Oxaliplatin and Bevacizumab (Avastin™) With Either Fluorouracil and Leucovorin or Capecitabine in Treating Patients With Advanced Colorectal Cancer

This study has been completed.
Information provided by:
National Cancer Institute (NCI)
ClinicalTrials.gov Identifier:
First received: June 5, 2003
Last updated: November 5, 2013
Last verified: April 2004

RATIONALE: Drugs used in chemotherapy, such as oxaliplatin, fluorouracil, leucovorin, and capecitabine, work in different ways to stop tumor cells from dividing so they stop growing or die. Combining more than one drug and giving them in different combinations may kill more tumor cells. Monoclonal antibodies, such as bevacizumab (Avastin™), can block cancer growth in different ways. Some block the ability of cancer cells to grow and spread. Others find cancer cells and help kill them or deliver cancer-killing substances to them. It is not yet known which regimen works better in treating advanced colorectal cancer.

PURPOSE: This randomized phase III trial is to see if oxaliplatin and bevacizumab work better when combined with either fluorouracil and leucovorin or capecitabine in treating patients who have metastatic or recurrent colorectal cancer.

Condition Intervention Phase
Colorectal Cancer
Biological: bevacizumab
Drug: capecitabine
Drug: fluorouracil
Drug: leucovorin calcium
Drug: oxaliplatin
Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Randomized, Prospective Study Comparing Three Regimens Of Eloxatin ™ Plus Fluoropyrimidine For Evaluation Of Safety And Tolerability In First Line Treatment Of Patients With Advanced Colorectal Cancer (Tree Study)

Resource links provided by NLM:

Further study details as provided by National Cancer Institute (NCI):

Study Start Date: May 2003
Study Completion Date: February 2011
Detailed Description:


  • Compare the incidence of grade 3 and 4 toxic effects occurring within the first 12 weeks of treatment with 2 different schedules of oxaliplatin, bevacizumab (Avastin™), leucovorin calcium, and fluorouracil or with oxaliplatin, Avastin™, and capecitabine in patients with advanced colorectal cancer.
  • Compare the overall response rate, progression-free survival, and time to treatment failure in patients treated with these regimens.
  • Compare the composite toxicity of these regimens in these patients.

OUTLINE: This is a randomized, open-label, multicenter study. Patients are randomized to 1 of 3 treatment arms.

  • Arm I: Patients receive bevacizumab (Avastin™) IV over 30-90 minutes, oxaliplatin IV over 2 hours, and leucovorin calcium IV over 2 hours on day 1 and fluorouracil (5-FU) IV over 46 hours beginning on day 1. Courses repeat every 14 days in the absence of disease progression or unacceptable toxicity.
  • Arm II: Patients receive Avastin™ IV over 30-90 minutes and oxaliplatin IV over 2 hours on days 1 and 15 and leucovorin calcium IV over 10 minutes and 5-FU IV over 3 minutes on days 1, 8, and 15. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
  • Arm III: Patients receive Avastin™ IV over 30-90 minutes and oxaliplatin IV over 2 hours on day 1 and oral capecitabine twice daily on days 1-14. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.

Patients are followed at 1 month, every 3 months for at least 2 years, and then every 6 months thereafter.

PROJECTED ACCRUAL: A total of 375 patients (125 per treatment arm) will be accrued for this study.


Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No


  • Histologically confirmed adenocarcinoma of the colon or rectum

    • Metastatic or recurrent disease not amenable to potentially curative treatment
  • At least 1 unidimensionally measurable lesion at least 20 mm by conventional techniques OR at least 10 mm by spiral CT scan

    • Histological or cytological confirmation is required for a solitary target lesion
  • No CNS metastases



  • 18 and over

Performance status

  • ECOG 0-1

Life expectancy

  • Not specified


  • Absolute neutrophil count at least 1,500/mm^3
  • Platelet count at least 100,000/mm^3


  • Bilirubin no greater than 2 times upper limit of normal (ULN)
  • SGPT and SGOT no greater than 3 times ULN


  • Creatinine no greater than 1.5 times ULN
  • Creatinine clearance at least 30 mL/min


  • No myocardial infarction within the past 6 months
  • No clinical evidence of congestive heart failure
  • No unstable coronary artery disease


  • No interstitial pneumonia
  • No extensive symptomatic fibrosis of the lungs


  • Able to tolerate oral medication
  • No lack of physical integrity of the upper gastrointestinal tract
  • No malabsorption syndrome
  • No swallowing difficulties


  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception during and for 6 months after study participation
  • No other concurrent serious illness
  • No uncontrolled infection
  • No other concurrent malignancy except nonmelanoma skin cancer or carcinoma in situ of the cervix or any other cancer for which the patient has been off all therapy and in remission for at least 5 years
  • No peripheral neuropathy
  • No hypersensitivity to any of the study drugs or their ingredients
  • No known dihydropyrimidine dehydrogenase deficiency
  • No other medical or psychiatric disorder that would preclude giving informed consent or complying with study


Biologic therapy

  • No concurrent prophylactic hematopoietic growth factor therapy
  • No prior bevacizumab (Avastin™)


  • At least 6 months since prior adjuvant fluorouracil, leucovorin calcium, and irinotecan
  • No prior oxaliplatin
  • No prior chemotherapy for metastatic or recurrent disease
  • No other concurrent chemotherapy

Endocrine therapy

  • Not specified


  • No concurrent radiotherapy unless for the control of bone pain


  • Recovered from prior surgery
  • No prior organ allografts


  • More than 4 weeks since prior investigational drugs
  • No concurrent iced mouth rinses for the prevention of stomatitis
  • No concurrent cold cap alopecia prevention
  • No concurrent pyridoxine
  • No concurrent sorivudine or chemically-related analogues (e.g., brivudine)
  • No concurrent chronic aspirin, nonsteroidal anti-inflammatory drugs, or warfarin
  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 ClinicalTrials.gov identifier: NCT00062426

  Show 52 Study Locations
Sponsors and Collaborators
Prologue Research International
Study Chair: Richard A. Gams, MD Prologue Research International
Investigator: Lauri Welles, MD Sanofi-Synthelabo
  More Information

ClinicalTrials.gov Identifier: NCT00062426     History of Changes
Other Study ID Numbers: CDR0000304771  PROLOGUE-SANOFI-ARD5099  SANOFI-ARD5099 
Study First Received: June 5, 2003
Last Updated: November 5, 2013
Health Authority: United States: Federal Government

Keywords provided by National Cancer Institute (NCI):
adenocarcinoma of the colon
adenocarcinoma of the rectum
recurrent colon cancer
stage IV colon cancer
recurrent rectal cancer
stage IV rectal cancer

Additional relevant MeSH terms:
Colorectal Neoplasms
Colonic Diseases
Digestive System Diseases
Digestive System Neoplasms
Gastrointestinal Diseases
Gastrointestinal Neoplasms
Intestinal Diseases
Intestinal Neoplasms
Neoplasms by Site
Rectal Diseases
Angiogenesis Inhibitors
Angiogenesis Modulating Agents
Antimetabolites, Antineoplastic
Antineoplastic Agents
Growth Inhibitors
Growth Substances
Immunologic Factors
Immunosuppressive Agents
Molecular Mechanisms of Pharmacological Action
Pharmacologic Actions
Physiological Effects of Drugs
Protective Agents

ClinicalTrials.gov processed this record on May 03, 2016