PROSPECT-R

  • Research type

    Research Study

  • Full title

    PROSPECT-R: A Prospective Translational Study Investigating Molecular Predictors of Resistance and Response to Regorafenib monotherapy in RAS Mutant Metastatic Colorectal Cancer

  • IRAS ID

    150241

  • Contact name

    David Cunningham

  • Contact email

    david.cunningham@rmh.nhs.uk

  • Sponsor organisation

    Royal Marsden NHS Foundation Trust

  • Eudract number

    2014-003579-51

  • Duration of Study in the UK

    2 years, 6 months, 1 days

  • Research summary

    Colorectal cancer is one of the commonest cancers in the world. Although treatment options have improved in recent years, the outcome from un-resectable and/or metastatic colorectal cancer (mCRC) (i.e. cancer with secondaries that have spread beyond the bowel) remains poor with high mortality and 5-year survival of less than 5%. Previous studies have shown that tumours survive by having their own blood supply through a process called angiogenesis. One of the proven treatment strategies in management of mCRC includes using agents that can block the blood supply of the tumour (anti-angiogenic therapy). Regorafenib is an oral small molecule which targets the blood supply of the tumour in addition to targeting multiple other key signalling proteins responsible for colorectal cancer progression. In a large clinical trial, regorafenib has shown improvement in survival of the patients who had failed on all previous lines of chemotherapy. There are however currently no biomarkers to identify the patients who are likely to benefit from regorafenib or any other anti-angiogenesis therapies like bevacizumab and aflibercept (used in management of colorectal cancer). Keeping in view the cost implications and potential side effects from these treatments, it is an area of un-met need to identify biomarkers of response and resistance to these therapies so that only the patients who are likely to gain benefit are offered these treatments. PROSPECT-R is an exploratory prospective translational research study to obtain research biopsies of mCRC tumour tissue prior to commencement of Regorafenib treatment and again at development of resistance;and at 8 weeks from treatment, in patients who show response or disease control on the treatment. Additionally serial research blood specimens will be collected every four weeks during treatment. The aim of the study will be to identify novel predictive biomarkers of resistance and response to regorafenib therapy .

  • REC name

    London - Fulham Research Ethics Committee

  • REC reference

    14/LO/1812

  • Date of REC Opinion

    5 Nov 2014

  • REC opinion

    Further Information Favourable Opinion