Combination Chemotherapy With or Without Cetuximab Before and After Surgery in Treating Patients With Resectable Liver Metastases Caused By Colorectal Cancer
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Purpose
RATIONALE: Drugs used in chemotherapy, such as oxaliplatin, fluorouracil, leucovorin, and capecitabine, 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 combination chemotherapy together with monoclonal antibodies before surgery may make the tumor smaller and reduce the amount of normal tissue that needs to be removed. Giving these treatments after surgery may kill any tumor cells that remain after surgery. It is not yet known whether combination chemotherapy is more effective with or without cetuximab in treating liver metastases caused by colorectal cancer.
PURPOSE: This randomized phase III trial is studying combination chemotherapy to compare how well it works when given with or without cetuximab before and after surgery in treating patients with resectable liver metastases caused by colorectal cancer.
| Condition | Intervention | Phase |
|---|---|---|
|
Colorectal Cancer Metastatic Cancer |
Biological: cetuximab Drug: capecitabine Drug: fluorouracil Drug: leucovorin calcium Drug: oxaliplatin Other: study of socioeconomic and demographic variables Procedure: adjuvant therapy Procedure: neoadjuvant therapy Procedure: quality-of-life assessment |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | A Prospective Randomised Open Label Trial of Oxaliplatin/Fluoropyrimidine Versus Oxaliplatin/Fluoropyrimidine Plus Cetuximab Pre and Post Operatively in Patients With Resectable Colorectal Liver Metastasis Requiring Chemotherapy |
- Progression-free survival [ Time Frame: end of study ] [ Designated as safety issue: No ]
- Response rate before surgery as assessed by RECIST criteria [ Time Frame: end of study ] [ Designated as safety issue: No ]
- Pathological resection status [ Time Frame: end of study ] [ Designated as safety issue: No ]
- Overall survival [ Time Frame: end of study ] [ Designated as safety issue: No ]
- Toxicity [ Time Frame: end of study ] [ Designated as safety issue: Yes ]
- Quality of life as assessed by the EQ-5D, EORTC QLQ-C30, and EORTC QLQ-LMC21 [ Time Frame: end of study ] [ Designated as safety issue: No ]
- Cost effectiveness [ Time Frame: end of study ] [ Designated as safety issue: No ]
- Safety [ Time Frame: end of study ] [ Designated as safety issue: Yes ]
| Estimated Enrollment: | 340 |
| Study Start Date: | February 2007 |
| Estimated Primary Completion Date: | December 2014 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: OxMdG / IrMdG chemotherapy
OxMdG / IrMdG chemotherapy for 12 weeks Followed by surgery OxMdG / IrMdG chemotherapy for 12 weeks
|
Drug: capecitabine Drug: fluorouracil Drug: leucovorin calcium Drug: oxaliplatin Other: study of socioeconomic and demographic variables Procedure: adjuvant therapy Procedure: neoadjuvant therapy Procedure: quality-of-life assessment |
|
Experimental: OxMdG / IrMdG chemotherapy with cetuximab
OxMdG / IrMdG chemotherapy with cetuximab for 12 weeks Followed by Surgery OxMdG / IrMdG chemotherapy with cetuximab for 12 weeks
|
Biological: cetuximab Drug: capecitabine Drug: fluorouracil Drug: leucovorin calcium Drug: oxaliplatin Other: study of socioeconomic and demographic variables Procedure: adjuvant therapy Procedure: neoadjuvant therapy Procedure: quality-of-life assessment |
Show Detailed Description
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
DISEASE CHARACTERISTICS:
Histologically* or radiologically confirmed primary adenocarcinoma of the colon or rectum
- Advanced and/or metastatic disease NOTE: *Liver metastases should not be biopsied
Must have potentially resectable liver metastases present, as defined by any of the following:
- Metachronous metastases AND complete resection of the primary tumor without gross or microscopic evidence of residual disease (R0)
- Synchronous metastases AND R0 resection of the primary tumor > 1 month before study entry
- Synchronous metastases with sufficient evidence (e.g., by CT scan or diagnostic laparoscopy) that both the primary tumor and the liver metastases can be completely resected during the same procedure and resection of primary tumor can be delayed for 3-4 months
- Suboptimally resectable disease (i.e., potentially resectable disease with compromise of the resection margins)
- No detectable extrahepatic tumor that cannot be completely resected
- Unidimensionally measurable disease
- No brain metastases
PATIENT CHARACTERISTICS:
- WHO performance status 0-2
- WBC ≥ 4,000/mm³
- ANC ≥ 1,500/mm³
- Platelet count > 150,000/mm³
- Bilirubin ≤ 1.25 times upper limit of normal (ULN)
- Alkaline phosphatase ≤ 5 times ULN
- AST or ALT ≤ 3 times ULN
- Creatinine clearance > 50 mL/min OR glomerular filtration rate > 50 mL/min
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception during and for ≥ 3 months after completion of study treatment
- No psychiatric or neurological condition that would preclude study compliance
- No partial or complete bowel obstruction
- No preexisting neuropathy > grade 1
- No other prior or concurrent malignant disease that, in the opinion of the investigator, would preclude study treatment
- No concurrent severe uncontrolled medical illness (including poorly-controlled angina or myocardial infarction within the past 3 months) that would preclude study treatment
- No known hypersensitivity reaction to any of the components of the study drugs
PRIOR CONCURRENT THERAPY:
- No prior systemic chemotherapy for metastatic disease
- More than 6 months since prior adjuvant chemotherapy comprising fluorouracil, leucovorin calcium, capecitabine, or irinotecan hydrochloride
- More than 1 month since prior rectal chemoradiotherapy comprising fluorouracil and leucovorin calcium
- No concurrent contraindicated medication
Contacts and Locations| Contact: Louisa Little | 02380795154 |
| United Kingdom | |
| Basildon University Hospital | Recruiting |
| Basildon, England, United Kingdom, SS16 5NL | |
| Contact: Pauline Leonard, MD 44-1702-435-555 | |
| Basingstoke and North Hampshire NHS Foundation Trust | Recruiting |
| Basingstoke, England, United Kingdom, RG24 9NA | |
| Contact: Charlotte Rees, MD 44-125-631-4793 | |
| Royal Bournemouth Hospital | Recruiting |
| Bournemouth, England, United Kingdom, BH7 7DW | |
| Contact: Tamas Hickish, MD 44-1202-303-626 tamas.hickish@rbch.nhs.uk | |
| Addenbrooke's Hospital | Recruiting |
| Cambridge, England, United Kingdom, CB2 0QQ | |
| Contact: Pippa Corrie, PhD, FRCP 44-1223-274-401 pippa.corrie@addenbrookes.nhs.uk | |
| St. Luke's Cancer Centre at Royal Surrey County Hospital | Recruiting |
| Guildford, England, United Kingdom, GU2 7XX | |
| Contact: Sharadah Essapen, MD 44-1483-571-122 | |
| Aintree University Hospital | Recruiting |
| Liverpool, England, United Kingdom, L9 7AL | |
| Contact: Graeme J. Poston, MD 44-151-525-5980 graeme.poston@aintree.nhs.uk | |
| Royal Liverpool University Hospital | Recruiting |
| Liverpool, England, United Kingdom, L9 7AL | |
| Contact: Paula Ghaneh, MD | |
| Charing Cross Hospital | Recruiting |
| London, England, United Kingdom, W6 8RF | |
| Contact: Charles P. Lowdell, MD, BSc, MBBS, FRCP, FRCR 44-208-383-0576 charles.lowdell@imperial.nhs.uk | |
| Royal Marsden - London | Recruiting |
| London, England, United Kingdom, SW3 6JJ | |
| Contact: David Cunningham, MD 44-20-8661-3156 | |
| UCL Cancer Institute | Recruiting |
| London, England, United Kingdom, NW3 2PF | |
| Contact: Astrid Mayer, MD 44-207-794-0500 a.mayer@ucl.ac.uk | |
| Saint Bartholomew's Hospital | Recruiting |
| London, England, United Kingdom, EC1A 7BE | |
| Contact: Sarah Slater, MD 44-20-7601-8391 | |
| Clatterbridge Centre for Oncology | Recruiting |
| Merseyside, England, United Kingdom, CH63 4JY | |
| Contact: David Smith, MD 44-151-334-1155 david.smith@ccotrust.nhs.uk | |
| St. Mary's Hospital | Recruiting |
| Newport, England, United Kingdom, PO30 5TG | |
| Contact: Christopher Baughan, MD 44-1983-524-081 | |
| Cancer Research Centre at Weston Park Hospital | Recruiting |
| Nottingham, England, United Kingdom, NG5 1PB | |
| Contact: J. Hornbuckle, MD 44-115-969-1169 ext. 47599 | |
| Dorset Cancer Centre | Recruiting |
| Poole Dorset, England, United Kingdom, BH15 2JB | |
| Contact: Tamas Hickish, MD 44-1202-442-532 | |
| Salisbury District Hospital | Recruiting |
| Salisbury, England, United Kingdom, SP2 8BJ | |
| Contact: Tim J. Iveson, MD 44-1722-336-262 ext. 4688 | |
| Southampton General Hospital | Recruiting |
| Southampton, England, United Kingdom, SO16 6YD | |
| Contact: John N. Primrose, MD 44-23-8079-6144 j.n.primrose@soton.ac.uk | |
| Royal Marsden - Surrey | Recruiting |
| Sutton, England, United Kingdom, SM2 5PT | |
| Contact: David Cunningham, MD 44-20-8661-3279 david.cunningham@rmh.nhs.uk | |
| Southend University Hospital NHS Foundation Trust | Recruiting |
| Westcliff-On-Sea, England, United Kingdom, SS0 0RY | |
| Contact: Pauline Leonard, MD 44-1702-435-555 | |
| Worthing Hospital | Recruiting |
| Worthing, England, United Kingdom, BN11 2DH | |
| Contact: Andrew Webb, MD 44-1903-205-111 | |
| Velindre Cancer Center at Velindre Hospital | Recruiting |
| Cardiff, Wales, United Kingdom, CF14 2TL | |
| Contact: Timothy Maughan, MD 44-2920-316-904 | |
| University Hospital of Wales | Recruiting |
| Cardiff, Wales, United Kingdom, CF14 4XW | |
| Contact: Timothy Maughan, MD 44-2920-316-904 | |
| Study Chair: | John N. Primrose, MD | University Hospital Southampton NHS Foundation Trust. |
More Information
Additional Information:
No publications provided
| Responsible Party: | University of Southampton |
| ClinicalTrials.gov Identifier: | NCT00482222 History of Changes |
| Other Study ID Numbers: | CDR0000549541, USCTU-4351, USCTU-EPOC, EUDRACT-2006-003121-82, ISRCTN22944367, EU-20732 |
| Study First Received: | June 4, 2007 |
| Last Updated: | January 22, 2013 |
| Health Authority: | UK: Medicines and Healthcare producets Regulatory Agency |
Keywords provided by University of Southampton:
|
adenocarcinoma of the colon stage IV colon cancer adenocarcinoma of the rectum stage IV rectal cancer |
liver metastases recurrent colon cancer recurrent rectal cancer |
Additional relevant MeSH terms:
|
Colorectal Neoplasms Neoplasm Metastasis Neoplasms Neoplasms, Second Primary Liver Neoplasms Intestinal Neoplasms Gastrointestinal Neoplasms Digestive System Neoplasms Neoplasms by Site Digestive System Diseases Gastrointestinal Diseases Colonic Diseases Intestinal Diseases Rectal Diseases Neoplastic Processes |
Pathologic Processes Liver Diseases Fluorouracil Capecitabine Oxaliplatin Cetuximab Leucovorin Levoleucovorin Antimetabolites Molecular Mechanisms of Pharmacological Action Pharmacologic Actions Antimetabolites, Antineoplastic Antineoplastic Agents Therapeutic Uses Immunosuppressive Agents |
ClinicalTrials.gov processed this record on May 22, 2013