Chemotherapy With or Without Surgery in Treating Patients With Metastatic Colorectal Cancer That Cannot Be Removed by Surgery
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ClinicalTrials.gov Identifier: NCT01086618 |
Recruitment Status :
Completed
First Posted : March 15, 2010
Last Update Posted : August 26, 2013
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RATIONALE: Drugs used in chemotherapy work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving chemotherapy after surgery may kill any tumor cells that remain after surgery. It is not yet known whether chemotherapy is more effective when given alone or together with surgery in treating patients with colorectal cancer.
PURPOSE: This randomized phase II/III trial is studying how well chemotherapy works and compares it with surgery followed by chemotherapy in treating patients with metastatic colorectal cancer that can not be removed by surgery.
Condition or disease | Intervention/treatment | Phase |
---|---|---|
Colorectal Cancer | Drug: systemic chemotherapy Procedure: adjuvant therapy Procedure: quality-of-life assessment Procedure: therapeutic conventional surgery | Phase 2 Phase 3 |
OBJECTIVES:
- To determine whether overall survival is improved in patients with asymptomatic, unresectable metastatic colorectal cancer treated with chemotherapy alone versus surgery followed by chemotherapy.
OUTLINE: This is a multicenter study. Patients are randomized to 1 of 2 treatment arms.
- Arm I (control arm): Patients receive systemic chemotherapy according to standard local practice. Patients who develop symptoms from their primary tumor receive treatment as required including surgery, if indicated.
- Arm II (experimental arm): Patients undergo surgery at the discretion of the surgeon. Beginning 8 weeks after completion of surgery, patients receive chemotherapy according to standard local practice.
Patients complete quality-of-life questionnaires (EQ-5D) at baseline and then periodically during and after completion of study treatment.
After completion of study treatment, patients are followed every 3 months.
Peer Reviewed and Funded or Endorsed by Cancer Research UK
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 500 participants |
Allocation: | Randomized |
Primary Purpose: | Treatment |
Official Title: | A Randomized Trial of Initial Surgery in Advanced Asymptomatic Colorectal Cancer Patients Receiving Chemotherapy for Metastatic Disease |
Study Start Date : | January 2010 |
Actual Primary Completion Date : | January 2013 |
Actual Study Completion Date : | July 2013 |

- Accrual rate in months 10 to 12 (phase II)
- Overall survival for ≥ 2 years (phase III)
- Morbidity of surgery (phase II)
- Percentage of patients who receive chemotherapy following surgery (must be over 80%) (phase II)
- Morbidity of chemotherapy and surgery (phase III)
- Quality of life (phase III)
- Economic evaluation (phase III)

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Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
DISEASE CHARACTERISTICS:
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Histologically or cytologically confirmed colorectal cancer
- Metastases which are unresectable at presentation
- No known unresectable primary tumor on CT/MRI scan
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Primary tumor does not require immediate or emergency intervention including surgery, radiotherapy, laser, or stenting
- Patients who are treated with colonic stents are eligible
- No unequivocal extensive peritoneal metastases
PATIENT CHARACTERISTICS:
- WHO performance status 0-1
- Must be fit for systemic chemotherapy and surgery
- Hemoglobin > 10.0 g/dL
- WBC > 3.0 x 10^9/L
- Platelet count > 100 x 10^9/L
- Bilirubin < 25 μmol/L
- GFR > 50 mL/min
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception during and for 3 months (female) or up to 2 months (male) after completion of study therapy
- No history of malignant disease within the past 5 years except for nonmelanomatous skin cancer or carcinoma in situ of the cervix
- No serious medical co-morbidity (e.g., uncontrolled inflammatory bowel disease, uncontrolled angina, recent [within the past 6 months] myocardial infarction, or another serious medical condition) judged to compromise ability to tolerate chemotherapy and/or surgery
PRIOR CONCURRENT THERAPY:
- See Disease Characteristics
- Concurrent participation in a trial of chemotherapy, if eligible, allowed
- Concurrent short-course radiotherapy for operable rectal cancer allowed

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): NCT01086618
United Kingdom | |
University College Hospital | |
London, England, United Kingdom, NW1 2BU |
Principal Investigator: | Austin Obichere, MD | University College London Hospitals |
ClinicalTrials.gov Identifier: | NCT01086618 |
Other Study ID Numbers: |
CDR0000667364 UCL-08/0079 UCL-ISAAC ISRCTN10963271 EU-21008 CRUK-C32436/A10431 EUDRACT-2008-005911-16 MREC-09/H1102/60 NCRI-UCL-08/0079 |
First Posted: | March 15, 2010 Key Record Dates |
Last Update Posted: | August 26, 2013 |
Last Verified: | March 2010 |
stage IV colon cancer stage IV rectal cancer |
Colorectal Neoplasms Intestinal Neoplasms Gastrointestinal Neoplasms Digestive System Neoplasms Neoplasms by Site Neoplasms |
Digestive System Diseases Gastrointestinal Diseases Colonic Diseases Intestinal Diseases Rectal Diseases |