A Study of 1018 Immunostimulatory Sequence (ISS) Administered With Irinotecan and Cetuximab to Treat Patients With Previously Treated Metastatic Colorectal Cancer

This is a Phase I, open-label study of escalating dose levels of 1018 ISS in combination with
irinotecan and cetuximab in patients with previously treated metastatic colorectal cancer.
Approximately 15 patients will be treated. The objectives of this study are to establish a
safe, tolerable, and active dose of 1018 ISS, determine tumor response, time to disease
progression, and overall survival in treated patients.

The safety and tolerability of 1018 ISS will be evaluated by periodic laboratory assessments,
physical examinations, and compilation of adverse events.

Once study patients have been consented, screened, and assigned to one of the dose levels of
1018 ISS, patients will receive two 4 week cycles of 1018 ISS therapy plus irinotecan every
other week and cetuximab weekly. Irinotecan and cetuximab will continue thereafter until
disease progression, unacceptable toxicity, or until the patient refuses treatment.

Inclusion Criteria:

- Signed, written, informed consent must be obtained from the patient or their legal
representative before any study-specific procedures are performed

- Confirmed diagnosis of adenocarcinoma of the colon or rectum not amenable to curative
surgery

- One or more prior systemic therapy regimens for metastatic cancer which must have
included a fluoropyrimidine (5-fluorouracil (FU) by infusion or capecitabine),
oxaliplatin or irinotecan with or without bevacizumab

Exclusion Criteria:

- Clinically significant obstructive symptoms, intestinal bleeding, or chronic or recent
acute gastrointestinal disorder with diarrhea as a major symptom

- History of unstable or deteriorating cardiovascular or cerebrovascular disease within
3 months before the first dose of protocol therapy

- Clinical evidence of brain metastases or central nervous system disease

- Pregnant or lactating women

- Serious medical or psychiatric illness

- Malignancy other than colorectal carcinoma within the past 2 years, except curatively
treated, superficial skin cancer or carcinoma in situ of the cervix

- Patients who have been on any experimental study or anti-tumor therapy, received
radiotherapy, or had prior surgery (except venous access device placement) within 28
days before the first dose of protocol therapy