Genetic Testing in Screening Patients with Metastatic or Unresectable Colon or Rectal Cancer for a COLOMATE Trial
Colon/Rectal Cancer
Unknown Primary
18 Years and older, Male and Female
ACCRU-GI-1611 (primary)
NCI-2018-02862
Summary
This trial screens patients with colon or rectal cancer that has spread to other places in the body (metastatic) or cannot be removed by surgery (unresectable) for genetic mutations for recommendation to a molecularly assigned therapy. Identifying gene mutations may help patients enroll onto target companion trials that target these mutations.
Objectives
PRIMARY OBJECTIVES:
I. To perform blood-based genomic profiling on patients with treatment refractory metastatic colorectal cancer (CRC) to facilitate accrual to molecularly assigned therapies.
II. To facilitate clinically annotated genomic analyses.
OUTLINE:
Patients submit blood samples for genetic testing.
Eligibility
- Histological confirmation of adenocarcinoma of the colon or rectum that is metastatic and/ or unresectable
- Progression, intolerance, or contraindication to a fluoropyrimidine (e.g., 5- fluorouracil or capecitabine), oxaliplatin, irinotecan, an anti-VEGF monoclonal antibody (bevacizumab, ziv-aflibercept, or ramucirumab), and an anti-PD-1 monoclonal antibody (nivolumab or pembrolizumab) if tumor has deficient mismatch repair proteins (dMMR) or is microsatellite instability-high (MSI-H)
- For patients with KRAS and NRAS wild-type tumors, progression, intolerance, or contraindication to an anti-EGFR monoclonal antibody (cetuximab or panitumumab)
* Note: If tissue is known to be positive for HER2 expression (IHC 3+) or the tumor has ERBB2 (HER2) amplification detected by a Clinical Laboratory Improvement Act (CLIA)-certified assay, prior treatment with anti-EGFR therapy is not required
- At least one site of disease that is measurable by Response Evaluation Criteria in Solid Tumors (RECIST) criteria (version 1.1) that has not been previously irradiated; if the patient has had previous radiation to the target lesion(s), there must be evidence of progression since the radiation
- Life expectancy >= 3 months per estimation of investigator
- Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0, 1, or 2
- Capable of understanding and complying with the protocol requirements and has signed the informed consent document
- Satisfy at least one of the following two conditions:
* Willing and able to provide blood sample for screening purposes
* Guardant 360 testing completed =< 60 days prior to registration
**Clinical trials are research studies that involve people. These studies test new ways to prevent, detect, diagnose, or treat diseases. People who take part in cancer clinical trials have an opportunity to contribute to scientists’ knowledge about cancer and to help in the development of improved cancer treatments. They also receive state-of-the-art care from cancer experts...
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