COVID-19 is an emerging, rapidly evolving situation.
Get the latest public health information from CDC:

Get the latest research information from NIH: Menu

Radiation Therapy, Chemotherapy, and Cetuximab Followed by Surgery, Chemotherapy, and Cetuximab in Treating Patients With Locally Advanced or Metastatic Rectal Cancer That Can Be Removed by Surgery

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00541112
Recruitment Status : Terminated (Toxicity and lack of efficacy)
First Posted : October 8, 2007
Last Update Posted : February 11, 2020
Information provided by (Responsible Party):

Tracking Information
First Submitted Date  ICMJE October 5, 2007
First Posted Date  ICMJE October 8, 2007
Last Update Posted Date February 11, 2020
Actual Study Start Date  ICMJE October 29, 2007
Actual Primary Completion Date January 29, 2010   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: October 13, 2007)
Complete remission at ≥ 6 months by abdomino-pelvic-thoracic scan and a pelvic MRI
Original Primary Outcome Measures  ICMJE
 (submitted: October 5, 2007)
Complete remission at â ¥ 6 months by abdomino-pelvic-thoracic scan and a pelvic MRI
Change History
Current Secondary Outcome Measures  ICMJE
 (submitted: October 5, 2007)
  • Preoperative clinical response
  • Progression-free survival
  • Overall survival
  • Early toxicity before surgery
  • Early toxicity due to surgery (mortality at 30 days, postoperative complications, surgical recovery)
  • Late toxicity
  • Late radiotherapy toxicity by CTC AE v. 3.0
  • Objective response of measurable metastases by RECIST
  • Sexual function
  • Downstaging and downsizing of patients with operable disease
  • Surgical complications
  • Sphincter function
  • Predictive biomarkers of response to cetuximab
Original Secondary Outcome Measures  ICMJE Same as current
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
Descriptive Information
Brief Title  ICMJE Radiation Therapy, Chemotherapy, and Cetuximab Followed by Surgery, Chemotherapy, and Cetuximab in Treating Patients With Locally Advanced or Metastatic Rectal Cancer That Can Be Removed by Surgery
Official Title  ICMJE Phase II Multicenter Study of the Impact of the Therapeutic Sequence of Radiochemotherapy (50 Gy + Capecitabine + Oxaliplatin + Cetuximab) Followed by Total Mesorectal Excision Surgery Then Post-surgery Chemotherapy (FOLFOX 4 + Cetuximab) in Synchronous Locally Advanced or Metastatic Cancers of the Rectum With Metastases Resectable From the Start (T3-4 Nx or T2 N+ M1).
Brief Summary

RATIONALE: Radiation therapy uses high-energy x-rays to kill tumor cells. Drugs used in chemotherapy, such as capecitabine, oxaliplatin, fluorouracil, and leucovorin, 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 combination chemotherapy and cetuximab before surgery may make the tumor smaller and reduce the amount of normal tissue that needs to be removed. Giving chemotherapy and cetuximab after surgery may kill any tumor cells that remain after surgery.

PURPOSE: This phase II clinical trial is studying how well giving radiation therapy together with chemotherapy and cetuximab followed by surgery, chemotherapy, and cetuximab works in treating patients with locally advanced or metastatic rectal cancer that can be removed by surgery.

Detailed Description



  • Determine the complete remission rate at 6 months after neoadjuvant radiotherapy, capecitabine, and oxaliplatin (XELOX), and cetuximab followed by surgery, adjuvant FOLFOX 4, and cetuximab in patients with synchronous locally advanced or metastatic cancer of the rectum with resectable metastases (T3-4 Nx or T2 N+ M1).


  • Determine progression-free survival.
  • Determine overall survival.
  • Assess toxicities.
  • Evaluate objective response in patients with measurable metastases.
  • Determine the rate of local recurrence.
  • Evaluate the downstaging and downsizing of patients with operable disease.
  • Evaluate surgical complications in patients with operable disease.
  • Evaluate biological markers predictive of response to cetuximab.

OUTLINE: This is a multicenter study.

  • Neoadjuvant therapy: Patients undergo radiotherapy for 5 weeks and receive concurrent oral capecitabine twice daily on days 1-5 of each week and oxaliplatin IV over 2 hours on day 1 of each week (XELOX). Patients also receive cetuximab IV on day 1 of the first week and on days 1-7 of weeks 2-5.
  • Surgery: At 6 weeks after completing chemoradiotherapy, patients with resectable disease undergo surgery comprising total mesorectal excision. Patients with progressive disease, nonresectable tumor, or who require R2 surgery are removed from the study.
  • Adjuvant therapy: Patients who undergo surgery, with or without removal of metastases, receive FOLFOX 4, comprising oxaliplatin IV over 2 hours, fluorouracil IV over 46 hours, and leucovorin calcium IV on day 1, and cetuximab IV. Treatment repeats every 2 weeks for up to 6 courses (approximately 3 months). Patients who have not undergone prior surgical resection of metastases may have surgery to remove metastases after completing this second regimen of chemotherapy.

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

Study Type  ICMJE Interventional
Study Phase  ICMJE Phase 2
Study Design  ICMJE Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Condition  ICMJE Colorectal Cancer
Intervention  ICMJE
  • Biological: cetuximab
  • Drug: capecitabine
  • Drug: fluorouracil
  • Drug: leucovorin calcium
  • Drug: oxaliplatin
  • Procedure: adjuvant therapy
  • Procedure: conventional surgery
  • Procedure: neoadjuvant therapy
  • Radiation: radiation therapy
Study Arms  ICMJE Not Provided
Publications * Not Provided

*   Includes publications given by the data provider as well as publications identified by Identifier (NCT Number) in Medline.
Recruitment Information
Recruitment Status  ICMJE Terminated
Actual Enrollment  ICMJE
 (submitted: February 7, 2020)
Original Enrollment  ICMJE
 (submitted: October 5, 2007)
Actual Study Completion Date  ICMJE January 29, 2010
Actual Primary Completion Date January 29, 2010   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE


  • Histologically confirmed adenocarcinoma of the rectum

    • Locally advanced (T3-4 Nx) or metastatic (T2 N+ M1) synchronous disease

      • Metastases must be resectable
    • Primary tumor examined by endorectal echography and MRI
  • Measurable disease by thoraco-abdomino-pelvic scanner
  • Disease considered susceptible to treatment with radiotherapy and chemotherapy
  • No diffuse metastases considered nonresectable
  • No acute occlusion not caused by colostomy


Inclusion criteria:

  • ECOG performance status 0-2
  • WBC ≥ 4,000/mm^3
  • Absolute neutrophil count ≥ 1,500/mm^3
  • Platelet count ≥ 100,000/mm^3
  • Hemoglobin ≥ 10 g/dL
  • Creatinine ≤ 130 µmol/L
  • Transaminases ≤ 5 times upper limit of normal (ULN)
  • Total bilirubin ≤ 1.5 times ULN
  • Alkaline phosphatase ≤ 2.5 times ULN
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients of must use effective contraception

Exclusion criteria:

  • Contraindication to therapy with capecitabine, oxaliplatin, cetuximab, and/or radiotherapy
  • Impossible to perform translational analyses
  • Uncontrolled severe illness
  • Severe renal or hepatic insufficiency
  • Cardiac insufficiency or symptomatic coronary disease
  • Sensitive peripheral neuropathy
  • Uncontrolled diabetes
  • Other malignancy within the past 10 years except previously treated basal cell skin cancer or carcinoma in situ of the cervix
  • Impossible to participate in study due to geographic, social, or psychiatric reasons
  • Patients who are under supervision or incarcerated


  • See Disease Characteristics
  • No prior anticancer chemotherapy or radiotherapy for this cancer
  • No therapy with coumarin anticoagulants, phenytoin, sorivudine, brivudine, antacids, or allopurinol
  • No concurrent participation in another therapeutic study or receiving another experimental drug
Sex/Gender  ICMJE
Sexes Eligible for Study: All
Ages  ICMJE 18 Years to 80 Years   (Adult, Older Adult)
Accepts Healthy Volunteers  ICMJE No
Contacts  ICMJE Contact information is only displayed when the study is recruiting subjects
Listed Location Countries  ICMJE France
Removed Location Countries  
Administrative Information
NCT Number  ICMJE NCT00541112
Other Study ID Numbers  ICMJE CDR0000565937
FRE-FNCLCC-ACCORD-14/0604 ( Other Identifier: FNCLCC )
2006-003336-30 ( EudraCT Number )
Has Data Monitoring Committee Not Provided
U.S. FDA-regulated Product
Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
IPD Sharing Statement  ICMJE Not Provided
Responsible Party UNICANCER
Collaborators  ICMJE Not Provided
Investigators  ICMJE
Principal Investigator: David Azria, MD, PhD Institut du Cancer de Montpellier - Val d'Aurelle
Verification Date February 2020

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP