Temsirolimus (CCI-770, Torisel) Combined With Cetuximab in Cetuximab-Refractory Colorectal Cancer

• Because this is a study to determine the highest dose of cetuximab that can be safely given with temsirolimus, groups of 3 participants will be treated at gradually increasing doses of cetuximab. Each group of 3 participants must complete 4 weeks (1 cycle) of treatment before the following group of 3 participants can start treatment at the higher dose.
• Cetuximab is administered intravenously 7 days before the treatment cycle begins. Participants will receive a cetuximab infusion every week of the treatment cycle (days 1, 8, 15, 22) along with temsirolimus. Temsirolimus is also given intravenously.
• As a precaution, participants will be pre-medicated with Benadryl/diphenhydramine to help prevent an allergic reaction.
• During the study participants will have weekly clinical visits. Each clinic visit will last approximately 2-3 hours. During the clinic visit, the following tests and procedures will be performed: Physical exam; vital signs; and blood tests. A CT scan will be performed after every 2 cycles (8 weeks).
• Pharmacokinetic (PK) blood samples will be taken at various points during the study. For each PK sample, we will take about 1 teaspoon of blood. There will be a total of 22 tubes of blood taken for the PK study.

• Colorectal Cancer
• Colorectal Adenocarcinoma

• Drug: Temsirolimus
  Given intravenously every week of each 28-day cycle (days 1, 7, 15, 22). Participants can continue to receive study treatment as long at their tumor is responding.
• Drug: Cetuximab
  One dose is given intravenously 7 days prior to the start of each 28-day cycle, then it is given every week (along with temsirolimus)of each 28-day cycle (on days 1, 7, 15, 22). Participants can continue to receive study treatment as long at their tumor is responding.

Inclusion Criteria:

• Previously treated metastatic colorectal adenocarcinoma, histologically proven. Subjects must have previously received and had evidence of progression on cetuximab, bevacizumab, 5FU, irinotecan, and oxaliplatin, or demonstrated intolerance to those agents (except cetuximab).
• Measurable disease by RECIST criteria
• ECOG Performance Status 0 or 1.
• Male or female, 18 years of age or older.
• Life expectancy greater than or equal to 12 weeks.
• At least 2 weeks have elapsed between previous anti-cancer therapy AND resolution of any skin rash related to prior treatment with an epidermal growth factor receptor inhibitor.
• Lab values within ranges as outlined in protocol

Exclusion Criteria:

• Diagnosis of second malignancy within the last 3 years, except for adequately treated basal cell carcinoma or squamous cell skin cancer.
• Ongoing cardiac dysrhythmias of NCI CTCAE grade >/=2, atrial fibrillation, QTc prolongation to >450msec for males and >470 msec for females.
• Known immunodeficiency disorders or active infections requiring treatment
• Pregnancy or breastfeeding
• Brain metastases, spinal cord compression, carcinomatous meningitis, or leptomeningeal disease
• Prior radiation therapy or major surgery within 2 weeks of study entry
• Prior radiation therapy to > 25% of the bone marrow
• Treatment with other experimental or alternative therapies during the course of the trial
• History of hypersensitivity to polysorbate or cetuximab

• Dana-Farber Cancer Institute
• Brigham and Women's Hospital
• Wyeth is now a wholly owned subsidiary of Pfizer