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Vitamin C Intravenously With Chemotherapy in Advanced Colorectal Cancer (Vitality)

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.
 
ClinicalTrials.gov Identifier: NCT02969681
Recruitment Status : Unknown
Verified February 2019 by Ruihua Xu, Sun Yat-sen University.
Recruitment status was:  Recruiting
First Posted : November 21, 2016
Last Update Posted : February 27, 2019
Sponsor:
Information provided by (Responsible Party):
Ruihua Xu, Sun Yat-sen University

Brief Summary:
Preclinical study has shown that human colorectal cancer cells harboring KRAS or BRAF mutations are selectively killed by high levels of ascorbic acid (AA). High dose of AA aslo impairs tumor growth in Apc/KRASG12D mutant mice. Previous phase Ⅰ studies have found that high dose iv AA is well tolerated in cancer patients.This protocol is a phase Ⅲ study of AA infusions combined with treatment with FOLFOX +/- bevacizumab versus treatment with FOLFOX +/- bevacizumab alone as first-line therapy in patients with recurrent or advanced colorectal cancer.

Condition or disease Intervention/treatment Phase
Colorectal Neoplasms Drug: ascorbic acid Drug: Chemotherapy Phase 3

Detailed Description:
Linus Pauling and Dr Ewan Cameron have published two retrospective studies about using high dose vitamin C to treat cancer patients forty years ago. Their studies have shown that high dose vitamin C usage could significantly prolong overall survival of patients with advanced cancer. Recently, preclinical study has shown that human colorectal cancer cells harboring KRAS or BRAF mutations are selectively killed by high levels of ascorbic acid (AA). High dose of AA impairs tumor growth in Apc/KRASG12D mutant mice. Previous phaseⅠ clinical trials have found that high dose (1.5g/kg or 90g/m2) iv AA is well tolerated in cancer patients. This protocol is a phase Ⅲ, study of ascorbic acid (AA) infusions combined with treatment with FOLOX +/- bevacizumab versus treatment with FOLFOX +/- bevacizumab alone as first-line therapy in patients with recurrent or advanced colorectal cancer.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 428 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Phase Ⅲ Study of IV Ascorbic Acid in Combination With FOLFOX+/- Bevacizumab vs Treatment With FOLFOX+/- Bevacizumab Alone as First-line Therapy for Advanced Colorectal Cancer
Study Start Date : January 2017
Estimated Primary Completion Date : December 2019
Estimated Study Completion Date : December 2020

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Vitamin C

Arm Intervention/treatment
Experimental: Ascorbic Acid with chemotherapy group

Ascorbic Acid with mFOLFOX6 with or without bevacizumab Ascorbic Acid (1.5g/kg/day, D1-3) every 2 weeks

mFOLFOX6:

  • Oxaliplatin 85 mg/m² d1 concurrent with
  • Leucovorin 400 mg/m², followed by
  • Bolus 5FU 400 mg/m² , followed by
  • Infusional 5FU 2400 mg/m² over 46 hours, every 2 weeks

with or without bevacizumab 5mg/kg, every 2 weeks

Drug: ascorbic acid
1.5g/kg/day, D1-3, every 2 weeks
Other Name: Vitamin C

Drug: Chemotherapy
  • mFOLFOX6
  • Oxaliplatin 85 mg/m² d1 concurrent with
  • Leucovorin 400 mg/m², followed by
  • Bolus 5FU 400 mg/m² , followed by
  • Infusional 5FU 2400 mg/m² over 46 hours, every 2 weeks

with or without bevacizumab 5mg/kg, every 2 weeks

Other Name: mFOLFOX6+/- bevacizumab

Active Comparator: Chemotherapy group

mFOLFOX6:

  • Oxaliplatin 85 mg/m² d1 concurrent with
  • Leucovorin 400 mg/m², followed by
  • Bolus 5FU 400 mg/m² , followed by
  • Infusional 5FU 2400 mg/m² over 46 hours, every 2 weeks

with or without bevacizumab 5mg/kg, every 2 weeks

Drug: Chemotherapy
  • mFOLFOX6
  • Oxaliplatin 85 mg/m² d1 concurrent with
  • Leucovorin 400 mg/m², followed by
  • Bolus 5FU 400 mg/m² , followed by
  • Infusional 5FU 2400 mg/m² over 46 hours, every 2 weeks

with or without bevacizumab 5mg/kg, every 2 weeks

Other Name: mFOLFOX6+/- bevacizumab




Primary Outcome Measures :
  1. Progression Free Survival [ Time Frame: up to 5 years ]
    Time-to-event outcome measure (initial disease progression) measured in days from cycle 1 day 1 to day of first progression as defined by RECIST1.1 criteria from NCI


Secondary Outcome Measures :
  1. Overall Survival [ Time Frame: up to 5 years ]
    Time to event outcome measure (death), measured in days from cycle 1 day 1

  2. Response Rate [ Time Frame: up to 5 years ]
    To utilize CT or PET/CT scans to assess overall tumor response rate (complete and partial response) and evaluate disease progression in subjects with advanced or recurrent RAS mutant colorectal cancer treated with the combination of ascorbic acid and FOLOX/FORFIRI +/- bevacizumab versus treatment with FOLFOX/FORFIRI +/- bevacizumab alone



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 75 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

Age≥18 years, ≤75 years; Histologically proven metastatic adenocarcinoma of colorectal cancer (stage Ⅳ disease), unresectable metastatic disease; measurable disease; G6PD status > lower limit of normal; Eastern Cooperative Oncology Group (ECOG) performance status 0 to 1; Life expectancy of at least 12 weeks; ANC ≥1,500/mm3; Hemoglobin > 8g/dL; platelet ≥ 100,000/mm3; Laboratory at baseline evaluation for inclusion in the study: creatinine ≤1.5X upper limit [if the creatinine is elevated, but ≤1.5X the ULN, a 24 hour creatinine clearance will be obtained, Creatinine clearance > 50 mL/min (calculated according to Cockroft and Gault)]; Transaminase (AST/ALT) ≤2.5X upper limit of normal and bilirubin levels ≤1.5X upper limit of normal without liver metastasis; Transaminase (AST/ALT) ≤5X upper limit of normal and bilirubin levels ≤1.5X upper limit of normal with liver metastasis; Women of childbearing potential will confirm a negative pregnancy test and must practice effective contraception during the study; Written informed consent

Exclusion Criteria:

Prior treatment for metastatic disease (adjuvant therapy with fluoropyrimidines +/-oxaliplatin based regimens allowed if stopped 12 months prior to registration on study); Surgery (excluding diagnostic biopsy) or irradiation within 3 weeks prior to study entry; Administration of any investigational drug or agent/procedure, i.e. participation in another trial within 4 weeks before beginning treatment; Concurrent chronic systemic immune therapy, chemotherapy, radiation therapy (palliative radiation therapy allowed) or hormone therapy not indicated in the study protocol; Brain metastasis (known or suspected); Pregnant or lactating women; Other uncontrolled concomitant illness, including serious uncontrolled intercurrent infection; Known allergy or any other adverse reaction to any of the drugs or to any related compound; Previous (within 5 years) or concurrent malignancies at other sites with the exception of surgically cured or adequately treated carcinoma in-situ of the cervix and basal cell carcinoma of the skin; Patients who are on strong inducers of CYP3A4 which include but are not limited to: Aminoglutethimide, Bexarotene, Bosentan, Carbamazepine, Dexamethasone, Efavirenz, Fosphenytoin, Griseofulvin, Modafinil, Nafcillin, Nevirapine, Oxcarbazepine, Phenobarbital, Phenytoin, Primidone, Rifabutin, Rifampin, Rifapentine, St. John's wort; Medical, social or psychological condition which, in the opinion of the investigator, would not permit the patient to complete the study or sign meaningful informed consent; Organ allograft requiring immunosuppressive therapy; Patients with HIV infection


Information from the National Library of Medicine

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): NCT02969681


Contacts
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Contact: Feng Wang, MD.,PhD. +862087343795 wangfeng@sysucc.org.cn

Locations
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China, Guangdong
Medical Oncology,Sun Yat-sen University Cancer Center Recruiting
Guangzhou, Guangdong, China, 510060
Contact: Feng Wang, M.D,Ph.D    86-18620880867    wangfeng@sysucc.org.cn   
Principal Investigator: Ruihua Xu, M.D,Ph.D         
Sub-Investigator: Feng Wang, M.D,Ph.D         
Sponsors and Collaborators
Sun Yat-sen University
Investigators
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Principal Investigator: Rui-hua Xu, MD.,PhD. Sun Yat-sen University
Publications:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
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Responsible Party: Ruihua Xu, Clinical Professor, Sun Yat-sen University
ClinicalTrials.gov Identifier: NCT02969681    
Other Study ID Numbers: VitC001
First Posted: November 21, 2016    Key Record Dates
Last Update Posted: February 27, 2019
Last Verified: February 2019
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Undecided
Additional relevant MeSH terms:
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Colorectal Neoplasms
Intestinal Neoplasms
Gastrointestinal Neoplasms
Digestive System Neoplasms
Neoplasms by Site
Neoplasms
Digestive System Diseases
Gastrointestinal Diseases
Colonic Diseases
Intestinal Diseases
Rectal Diseases
Ascorbic Acid
Physiological Effects of Drugs
Vitamins
Micronutrients
Antioxidants
Molecular Mechanisms of Pharmacological Action
Protective Agents