A Phase 3 interventional study of Xilonix and Placebo in Metastatic Colorectal Cancer, sponsored by Janssen Research & Development, LLC. Terminated at 113 sites in 13 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2021-06-29.
Sponsored by Janssen Research & Development, LLC · Phase 3, Interventional, and Treatment
The purpose of this study is to determine if the True Human Monoclonal antibody Xilonix (MABp1) can prolong the life of colorectal carcinoma patients that are refractory to standard therapy.
In the setting of refractory, metastatic disease a complete resolution of tumor burden is not a reasonable expectation. Instead, the primary goal of anti-tumor therapy at this stage is to eliminate or reduce the symptomatic effects of the tumor, while trying to prolong survival for as long as possible. Due to treatment related morbidity however, few treatment modalities are ideal for this objective. Even with the most recent targeted agents (such as multi-kinase inhibitors), drug related toxicities frequently lead to relatively short treatment durations. With discontinuation of therapy, disease progression is uncontrolled and prognosis is poor.
New agents that control disease progression-while improving tumor-related symptoms, rather than causing significant therapy related morbidity-are vitally needed to treat patients with advanced cancer, including those with colorectal cancer. An approach has been taken to develop such an agent using a monoclonal antibody to block the chronic inflammation involved in both malignant disease progression and constitutional symptoms.
Xilonix™ is expected to inhibit tumor growth and metastasis by interrupting crucial signals that drive angiogenesis and invasiveness. The antibody therapy may also block tumor microenvironment infiltration by leukocytes (such as myeloid suppressor cells) that suppress antitumor immunity, enabling better host immune control of the disease. In addition to local effects on the tumor, Xilonix™ is expected to work systemically to correct the metabolic dysregulation, fatigue and anxiety mediated by chronic inflammatory signaling to the central nervous system.
5,599 studies on the registry are indexed under Colorectal Neoplasms; 1,459 are open to participants now.
This study's enrollment of 643 is above the median of 77 across 4,123 interventional studies indexed under Colorectal Neoplasms.
Browse Colorectal Neoplasms studies →Janssen Research & Development, LLC is the lead sponsor of 912 studies on the registry; 76 are open to participants now.
Of its 278 completed or terminated interventional studies of FDA-regulated products, 131 (47%) have results posted.
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Exclusion Criteria:
MABp1 administered IV every two weeks, plus best supportive care
Drug: Xilonix
Placebo administered IV every two weeks, plus best supportive care
Drug: Placebo
Xilonix is a True Human Monoclonal Antibody targeting Interleukin 1 alpha, and is administered intravenously every 2 weeks with best supportive care until clinical or radiographic progression.
Also known as: MABp1, CA-18C3
Placebo plus best supportive care will be administered intravenously every 2 weeks until clinical or radiographic progression.
Overall Survival (OS)
Overall survival time was defined as the duration from the date of randomization until death or last follow-up. OS was summarized by Kaplan-Meier method and compared between the treatment groups using un-adjusted log-rank test.
Time frame: Up to 18 months
Change From Baseline in Lean Body Mass (LBM) Measured by Dual-energy X-ray Absorptiometry (DEXA) Scans
Change from baseline in LBM as measured by Dexa scans was reported. DEXA is an X-ray imaging modality used to determine the mass of one material in the presence of another material, using the knowledge of their unique X-ray attenuation at different energies.
Time frame: Baseline and Week 8
Change From Baseline in Symptom Scale and Global Health Status/Quality of Life (QoL) Assessed Through the Cancer-specific European Organization for Research and Treatment of Cancer - Quality of Life Questionnaire (EORTC QLQ-C30)
The EORTC QLQ-C30 questionnaire incorporates nine multi-item scales: 5 functional scales (physical, cognitive, role, emotional, and social); 3 symptom scales (pain, fatigue, and appetite loss) and a Global Health Status/QoL scale. Each item, except Global Health Status, is answered on a four-point scale (1-4): 1-not at all, 2-a little, 3-quite a bit, 4-very much. Response to Global Health Status is measured on a 1 to 7 scale. "1" being very poor and "7" being excellent. Each scale (symptom scale \[pain, fatigue, and appetite loss\] and Global Health Status/Quality of Life \[QoL\] scale) was linearly transformed to be in range from 0-100 where a higher score represents good health status, while lower scores indicate poor health status. As planned, the data for symptom scales (pain, fatigue, appetite loss) and a Global Health Status/QoL scale was evaluated and reported.
Time frame: Baseline and Week 8
Change From Baseline in Platelet Counts
Change from baseline in platelet counts up to Week 8 was evaluated.
Time frame: Baseline and Week 8
Progression Free Survival (PFS)
PFS was defined as time from randomization to tumor progression or death. Progressive Disease defined as increase in tumor burden greater than or equals to (\>=) 25 (%) percent relative to nadir (minimum recorded tumor burden) confirmation by a repeat, consecutive assessment no less than 4 weeks from the date first documented. Participants surviving without disease progression at end of study were censored. PFS was compared by Kaplan-Meier method using log-rank test.
Time frame: Up to 18 Months
Percentage of Participants With Objective Response (OR)
The percentage of OR was estimated by dividing the total number of confirmed complete response (CR) and partial response (PR) by the total number of participants randomized where CR was complete disappearance of all lesions (whether measurable or not, and no new lesions); confirmation by a repeat, consecutive assessment no less than 4 weeks from the date first documented and PR was decrease in tumor burden \>= 50 % relative to baseline confirmed by a consecutive assessment at least 4 weeks after first documentation.
Time frame: Up to 18 months
Percentage of Participants With Disease Control
Percentage of participants who achieved disease control was estimated by dividing the total number of confirmed CRs, PRs and stable disease (SD) by the total number of participants randomized where CR was complete disappearance of all lesions (whether measurable or not, and no new lesions); confirmation by a repeat, consecutive assessment no less than 4 weeks from the date first documented, PR was decrease in tumor burden \>= 50% relative to baseline confirmed by a consecutive assessment at least 4 weeks after first documentation and SD defined as not meeting criteria for CR and PR, in absence of Progressive Disease (increase in tumor burden \>= 25 % relative to nadir (minimum recorded tumor burden) confirmation by a repeat, consecutive assessment no less than 4 weeks from the date first documented).
Time frame: Up to 18 months
| Milestone | Xilonix | Placebo |
|---|---|---|
| Started | 430 | 213 |
| Treated | 411 | 200 |
| Completed | 0 | 0 |
| Not completed | 430 | 213 |
| Withdrew: Adverse event | 27 | 7 |
| Withdrew: Death | 28 | 13 |
| Withdrew: Lack of efficacy | 299 | 151 |
| Withdrew: Lost to follow-up | 1 | 1 |
| Withdrew: Withdrawal by subject | 38 | 18 |
| Withdrew: Physician decision | 17 | 10 |
| Withdrew: Protocol terminated | 1 | 0 |
| Withdrew: Randomized but never treated | 19 | 13 |
Overall survival time was defined as the duration from the date of randomization until death or last follow-up. OS was summarized by Kaplan-Meier method and compared between the treatment groups using un-adjusted log-rank test.
| Months | Xilonix | Placebo |
|---|---|---|
| Overall Survival (OS) | 5.6 (4.9 to 6.2) | 5.4 (4.6 to 6.2) |
Change from baseline in LBM as measured by Dexa scans was reported. DEXA is an X-ray imaging modality used to determine the mass of one material in the presence of another material, using the knowledge of their unique X-ray attenuation at different energies.
| kilogram (kg) | Xilonix | Placebo |
|---|---|---|
| Change From Baseline in Lean Body Mass (LBM) Measured by Dual-energy X-ray Absorptiometry (DEXA) Scans | 0.51 ± 0.158 | -0.21 ± 0.231 |
The EORTC QLQ-C30 questionnaire incorporates nine multi-item scales: 5 functional scales (physical, cognitive, role, emotional, and social); 3 symptom scales (pain, fatigue, and appetite loss) and a Global Health Status/QoL scale. Each item, except Global Health Status, is answered on a four-point scale (1-4): 1-not at all, 2-a little, 3-quite a bit, 4-very much. Response to Global Health Status is measured on a 1 to 7 scale. "1" being very poor and "7" being excellent. Each scale (symptom scale \[pain, fatigue, and appetite loss\] and Global Health Status/Quality of Life \[QoL\] scale) was linearly transformed to be in range from 0-100 where a higher score represents good health status, while lower scores indicate poor health status. As planned, the data for symptom scales (pain, fatigue, appetite loss) and a Global Health Status/QoL scale was evaluated and reported.
| Units on a scale | Xilonix | Placebo |
|---|---|---|
| Global Health Status/Qol | -6.64 ± 1.392 | -8.16 ± 2.041 |
| Pain | 8.50 ± 1.707 | 10.27 ± 2.503 |
| Fatigue | 7.42 ± 1.516 | 8.82 ± 2.223 |
| Appetite Loss | 9.34 ± 2.010 | 11.84 ± 2.947 |
Change from baseline in platelet counts up to Week 8 was evaluated.
| 1000 cells/cubic millimeter | Xilonix | Placebo |
|---|---|---|
| Change From Baseline in Platelet Counts | 5.50 ± 4.721 | 16.19 ± 7.082 |
PFS was defined as time from randomization to tumor progression or death. Progressive Disease defined as increase in tumor burden greater than or equals to (\>=) 25 (%) percent relative to nadir (minimum recorded tumor burden) confirmation by a repeat, consecutive assessment no less than 4 weeks from the date first documented. Participants surviving without disease progression at end of study were censored. PFS was compared by Kaplan-Meier method using log-rank test.
| Months | Xilonix | Placebo |
|---|---|---|
| Progression Free Survival (PFS) | 2.1 (2.1 to 2.1) | 2.1 (2.0 to 2.1) |
The percentage of OR was estimated by dividing the total number of confirmed complete response (CR) and partial response (PR) by the total number of participants randomized where CR was complete disappearance of all lesions (whether measurable or not, and no new lesions); confirmation by a repeat, consecutive assessment no less than 4 weeks from the date first documented and PR was decrease in tumor burden \>= 50 % relative to baseline confirmed by a consecutive assessment at least 4 weeks after first documentation.
| Percentage of Participants | Xilonix | Placebo |
|---|---|---|
| Percentage of Participants With Objective Response (OR) | 0 | 0 |
Percentage of participants who achieved disease control was estimated by dividing the total number of confirmed CRs, PRs and stable disease (SD) by the total number of participants randomized where CR was complete disappearance of all lesions (whether measurable or not, and no new lesions); confirmation by a repeat, consecutive assessment no less than 4 weeks from the date first documented, PR was decrease in tumor burden \>= 50% relative to baseline confirmed by a consecutive assessment at least 4 weeks after first documentation and SD defined as not meeting criteria for CR and PR, in absence of Progressive Disease (increase in tumor burden \>= 25 % relative to nadir (minimum recorded tumor burden) confirmation by a repeat, consecutive assessment no less than 4 weeks from the date first documented).
| Percentage of Participants | Xilonix | Placebo |
|---|---|---|
| Percentage of Participants With Disease Control | 25 | 27.3 |
Collected over Up to 18 months. Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Xilonix | 28/411 (6.8%) | 169/411 (41.1%) | 324/411 (78.8%) |
| Placebo | 13/200 (6.5%) | 84/200 (42%) | 167/200 (83.5%) |
| Event | Xilonix | Placebo |
|---|---|---|
| Disease ProgressionGeneral disorders | 21/411 | 14/200 |
| DyspnoeaRespiratory, thoracic and mediastinal disorders | 12/411 | 9/200 |
| Abdominal PainGastrointestinal disorders | 9/411 | 6/200 |
| Hepatic FailureHepatobiliary disorders | 11/411 | 3/200 |
| AnaemiaBlood and lymphatic system disorders | 3/411 | 5/200 |
| General Physical Health DeteriorationGeneral disorders | 8/411 | 5/200 |
| Colorectal CancerNeoplasms benign, malignant and unspecified (incl cysts and polyps) | 8/411 | 5/200 |
| SepsisInfections and infestations | 3/411 | 4/200 |
| Metastases to Central Nervous SystemNeoplasms benign, malignant and unspecified (incl cysts and polyps) | 3/411 | 4/200 |
| Acute Kidney InjuryRenal and urinary disorders | 8/411 | 1/200 |
| Event | Xilonix | Placebo |
|---|---|---|
| FatigueGeneral disorders | 109/411 | 60/200 |
| Decreased AppetiteMetabolism and nutrition disorders | 84/411 | 51/200 |
| NauseaGastrointestinal disorders | 79/411 | 46/200 |
| Abdominal PainGastrointestinal disorders | 78/411 | 41/200 |
| AstheniaGeneral disorders | 63/411 | 35/200 |
| ConstipationGastrointestinal disorders | 51/411 | 31/200 |
| PyrexiaGeneral disorders | 38/411 | 27/200 |
| Back PainMusculoskeletal and connective tissue disorders | 44/411 | 27/200 |
| CoughRespiratory, thoracic and mediastinal disorders | 40/411 | 27/200 |
| DyspnoeaRespiratory, thoracic and mediastinal disorders | 49/411 | 27/200 |
Baseline analysis population included all participants who were randomized and received at least one infusion of study drug.
| Age, Continuous(years) | Xilonix | Placebo | Total |
|---|---|---|---|
| Mean | 62.9 ± 10.14 | 61.1 ± 9.98 | 62.3 ± 10.11 |
| Sex: Female, Male(Participants) | Xilonix | Placebo | Total |
|---|---|---|---|
| Female | 159 | 94 | 253 |
| Male | 252 | 106 | 358 |
| Race/Ethnicity, Customized(Participants) | Xilonix | Placebo | Total |
|---|---|---|---|
| American Indian or Alaska Native | 0 | 0 | 0 |
| Asian | 15 | 2 | 17 |
| Black or African American | 20 | 8 | 28 |
| Native Hawaiian or Other Pacific Islander | 0 | 0 | 0 |
| White | 355 | 186 | 541 |
| More than one race | 0 | 0 | 0 |
| Unknown or Not Reported | 0 | 0 | 0 |
| Other | 21 | 4 | 25 |
| Region of Enrollment(Participants) | Xilonix | Placebo | Total |
|---|---|---|---|
| Australia | 18 | 7 | 25 |
| Austria | 12 | 3 | 15 |
| Belgium | 49 | 27 | 76 |
| Czech Republic | 8 | 3 | 11 |
| England | 7 | 3 | 10 |
| Hungary | 8 | 3 | 11 |
| Israel | 4 | 3 | 7 |
| Italy | 11 | 7 | 18 |
| Netherlands | 8 | 4 | 12 |
| Poland | 30 | 18 | 48 |
| Spain | 118 | 55 | 173 |
| Switzerland | 3 | 3 | 6 |
| USA | 135 | 64 | 199 |
| Age (years)(Participants) | Xilonix | Placebo | Total |
|---|---|---|---|
| < 65 years | 229 | 122 | 351 |
| Between 65 and 75 years | 141 | 64 | 205 |
| > 75 years | 41 | 14 | 55 |
| Missing | 0 | 0 | 0 |
Showing the first 100 of 113 sites across 13 countries.
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