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Colorectal CancerPhase 3NCT00482222

Combination Chemotherapy With or Without Cetuximab Before and After Surgery in Treating Patients With Resectable Liver Metastases Caused By Colorectal Cancer

A Phase 3 study testing cetuximab, capecitabine and fluorouracil in people with Colorectal Cancer and Metastatic Cancer, run by University of Southampton at 22 sites in United Kingdom.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

RATIONALE: Drugs used in chemotherapy, such as oxaliplatin, fluorouracil, leucovorin, and capecitabine, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Monoclonal antibodies, such as cetuximab, can block tumor growth in different ways. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Colorectal Cancer, Metastatic Cancer
What is being tested?
cetuximab, capecitabine and fluorouracil
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
340 participants
Where
22 sitesUnited Kingdom
Study dates
Feb 2007to Dec 2014
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 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

DISEASE CHARACTERISTICS:

  • Histologically* or radiologically confirmed primary adenocarcinoma of the colon or rectum
  • Advanced and/or metastatic disease NOTE: *Liver metastases should not be biopsied
  • Must have potentially resectable liver metastases present, as defined by any of the following:
  • Metachronous metastases AND complete resection of the primary tumor without gross or microscopic evidence of residual disease (R0)
  • Synchronous metastases AND R0 resection of the primary tumor > 1 month before study entry
  • Synchronous metastases with sufficient evidence (e.g., by CT scan or diagnostic laparoscopy) that both the primary tumor and the liver metastases can be completely resected during the same procedure and resection of primary tumor can be delayed for 3-4 months
  • Suboptimally resectable disease (i.e., potentially resectable disease with compromise of the resection margins)
  • No detectable extrahepatic tumor that cannot be completely resected
  • Unidimensionally measurable disease
  • No brain metastases

PATIENT CHARACTERISTICS:

  • WHO performance status 0-2
  • WBC ≥ 4,000/mm³
  • ANC ≥ 1,500/mm³
  • Platelet count > 150,000/mm³
  • Bilirubin ≤ 1.25 times upper limit of normal (ULN)
  • Alkaline phosphatase ≤ 5 times ULN
  • AST or ALT ≤ 3 times ULN
  • Creatinine clearance > 50 mL/min OR glomerular filtration rate > 50 mL/min
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception during and for ≥ 3 months after completion of study treatment
  • No psychiatric or neurological condition that would preclude study compliance
  • No partial or complete bowel obstruction
  • No preexisting neuropathy > grade 1
  • No other prior or concurrent malignant disease that, in the opinion of the investigator, would preclude study treatment
  • No concurrent severe uncontrolled medical illness (including poorly-controlled angina or myocardial infarction within the past 3 months) that would preclude study treatment
  • No known hypersensitivity reaction to any of the components of the study drugs

PRIOR CONCURRENT THERAPY:

  • No prior systemic chemotherapy for metastatic disease
  • More than 6 months since prior adjuvant chemotherapy comprising fluorouracil, leucovorin calcium, capecitabine, or irinotecan hydrochloride
  • More than 1 month since prior rectal chemoradiotherapy comprising fluorouracil and leucovorin calcium
  • No concurrent contraindicated medication

Trial locations and contacts

22 sites in 1 country.

Louisa Little contact

02380795154

22 sites in 1 country

United Kingdom22 sites, 22 recruiting
  • Basildon University Hospital

    Basildon, England, SS16 5NL

    Pauline Leonard, MD, 44-1702-435-555

    Recruiting
  • Basingstoke and North Hampshire NHS Foundation Trust

    Basingstoke, England, RG24 9NA

    Charlotte Rees, MD, 44-125-631-4793

    Recruiting
  • Royal Bournemouth Hospital

    Bournemouth, England, BH7 7DW

    Tamas Hickish, MD, 44-1202-303-626, tamas.hickish@rbch.nhs.uk

    Recruiting
  • Addenbrooke's Hospital

    Cambridge, England, CB2 0QQ

    Pippa Corrie, PhD, FRCP, 44-1223-274-401, pippa.corrie@addenbrookes.nhs.uk

    Recruiting
  • Velindre Cancer Center at Velindre Hospital

    Cardiff, Wales, CF14 2TL

    Timothy Maughan, MD, 44-2920-316-904

    Recruiting
  • University Hospital of Wales

    Cardiff, Wales, CF14 4XW

    Timothy Maughan, MD, 44-2920-316-904

    Recruiting
  • St. Luke's Cancer Centre at Royal Surrey County Hospital

    Guildford, England, GU2 7XX

    Sharadah Essapen, MD, 44-1483-571-122

    Recruiting
  • Aintree University Hospital

    Liverpool, England, L9 7AL

    Graeme J. Poston, MD, 44-151-525-5980, graeme.poston@aintree.nhs.uk

    Recruiting
  • Royal Liverpool University Hospital

    Liverpool, England, L9 7AL

    Paula Ghaneh, MD

    Recruiting
  • Saint Bartholomew's Hospital

    London, England, EC1A 7BE

    Sarah Slater, MD, 44-20-7601-8391

    Recruiting
  • UCL Cancer Institute

    London, England, NW3 2PF

    Astrid Mayer, MD, 44-207-794-0500, a.mayer@ucl.ac.uk

    Recruiting
  • Royal Marsden - London

    London, England, SW3 6JJ

    David Cunningham, MD, 44-20-8661-3156

    Recruiting
  • Charing Cross Hospital

    London, England, W6 8RF

    Charles P. Lowdell, MD, BSc, MBBS, FRCP, FRCR, 44-208-383-0576, charles.lowdell@imperial.nhs.uk

    Recruiting
  • Clatterbridge Centre for Oncology

    Merseyside, England, CH63 4JY

    David Smith, MD, 44-151-334-1155, david.smith@ccotrust.nhs.uk

    Recruiting
  • St. Mary's Hospital

    Newport, England, PO30 5TG

    Christopher Baughan, MD, 44-1983-524-081

    Recruiting
  • Cancer Research Centre at Weston Park Hospital

    Nottingham, England, NG5 1PB

    J. Hornbuckle, MD, 44-115-969-1169 ext. 47599

    Recruiting
  • Dorset Cancer Centre

    Poole Dorset, England, BH15 2JB

    Tamas Hickish, MD, 44-1202-442-532

    Recruiting
  • Salisbury District Hospital

    Salisbury, England, SP2 8BJ

    Tim J. Iveson, MD, 44-1722-336-262 ext. 4688

    Recruiting
  • Southampton General Hospital

    Southampton, England, SO16 6YD

    John N. Primrose, MD, 44-23-8079-6144, j.n.primrose@soton.ac.uk

    Recruiting
  • Royal Marsden - Surrey

    Sutton, England, SM2 5PT

    David Cunningham, MD, 44-20-8661-3279, david.cunningham@rmh.nhs.uk

    Recruiting
  • Southend University Hospital NHS Foundation Trust

    Westcliff-on-Sea, England, SS0 0RY

    Pauline Leonard, MD, 44-1702-435-555

    Recruiting
  • Worthing Hospital

    Worthing, England, BN11 2DH

    Andrew Webb, MD, 44-1903-205-111

    Recruiting

Other trials in United Kingdom

About this study

Official title: A Prospective Randomised Open Label Trial of Oxaliplatin/Fluoropyrimidine Versus Oxaliplatin/Fluoropyrimidine Plus Cetuximab Pre and Post Operatively in Patients With Resectable Colorectal Liver Metastasis Requiring Chemotherapy

RATIONALE: Drugs used in chemotherapy, such as oxaliplatin, fluorouracil, leucovorin, and capecitabine, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Monoclonal antibodies, such as cetuximab, can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Giving combination chemotherapy together with monoclonal antibodies before surgery may make the tumor smaller and reduce the amount of normal tissue that needs to be removed. Giving these treatments after surgery may kill any tumor cells that remain after surgery. It is not yet known whether combination chemotherapy is more effective with or without cetuximab in treating liver metastases caused by colorectal cancer.

PURPOSE: This randomized phase III trial is studying combination chemotherapy to compare how well it works when given with or without cetuximab before and after surgery in treating patients with resectable liver metastases caused by colorectal cancer.

Read the detailed description

OBJECTIVES:

Primary

  • Compare progression-free survival of patients with resectable colorectal liver metastases treated with neoadjuvant and adjuvant combination chemotherapy with vs without cetuximab.

Secondary

  • Compare the overall survival of patients treated with these regimens.
  • Compare the quality of life of patients treated with these regimens.
  • Compare the cost effectiveness of these regimens in these patients.

OUTLINE: This is a prospective, randomized, multicenter, open-label study. Patients are stratified according to participating center and assigned chemotherapy regimen. Patients are randomized to 1 of 2 treatment arms.

  • Neoadjuvant therapy:
  • Arm I: Patients receive 1 of the following chemotherapy regimens:
  • OxMdG: Patients receive leucovorin calcium IV over 2 hours and oxaliplatin IV over 2 hours on day 1. Patients also receive fluorouracil IV continuously over 46 hours beginning on day 1. Treatment repeats every 2 weeks for up to 6 courses in the absence of disease progression or unacceptable toxicity.
  • CAPOX: Patients receive oxaliplatin IV over 2 hours on day 1 and oral capecitabine twice daily on days 1-14. Treatment repeats every 3 weeks for up to 4 courses in the absence of disease progression or unacceptable toxicity.
  • Arm II: Patients receive 1 of the following regimens:
  • OxMdG + cetuximab: Patients receive cetuximab IV over 1-2 hours on day 1 and OxMdG chemotherapy as in arm I. Treatment repeats every 2 weeks for up to 6 courses in the absence of disease progression or unacceptable toxicity.
  • CAPOX + cetuximab: Patients receive cetuximab IV over 1-2 hours on days 1, 8, and 15 and CAPOX chemotherapy as in arm I. Treatment repeats every 3 weeks for up to 4 courses in the absence of disease progression or unacceptable toxicity.
  • Surgery: Beginning 2-6 weeks after completion of chemotherapy, patients in both arms undergo liver resection.
  • Adjuvant therapy: Beginning 4-8 weeks after completion of surgery, patients receive treatment (OxMdG or CAPOX with or without cetuximab) as in arm I or II of neoadjuvant therapy.
  • Arm I: Treatment with OxMdG repeats every 2 weeks for up to 6 courses and treatment with CAPOX repeats every 3 weeks for up to 4 courses in the absence of disease progression or unacceptable toxicity.
  • Arm II: Treatment with OxMdG + cetuximab repeats every 2 weeks for up to 6 courses and treatment with CAPOX + cetuximab repeats every 3 weeks for up to 4 courses in the absence of disease progression or unacceptable toxicity.

Quality of life is assessed at baseline, every 12 weeks during chemotherapy, at completion of study treatment, every 3 months for 1 year, and then every 6 months thereafter.

Cost per life year and per quality-adjusted life year is assessed at baseline, every 12 weeks during treatment, and then at 3, 5, and 10 years.

After completion of study treatment, patients are followed every 3 months for 2 years and then every 6 months for 3 years.

Peer Reviewed and Funded or Endorsed by Cancer Research UK

Keywords
adenocarcinoma of the colon, stage IV colon cancer, adenocarcinoma of the rectum, stage IV rectal cancer, liver metastases, recurrent colon cancer, recurrent rectal cancer
Medical subject headings
Colorectal Neoplasms, Neoplasm Metastasis, 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 NCT00482222
Study groupRoleWhat they receive
OxMdG / IrMdG chemotherapyActive comparatorOxMdG / IrMdG chemotherapy for 12 weeks Followed by surgery OxMdG / IrMdG chemotherapy for 12 weeks
Receives: Drug: capecitabine; Drug: fluorouracil; Drug: leucovorin calcium; Drug: oxaliplatin; Other: study of socioeconomic and demographic variables; Procedure: adjuvant therapy; Procedure: neoadjuvant therapy; Procedure: quality-of-life assessment
OxMdG / IrMdG chemotherapy with cetuximabExperimentalOxMdG / IrMdG chemotherapy with cetuximab for 12 weeks Followed by Surgery OxMdG / IrMdG chemotherapy with cetuximab for 12 weeks
Receives: Biological: cetuximab; Drug: capecitabine; Drug: fluorouracil; Drug: leucovorin calcium; Drug: oxaliplatin; Other: study of socioeconomic and demographic variables; Procedure: adjuvant therapy; Procedure: neoadjuvant therapy; Procedure: quality-of-life assessment

What is being measured

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

  1. Progression-free survival

    Measured: end of study

Secondary outcomes (7)
  1. Response rate before surgery as assessed by RECIST criteria

    Measured: end of study

  2. Pathological resection status

    Measured: end of study

  3. Overall survival

    Measured: end of study

  4. Toxicity

    Measured: end of study

  5. Quality of life as assessed by the EQ-5D, EORTC QLQ-C30, and EORTC QLQ-LMC21

    Measured: end of study

  6. Cost effectiveness

    Measured: end of study

  7. Safety

    Measured: end of study

Timeline

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

  1. First posted5 Jun 2007 (estimated)
  2. Study startFeb 2007
  3. Primary completionDec 2014 (estimated)

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
Parallel groups
Masking
None (open label)
Enrolment
340 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00482222
Sponsor's protocol ID
CDR0000549541
Other IDs
USCTU-4351, USCTU-EPOC, EUDRACT-2006-003121-82, ISRCTN22944367, EU-20732
Status last verified
Apr 2008
First submitted
4 Jun 2007
Last updated
23 Jan 2013
Results posted
No
Data monitoring committee
Yes

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing cetuximab, capecitabine and fluorouracil in people with Colorectal Cancer and Metastatic Cancer, run by University of Southampton at 22 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: status not confirmed, as of the sponsor's last update on 23 Jan 2013. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 22 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?

Results are not available in the source record.

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

Contact Louisa Little (02380795154), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Progression-free survival (time frame: end of study). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 23 Jan 2013.

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