Study of Encorafenib + Cetuximab Plus or Minus Binimetinib vs. Irinotecan/Cetuximab or Infusional 5-Fluorouracil (5-FU)/Folinic Acid (FA)/Irinotecan (FOLFIRI)/Cetuximab With a Safety Lead-in of Encorafenib + Binimetinib + Cetuximab in Patients With BRAF V600E-mutant Metastatic Colorectal Cancer (BEACON CRC)

Pfizer

Status and phase: Completed; Phase 3

Conditions: BRAF V600E-mutant Metastatic Colorectal Cancer

Treatments: Drug: Irinotecan; Drug: Encorafenib; Drug: Binimetinib; Drug: Folinic Acid; Drug: 5-Fluorouracil; Drug: Cetuximab

Study type: Interventional

Funder types: Industry

Identifiers

NCT02928224

C4221009 (Other Identifier)

BEACON CRC (Other Identifier)

ARRAY-818-302

2015-005805-35 (EudraCT Number)

Details and patient eligibility

About

This is a multicenter, randomized, open-label, 3-arm Phase 3 study to evaluate encorafenib + cetuximab plus or minus binimetinib versus Investigator's choice of either irinotecan/cetuximab or FOLFIRI/cetuximab, as controls, in patients with BRAFV600E mCRC whose disease has progressed after 1 or 2 prior regimens in the metastatic setting. The study contains a Safety Lead-in Phase in which the safety and tolerability of encorafenib + binimetinib + cetuximab will be assessed prior to the Phase 3 portion of the study.

Enrollment: 702 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Key Inclusion Criteria:

• Age ≥ 18 years at time of informed consent
• Histologically- or cytologically-confirmed CRC that is metastatic
• Presence of BRAFV600E in tumor tissue as previously determined by a local assay at any time prior to Screening or by the central laboratory
• Progression of disease after 1 or 2 prior regimens in the metastatic setting
• Evidence of measurable or evaluable non-measurable disease per RECIST, v1.1
• Adequate bone marrow, cardiac, kidney and liver function
• Able to take oral medications
• Female patients are either postmenopausal for at least 1 year, are surgically sterile for at least 6 weeks, or must agree to take appropriate precautions to avoid pregnancy from screening through follow-up if of childbearing potential
• Males must agree to take appropriate precautions to avoid fathering a child from screening through follow-up

Key Exclusion Criteria:

• Prior treatment with any RAF inhibitor, MEK inhibitor, cetuximab, panitumumab or other epidermal growth factor receptor (EGFR) inhibitors
• Prior irinotecan hypersensitivity or toxicity that would suggest an inability to tolerate irinotecan 180 mg/m2 every 2 weeks
• Symptomatic brain metastasis or leptomeningeal disease
• History or current evidence of retinal vein occlusion or current risk factors for retinal vein occlusion (e.g., uncontrolled glaucoma or ocular hypertension, history of hyperviscosity or hypercoagulability syndromes)
• Known history of acute or chronic pancreatitis
• History of chronic inflammatory bowel disease or Crohn's disease requiring medical intervention (immunomodulatory or immunosuppressive medications or surgery) ≤12 months prior to randomization
• Uncontrolled blood pressure despite medical treatment
• Impaired GI function or disease that may significantly alter the absorption of encorafenib or binimetinib (e.g., ulcerative diseases, uncontrolled vomiting, malabsorption syndrome, small bowel resection with decreased intestinal absorption)
• Concurrent or previous other malignancy within 5 years of study entry, except cured basal or squamous cell skin cancer, superficial bladder cancer, prostate intraepithelial neoplasm, carcinoma in-situ of the cervix, or other noninvasive or indolent malignancy
• History of thromboembolic or cerebrovascular events ≤ 6 months prior to starting study treatment, including transient ischemic attacks, cerebrovascular accidents, deep vein thrombosis or pulmonary emboli
• Concurrent neuromuscular disorder that is associated with the potential of elevated creatine (phosphor)kinase (CK) (e.g., inflammatory myopathies, muscular dystrophy, amyotrophic lateral sclerosis, spinal muscular atrophy)
• Residual common terminology criteria for adverse events (CTCAE) ≥ Grade 2 toxicity from any prior anticancer therapy, with the exception of Grade 2 alopecia or Grade 2 neuropathy
• Known history of HIV infection
• Active hepatitis B or hepatitis C infection
• Known history of Gilbert's syndrome
• Known contraindication to receive cetuximab or irinotecan at the planned doses

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Sequential Assignment

Masking: None (Open label)

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702 participants in 3 patient groups

Safety Lead-in, Triplet Arm

Experimental group

Description:

Encorafenib + binimetinib + cetuximab.

Treatment:

Drug: Cetuximab

Drug: Encorafenib

Drug: Binimetinib

Doublet Arm

Experimental group

Description:

Encorafenib + cetuximab.

Treatment:

Drug: Cetuximab

Drug: Encorafenib

Control Arm

Active Comparator group

Description:

Investigator's choice of either irinotecan/cetuximab or FOLFIRI/cetuximab.

Treatment:

Drug: Cetuximab

Drug: 5-Fluorouracil

Drug: Folinic Acid

Drug: Irinotecan