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Colonic CancerPhase 3NCT04316013

Volatile Anaesthesia and Perioperative Outcomes Related to Cancer: the VAPOR-C Trial

A Phase 3 study testing Sevoflurane, Propofol and Lidocaine IV in people with Colonic Cancer and Rectal Cancer, run by Peter MacCallum Cancer Centre, Australia at 27 sites in 3 countries.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

VAPOR-C is a randomised study of the impact of IV versus inhaled anaesthesia (propofol versus sevoflurane) and lidocaine versus no lidocaine on duration of disease free survival inpatients with either colorectal or non small cell lung cancer. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Sevoflurane, Propofol and Lidocaine IV
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
254 participants
Where
27 sitesin 3 countries
Study dates
31 Jul 2020to 28 Feb 2025
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

  • Male or female patients aged 18 years or older at screening
  • Has provided written informed consent for the trial
  • Patient with American Joint committee on Cancer (AJCC) 8th edition Stage I-III colorectal cancer or Stage I-IIIa NSCLC, as confirmed by histological or cytological diagnosis. In cases where a histological diagnosis is not possible, suspected diagnosis through imaging techniques is acceptable.
  • Patient has an American Society of Anaesthesiologists (ASA) score of 1 to 3
  • Scheduled to receive elective, surgical resection with curative intent
  • Surgery expected to last ≥2 hours and expected to require ≥2 nights hospital stay
  • Able to comply with protocol requirements and follow-up procedures

Who cannot join

  • Confirmed or suspected allergy to propofol, sevoflurane or intravenous lidocaine
  • Patient with significant liver disease (with elevated International Normalised Ratio (INR) or bilirubin and/or low albumin; i.e. Childs-Pugh Score >Class A;
  • Patient at personal or familial risk of malignant hyperthermia or porphyria
  • Patient with a history of other malignancies within the past 5 years. However, patients with malignancies managed with curative therapy and considered to be at low risk of recurrence such as treated skin basal cell carcinoma, squamous cell carcinoma, malignant melanoma ≤1.0mm without ulceration, localised thyroid cancer, cervical carcinoma in situ or prior malignancies with high likelihood of cure (e.g. low grade prostate and breast cancer) may be included in the study
  • Patient has distant metastases
  • Patient with an actual body weight less than 45kg
  • Patients taking the following drugs that are moderate-strong inhibitors of the CYP1A2 and CYP3A4 metabolic pathways within 72 hours prior to surgery: Antibiotics - 'mycin' class: Clarithromycin, Telithromycin, Azithromycin, Erythromycin Antibiotics - 'floxacin' class Ciprofloxacin (exception: can be used preoperatively within a bowel prep regime), Norfloxacin, Levofloxacin, Sparfloxacin Antibiotics - other: Chloramphenicol, Isoniazid Antifungals: Fluconazole, Itraconazole, Ketoconazole, Posaconazole, Voriconazole Antiretrovirals: Atazanavir; Darunavir; Indinavir; Lopinavir; Nelfinavir; Ombitasvir, Paritaprevir, Ritonavir and Saquinavir. Antidepressants/ADHD: Fluvoxamine, Enoxacine. Calcium-channel blockers: Diltiazem, Verapamil Monoclonal Antibodies: Ceritinib, Idelalisib, Lonafarnib, Tucatinib. Other strong cytochrome P450 3A4 inhibitors: Cimetidine, Cobicistat; grapefruit juice, Mifepristone, Nefazodone.

Trial locations and contacts

27 sites in 3 countries.

27 sites in 3 countries

Australia22 sites
  • Royal Adelaide Hospital

    Adelaide, South Australia, 5000

  • Ballarat Base Hospital

    Ballarat Central, Victoria, 3350

  • Box Hill Hospital

    Box Hill, Victoria, 3128

  • Chris O'Brien Lifehouse

    Camperdown, New South Wales, 2050

  • Royal Prince Alfred Hospital

    Camperdown, New South Wales, 2050

  • Northern Hospital

    Epping, Victoria, 3076

  • St Vincent's Hospital, Melbourne

    Fitzroy, Victoria, 3065

  • Western Health Footscray Hospital

    Footscray, Victoria, 3011

  • Austin Health

    Heidelberg, Victoria, 3084

  • Royal Brisbane and Women's Hospital

    Herston, Queensland, 4029

  • Royal Hobart Hospital

    Hobart, Tasmania, 7000

  • Mackay Base Hospital

    Mackay, Queensland, 4740

  • Peter MacCallum Cancer Centre

    Melbourne, Victoria, 3000

  • The Alfred Hospital

    Melbourne, Victoria, 3004

  • The Royal Melbourne Hospital

    Parkville, Victoria, 3050

  • Prince of Wales Hospital

    Randwick, New South Wales, 2031

  • RedCliffe Hospital

    Redcliffe, Queensland, 4020

  • Rockhampton Hospital

    Rockhampton, Queensland, 4700

  • Goulburn Valley Health

    Shepparton, Victoria, 3630

  • Gold Coast University Hospital

    Southport, Queensland, 4215

  • Northeast Health, Wangaratta

    Wangaratta, Victoria, 3677

  • Princess Alexandra Hospital

    Woolloongabba, Queensland, 4102

Other trials in Australia

United States3 sites
  • Cleveland Clinic

    Cleveland, Ohio, 44195

  • The University of Texas MD Anderson Cancer Centre

    Houston, Texas, 77030

  • University of Pittsburgh Medical Center

    Pittsburgh, Pennsylvania, 15213

Other trials in United States

New Zealand2 sites
  • North Shore Hospital

    Auckland, 0620

  • Auckland City Hospital

    Auckland, 2023

Other trials in New Zealand

About this study

VAPOR-C is a randomised study of the impact of IV versus inhaled anaesthesia (propofol versus sevoflurane) and lidocaine versus no lidocaine on duration of disease free survival inpatients with either colorectal or non small cell lung cancer.

Read the detailed description

VAPOR-C is a pragmatic, event-driven, randomised controlled trial, with a single blind 2x2 factorial design for sevoflurane/propofol and for intravenous lidocaine infusion / no lidocaine infusion.

This trial is designed to test for superiority in disease free survival (DFS) of propofol (total intravenous anaesthesia -TIVA) over sevoflurane (inhalational volatile anaesthesia) and intravenous lidocaine over no lidocaine in patients undergoing surgery for colorectal or non small cell lung cancer (NSCLC). The combination of two cancer types will help address the need to demonstrate the effects of anaesthetic technique across cancers to inform generalisable anaesthesia guidelines. Both NSCLC and colorectal cancer are important for this study due to high incidence rate, many longer-term survivors, and importantly the high risk of local or distant recurrence despite complete surgical resection. In addition, the study will collect additional data in a nested cohort related to the exploratory objectives.

The study aims to recruit 3,500 patients in Australia, New Zealand, Canada, United States and Europe.

Being tested
Sevoflurane, Propofol, Lidocaine IV
Medical subject headings
Colonic Neoplasms, Rectal Neoplasms, Carcinoma, Non-Small-Cell Lung

What participants receive

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

  • SevofluraneDrug

    Inhaled anaesthetic used for maintenance of anaesthesia, dosed as per standard practice

  • PropofolDrug

    Intravenous anaesthetic used for induction and maintenance of anaesthesia

  • Lidocaine IVDrug

    1.5mg/kg loading dose over 20 minutes, followed by an infusion of 2mg/kg/hr up to 4 hours and 1.5mg/kg/hour thereafter. Bolus and maintenance dosages of lidocaine will be per actual body weight and capped at a maximum of 100 kg.

Study groups in NCT04316013
Study groupRoleWhat they receive
AActive comparatorSevoflurane + intravenous lidocaine
Receives: Drug: Sevoflurane; Drug: Lidocaine IV
BActive comparatorSevoflurane
Receives: Drug: Sevoflurane
CActive comparatorPropofol TIVA + intravenous lidocaine
Receives: Drug: Propofol; Drug: Lidocaine IV
DActive comparatorPropofol TIVA
Receives: Drug: Propofol

What is being measured

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

  1. Comparison of disease free survival (DFS) with propofol-TIVA versus sevoflurane

    The study will collect endpoint data for each participant on time of disease progression. This will be used to compare disease free survival across arms.

    Measured: Until 3 years from participant index surgery date

  2. Comparison of disease free survival (DFS) with lidocaine compared with no lidocaine

    The study will collect endpoint data for each participant on time of disease progression. This will be used to compare disease free survival across arms.

    Measured: Until 3 years from participant index surgery date

Secondary outcomes (14)
  1. Comparison of overall survival (OS) with propofol-TIVA versus sevoflurane

    The study will collect endpoint data for each participant on survival status. This will be used to compare overall survival across arms.

    Measured: Until 3 years from participant index surgery date

  2. Days alive and at home with propofol-TIVA versus sevoflurane

    Data will be collected at thirty days post surgery regarding date of discharge from hospital and survival status. This is then used to calculate number of days alive and at home (i.e. out of hospital) and compare across arms.

    Measured: 30 days post surgery

  3. Overall survival with intravenous lidocaine versus no lidocaine

    The study will collect endpoint data for each participant on survival status. This will be used to compare overall survival across arms.

    Measured: Until 3 years from participant index surgery date

  4. Days alive and at home with intravenous lidocaine versus no lidocaine

    Data will be collected at thirty days post surgery regarding date of discharge from hospital and survival status. This is then used to calculate number of days alive and at home (i.e. out of hospital) and compare across arms.

    Measured: 30 days post surgery

  5. Comparison of post-operative complications with propofol-TIVA versus sevoflurane

    Short term postoperative morbidity assessed by the Post Operative Morbidity Scale (POMS) with Clavien-Dindo severity grading.

    POMS is an 18-item tool that addresses nine domains of morbidity relevant to the post-surgical patient . The severity in each POMS domain will then be graded according to the Clavien-Dindo Classification on the basis of treatment applied to correct each respective complication , and captures complications within 5 grades.

    Measured: 5 days post surgery or at discharge if earlier

  6. Comparison of post-operative complications with intravenous lidocaine versus no lidocaine

    Short term postoperative morbidity assessed by the Post Operative Morbidity Scale (POMS) with Clavien-Dindo severity grading.

    POMS is an 18-item tool that addresses nine domains of morbidity relevant to the post-surgical patient . The severity in each POMS domain will then be graded according to the Clavien-Dindo Classification on the basis of treatment applied to correct each respective complication , and captures complications within 5 grades.

    Measured: 5 days post surgery or at discharge if earlier

  7. Comparison of chronic post surgical pain with propofol-TIVA versus sevoflurane

    Pain measured using the Brief Pain Inventory Short Form. Patient reported pain on a scale of 0 to 10 where 0 is no pain and 10 is worst pain.

    Pain measured using the Neuropathic Pain Questionnaire. Patient reported neuropathic pain on a scale of 0 to 100 where 0 is no pain and 100 is worst pain.

    Measured: At 90 days and 12 months post surgery

  8. Comparison of chronic post surgical pain with intravenous lidocaine versus no lidocaine

    Pain measured using the Brief Pain Inventory Short Form. Patient reported pain on a scale of 0 to 10 where 0 is no pain and 10 is worst pain.

    Pain measured using the Neuropathic Pain Questionnaire. Patient reported neuropathic pain on a scale of 0 to 100 where 0 is no pain and 100 is worst pain.

    Measured: At 90 days and 12 months post surgery

  9. Safety profile of propofol-TIVA versus sevoflurane

    Toxicities measured using CTCAE V 5 .0

    Measured: during surgery until discharge from Post Anaesthetic Care Unit (PACU) or within the first 4 hours of ICU admission

  10. Safety Profile intravenous lidocaine versus no lidocaine

    Toxicities measured using CTCAE V 5 .0

    Measured: during surgery until discharge from Post Anaesthetic Care Unit (PACU) or within the first 4 hours of ICU admission

  11. Concomitant medication use with propofol-TIVA versus sevoflurane

    From 2 weeks prior to surgery up to Day 5 post-surgery administration of relevant medications will be recorded

    Measured: 5 days post anaesthesia

  12. Concomitant medications use with intravenous lidocaine versus no lidocaine

    From 2 weeks prior to surgery up to Day 5 post-surgery administration of relevant medications will be recorded

    Measured: 5 days post anaesthesia

  13. Health utility with propofol-TIVA versus sevoflurane

    The EQ-5D-5L is a standardised instrument for use as a measure of health outcome and is applicable to a wide range of health conditions and treatments. This five item scale covers the following dimensions (5D): mobility, self-care, usual activities, pain/discomfort and anxiety/depression, with each dimension having five levels (5L). The use of the EQ-5D-5L will enable utility valuations to be estimated for health states experienced.

    Measured: At 30 days, 90 days and every 12 months post surgery up to 3 years

  14. Health utility with intravenous lidocaine versus no lidocaine

    The EQ-5D-5L is a standardised instrument for use as a measure of health outcome and is applicable to a wide range of health conditions and treatments. This five item scale covers the following dimensions (5D): mobility, self-care, usual activities, pain/discomfort and anxiety/depression, with each dimension having five levels (5L). The use of the EQ-5D-5L will enable utility valuations to be estimated for health states experienced

    Measured: At 30 days, 90 days and every 12 months post surgery up to 3 years

Timeline

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

  1. First posted20 Mar 2020
  2. Study start31 Jul 2020
  3. Primary completion28 Feb 2025
  4. Study completion28 Feb 2025

Why it stopped: Not meeting recruitment timelines

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
Other
Allocation
Randomised
Intervention model
Parallel groups
Model description
This is an event-driven, international multicentre, randomised controlled trial with a 2x2 factorial design. Patients with stage I-III colorectal cancer or stage I-IIIa NSCLC are eligible and will be randomised in the ratio of 1:1:1:1 using permuted block randomisation with stratification by cancer type (Colon, Rectal or NSCLC), and by site to receive either 1) sevoflurane maintenance anaesthesia and lidocaine infusion or 2) sevoflurane maintenance anaesthesia; or 3), propofol maintenance anaesthesia and lidocaine infusion or 4), propofol maintenance anaesthesia .
Masking
Single blind
Who is masked
Participant
Enrolment
254 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04316013
Sponsor's protocol ID
18/044
Status last verified
Mar 2025
First submitted
22 Jan 2020
Last updated
14 Mar 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Sevoflurane, Propofol and Lidocaine IV in people with Colonic Cancer and Rectal Cancer, run by Peter MacCallum Cancer Centre, Australia at 27 sites in 3 countries.

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 7 inclusion and 7 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: stopped early, as of the sponsor's last update on 14 Mar 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 27 sites in Australia, United States, New Zealand. 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 was stopped early (reason given: Not meeting recruitment timelines). Results are not available in the source record.

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?

Comparison of disease free survival (DFS) with propofol-TIVA versus sevoflurane (time frame: Until 3 years from participant index surgery date). 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?
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 14 Mar 2025.

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