Modelle 001, TS-inhibition in Colorectal Liver Metastases Comparing Arfolitixorin and Calciumfolinate
Last updated on July 2021Recruitment
- Recruitment Status
- Recruiting
- Estimated Enrollment
- Same as current
Summary
- Conditions
- Metastatic Colorectal Cancer
- Type
- Interventional
- Phase
- Phase 1Phase 2
- Design
- Allocation: RandomizedIntervention Model: Parallel AssignmentIntervention Model Description: A total of 30 patients will be included in the study and will be equally randomised in three steps. In the first phase, six patients will receive a reduced dose 5-FU; 250 mg / m², of which three patients will be randomized to additional Calciumfolinate and three patients will be randomized to additional Arfolitixorin. P When all six patients have been followed up in the context of visits consultation, a clinical safety evaluation (SE) of all AE, and SAE will be performed by two independent physicians If the responsible physicians finds that it is safe that the study will continue, we intend to increase the dose of 5-FU 500 mg / m, after which additional 12 patients will be included. After inclusion of 6 patients receiving 5-FU 500 mg /m² in combination with Arfolitixorin in the dose of 30mg/m2 a dose adjustment will take place and the last 12 patients will be randomised to either Calciumfolinate 60 mg/m2 or Arfolitixorin 120 /m2.Masking: Triple (Participant, Care Provider, Investigator)Masking Description: Randomisation will be performed by a sealed envelope system. The randomisation envelopes are kept in a locked cabinet together with the randomisation list Two sets of code envelopes are prepared. The study personnel that will be responsible for study drug administration will have one set for the randomisation of patients and one set will be held by the investigator for emergency code breaking. The code envelopes are prepared for each patient and contain information about what treatment the patient should receive. The randomisation will be made by the study personnel responsible for the administration of the study drugs at the day of the surgery. The patients will be randomised in consecutive order. The date and time of randomisation should be recorded on the document followed by a signature of the person opening the envelope.Primary Purpose: Treatment
Participation Requirements
- Age
- Between 18 years and 100 years
- Gender
- Both males and females
Description
Arfolitixorin ([6R] 5,10-methylenetetrahydrofolate) is a folate based biomodulator designed to replace leucovorin. Arfolitixorin is the key active metabolite of leucovorin (LV) and does in contrast to LV not require enzymatic metabolic activation. In clinical practice, LV is administered in the form...
Arfolitixorin ([6R] 5,10-methylenetetrahydrofolate) is a folate based biomodulator designed to replace leucovorin. Arfolitixorin is the key active metabolite of leucovorin (LV) and does in contrast to LV not require enzymatic metabolic activation. In clinical practice, LV is administered in the form of Calciumfolinate. A hypothesis is therefore that patients which are not capable of metabolizing LV could have a better antitumoral effect with Arfolitixorin administration. The antitumoural effect could be measured as inhibition of the enzyme thymidylate synthase, an enzyme essential for DNA synthesis. Primary objective The primary objective is to compare the properties of Arfolitixorin and Calciumfolinate together with 5-fluorouracil (5-FU) on thymidylate synthase (TS) (i.e. measured as thymidylate synthase inhibition) in tumour and adjacent liver tissue in patients with liver metastases from colorectal cancer receiving a peroperative intravenous administration of Arfolitixorin or Calciumfolinate. Secondary objectives To study safety in terms of adverse events and laboratory measurements; haematology and clinical chemistry. To explore differences in pharmacokinetics of folates and folate metabolites in plasma. To study gene expression in tumour and adjacent hepatic tissue and its correlation to tissue concentration. To investigate the relation between the levels of deoxyuridine (dU) in plasma with the amount of TS inhibition in tumour tissue, in order to evaluate dU as a surrogate marker for TS-inhibition. Study population: Thirty adult patients with colorectal cancer and liver metastases, indicated for surgical removal will be randomised.
Tracking Information
- NCT #
- NCT04126655
- Collaborators
- Isofol Medical AB
- Investigators
- Principal Investigator: Helena Taflin, MD, PhD Vastra Gotaland Region
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