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Capecitabine, Oxaliplatin, Selenomethionine, and Radiation Therapy in Treating Patients Undergoing Surgery For Newly Diagnosed Stage II or III Rectal Adenocarcinoma

This study has been terminated.
(Withdrawn due to poor/low accrual)
National Cancer Institute (NCI)
Information provided by (Responsible Party):
Roswell Park Cancer Institute Identifier:
First received: February 26, 2008
Last updated: January 19, 2016
Last verified: January 2016

RATIONALE: Drugs used in chemotherapy, such as capecitabine and oxaliplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Selenomethionine may slow the growth of tumor cells. Radiation therapy uses high-energy x-rays to kill tumor cells. Giving combination chemotherapy together With selenomethionine and radiation therapy may kill more tumor cells.

PURPOSE: This phase II trial is studying how well selenomethionine works when given together with capecitabine, oxaliplatin, and radiation therapy in treating patients undergoing surgery for newly diagnosed stage II or stage III rectal cancer.

Condition Intervention Phase
Colorectal Cancer Dietary Supplement: selenomethionine Drug: capecitabine Drug: oxaliplatin Other: laboratory biomarker analysis Other: pharmacological study Procedure: adjuvant therapy Procedure: neoadjuvant therapy Procedure: therapeutic conventional surgery Radiation: radiation therapy Phase 2

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase II Study of Capecitabine, Oxaliplatin and Selenomethionine and Radiation Therapy in Patients With Stage II and III Rectal Adenocarcinoma

Resource links provided by NLM:

Further study details as provided by Roswell Park Cancer Institute:

Primary Outcome Measures:
  • Complete Pathological Response Rate [ Time Frame: After completion of capecitabine, oxaliplatin, selenomethionine, and radiation, and before surgery. Assessed endoscopically. ]
  • Rate of T-downstaging With Capecitabine, Oxaliplatin, Selenomethionine, and Radiotherapy [ Time Frame: After completion of capecitabine, oxaliplatin, selenomethionine, and radiation, and before surgery. Assessed endoscopically. ]

Secondary Outcome Measures:
  • Safety and Tolerability as Assessed by NCI CTCAE Version 3.0 [ Time Frame: Adverse events were queried for and collected every cycle for the duration of treatment. ]
  • Dose Intensity [ Time Frame: During treatment with capecitabine, oxaliplatin, selenomethionine. ]
  • Local Relapse Rate [ Time Frame: For up to 5 years following surgery. ]
  • Distant Relapse Rate [ Time Frame: For up to 5 years following surgery. ]

Enrollment: 5
Study Start Date: March 2008
Study Completion Date: December 2009
Primary Completion Date: October 2009 (Final data collection date for primary outcome measure)
Detailed Description:



  • To determine the complete pathological response rate of the combination of capecitabine, oxaliplatin, selenomethionine, and radiotherapy in patients with stage II or III rectal adenocarcinoma.
  • To determine the T-downstaging rate with this regimen in patients with stage II or III rectal adenocarcinoma.


  • To determine the safety of this regimen by assessing toxicity and dose intensity of the various components of this regimen.
  • To determine the rate of local relapse.
  • To determine the rate of distant relapse.

OUTLINE: Patients receive neoadjuvant therapy comprising oral selenomethionine twice daily for 1 week prior to radiotherapy and then once daily for 6 weeks. Patients also receive oxaliplatin IV over 2 hours on days 1-7 and oral capecitabine twice daily on days 1-5 for 6 weeks and undergo radiotherapy 5 days a week for 6 weeks. Treatment continues in the absence of disease progression or unacceptable toxicity.

Within 4-8 weeks after completion of neoadjuvant therapy, patients undergo curative-intent surgery. Beginning 4-8 weeks after surgery, patients may receive up to 9 courses of standard adjuvant combination chemotherapy (FOLFOX).

Blood samples are collected at baseline and weekly during treatment and analyzed by absorption spectrophotometry for selenium measurement of drug concentration. Pharmacokinetic studies are also performed.

After completion of study treatment, patients are followed for up to 5 years.


Ages Eligible for Study:   18 Years to 75 Years   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No


  • Histologically confirmed rectal adenocarcinoma that is involving the distal 12 cm of the rectum (above the anal verge)

    • Staged within 8 weeks prior to initiation of study by endoscopic ultrasound OR MRI or CT scan if endorectal ultrasound is non-conclusive or non-tolerable
    • T3-T4 tumor or evidence of lymph node involvement defined by the presence of at least 1 enlarged peri-rectal lymph node
  • No evidence of distant or known metastases


  • ECOG performance status (PS) 0-1 OR Karnofsky PS 70-100%
  • Life expectancy > 1 year
  • Leukocytes ≥ 3,000/µL
  • Absolute neutrophil count ≥ 1,500/µL
  • Platelet count ≥ 100,000/µL
  • Total bilirubin ≤ upper limit of normal (ULN)
  • AST/ALT ≤ 2.5 times ULN
  • Creatinine ≤ ULN OR creatinine clearance ≥ 60 mL/min
  • Able to receive oral medication
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • No other concurrent or previous malignancies unless disease free for > 5 years (excluding nonmelanoma skin cancer)
  • No neuropathy ≥ grade 2
  • No history of allergic reaction attributed to compounds of similar chemical or biologic composition to oxaliplatin, capecitabine, or selenomethionine
  • No uncontrolled intercurrent illness including, but not limited to, any of the following:

    • Ongoing or active infection
    • Symptomatic congestive heart failure
    • Unstable angina pectoris
    • Cardiac arrhythmia
    • Psychiatric illness/social situations that would limit compliance with study requirements


  • No prior radiotherapy to the pelvis
  • No prior chemotherapy
  • No other concurrent investigational or anticancer agents or therapies
  • No concurrent vitamin B6 supplementation (except as part of a standard, multivitamin supplement)
  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 identifier: NCT00625183

United States, New York
Roswell Park Cancer Institute
Buffalo, New York, United States, 14263-0001
Sponsors and Collaborators
Roswell Park Cancer Institute
National Cancer Institute (NCI)
Principal Investigator: Marwan Fakih, MD Roswell Park Cancer Institute
  More Information

Responsible Party: Roswell Park Cancer Institute Identifier: NCT00625183     History of Changes
Other Study ID Numbers: I 113607
Study First Received: February 26, 2008
Results First Received: September 19, 2014
Last Updated: January 19, 2016

Keywords provided by Roswell Park Cancer Institute:
adenocarcinoma of the rectum
stage II rectal cancer
stage III rectal cancer

Additional relevant MeSH terms:
Colorectal Neoplasms
Intestinal Neoplasms
Gastrointestinal Neoplasms
Digestive System Neoplasms
Neoplasms by Site
Digestive System Diseases
Gastrointestinal Diseases
Colonic Diseases
Intestinal Diseases
Rectal Diseases
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Antimetabolites, Antineoplastic
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Protective Agents
Physiological Effects of Drugs
Trace Elements
Growth Substances processed this record on September 21, 2017