Radiation Therapy, Irinotecan, and Cetuximab in Treating Patients Who Are Undergoing Surgery for Stage III or Stage IV Rectal Cancer

The recruitment status of this study is unknown because the information has not been verified recently.
Verified April 2008 by National Cancer Institute (NCI).
Recruitment status was  Recruiting
Sponsor:
Information provided by:
National Cancer Institute (NCI)
ClinicalTrials.gov Identifier:
NCT00392470
First received: October 25, 2006
Last updated: May 24, 2011
Last verified: April 2008
  Purpose

RATIONALE: Specialized radiation therapy that delivers a high dose of radiation directly to the tumor may kill more tumor cells and cause less damage to normal tissue. Drugs used in chemotherapy, such as irinotecan, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Monoclonal antibodies, such as cetuximab, can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Giving radiation therapy together with irinotecan and cetuximab before surgery may make the tumor smaller and reduce the amount of normal tissue that needs to be removed.

PURPOSE: This phase I trial is studying the side effects and best dose of irinotecan when given together with cetuximab and radiation therapy in treating patients who are undergoing surgery for stage III or stage IV rectal cancer.


Condition Intervention Phase
Colorectal Cancer
Biological: cetuximab
Drug: irinotecan hydrochloride
Procedure: conventional surgery
Procedure: neoadjuvant therapy
Radiation: 3-dimensional conformal radiation therapy
Radiation: intensity-modulated radiation therapy
Phase 1

Study Type: Interventional
Study Design: Primary Purpose: Treatment
Official Title: Neoadjuvant Conformal Radiotherapy and Concomitant CPT-11 and EGFR Inhibition With Cetuximab in Patients With Rectal Cancer Phase I Study

Resource links provided by NLM:


Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Radiological (clinical) tumor response before surgery [ Designated as safety issue: No ]
  • Pathologic response rate and histological degree of tumor regression as measured by Mandard TRG score [ Designated as safety issue: No ]

Estimated Enrollment: 20
Study Start Date: August 2006
Detailed Description:

OBJECTIVES:

Primary

  • Determine the toxicity of irinotecan hydrochloride and cetuximab in patients with stage III or IV rectal cancer undergoing conformal or intensity-modulated radiotherapy.

Secondary

  • Determine the rate of pathologic response and histological degree of tumor regression in patients treated with this regimen.
  • Determine the complete resection rate (R0) in patients treated with this regimen.
  • Determine the sphincter preservation rate in patients treated with this regimen.
  • Determine the 30-day postoperative complication rate in patients treated with this regimen.
  • Determine the local and distant relapse rate and site of disease failure in patients treated with this regimen.
  • Estimate the predictive value of fludeoxyglucose F 18 positron emission tomography/CT scan for treatment response compared to endoscopic ultrasonography (EUS), CT scan, and MRI in patients treated with this regimen.
  • Determine the late toxicity of this regimen in these patients.
  • Determine the clinical (radiological) tumor response (i.e., MRI, CT scan, EUS) in patients treated with this regimen.

OUTLINE: This is a dose-escalation study of irinotecan hydrochloride.

Patients receive cetuximab IV over 1-2 hours on days 1, 8, 15, 22, 29, 36, and 43 followed by irinotecan hydrochloride IV over 30 minutes on days 1, 8, 15, 22, and 29. Patients also undergo conformal radiotherapy or intensity-modulated radiotherapy on days 1-5 for 5 weeks. Patients undergo radical surgery 3-4 weeks after completion of neoadjuvant therapy.

Cohorts of 3-6 patients receive escalating doses of irinotecan hydrochloride until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity.

After completion of study treatment, patients are followed periodically for at least 5 years.

PROJECTED ACCRUAL: A total of 20 patients will be accrued for this study.

  Eligibility

Ages Eligible for Study:   18 Years to 74 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Histologically confirmed adenocarcinoma of the rectum

    • T3-4 and/or N+ (stage IIIB, IIIC, or IV disease)
  • Liver or lung metastasis allowed
  • No recurrent disease

PATIENT CHARACTERISTICS:

  • WHO performance status 0 or 1
  • Hematologic, liver, and renal function normal
  • Considered fit for chemotherapy, radiotherapy, and surgery
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception during and for 3 months after completion of study treatment
  • No symptomatic heart disease or myocardial infarction during the past 6 months
  • No chronic inflammatory bowel disease
  • No malignant tumor during the past 5 years except for completely surgically resected carcinoma of the cervix or squamous cell carcinoma of the skin
  • No other concurrent malignant tumor

PRIOR CONCURRENT THERAPY:

  • No prior chemotherapy or radiotherapy for rectal cancer
  • No prior radiotherapy to the pelvis
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00392470

Locations
Switzerland
Kantonsspital Aarau Recruiting
Aarau, Switzerland, CH-5000
Contact: Peter Moosmann, MD, PhD    41-62-838-6051    peter.moosmann@ksa.ch   
Institut Ludwig de Recherche sur le Cancer Recruiting
Epalinges, Switzerland, 1066
Contact: Curzio Ruegg, MD    44-412-1692-5853      
Centre Hospitalier Universitaire Vaudois Recruiting
Lausanne, Switzerland, CH-1011
Contact: Michael Montemurro, MD    41-21-314-4530      
Sponsors and Collaborators
Centre Hospitalier Universitaire Vaudois
Investigators
Study Chair: Michael Montemurro, MD Centre Hospitalier Universitaire Vaudois
  More Information

Additional Information:
No publications provided

ClinicalTrials.gov Identifier: NCT00392470     History of Changes
Other Study ID Numbers: CDR0000512816, CHUV-CEPO-CORCC-204-5, EU-20645, PFIZER-CHUV-CAPO-CARK-204-5, MERCK-CHUV-CAPO-CARK-204-5
Study First Received: October 25, 2006
Last Updated: May 24, 2011
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
adenocarcinoma of the rectum
stage III rectal cancer
stage IV rectal cancer

Additional relevant MeSH terms:
Colorectal Neoplasms
Intestinal Neoplasms
Gastrointestinal Neoplasms
Digestive System Neoplasms
Neoplasms by Site
Neoplasms
Digestive System Diseases
Gastrointestinal Diseases
Colonic Diseases
Intestinal Diseases
Rectal Diseases
Cetuximab
Irinotecan
Antineoplastic Agents
Therapeutic Uses
Pharmacologic Actions
Antineoplastic Agents, Phytogenic
Radiation-Sensitizing Agents
Topoisomerase I Inhibitors
Topoisomerase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action

ClinicalTrials.gov processed this record on September 22, 2014