Calcium Aluminosilicate Anti-Diarrheal in Treating and Preventing Diarrhea in Patients With Metastatic Colorectal Cancer Receiving Irinotecan
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Purpose
RATIONALE: Calcium aluminosilicate anti-diarrheal (CASAD) may help treat and prevent diarrhea caused by irinotecan. It is not yet known whether CASAD is more effective than a placebo in treating and preventing diarrhea in patients receiving irinotecan.
PURPOSE: This randomized phase II trial is studying CASAD to see how well it works compared with a placebo in treating and preventing diarrhea in patients with metastatic colorectal cancer receiving irinotecan.
| Condition | Intervention | Phase |
|---|---|---|
|
Chemotherapeutic Agent Toxicity Colorectal Cancer Diarrhea |
Drug: calcium aluminosilicate anti-diarrheal Other: placebo |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Double Blind (Subject, Caregiver, Investigator) Primary Purpose: Supportive Care |
| Official Title: | Phase II, Randomized, Double Blind Comparison of CASAD vs. Placebo for the Treatment and Prevention of Diarrhea in Patients With Metastatic Colorectal Cancer |
- Incidence of grade 3 or 4 diarrhea as assessed by NCI Common Terminology Criteria for Adverse Events (CTCAE) version 3.0 [ Time Frame: 6 weeks ] [ Designated as safety issue: No ]Number of grade 3/4 diarrhea occurences used to compare the efficacy of Calcium Aluminosilicate Anti-Diarrheal (CASAD) with that of placebo in reducing the incidence of Grade 3 or Grade 4 diarrhea after 6 weeks by CTCAE criteria.
- Number of Stools per day [ Time Frame: 6 weeks ] [ Designated as safety issue: No ]
- Chemotherapy dose reductions and delays due to diarrhea [ Time Frame: 6 weeks ] [ Designated as safety issue: Yes ]
- Quality of life as assessed by the MD Anderson Symptom Inventory [ Time Frame: 6 weeks ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 100 |
| Study Start Date: | February 2009 |
| Estimated Primary Completion Date: | July 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Arm I: CASAD
Oral calcium aluminosilicate anti-diarrheal (CASAD) 4 times daily for 6 weeks in the absence of disease progression or unacceptable toxicity. Participants who develop grade 3 or 4 diarrhea may receive CASAD for an additional 6 weeks.
|
Drug: calcium aluminosilicate anti-diarrheal
Given orally
|
|
Placebo Comparator: Arm II: Placebo
Oral placebo 4 times daily for 6 weeks in the absence of disease progression or unacceptable toxicity. Participants who develop grade 3 or 4 diarrhea may then receive CASAD for 6 weeks.
|
Other: placebo
Given orally
|
Detailed Description:
OBJECTIVES:
Primary
- To compare the efficacy of calcium aluminosilicate anti-diarrheal (CASAD) versus placebo in reducing the incidence of grade 3 or 4 diarrhea in patients with metastatic colorectal cancer receiving an irinotecan-based chemotherapy regimen.
Secondary
- To compare stools per day in patients treated with these drugs.
- To compare chemotherapy dose reductions and delays due to diarrhea in patients treated with these drugs.
- To compare quality of life of patients treated with these drugs.
- To compare the safety of these drugs in these patients.
- To compare the incidence of grade 3 or 4 diarrhea in patients treated with these drugs.
OUTLINE: This is a multicenter study. Patients are stratified according to chemotherapy regimen (irinotecan hydrochloride in combination with fluorouracil and/or biologic therapy vs irinotecan hydrochloride alone). Patients are randomized to 1 of 2 treatment arms.
- Arm I: Patients receive oral calcium aluminosilicate anti-diarrheal (CASAD) 4 times daily for 6 weeks in the absence of disease progression or unacceptable toxicity. Patients who develop grade 3 or 4 diarrhea and are removed from the study may receive CASAD for an additional 6 weeks.
- Arm II: Patients receive oral placebo 4 times daily for 6 weeks in the absence of disease progression or unacceptable toxicity. Patients who develop grade 3 or 4 diarrhea and are removed from the study may then receive CASAD for 6 weeks.
Patients undergo quality-of-life assessment at baseline and at weeks 3, 5, and 6.
After completion of study treatment, patients are followed for 30 days.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
DISEASE CHARACTERISTICS:
Diagnosis of colorectal cancer
- Metastatic disease
- Scheduled to receive irinotecan hydrochloride alone or in combination with fluorouracil, cetuximab, leucovorin calcium, or other biological therapy (including bevacizumab)
No uncontrolled brain metastasis
- Previously treated brain metastasis allowed
PATIENT CHARACTERISTICS:
- Eastern Cooperative Oncology Group (ECOG) performance status 0-2
- Absolute neutrophil count (ANC) > 1,000/mm³
- Platelet count > 100,000/mm³
- Total bilirubin < 1.5 times upper limit of normal (ULN)
- Aspartate aminotransferase (AST or SGOT) and/or alanine aminotransferase (ALT or SGPT) < 2.5 times ULN (< 5 times ULN if liver metastasis is present)
- Alkaline phosphatase < 2.5 times ULN
- Creatinine clearance > 35 mL/min
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
- No known UDP-glucuronosyltransferase 1A1 (UGT1A1) deficiency with homozygotes.
- No known history of Gilbert's disease
- No diarrhea > grade 1
No serious illness or medical condition, including any of the following:
- Uncontrolled congestive heart failure
- Uncontrolled hypertension (i.e., blood pressure > 150/100 mm Hg)
- Uncontrolled arrhythmia
- Active angina pectoris
- Symptomatic heart disease according to New York Heart Association(NYHA) class II-IV
- No serious uncontrolled active infection
- No existing colostomy or ileostomy
- Not able to take and document oral study medications
- No history of allergies to irinotecan hydrochloride
- No history of significant neurological or psychiatric disorders that would preclude giving consent or participating in study treatment or follow up
PRIOR CONCURRENT THERAPY:
- See Disease Characteristics
- Prior treatment for metastatic disease allowed
- At least 4 weeks since prior irinotecan
More than 2 weeks since prior chemotherapy
- Irinotecan alone or in combination with other chemotherapy or biologic agents allowed
- More than 4 weeks since prior radiotherapy
- No concurrent radiotherapy
- No concurrent medication schedule that does not permit a 2-hour window between administration of calcium aluminosilicate anti-diarrheal (CASAD) and other medications
Contacts and Locations| United States, Oregon | |
| CCOP - Columbia River Oncology Program | |
| Portland, Oregon, United States, 97225 | |
| United States, Texas | |
| M. D. Anderson Cancer Center at University of Texas | |
| Houston, Texas, United States, 77030-4009 | |
| Study Chair: | Brian K. Kee, MD | M.D. Anderson Cancer Center |
| Study Chair: | Michael J. Fisch, MD, MPH, FACP | M.D. Anderson Cancer Center |
More Information
Additional Information:
No publications provided
| Responsible Party: | M.D. Anderson Cancer Center |
| ClinicalTrials.gov Identifier: | NCT00748215 History of Changes |
| Other Study ID Numbers: | MDA-2008-0005, MDA-2008-0005, CDR0000612205 |
| Study First Received: | September 5, 2008 |
| Last Updated: | November 19, 2012 |
| Health Authority: | United States: Food and Drug Administration |
Keywords provided by M.D. Anderson Cancer Center:
|
diarrhea chemotherapeutic agent toxicity recurrent colon cancer |
recurrent rectal cancer stage IV colon cancer stage IV rectal cancer |
Additional relevant MeSH terms:
|
Diarrhea Colorectal Neoplasms Intestinal Neoplasms Gastrointestinal Neoplasms Digestive System Neoplasms Neoplasms by Site Neoplasms Digestive System Diseases Gastrointestinal Diseases Colonic Diseases Intestinal Diseases |
Rectal Diseases Signs and Symptoms, Digestive Signs and Symptoms Antidiarrheals Loperamide Calcium, Dietary Gastrointestinal Agents Therapeutic Uses Pharmacologic Actions Bone Density Conservation Agents Physiological Effects of Drugs |
ClinicalTrials.gov processed this record on May 22, 2013