Cetuximab Plus Irinotecan in Colorectal Cancer Patients Who Progressed After Failure With Cetuximab Plus Irinotecan

Inclusion Criteria:

• Histologically confirmed colon cancer that is metastatic or unresectable
• Progressed on cetuximab plus irinotecan based combination prior to enrolling on this study
• Patient must have tumor tissue tested for KRAS mutation and should be confirmed to carry a wild type
• ECOG less than or equal to 1
• Must have adequate organ and marrow function
• Ability to understand and the willingness to sign a written informed consent document.
• Presence of measurable disease defined as a lesion ≥ 2 cm by CT (or 1 cm by spiral CT). All sites of disease should be evaluated ≤ 3 weeks before treatment initiation
• Patients should have failed or been deemed intolerant to other standard chemotherapy treatments such as oxaliplatin and fluoropyrimidines

Exclusion Criteria:

• Patients may not be receiving any other investigational agents that are not included in this study. Prior investigational anticancer agents wil not be allowed within 4 weeks prior to study treatment. Herbal medicine and vitamins wil not be considered as contraindications for enrollment on study.
• Patients with known brain metastases are not eligible unless brain metastases are treated and stable on radiographic follow-up and without significant symptomatology
• History of other invasive cancers with current evidence of disease
• Patients should be off chemotherapy or other targeted therapies for at least 3 weeks before study treatment. Mitomycin C treatment should be at least 6 weeks before study treatment
• History of allergic reactions to irinotecan
• Prior severe infusion reaction to cetuximab
• History of allergic reaction to tetracycline or doxycycline
• Need for prior dose reduction on cetuximab secondary to grade 3 skin toxicity
• Active skin toxicity of grade 2 or higher at the time of study enrollment
• Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
• Pregnant women are excluded from this study because the chemotherapeutic agents proposed are category D agents with the potential for teratogenic or abortifacient effects. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with chemotherapy, breastfeeding should be discontinued if the mother is treated on this study.
• Grade 2 or higher hypomagnesemia at baseline evaluation