A Phase 2 interventional study of Durvalumab and Trametinib in Malignant Neoplasms of Digestive Organs, Colorectal Cancer and Colon Cancer, sponsored by M.D. Anderson Cancer Center. Completed at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2023-06-15.
Sponsored by M.D. Anderson Cancer Center · Phase 2, Interventional, and Treatment
The goal of this clinical research study is to learn if durvalumab and trametinib can help to control microsatellite stable (MSS) colorectal cancer. The safety of these drugs will also be studied.
This is an investigational study. Durvalumab is FDA approved and commercially available for the treatment of previously treated advanced bladder cancer. Trametinib is FDA approved in combination with another drug called dabrafenib for the treatment of unresectable or metastatic melanoma with BRAF V600E or BRAF V600K.
It is investigational to use durvalumab and trametinib to treat MSS colorectal cancer.
Up to 56 participants will be enrolled in this study. All will take part at MD Anderson.
Study Drug Administration:
Each cycle is 28 days.
Participant will take trametinib tablets by mouth every day with at least 8 ounces of water. Each dose should be taken at about the same time each day, 1 hour before or 2 hours after a meal. Participant should not crush, cut, or chew the tablets. If participant misses a dose of trametinib, participant may take the tablets as soon as participant remembers but only if participant's next scheduled dose is at least 12 hours later. If participant's next scheduled dose is less than 12 hours, participant should wait and take participant's next dose as scheduled.
Participant will take trametinib alone for the first 7 days of the study and then participant will begin receiving it in combination with durvalumab.
Every 4 weeks, participant will receive durvalumab by vein over about 60 minutes.
Length of Treatment:
Participant will be able to receive the study drugs for as long as the doctor thinks it is in participant's best interest. Participant no longer will take the study drugs if intolerable side effects occur or if the study doctor decides that the drugs are no longer working.
It is expected that participation in this study may last about 12 months.
Participation in this study will be over after follow-up.
Study Visits:
On Day 1 of Weeks 0, 2, 4, 6, 12, and then every 4 weeks after that (Weeks 16, 20, 24, and so on):
On Day 1 of Week 8:
On Day 1 of Week 16 and then every 8 weeks after that (Weeks 24, 32, 40, and so on), participant will have a CT scan.
End-of-Treatment:
About 28 days after participant's last dose of study drugs, participant will have a physical exam.
Follow-Up:
After participant's end-of-treatment visit, participant will be called by the study staff every 3 months for up to 18 months to ask how participant is doing. Each call should last about 5-10 minutes.
Exclusion Criteria:
Participants take Trametinib tablets by mouth every day. Trametinib taken alone for the first 7 days of the study then participants begin receiving it in combination with Durvalumab. Participants receive Durvalumab by vein every 4 weeks. Each cycle is 28 days.
Drug: Durvalumab · Drug: Trametinib
Dose Escalation and Dose Expansion Dose: 1500 mg by vein every 4 weeks in a 28 day cycle.
Also known as: MEDI4736
Dose Escalation Starting Dose: 2mg by mouth daily in a 28 day cycle. Dose Expansion Dose: MTD from Dose Escalation.
Also known as: GSK1120212
Immune-related Best Overall Response Rate.
Best overall response rate (CR+PR) by immune-related response rate.
Time frame: From Baseline to 2 years
Progression Free Survival as Determined by irRC
The Kaplan-Meier method GraphPad software, V.8 was used for statistical analyses.
Time frame: From Baseline to up to 2 years
Overall Survival
The Kaplan-Meier method GraphPad software, V.8 was used for statistical analyses.
Time frame: From Baseline to 2 years
Disease Control Rate
Disease control rate (DCR) describes the percentage of patients with advanced cancer whose therapeutic intervention has led to a complete response, partial response, or stable disease.
Time frame: From Baseline to 2 years.
29 patients were enrolled to the first stage at The University of Texas MD Anderson Cancer Center.
| Milestone | Durvalumab + Trametinib |
|---|---|
| Started | 29 |
| Completed | 29 |
| Not completed | 0 |
Best overall response rate (CR+PR) by immune-related response rate.
| Participants | Durvalumab + Trametinib |
|---|---|
| Immune-related Best Overall Response Rate. | 1 |
The Kaplan-Meier method GraphPad software, V.8 was used for statistical analyses.
| months | Durvalumab + Trametinib |
|---|---|
| Progression Free Survival as Determined by irRC | 3.2 (2.5 to 3.8) |
The Kaplan-Meier method GraphPad software, V.8 was used for statistical analyses.
| months | Durvalumab + Trametinib |
|---|---|
| Overall Survival | 6.9 (5.7 to 8) |
Disease control rate (DCR) describes the percentage of patients with advanced cancer whose therapeutic intervention has led to a complete response, partial response, or stable disease.
| percentage | Durvalumab + Trametinib |
|---|---|
| Complete Response | 0 |
| Partial Response | 3.4 |
| Stable Disease | 24 |
Collected over from Baseline to 2 years. Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Durvalumab + Trametinib | 12/29 (41.4%) | 0/29 (0%) | 29/29 (100%) |
| Event | Durvalumab + Trametinib |
|---|---|
| RashSkin and subcutaneous tissue disorders | 25/29 |
| AnemiaInvestigations | 12/29 |
| DiarrheaGastrointestinal disorders | 11/29 |
| AnorexiaGastrointestinal disorders | 11/29 |
| Alkaline phosphataseInvestigations | 11/29 |
| FatigueGeneral disorders | 9/29 |
| Aspartrate aminotransferaseInvestigations | 9/29 |
| ThrombocytopeniaInvestigations | 8/29 |
| NauseaGastrointestinal disorders | 7/29 |
| Alanine aminotransferaseInvestigations | 7/29 |
| Age, Continuous(years) | Durvalumab + Trametinib |
|---|---|
| Median | 48 (28 to 75) |
| Sex: Female, Male(Participants) | Durvalumab + Trametinib |
|---|---|
| Female | 14 |
| Male | 15 |
| Ethnicity (NIH/OMB)(Participants) | Durvalumab + Trametinib |
|---|---|
| Hispanic or Latino | 3 |
| Not Hispanic or Latino | 0 |
| Unknown or Not Reported | 26 |
| Race (NIH/OMB)(Participants) | Durvalumab + Trametinib |
|---|---|
| American Indian or Alaska Native | 0 |
| Asian | 3 |
| Native Hawaiian or Other Pacific Islander | 0 |
| Black or African American | 2 |
| White | 21 |
| More than one race | 0 |
| Unknown or Not Reported | 3 |
| Region of Enrollment(participants) | Durvalumab + Trametinib |
|---|---|
| United States | 29 |
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M.D. Anderson Cancer Center