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Rectal CancerPhase 3GRECCAR15NCT03879109

Chemotherapy Followed by Pelvic Reirradiation Versus Chemotherapy Alone as Pre-operative Treatment for Locally Recurrent Rectal Cancer

A Phase 3 study testing Chemotherapy FOLFIRINOX, 6 cycles, Radiochemotherapy and Surgery in people with Rectal Cancer, run by University Hospital, Bordeaux at 13 sites in France.

Completed

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

Official record
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Trial summary

GRECCAR 15 is focused on Locally Recurrent Rectal Cancer (LRRC) for patients with previous pelvic radiotherapy for the primary rectal cancer. This situation leads to a 20% higher risk of non-curative resection for the LRRC management (R1 status) impacting significantly the overall survival. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Rectal Cancer
What is being tested?
Chemotherapy FOLFIRINOX, 6 cycles, Radiochemotherapy and Surgery
Could I receive a placebo?
No, everyone receives an active treatment
How many people
58 participants
Where
13 sitesFrance
Study dates
8 Jul 2019to 10 Feb 2026
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

Who may be able to join

  • Signed and dated informed consent
  • Age ≥18 years
  • LRRC (histologically proven) ≤ 15 cm from the anal verge
  • First or second LRRC (histologically proven) ≤ 15 cm from the anal verge
  • Previous pelvic irradiation for the primary rectal cancer or primary recurrence (25-50.4Gy)
  • No distant metastasis
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  • Resectable locally recurrent rectal cancer (according to the International consensus, absolute contraindications for resectabililty are bilateral sciatic nerve involvement, circumferential bone involvement, high sacral involvement requiring total sacrectomy; relative contraindications for resectabilty are sciatic notch involvement and encasement external iliac vessels)
  • Adequate hematologic function : Hemoglobin ≥ 9 g/dL, leukocytes ≥ 4000/mm3, neutrophil count ≥ 1500/mm3, blood platelets ≥ 100 000/mm3
  • Adequate hepatic function : total bilirubin ≤ 1,5 x ULN, ASAT et ALAT ≤ 3 x ULN, alkalin phosphatases ≤ 3 x ULN
  • Adequate renal function : creatinine clearance ≥ 30 ml/min
  • ECOG performance status < 2
  • Women not sterilized by the first treatment (ovarian transposition) and males (and their female partners) patients agree to use two methods of effective contraception (one of them being a barrier method) during the study, for at least 6 months for men and for women after the last administration of study treatment
  • Patient affiliated to a social security system or beneficiary of the same
  • Willingness and ability to comply with scheduled visits, treatment plans, laboratory tests, and other study procedures

Who cannot join

  • Recurrent rectal cancer after local excision
  • Concomitant cancer or medical history of cancer within 5 years other than cancers treated in situ (cervical carcinoma or basocellular carcinoma or spinocellular carcinoma)
  • Contraindication for chemotherapy Contraindication for chemotherapy (refer to Summary of characteristics of the products of the study drugs available at http://base-donnees-publique.medicaments.gouv.fr) or radiotherapy or surgery
  • Symptomatic cardiac or coronary insufficiency
  • Personal or family history of long QT syndrome congenital
  • ECG at screening or baseline (predose) with QT/QTc > 450 msec (male) or QT/QTc > 470 msec (female)
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  • Chronic inflammatory bowel disease and/or bowel obstruction
  • Patients with hypocalcemia, hypokalemia, hypomagnesemia.
  • Progressive active infection (HIV or chronic hepatitis B or C) or any other severe medical condition that may preclude the delivery of treatment
  • Complete or partial Dihydropyrimidine deshydrogenase (DPD) deficiency (uracilemia ≥ 16 ng/mL)
  • If contraindication to FOLFIRINOX, possibility to administred FOLFOX or FOLFIRI +/-EGFR (Contraindication to oxaliplatin: peripheral neuropathy > grade 1 (CTCAE grading system v5.0)
  • Peripheral neuropathy > grade 1 (CTCAE grading system v5.0)
  • Concomitant treatment with millepertuis, yellow fever vaccine, live attenuated vaccine, phenytoin, warfarin or sorivudine (or chemically equivalent)
  • Pregnant or breast-feeding woman
  • Persons deprived of liberty or under guardianship or incapable of giving consent
  • Any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol or follow-up schedule, as assessed by investigator

Trial locations and contacts

13 sites in 1 country.

13 sites in 1 country

France13 sites
  • Institut Sainte Catherine

    Avignon

  • CHU Bordeaux

    Bordeaux

  • CHU Grenoble

    Grenoble

  • Centre Oscar Lambret

    Lille

  • Hospices Civils de Lyon, HCL

    Lyon

  • Institut Paoli Calmette

    Marseille

  • Institut du Cancer de Montpellier

    Montpellier

  • CHRU Nancy

    Nancy

  • Groupe Hospitalier Paris Saint-Joseph

    Paris

  • CHU Rennes

    Rennes

  • CHU Rouen

    Rouen

  • Institut de Cancérologie de l'Ouest

    Saint-Herblain

  • CHU Toulouse

    Toulouse

Other trials in France

About this study

Official title: A Phase III Randomized Trial Evaluating Chemotherapy Followed by Pelvic Reirradiation Versus Chemotherapy Alone as Pre-operative Treatment for Locally Recurrent Rectal Cancer (GRECCAR - PRODIGE - FRENCH)

GRECCAR 15 is focused on Locally Recurrent Rectal Cancer (LRRC) for patients with previous pelvic radiotherapy for the primary rectal cancer. This situation leads to a 20% higher risk of non-curative resection for the LRRC management (R1 status) impacting significantly the overall survival. The widespread use of neoadjuvant radiotherapy for primary rectal cancer introduces this new problem: the treatment of LRRC in previously irradiated area.

The objective of GRECCAR 15 is to assess the efficacy of neoadjuvant chemotherapy followed by pelvic reirradiation versus neoadjuvant chemotherapy alone on the rate of curative surgery (R0) in previously irradiated patients with LRRC.

Read the detailed description

The incidence of rectal cancer in the European Union is 15-25/100 000 per year. There is a 5-10% rate of locally recurrent rectal cancer (LRRC), with an overall survival rate of 40% at 5 years after complete resection. Curative surgery of LRRC requires multi-visceral resections which are associated with significant post-operative morbidity of 60%. Despite the combination of a potential curability and the high post-operative morbidity, there are currently neither good data from prospective randomized studies regarding optimum preoperative treatments for LRRC nor is there data assessing the efficacy of response to any such treatments. Moreover, the widespread use of neoadjuvant radiotherapy for primary cancer introduced a new problem: the treatment of LRRC in previously irradiated area. Some studies investigated various modalities of reirradiation and showed acceptable late toxicity and encouraging outcome. GRECCAR 15 would be the first prospective randomized trial so far to evaluate the interest of pelvic reirradiation for LRRC, in previously irradiated patients.

The objective is to assess the efficacy of neoadjuvant chemotherapy followed by pelvic reirradiation versus neoadjuvant chemotherapy alone on the rate of curative surgery (R0) in previously irradiated patients with LRRC.

Patients will be followed every 4 months during 2 years, and every 6 months the last year with chest, abdominal and pelvic scan and tumour markers.

Conditions
Rectal Cancer
Being tested
Chemotherapy FOLFIRINOX, 6 cycles, Radiochemotherapy, Surgery
Keywords
Locally recurrent rectal cancer, Pelvic reirradiation, Oncological surgery
Medical subject headings
Rectal Neoplasms

What participants receive

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

  • Chemotherapy FOLFIRINOX, 6 cyclesDrug

    • oxaliplatin: 85 mg/m2
    • irinotecan: 180 mg/m²
    • folinic acid: 400 mg/m2
    • 5FU : 400 mg/m2 (bolus)
    • 5FU : 2400 mg/m2 (continuous infusion)
  • RadiochemotherapyRadiation

    Reirradiation consists in conformational intensity modulated external irradiation (Intensity-modulated radiotherapy Volumetric Modulated Arc Therapy or tomotherapy) delivering a 30.6 Gy dose with high-energy photons in fractions of 1.8 Gy per day (17 fractions) 5 days a week With Concomitant chemotherapy including Capecitabine 1600 mg/m²/day, five days a week.

  • SurgeryProcedure or surgery

    Surgery will be performed at:

    • Arm A: 8 weeks (±1) after the end of treatment
    • Arm B: 6 weeks (±1) after the end of treatment

    Surgical procedures are defined into three categories:

    • Total mesorectal excision (TME)
    • Extended-TEM (e-TME)
    • Pelvic exenteration (PE)
Study groups in NCT03879109
Study groupRoleWhat they receive
Arm A: Induction Chemotherapy followed by Pelvic reirradiationExperimentalProtocol of chemotherapy FOLFIRINOX*, 6 cycles : * oxaliplatin: 85 mg/m2 * irinotecan: 180 mg/m² * folinic acid: 400 mg/m2 * 5FU : 400 mg/m2 (bolus) * 5FU : 2400 mg/m2 (continuous infusion) Protocol of reirradiation consists in conformational intensity modulated external irradiation, delivering a 30.6 Gy dose (1.8 Gy/day), with concomitant chemotherapy including Capecitabine 1600 mg/m²/day, five days a week.
Receives: Drug: Chemotherapy FOLFIRINOX, 6 cycles; Radiation: Radiochemotherapy; Procedure: Surgery
Arm B: Chemotherapy aloneActive comparatorProtocol of chemotherapy FOLFIRINOX*, 6 cycles : * oxaliplatin: 85 mg/m2 * irinotecan: 180 mg/m² * folinic acid: 400 mg/m2 * 5FU : 400 mg/m2 (bolus) * 5FU : 2400 mg/m2 (continuous infusion)
Receives: Drug: Chemotherapy FOLFIRINOX, 6 cycles; Procedure: Surgery

What is being measured

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

  1. Proportion of curative surgery

    To determine the rate of R0 resection

    Measured: At surgery, expected average 6 to 8 weeks after neoadjuvant treatment

Secondary outcomes (9)
  1. Disease Free Survival

    Rate of disease-free survival at 3 years

    Measured: From surgery until 3 years of follow-up

  2. Overall Survival

    Rate of overall survival at 3 years

    Measured: From surgery until 3 years of follow-up

  3. Surgical morbidity

    To analyse surgical morbidity (Dindo classification) during first 30 days after the surgery

    Measured: From surgery until 30 days after surgery

  4. Surgical mortality

    To analyse surgical mortality (Dindo classification) during first 30 days after the surgery

    Measured: From surgery until 30 days after surgery

  5. Compliance to treatment

    Proportion of patients receiving full allocated neoadjuvant treatment

    Measured: From beginning of neoadjuvant treatment until surgery, expected average 20 weeks after neoadjuvant treatment

  6. Proportion of good tumor response

    Rate of tumor with a decreasing size of 50% at least after preoperative treatment at MRI

    Measured: At 6 weeks (Arm A) and 4 weeks (Arm B) after neoadjuvant treatment

  7. Quality of life (QLQ CR-30)

    The scores of questionnaire QLQ C-30 will be examined The EORTC QLQ-C30 is a patients self-rating questionnaire that measures physical, role, social, emotional, and cognitive functions as well as overall QoL. Scores can be linearly transformed to provide a score from 0 to 100. Higher scores represent better functioning on the functional scales and a higher level of symptoms of the symptom scales.

    Measured: Before neoadjuvant treatment, before surgery, 4 months, one year and two years after surgery

  8. Quality of life (QLQ CR-29)

    The scores of questionnaire QLQ CR-29 will be examined. The EORTC QLQ-CR29 has five functional and 18 symptom scales. Scores can be linearly transformed to provide a score from 0 to 100. Higher scores represent better functioning on the functional scales and a higher level of symptoms of the symptom scales.

    Measured: Before neoadjuvant treatment, before surgery, 4 months, one year and two years after surgery

  9. Tolerance to treatment

    Number of patients with adverse events

    Measured: From beginning of neoadjuvant treatment until 1 year after surgery

Timeline

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

  1. First posted18 Mar 2019
  2. Study start8 Jul 2019
  3. Primary completion30 Jun 2024
  4. Study completion10 Feb 2026

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
58 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03879109
Sponsor's protocol ID
CHUBX 2017/52
Acronym
GRECCAR15
Status last verified
Jul 2026
First submitted
13 Mar 2019
Last updated
8 Jul 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Denost Q, Frison E, Salut C, Sitta R, Rullier A, Harji D, Maillou-Martinaud H, Rullier E, Smith D, Vendrely V; on behalf the GRECCAR Group. A phase III randomized trial evaluating chemotherapy followed by pelvic reirradiation versus chemotherapy alone as preoperative treatment for locally recurrent rectal cancer - GRECCAR 15 trial protocol. Colorectal Dis. 2021 Jul;23(7):1909-1918. doi: 10.1111/codi.15670. Epub 2021 Jun 10.

    PubMed 33843133

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Chemotherapy FOLFIRINOX, 6 cycles, Radiochemotherapy and Surgery in people with Rectal Cancer, run by University Hospital, Bordeaux at 13 sites in France.

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

Who may be eligible to take part?

The sponsor lists 14 inclusion and 16 exclusion criteria. 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 8 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 13 sites in France. 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?

Proportion of curative surgery (time frame: At surgery, expected average 6 to 8 weeks after neoadjuvant treatment). 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 NCT03879109, which also lists 1 linked publication.

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 8 Jul 2026.

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