Neoadjuvant Treatment for Advanced Rectal Carcinoma (NACRE)
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ClinicalTrials.gov Identifier: NCT02551237 |
Recruitment Status :
Active, not recruiting
First Posted : September 16, 2015
Last Update Posted : March 2, 2022
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Condition or disease | Intervention/treatment | Phase |
---|---|---|
Rectal Carcinoma | Radiation: 50 Gy Drug: Capecitabine Radiation: 25 Gy | Phase 3 |

Study Type : | Interventional (Clinical Trial) |
Actual Enrollment : | 103 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | None (Open Label) |
Primary Purpose: | Treatment |
Official Title: | A Phase III Study Evaluating Two Neoadjuvant Treatments Radiochemotherapy (5 Weeks - 50Gy+Capecitabine) and Radiotherapy (1week - 25Gy) in Patient Over 75 With Locally Advanced Rectal Carcinoma |
Actual Study Start Date : | January 7, 2016 |
Actual Primary Completion Date : | August 29, 2020 |
Estimated Study Completion Date : | August 2030 |

Arm | Intervention/treatment |
---|---|
Active Comparator: Radiochemotherapy
Patients who will be treated with
The surgery will be planned 7 weeks (±1 week) after the end of preoperative treatment |
Radiation: 50 Gy
radiotherapy 50 Gy in 25 fractions of 2 Gy, five times per week, over a period of 5 weeks Drug: Capecitabine oral capecitabine 800 mg/m2 twice daily from the first day of radiotherapy and given 5 days per week during radiotherapy.
Other Name: Xeloda |
Experimental: Radiotherapy
Patients who will be treated with radiotherapy 25 Gy in 5 fractions of 5 Gy delivered in one week (short-course arm) without chemotherapy. The surgery will be planned 7 weeks (±1 week) after the end of preoperative treatment |
Radiation: 25 Gy
radiotherapy 25 Gy in 5 fractions of 5 Gy delivered in one week (short-course arm) |
- R0 resection rate [ Time Frame: 3 months ]Compare the efficacy between the arm A and the arm B (with an objective of non-inferiority)
- IADL (Instrumental Activities of Daily Living) Score [ Time Frame: 1 year ]Compare the maintenance of autonomy between the arm A and arm B (with an objective of superiority)
- Number of Participants With Treatment-Related Adverse Events as Assessed by CTCAE v4.03 [ Time Frame: 3 months ]Description of the Adverse Events during the pre-operative period.
- Post-operative complications [ Time Frame: 3 months ]according to Dindo-Clavien classification
- Death rate [ Time Frame: at 6 and 12 months ]Death rate is defined as the percentage of patients who died since the date of randomisation at 6 and 12 months post-surgery (M6 and M12) from any cause
- Overall survival (OS) [ Time Frame: 10 years ]The OS is defined as the interval between the date of randomization and the date of deaths from any cause
- Specific survival [ Time Frame: 10 years ]The specific survival is defined as the interval between the date of randomization and the date of deaths due to cancer.
- Disease free survival [ Time Frame: 10 years ]The disease free survival is defined as the interval between the date of randomization and the date of cancer relapse (local regional or distant), second cancer or death from any cause.
- Loco-regional disease free survival [ Time Frame: 10 years ]The disease free survival is defined as the interval between the date of randomization and the date of cancer relapse (local or regional).
- Rate of stoma [ Time Frame: at 6 and 12 months ]percentage of patients with definitive or transitional stoma after surgery.
- Instrumental Activities of Daily Living (IADL) [ Time Frame: Baseline, within 2 weeks before surgery and 3, 6 and 12 months after surgery ]Autonomy Assessment
- Activities of Daily Living (ADL) [ Time Frame: Baseline, within 2 weeks before surgery and 3, 6 and 12 months after surgery ]Autonomy Assessment
- Questionnaire G8 [ Time Frame: Baseline, within 2 weeks before surgery and 3, 6 and 12 months after surgery ]Geriatric Screening
- Mini-Mental Score Examination (MMSE) [ Time Frame: Baseline, within 2 weeks before surgery and 3, 6 and 12 months after surgery ]Cognitive functioning
- Walking gate [ Time Frame: Baseline, within 2 weeks before surgery and 3, 6 and 12 months after surgery ]
- Geriatric Depression Scale (GDS15) [ Time Frame: Baseline, within 2 weeks before surgery and 3, 6 and 12 months after surgery ]Depression Assessment
- Charlson score [ Time Frame: Baseline, within 2 weeks before surgery and 3, 6 and 12 months after surgery ]Comorbidities evaluation
- Mini Nutritional Assessment (MNA) [ Time Frame: Baseline, within 2 weeks before surgery and 3, 6 and 12 months after surgery ]Nutritional Evaluation
- EORTC QLQ-C30 + EDL14 [ Time Frame: Baseline, within 2 weeks before surgery and 3, 6 and 12 months after surgery ]Quality of Life (QLQ)

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Ages Eligible for Study: | 75 Years and older (Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Patient ≥75 years
- Eastern Cooperative Oncology Group (ECOG) ≤2
- Adenocarcinoma of the rectum histologically proven
- Tumor ≤12 cm from the anal margin, the measurement done by rigid rectoscopy or by sub peritoneal MRI
- Require a pre-operative treatment (tumor classified T3 or T4 resectable by MRI and tomodensitometry or T2 of the very low rectum)
- Patient operable
- No radiologically detectable metastases
- Absolute Neutrophile count (ANC) ≥1500/mm³; Platelets ≥100 000/mm³ and Hemoglobin ≥10 g/dL
- Bilirubin ≤1.5 x upper limit of normal (ULN), aspartate aminotransferase (ASAT) and alanine aminotransferase (ALAT) ≤1.5 x upper limit of normal (ULN), Alkaline Phosphatase ≤1.5 x upper limit of normal (ULN)
- Creatinine clearance ≥30 ml/min (Cockcroft and Gault)
- Public or private Health Insurance coverage
- Patient has been informed and signed the informed consent document
Exclusion Criteria:
- Non-resectable tumor
- History of chronic diarrhea or an inflammatory disease of the colon or rectum, or intestinal obstruction or sub-obstruction
- History of pelvic radiotherapy
- Any active febrile infection or any other serious underlying pathology that may prevent the patient from receiving the treatment
- Significant Cardiovascular diseases such as, but not limited to: cardiovascular or myocardial infarction ≤6 months before inclusion, congestive heart failure class II or higher (NYHA), unstable angina, arrhythmia requiring medication or uncontrolled hypertension;
- Significative cardiovascular conditions such as, but not limited to : Cardiac angioplasty or stenting, Myocardial infarction, Unstable angina, Coronary artery bypass graft surgery Symptomatic peripheral vascular disease, Class III or IV congestive heart failure, as defined by the New York Heart Association (NYHA), clinically significant irregular heartbeat requiring medication
- Severe and unexpected reactions to fluoropyrimidine therapy
- Any contra-indication to capecitabine and its excipients; patients with hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption should not included.
- Any other concomitant cancer or history of cancer in the last 3 years, with the exception of the in situ cancer of the uterus, treated, or squamous-cell or basal-cell carcinoma.
- Patients already included in another therapeutic trail with an experimental molecule
- Person deprived of liberty
- Patient that for geographical, social and/or physical reasons will not be able to follow the procedure as required by the protocol

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02551237

Principal Investigator: | Eric Francois | Centre Antoine Lacassagne |
Responsible Party: | UNICANCER |
ClinicalTrials.gov Identifier: | NCT02551237 |
Other Study ID Numbers: |
PRODIGE 42 GERICO12/UCGI 2015-A01365-44 ( Other Identifier: ID-RCB ) UC-0103/1503 ( Other Identifier: UNICANCER ) |
First Posted: | September 16, 2015 Key Record Dates |
Last Update Posted: | March 2, 2022 |
Last Verified: | February 2022 |
Elderly patient Radiotherapy Radio chemotherapy Neoadjuvant treatment |
Carcinoma Rectal Neoplasms Neoplasms, Glandular and Epithelial Neoplasms by Histologic Type Neoplasms Colorectal Neoplasms Intestinal Neoplasms Gastrointestinal Neoplasms Digestive System Neoplasms Neoplasms by Site |
Digestive System Diseases Gastrointestinal Diseases Intestinal Diseases Rectal Diseases Capecitabine Antimetabolites, Antineoplastic Antimetabolites Molecular Mechanisms of Pharmacological Action Antineoplastic Agents |