Radiation Therapy and Capecitabine With or Without Oxaliplatin in Treating Patients Who Are Undergoing Surgery for Stage II or Stage III Rectal Cancer
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| ClinicalTrials.gov Identifier: NCT00227747 |
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Recruitment Status :
Completed
First Posted : September 28, 2005
Last Update Posted : February 17, 2021
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RATIONALE: Radiation therapy uses high-energy x-rays to kill tumor cells. 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. Giving more than one drug (combination chemotherapy) may kill more tumor cells. Giving radiation therapy together with combination chemotherapy before surgery may shrink the tumor so it can be removed. It is not yet known whether giving radiation therapy together with capecitabine is more effective with or without oxaliplatin before surgery in treating rectal cancer.
PURPOSE: This randomized phase III trial is studying radiation therapy, capecitabine, and oxaliplatin to see how well they work compared to radiation therapy and capecitabine in treating patients who are undergoing surgery for stage II or stage III rectal cancer.
| Condition or disease | Intervention/treatment | Phase |
|---|---|---|
| Colorectal Cancer | Drug: capecitabine Drug: oxaliplatin Procedure: conventional surgery Procedure: neoadjuvant therapy Radiation: radiation therapy | Phase 3 |
OBJECTIVES:
Primary
- Compare the efficacy of neoadjuvant chemoradiotherapy comprising radiotherapy and capecitabine with vs without oxaliplatin followed by total mesorectal excision, in terms of the rate of complete surgical resection, in patients with resectable stage II or III rectal cancer.
Secondary
- Compare overall and disease-free survival of patients treated with these regimens.
- Compare clinical tumor response in patients treated with these regimens.
- Compare acute and late toxicity of these regimens in these patients.
- Determine biological parameters that predict tumor response and treatment-related toxicity in patients treated with these regimens.
- Compare sphincter preservation and function in patients treated with these regimens.
OUTLINE: This is a randomized, controlled, multicenter study. Patients are randomized to 1 of 2 treatment arms.
- Arm I: Patients undergo radiotherapy once daily 5 days a week and receive capecitabine once daily 5 days a week in weeks 1-5.
- Arm II: Patient undergo radiotherapy and receive capecitabine as in arm I. Patients also receive oxaliplatin once weekly in weeks 1-5.
All patients undergo total mesorectal excision 6 weeks after completion of chemoradiotherapy.
PROJECTED ACCRUAL: A total of 590 patients will be accrued for this study.
| Study Type : | Interventional (Clinical Trial) |
| Estimated Enrollment : | 598 participants |
| Allocation: | Randomized |
| Intervention Model: | Parallel Assignment |
| Masking: | None (Open Label) |
| Primary Purpose: | Treatment |
| Official Title: | Randomized Phase III Trial Comparing in a Preoperative Schedule the Result of Two Concurrent Chemoradiation Schemes (45 Gy + Capecitabine vs 50 Gy + Capecitabine - Oxaliplatin) on the Rate of Sterilization of the Operative Specimen in Resectable Rectal Carcinomas T3-4 No-2 Mo |
| Actual Study Start Date : | November 8, 2005 |
| Actual Primary Completion Date : | October 22, 2008 |
| Actual Study Completion Date : | July 15, 2013 |
| Arm | Intervention/treatment |
|---|---|
| Experimental: Radiothérapie + Xelox |
Drug: capecitabine Drug: oxaliplatin Procedure: conventional surgery Procedure: neoadjuvant therapy Radiation: radiation therapy |
| Active Comparator: Radiothérapie + Capécitabine |
Drug: capecitabine Procedure: conventional surgery Procedure: neoadjuvant therapy Radiation: radiation therapy |
- Rate of complete surgical resection
- Overall survival
- Disease-free survival
- Sphincter preservation
- Sphincter function
- Biological parameters that predict tumor response and treatment-related toxicity
- Acute and late toxicity
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| Ages Eligible for Study: | 18 Years to 80 Years (Adult, Older Adult) |
| Sexes Eligible for Study: | All |
| Accepts Healthy Volunteers: | No |
DISEASE CHARACTERISTICS:
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Histologically confirmed adenocarcinoma of the rectum
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T3-4, N0-2, M0 disease by endorectal ultrasound
- T2 disease located in the low rectum allowed provided lower pole is ≤ 6 cm from the anal verge
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- Tumor must be accessible to digital rectal examination (i.e., tumor located at low- or mid-rectum)
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Resectable disease treatable with chemoradiotherapy
- No unresectable disease (i.e., T4 disease with high risk for incomplete gross resection [i.e., R2])
PATIENT CHARACTERISTICS:
Age
- 18 to 80
Performance status
- ECOG 0-2
Life expectancy
- Not specified
Hematopoietic
- WBC ≥ 1,500/mm^3
- Platelet count ≥ 100,000/mm^3
- Hemoglobin > 10 g/dL
Hepatic
- Alkaline phosphatase normal
- Bilirubin normal
Renal
- Creatinine ≤ 130 μmol/L
- No severe renal insufficiency
Cardiovascular
- No cardiac insufficiency
- No symptomatic coronary artery disease
Other
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
- No contraindication to study treatment
- Prior acute intestinal obstruction allowed provided patient underwent surgical diversion with stoma
- No history of other cancer except basal cell skin cancer or carcinoma in situ of the cervix
- No peripheral neuropathy
- No uncontrolled diabetes
- No other uncontrolled severe disease
- No geographical, social, or psychological condition that would preclude study follow-up
PRIOR CONCURRENT THERAPY:
Biologic therapy
- Not specified
Chemotherapy
- No prior chemotherapy for cancer
- No other concurrent chemotherapy
Endocrine therapy
- Not specified
Radiotherapy
- No prior radiotherapy for cancer
Surgery
- Not specified
Other
- No concurrent phenytoin
- No concurrent participation in another clinical trial of an experimental medical treatment
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): NCT00227747
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| Study Chair: | Jean-Pierre Gerard, MD | Centre Antoine Lacassagne |
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | UNICANCER |
| ClinicalTrials.gov Identifier: | NCT00227747 |
| Other Study ID Numbers: |
CDR0000445034 FRE-FNCLCC-ACCORD-12/0405 EU-20522 |
| First Posted: | September 28, 2005 Key Record Dates |
| Last Update Posted: | February 17, 2021 |
| Last Verified: | February 2021 |
| Studies a U.S. FDA-regulated Device Product: | No |
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adenocarcinoma of the rectum stage II rectal cancer stage III rectal cancer |
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Colorectal Neoplasms Rectal Neoplasms Intestinal Neoplasms Gastrointestinal Neoplasms Digestive System Neoplasms Neoplasms by Site Neoplasms Digestive System Diseases Gastrointestinal Diseases |
Colonic Diseases Intestinal Diseases Rectal Diseases Capecitabine Oxaliplatin Antimetabolites, Antineoplastic Antimetabolites Molecular Mechanisms of Pharmacological Action Antineoplastic Agents |