3/14 | 4/10 | 2/3 | 5/12 | 5/7 |
| HEADACHENervous system disorders | 9/14 | 4/10 | 2/3 | 7/12 | 4/7 |
| WEIGHT DECREASEDInvestigations | 4/14 | 4/10 | 1/3 | 8/12 | 2/7 |
| DRY SKINSkin and subcutaneous tissue disorders | 3/14 | 2/10 | 0/3 | 7/12 | 4/7 |
| ANOREXIAMetabolism and nutrition disorders | 6/14 | 3/10 | 0/3 | 6/12 | 2/7 |
| CONSTIPATIONGastrointestinal disorders | 3/14 | 1/10 | 1/3 | 5/12 | 1/7 |
| Age, Continuous(years) | 1- to 12-years-old | 13- to 18-years-old | Total |
|---|---|---|---|
| Median | 8.0 (1.0 to 12.0) | 16.0 (13.0 to 18.0) | 10 (1.0 to 18.0) |
| Sex: Female, Male(Participants) | 1- to 12-years-old | 13- to 18-years-old | Total |
|---|---|---|---|
| Female | 15 | 9 | 24 |
| Male | 12 | 10 | 22 |
| Race/Ethnicity, Customized(Participants) | 1- to 12-years-old | 13- to 18-years-old | Total |
|---|---|---|---|
| Asian | 0 | 2 | 2 |
| Black or African American | 5 | 2 | 7 |
| White | 21 | 14 | 35 |
| Other | 1 | 1 | 2 |
| Disease diagnosis(Participants) | 1- to 12-years-old | 13- to 18-years-old | Total |
|---|---|---|---|
| CNS Primary Tumor | 17 | 9 | 26 |
| Non-CNS Primary Tumor | 10 | 10 | 20 |
| Performance Status(Participants) | 1- to 12-years-old | 13- to 18-years-old | Total |
|---|---|---|---|
| >70-100 | 19 | 16 | 35 |
| ≥50-70 | 8 | 3 | 11 |
| <50 | 0 | 0 | 0 |
This study is completed, as verified in Nov 2015. You cannot join it, but the record below documents what was studied.
Get an email when the registry record changes — status, dates, results — or when someone posts here.
Sign in to followQuestions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.
Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.
Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.
Eli Lilly and Company