AzTrials
AzTrials

Colorectal CancerPhase 3NCT00070213

Leucovorin and Fluorouracil With or Without Oxaliplatin Compared to Capecitabine With or Without Oxaliplatin in Treating Patients With Metastatic Colorectal Cancer

A Phase 3 study testing FOLFOX regimen, capecitabine and fluorouracil in people with Colorectal Cancer, run by Medical Research Council at 4 sites in United Kingdom.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

RATIONALE: Drugs used in chemotherapy, such as leucovorin, fluorouracil, capecitabine, and oxaliplatin, use different ways to stop tumor cells from dividing so they stop growing or die. Combining more than one drug may kill more tumor cells. Read more about this study

Who is it for?
Ages 0 to 120 years
Conditions the study is for
Colorectal Cancer
What is being tested?
FOLFOX regimen, capecitabine and fluorouracil
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
460 participants
Where
4 sitesUnited Kingdom
Study dates
Sep 2003to 1 Jun 2011
Phase
Phase 3
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 0 to 120 years
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

DISEASE CHARACTERISTICS:

  • Diagnosis of colorectal adenocarcinoma, defined by 1 of the following:
  • Prior or current histologically confirmed primary adenocarcinoma of the colon or rectum with clinical/radiological evidence of advanced/metastatic disease
  • Histologically or cytologically confirmed metastatic adenocarcinoma with clinical/radiological evidence of colorectal primary tumor
  • Unidimensionally measurable disease
  • Unfit and unsuitable for full-dose combination chemotherapy, which would include 1 of the following circumstances:
  • Unsuitable or unwilling to be entered into any full-dose chemotherapy protocol
  • Ineligible or unsuitable for first-line standard combination as per National Institute of Clinical Excellence guidance

PATIENT CHARACTERISTICS:

Age

  • Not specified

Performance status

  • WHO 0-2

Life expectancy

  • Not specified

Hematopoietic

  • WBC greater than 3,000/mm^3
  • Platelet count greater than 100,000/mm^3

Hepatic

  • Bilirubin no greater than 3 times upper limit of normal (ULN)
  • AST or ALT no greater than 2.5 times ULN

Renal

  • Creatinine clearance greater than 50 mL/min OR
  • Glomerular filtration rate greater than 30 mL/min

Cardiovascular

  • No uncontrolled angina
  • No recent myocardial infarction

Other

  • Not pregnant
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • No partial or complete bowel obstruction
  • No concurrent severe uncontrolled medical illness that would preclude study treatment
  • No psychiatric or neurological condition that would preclude giving informed consent or complying with oral study medication
  • No other prior or concurrent malignant disease that would preclude study treatment or assessment of response
  • No prior neuropathy greater than grade 1

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • Not specified

Chemotherapy

  • More than 4 months since prior adjuvant chemotherapy with fluorouracil with or without leucovorin calcium
  • More than 1 month since prior rectal chemoradiotherapy with fluorouracil with or without leucovorin calcium
  • No prior systemic palliative chemotherapy for metastatic disease

Endocrine therapy

  • Not specified

Radiotherapy

  • See Chemotherapy

Surgery

  • Not specified

Other

  • No concurrent brivudine or sorivudine

Trial locations and contacts

4 sites in 1 country.

United Kingdom4 sites
  • Velindre Cancer Center at Velindre Hospital

    Cardiff, Wales, CF14 2TL

  • Cookridge Hospital

    Leeds, England, LS16 6QB

  • Clinical Trials and Research Unit of the University of Leeds

    Leeds, England, LS2 9JT

  • Medical Research Council Clinical Trials Unit

    London, England, NW1 2DA

Other trials in United Kingdom

About this study

Official title: Drug Treatment for Bowel Cancer: Making the Best Choices When a Milder Treatment is Needed

RATIONALE: Drugs used in chemotherapy, such as leucovorin, fluorouracil, capecitabine, and oxaliplatin, use different ways to stop tumor cells from dividing so they stop growing or die. Combining more than one drug may kill more tumor cells. It is not yet known whether leucovorin and fluorouracil with or without oxaliplatin is more effective than capecitabine with or without oxaliplatin in treating patients who have metastatic colorectal cancer.

PURPOSE: This randomized phase III trial is studying four different chemotherapy regimens to compare how well they work in treating patients with metastatic colorectal cancer.

Read the detailed description

OBJECTIVES:

Primary

  • Compare the progression-free survival of patients with metastatic colorectal adenocarcinoma treated with leucovorin calcium and fluorouracil with vs without oxaliplatin or capecitabine with vs without oxaliplatin.
  • Compare the quality of life of patients treated with these fluorouracil-based vs capecitabine-based regimens.

Secondary

  • Compare the failure-free and overall survival of patients treated with these regimens.
  • Compare the toxic effects and adverse events associated with these regimens in these patients.
  • Compare the limited health assessments of patients treated with these regimens.
  • Compare the health economics associated with these regimens.

OUTLINE: This is a randomized, multicenter study. Patients are randomized to 1 of 4 treatment arms and receive 12 weeks of therapy.

  • Arm I (MdG regimen): Patients receive leucovorin calcium IV over 2 hours on day 1 and fluorouracil IV over 46 hours beginning on day 1. Treatment repeats every 14 days for up to 6 courses in the absence of disease progression or unacceptable toxicity.

Patients with disease progression during or within 8 weeks of the completion of this regimen may cross over and receive second-line therapy on arm II.

  • Arm II (OxMdG regimen): Patients receive leucovorin calcium IV over 2 hours and oxaliplatin IV over 2 hours on day 1 and fluorouracil IV over 46 hours beginning on day 1. Treatment repeats every 14 days for up to 6 courses in the absence of disease progression or unacceptable toxicity.

Patients with disease progression during or within 8 weeks of the completion of this regimen may receive second-line therapy or supportive care off-study.

  • Arm III (Cap regimen): Patients receive oral capecitabine twice daily on days 1-15. Treatment repeats every 21 days for up to 4 courses in the absence of disease progression or unacceptable toxicity.

Patients with disease progression during or within 8 weeks of the completion of this regimen may cross over and receive second-line therapy on arm IV.

  • Arm IV (OxCap regimen): Patients receive oxaliplatin IV over 2 hours on day 1 and oral capecitabine twice daily on days 1-15. Treatment repeats every 21 days for up to 4 courses in the absence of disease progression or unacceptable toxicity.

Patients with disease progression during or within 8 weeks of the completion of this regimen may receive second-line therapy or supportive care off-study.

All patients are then re-evaluated at least every 6 weeks and begin another 12 weeks of therapy at any evidence (e.g., clinical, radiological, or tumor marker) of disease progression. Patients with chemo-sensitive disease may repeat alternating 12-week therapy sessions and evaluation periods indefinitely.

Quality of life is assessed at baseline, at 12-14 weeks, at 24 weeks, and then every 3 months thereafter.

Patients are followed every 3 months.

Peer Reviewed and Funded or Endorsed by Cancer Research UK

PROJECTED ACCRUAL: A total of 460 patients (115 per treatment arm) will be accrued for this study within 2 years.

Keywords
adenocarcinoma of the colon, adenocarcinoma of the rectum, stage IV rectal cancer, stage IV colon cancer, recurrent rectal cancer, recurrent colon cancer
Medical subject headings
Colorectal Neoplasms, Colonic Neoplasms, Rectal Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT00070213
Study groupRoleWhat they receive
MdG (modified de Gramont)Active comparator2 weekly 5FU/FA schedule
Receives: Drug: FOLFOX regimen; Drug: fluorouracil; Drug: leucovorin calcium; Procedure: quality-of-life assessment
OxMdG (80%) for 12 weeksExperimentalMdG + oxaliplatin
Receives: Drug: FOLFOX regimen; Drug: fluorouracil; Drug: leucovorin calcium; Drug: oxaliplatin; Procedure: quality-of-life assessment
CapcitabineExperimentalNot described
Receives: Drug: capecitabine; Procedure: quality-of-life assessment
OxCapExperimentalNot described
Receives: Drug: capecitabine; Drug: oxaliplatin; Procedure: quality-of-life assessment

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Compare progression-free survival (PFS) in pts. treated w/ leucovorin calcium + fluorouracil (MdG) vs leucovorin calcium + fluorouracil + oxaliplatin (OxMdG) and in pts. treated w/ capecitabine (Cap) vs capecitabine + oxaliplatin (OxCap) at 1 yr

    Compare progression-free survival (PFS) in pts. treated w/ leucovorin calcium + fluorouracil (MdG) vs leucovorin calcium + fluorouracil + oxaliplatin (OxMdG) and in pts. treated w/ capecitabine (Cap) vs capecitabine + oxaliplatin (OxCap) at 1 yr

    Measured: PFS

  2. Compare health assessment in patients treated with MdG vs Cap and in patients treated with OxMdG vs OxCap at baseline and 14 weeks

    Compare health assessment in patients treated with MdG vs Cap and in patients treated with OxMdG vs OxCap at baseline and 14 weeks

    Measured: Baseline and 14 weeks

Secondary outcomes (10)
  1. Compare health assessment, including quality of life, in patients treated with MdG vs OxMdG and in patients treated with Cap vs OxCap at baseline and 14 and 24 weeks

    Compare health assessment, including quality of life, in patients treated with MdG vs OxMdG and in patients treated with Cap vs OxCap at baseline and 14 and 24 weeks

    Measured: Baseline, 14 and 24 weeks

  2. Compare toxicity/adverse events in patients treated with MdG vs OxMdG and in patients treated with Cap vs OxCap

    Compare toxicity/adverse events in patients treated with MdG vs OxMdG and in patients treated with Cap vs OxCap

    Measured: post 24 weeks

  3. Compare overall failure-free survival in patients treated with MdG vs OxMdG and in patients treated with Cap vs OxCap

    Compare overall failure-free survival in patients treated with MdG vs OxMdG and in patients treated with Cap vs OxCap

    Measured: post 24 weeks

  4. Compare overall survival in patients treated with MdG vs OxMdG and in patients treated with Cap vs OxCap

    Compare overall survival in patients treated with MdG vs OxMdG and in patients treated with Cap vs OxCap

    Measured: post 24 weeks

  5. Compare health economics in patients treated with MdG vs OxMdG and in patients treated with Cap vs OxCap

    Compare health economics in patients treated with MdG vs OxMdG and in patients treated with Cap vs OxCap

    Measured: Baseline, 14 and 24 weeks

  6. Compare health assessment in patients treated with MdG vs Cap and in patients treated with OxMdG vs OxCap

    Measured: Baseline, 14 and 24 weeks

  7. Compare toxicity/adverse events in patients treated with MdG vs Cap and in patients treated with OxMdG vs OxCap at baseline and 24 weeks

    Compare toxicity/adverse events in patients treated with MdG vs Cap and in patients treated with OxMdG vs OxCap at baseline and 24 weeks

    Measured: Baseline and 24 weeks

  8. Compare patients acceptability in patients treated with MdG vs Cap and in patients treated with OxMdG vs OxCap

    Compare patients acceptability in patients treated with MdG vs Cap and in patients treated with OxMdG vs OxCap

    Measured: post 24 weeks

  9. Compare PFS in patients treated with MdG vs Cap and in patients treated with OxMdG vs OxCap

    Compare PFS in patients treated with MdG vs Cap and in patients treated with OxMdG vs OxCap

    Measured: post 24 weeks

  10. Compare health economics in patients treated with MdG vs Cap and in patients treated with OxMdG vs OxCap

    Compare health economics in patients treated with MdG vs Cap and in patients treated with OxMdG vs OxCap

    Measured: Baseline, 14 and 24 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted7 Oct 2003 (estimated)
  2. Study startSep 2003
  3. Primary completion1 Jun 2011
  4. Study completion1 Jun 2011

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Single group
Enrolment
460 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00070213
Sponsor's protocol ID
CDR0000330142
Other IDs
NCRI-FOCUS2, MRC-CR09, EU-20303
Status last verified
Sep 2021
First submitted
3 Oct 2003
Last updated
27 Sep 2021
Results posted
No
Data monitoring committee
Yes

Publications

  • Seymour MT, Thompson LC, Wasan HS, Middleton G, Brewster AE, Shepherd SF, O'Mahony MS, Maughan TS, Parmar M, Langley RE; FOCUS2 Investigators; National Cancer Research Institute Colorectal Cancer Clinical Studies Group. Chemotherapy options in elderly and frail patients with metastatic colorectal cancer (MRC FOCUS2): an open-label, randomised factorial trial. Lancet. 2011 May 21;377(9779):1749-59. doi: 10.1016/S0140-6736(11)60399-1. Epub 2011 May 11.

    PubMed 21570111
  • Seymour MT, Maughan TS, Wasan HS, et al.: Capecitabine (Cap) and oxaliplatin (Ox) in elderly and/or frail patients with metastatic colorectal cancer: the FOCUS2 trial. [Abstract] J Clin Oncol 25 (Suppl 18): A-9030, 500s, 2007.

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing FOLFOX regimen, capecitabine and fluorouracil in people with Colorectal Cancer, run by Medical Research Council at 4 sites in United Kingdom.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 27 Sep 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 4 sites in United Kingdom. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Compare progression-free survival (PFS) in pts. treated w/ leucovorin calcium + fluorouracil (MdG) vs leucovorin calcium + fluorouracil + oxaliplatin (OxMdG) and in pts. treated w/ capecitabine (Cap) vs capecitabine + oxaliplatin (OxCap) at 1 yr (time frame: PFS). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00070213, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Sep 2021.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in