Comparison of Combination Chemotherapy Regimens With or Without Cetuximab in Treating Patients Who Have Undergone Surgery For Stage III Colon Cancer
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Purpose
This randomized phase III trial is comparing three different combination chemotherapy regimens to see how well they work when given with or without cetuximab in treating patients who have undergone surgery for stage III colon cancer. (As of 6/1/2005, patients will no longer receive irinotecan on this study.) Drugs used in chemotherapy, such as irinotecan hydrochloride, fluorouracil, leucovorin calcium, and oxaliplatin, work in different ways to stop tumor cells from dividing so they stop growing or die. Monoclonal antibodies such as cetuximab can locate tumor cells and either kill them or deliver tumor-killing substances to them without harming normal cells. Combining more than one chemotherapy drug with monoclonal antibody therapy and giving them after surgery may kill any remaining tumor cells. It is not yet known which combination chemotherapy regimen is more effective after surgery in treating colon cancer. (As of 6/1/2005, patients will no longer receive irinotecan on this study.
| Condition | Intervention | Phase |
|---|---|---|
|
Adenocarcinoma of the Colon Stage III Colon Cancer |
Drug: irinotecan hydrochloride Drug: oxaliplatin Drug: leucovorin calcium Drug: fluorouracil Biological: cetuximab |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | A Randomized Phase III Trial of Oxaliplatin (OXAL) Plus 5-Fluorouracil (5-FU)/Leucovorin (CF) With or Without Cetuximab (C225) After Curative Resection for Patients With Stage III Colon Cancer |
- Disease-free survival, defined as the time from surgery until the time to tumor recurrence of death, whichever is first [ Time Frame: At 5 years ] [ Designated as safety issue: No ]Estimated by the method of Kaplan and Meier.
- Comparison of disease free survival between arms [ Time Frame: From surgery until the time to tumor recurrence of death, whichever is first, assessed up to 8 years ] [ Designated as safety issue: No ]Estimated by the method of Kaplan and Meier.
- Overall survival [ Time Frame: From randomization to death, from any cause, assessed up to 8 years ] [ Designated as safety issue: No ]Estimated by the method of Kaplan and Meier.
- Toxicity based on the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 3.0 [ Time Frame: Assessed up to 8 years ] [ Designated as safety issue: Yes ]Calculated separately for each drug within a regimen, both by course and over the entire course of therapy.
| Estimated Enrollment: | 3768 |
| Study Start Date: | February 2004 |
| Primary Completion Date: | November 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Arm I (combination chemotherapy)
Patients receive oxaliplatin IV over 2 hours, leucovorin calcium IV over 2 hours, and fluorouracil IV continuously over 46-48 hours on days 1. Treatment repeats every 14 days for up to 12 courses in the absence of unacceptable toxicity or recurrent disease.
|
Drug: oxaliplatin
Given IV
Other Names:
Drug: leucovorin calcium
Given IV
Other Names:
Drug: fluorouracil
Given IV
Other Names:
|
|
Experimental: Arm II (combination chemotherapy)
Patients receive irinotecan IV over 2 hours on day 1 and leucovorin calcium and fluorouracil as in arm I. Treatment repeats every 14 days for up to 12 courses in the absence of unacceptable toxicity or recurrent disease.
|
Drug: irinotecan hydrochloride
Given IV
Other Names:
Drug: leucovorin calcium
Given IV
Other Names:
Drug: fluorouracil
Given IV
Other Names:
|
|
Experimental: Arm III (combination chemotherapy)
Patients receive the same treatment as in arm I for 6 courses followed by the same treatment as in arm II for 6 courses (total of 12 courses). Treatment continues in the absence of unacceptable toxicity or recurrent disease.
|
Drug: irinotecan hydrochloride
Given IV
Other Names:
Drug: oxaliplatin
Given IV
Other Names:
Drug: leucovorin calcium
Given IV
Other Names:
Drug: fluorouracil
Given IV
Other Names:
|
|
Experimental: Arm IV (combination chemotherapy, monoclonal antibody)
Patients receive cetuximab IV over 1 hour on days 1 and 8 and oxaliplatin, leucovorin calcium, and fluorouracil as in arm I. Treatment repeats every 14 days for up to 12 courses in the absence of unacceptable toxicity or recurrent disease.
|
Drug: oxaliplatin
Given IV
Other Names:
Drug: leucovorin calcium
Given IV
Other Names:
Drug: fluorouracil
Given IV
Other Names:
Biological: cetuximab
Given IV
Other Names:
|
|
Experimental: Arm V (combination chemotherapy, monoclonal antibody)
Patients receive cetuximab as in arm IV and irinotecan, leucovorin calcium, and fluorouracil as in arm II. Treatment repeats every 14 days for up to 12 courses in the absence of unacceptable toxicity or recurrent disease.
|
Drug: irinotecan hydrochloride
Given IV
Other Names:
Drug: leucovorin calcium
Given IV
Other Names:
Drug: fluorouracil
Given IV
Other Names:
Biological: cetuximab
Given IV
Other Names:
|
|
Experimental: Arm VI (combination chemotherapy, monoclonal antibody)
Patients receive cetuximab as in arm IV and chemotherapy as in arm III.
|
Drug: irinotecan hydrochloride
Given IV
Other Names:
Drug: oxaliplatin
Given IV
Other Names:
Drug: leucovorin calcium
Given IV
Other Names:
Drug: fluorouracil
Given IV
Other Names:
Biological: cetuximab
Given IV
Other Names:
|
Show Detailed Description
Eligibility| Ages Eligible for Study: | 18 Years to 69 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Histologically confirmed adenocarcinoma of the colon
- Stage III disease
- No resected stage IV disease
No rectal cancer
- Gross inferior (caudad) margin of the primary tumor must be ≥ 12 cm from the anal verge by rigid proctoscopy
Stage III tumor must have been completely resected within the past 56 days
- Must have documented en bloc resection in patients with tumor adherence to adjacent structures
- Tumor-related obstructions and colonic perforation are allowed
- Tumor samples must be available
At least 1 pathologically confirmed positive lymph node
- No evidence of residual involved lymph node disease
- Synchronous primary colon cancer allowed
- No distant metastatic disease
- Performance status - ECOG 0-2
- Absolute neutrophil count ≥ 1,500/mm^3
- Platelet count ≥ 100,000/mm^3
- Hemoglobin ≥ 9 g/dL
- Bilirubin ≤ 1.5 times upper limit of normal (ULN)
- Creatinine ≤ 1.5 times ULN
- No uncontrolled high blood pressure
- No unstable angina
- No symptomatic congestive heart failure
- No myocardial infarction with the past 6 months
- No New York Heart Association class III or IV heart disease
- No symptomatic pulmonary fibrosis
- No symptomatic interstitial pneumonitis
- No prior allergic reaction (known sensitivity) to chimerized or murine monoclonal antibody therapy
- No known allergy to platinum compounds
- No documented presence of human anti-mouse antibodies (HAMA)
- No active uncontrolled bacterial, viral, or systemic fungal infection
- HIV negative
- No clinically defined AIDS
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception during and for 2 months after study participation
- No inadequately treated gastrointestinal bleeding
- No ≥ grade 2 pre-existing peripheral sensory or motor neuropathy
- No other malignancy within the past 5 years except adequately treated basal cell or squamous cell skin cancer, carcinoma in situ of the cervix, or lobular carcinoma in situ in 1 breast
- No other concurrent medical condition that would preclude study participation
- No concurrent biologic therapy
- No concurrent oprelvekin
- No concurrent pegfilgrastim
- No prior chemotherapy for colon cancer
- No other concurrent chemotherapy
- No prior radiotherapy for colon cancer
- No concurrent targeted agents
- No prior agents directed against epidermal growth factor-receptor
- No concurrent ketoconazole or other potent inhibitors of CYP3A4 (e.g., itraconazole or voriconazole)
- No other concurrent anticancer therapy
Contacts and Locations
Show 894 Study Locations| Principal Investigator: | Frank Sinicrope | North Central Cancer Treatment Group |
More Information
No publications provided by National Cancer Institute (NCI)
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | National Cancer Institute (NCI) |
| ClinicalTrials.gov Identifier: | NCT00079274 History of Changes |
| Obsolete Identifiers: | NCT00170092 |
| Other Study ID Numbers: | NCI-2009-00639, N0147, U10CA025224, CDR0000355132 |
| Study First Received: | March 8, 2004 |
| Last Updated: | February 19, 2013 |
| Health Authority: | United States: Food and Drug Administration |
Additional relevant MeSH terms:
|
Adenocarcinoma Adenocarcinoma, Mucinous Colonic Neoplasms Carcinoma Neoplasms, Glandular and Epithelial Neoplasms by Histologic Type Neoplasms Neoplasms, Cystic, Mucinous, and Serous Colorectal Neoplasms Intestinal Neoplasms Gastrointestinal Neoplasms Digestive System Neoplasms Neoplasms by Site Digestive System Diseases Gastrointestinal Diseases |
Colonic Diseases Intestinal Diseases Antibodies Immunoglobulins Antibodies, Monoclonal Fluorouracil Oxaliplatin Irinotecan Cetuximab Camptothecin Leucovorin Levoleucovorin Immunologic Factors Physiological Effects of Drugs Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 16, 2013