Colorectal CancerPhase 3NCT05008809
Post-resection/Ablation Chemotherapy in Patients With Metastatic Colorectal Cancer (FIRE-9 - PORT / AIO-KRK-0418)
A Phase 3 study testing mFOLFOX6, mFOLFOXIRI and FOLFIRI in people with Colorectal Cancer, run by Dominik Paul Modest at 79 sites in Germany.
Trial summary
This is an open-label, randomized, controlled, multicenter, phase III study with two parallel arms. Patients with metastatic colorectal cancer after definite interventional therapy of all lesions are randomized in a 2:1 fashion (favoring active therapy) to investigate the efficacy, patient reported quality of life and… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Colorectal Cancer
- What is being tested?
- mFOLFOX6, mFOLFOXIRI and FOLFIRI
- Type of treatment
- Pill or oral medicine, Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 507 participants
- Where
- 79 sitesGermany
- Study dates
- 6 Dec 2021to Nov 2030
- Phase
- Phase 3
- Are there results?
- Not yet: the study is under way
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
- Patient's signed informed consent.
- Patient's age ≥18 years at the time of signing the informed consent.
- Histologically confirmed adenocarcinoma of the colon or rectum.
- Resected (R0 or R1) and/or effectively treated metastases (all techniques allowed) of colorectal cancer within 3-10 weeks before randomization (earlier randomisation allowed if at least 3 weeks interval between intervention and treatment start is guaranteed) AND resected primary tumor (synchronous or metachronous). In cases of synchronous metastases the interval of 3-10 weeks might be calculated following the removal of the primary tumor if this intervention was the last to address all tumor lesions.
- Absence of significant active wound healing complications (if applicable) at randomization. Resolved wound healing complications after resection/ablation are acceptable for inclusion into the trial.
- No radiographic evidence of active metastatic disease at study entry in a CT and/or MRI scan not older than 10 weeks prior randomization. Pre-surgery/ablation images are eligible for the study if all lesions have been addressed in the interval.
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- ECOG performance status 0-2.
- Adequate bone marrow, hepatic and renal organ function, defined by the following laboratory test results:
- Absolute neutrophil count >= 1.5 x 109/L (1500/µL)
- Hemoglobin ≥ 80 g/L (8 g/dL)
- Platelet count ≥ 100 x109/L (100000/µL) without transfusion
- Total serum bilirubin of ≤ 1.5 x upper limit of normal (ULN)
- Aspartate aminotransferase (AST/GOT) ≤ 3.0 × ULN.
- Calculated glomerular filtration rate (GFR) according to Cockcroft-Gault formula or according to MDRD ≥ 50 mL/min or serum creatinine ≤ 1.5 x ULN
- Patients without anticoagulation need to present with an INR < 1.5 x ULN and PTT < 1.5 x ULN. Patient with prophylactic or therapeutic anticoagulation are allowed into the trial.
- Proficient fluorouracil metabolism as defined:
- Prior treatment with 5-FU or capecitabine without unusual toxicity or
- If tested, normal DPD deficiency test according to the standard of the study site or
- If tested, in patients with DPD deficiency test with a CPIC activity score of 1.0-1.5 fluoropyrimidine/capecitabine dosage should be reduced by 50%
- For women of childbearing potential (WOCBP): negative pregnancy test within 14 days before randomization and agreement to remain abstinent (refrain from heterosexual intercourse) or use contraceptive methods with a failure rate of < 1% per year during the treatment period and for at least 9 months after the last dose of Oxaliplatin or for at least 6 months after the last dose of all other study treatment.
- A woman is considered to be of childbearing potential if she is post-menarcheal, has not reached a postmenopausal state (≥ 12 continuous months of amenorrhea with no identified cause other than menopause), and has not undergone surgical sterilization (removal of ovaries and/or uterus). Examples of contraceptive methods with a failure rate of < 1% per year include bilateral tubal ligation, male partner's sterilization, hormonal contraceptives that inhibit ovulation, hormone-releasing intrauterine devices, and copper intrauterine devices.
- For men: With female partners of childbearing potential, men must remain abstinent or use a condom plus an additional contraceptive method that together result in a failure rate of < 1% per year during the treatment period and for 6 months after the last dose of study treatment. Men must refrain from donating sperm during this same period.
Who cannot join
- Treatment of metastases greater than 3 cm with radio-frequency/microwave ablation within 24 months prior to study entry if applicable.
- Treatment of metastases greater than 5 cm with radiation (stereotactic/ brachytherapy) within 24 months prior to study entry if applicable.
- Any previous systemic therapy is allowed for inclusion into the trial. However, if previous oxaliplatin-containing chemotherapy at any time for metastatic or localized disease was carried out, the inclusion into the trial is permitted under the condition, that
- A total duration of oxaliplatin-based therapy of six months (i.e. 12 cycles of FOLFOX / FOLFOXIRI or 8 cycles CAPOX) is not exceeded - including therapy within the FIRE-9/PORT trial
- If already more than three months of oxaliplatin-based therapy (i.e. >6 cycles of FOLFOX / FOLFOXIRI or >4 cycles CAPOX) was used, the study therapy should be started with an irinotecan-based regimen (i.e. FOLFIRI or FOLFOXIRI) However, in the case of FOLFOXIRI therapy in the trial, the above mention regulation concerning the total dosing of oxaliplatin still applies (i.e. 12 cycles of FOLFOX / FOLFOXIRI or 8 cycles CAPOX should not be exceeded - including therapy within the FIRE-9/PORT trial).
- New York Heart Association Class III or greater heart failure by clinical judgement.
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- Myocardial infarction within 6 months prior to randomization; percutaneous transluminal coronary angioplasty (PTCA) with or without stenting within 6 months prior to randomization.
- Unstable angina pectoris.
- Unstable cardiac arrhythmia > grade 2 NCI CTCAE despite anti-arrhythmic therapy.
- Ongoing toxicities > grade 2 NCI CTCAE
- Active uncontrolled infection by investigator's perspective.
- Severe chronic non-healing wounds, ulcerous lesions or untreated bone fracture.
- Known hypersensitivity to 5-FU, folinic acid, irinotecan, oxaliplatin or capecitabine or to any of the other excipients listed in section 6.1 of the corresponding SmPC.
- Recent or concomitant treatment with brivudine.
- Peripheral sensitive neuropathy with functional impairment (> grade 1 acc. to CTCAE version 5.0 (see appendix 2)).
- Inflammatory bowel disease and/or bowel obstruction.
- Simultaneous application of Johannis herbs preparations.
- Pernicious or other megaloblastic anemia caused by vitamin B12 deficiency.
- Major surgical procedure, open biopsy, or significant traumatic injury within 21 days prior to randomization or at least to intended treatment start, or anticipation of need for major surgical procedure during the course of the study or non-recovery from side effects of any such procedure.
- Any other disease, metabolic dysfunction, physical examination finding, or clinical laboratory finding that contraindicates the use of an investigational drug, may affect the interpretation of the results, or may render the patient at high risk from treatment complications.
- Medical history of malignant disease other than mCRC with the following exceptions:
- patients who have been disease-free for at least three years before randomization
- patients with adequately treated and completely resected basal cell or squamous cell skin cancer, in situ cervical, breast or prostate cancer, stage I uterine cancer
- patients with any treated or untreated malignant disease that is associated with a 5-year survival prognosis of ≥ 90% and does not require active therapy
- Known alcohol or drug abuse.
- Pregnant or breastfeeding females.
- Participation in a clinical trial or experimental drug treatment within 28 days prior to potential inclusion in the clinical trial or within a period of 5 half-lives of the substances administered in a clinical trial or during an experimental drug treatment prior to potential inclusion in the clinical trial, depending on which period is longest, or simultaneous participation in another clinical trial while taking part in this clinical trial.
- Patients depending on Sponsor, investigator or study site.
- Suspected SARS-CoV-2 infection with or without symptoms (evaluation according to local policy in respective center with respect to actual status of pandemic and with reference to the policy that would apply to patients with similar therapy outside the trial). This may include assessment of vaccination status, anamnesis, physical examination and potentially antigen and/or PCR testing.
- Patient committed to an institution by virtue of an order issued either by the judicial or the administrative authorities.
- Limited legal capacity.
- Concomitant administration of strong CYP3A4 and/or UGT1A1 inducers (e.g. Rifampicin, Carbamazepin, Phenobarbital, Phenytoin or Apalutamid).
- Planned inoculation/vaccination with a live vaccine during treatment with Oxaliplatin and/or Irinotecan, and until 6 months after treatment with Irinotecan.
Trial locations and contacts
79 sites in 1 country. Contact the study team or a site near you to ask about taking part.
79 sites in 1 country
Germany79 sites, 72 recruiting
- Recruiting
Klinikum St. Marien Amberg
Amberg
Ludwig Fischer von Weikersthal, Dr.
- Recruiting
Helios Klinikum Bad Saarow
Bad Saarow
Daniel Pink, Dr.
- Recruiting
Klinikum Bayreuth
Bayreuth
Alexander Kiani, Prof. Dr.
- Recruiting
Charité Universitätsmedizin Berlin
Berlin, 13353
Dominik Modest, Prof. Dr., +49 30 450 ext. 553222, dominik.modest@charite.de
- Recruiting
Helios Klinikum Emil von Behring
Berlin
Börge Arndt, Dr.
- Recruiting
MVZ Onkologischer Schwerpunkt am Oskar-Helene-Heim
Berlin
Markus Schuler, Dr.
- Recruiting
Vivantes Klinikum am Urban Berlin
Berlin
Annette Dieing, Dr.
- Recruiting
Vivantes Klinikum Spandau Berlin
Berlin
Jörg-Christian Rath, Dr.
- Recruiting
St. Josef-Hospital Bochum
Bochum
Anke Reinacher-Schick, Prof. Dr.
- Recruiting
Johanniterkrankenhaus Bonn
Bonn
Yon-Dschun Ko, Prof. Dr.
- Withdrawn
Diakonie-Krankenhaus Bremen
Bremen
- Recruiting
Klinikum Chemnitz
Chemnitz
Jack Chater, Dr.
- Recruiting
Kliniken der Satdt Köln
Cologne
Bernhard Sibbing, Dr.
- Recruiting
Klinikum Darmstadt
Darmstadt
Carl Schimanski, Prof. Dr.
- Recruiting
DONAUISAR Klinikum Deggendorf
Deggendorf
Christian Spoer, Dr.
- Recruiting
Städtisches Klinikum Dessau
Dessau
Gerhard Behre, Prof. Dr.
- Recruiting
Onkologische-Gemeinschaftspraxis Dresden
Dresden
Lutz Jacobasch, Dr.
- Recruiting
Onkozentrum Dresden
Dresden
Steffen Dörfel
- Recruiting
Universitätsklinikum Düsseldorf
Düsseldorf
Christoph Roderburg, Prof. Dr.
- Recruiting
Kliniken Essen-Mitte
Essen
Christian Müller, Dr.
- Recruiting
Universitätsklinikum Essen
Essen
Stefan Kasper-Virchow, Prof. Dr.
- Recruiting
KHNW Frankfurt
Frankfurt
Thorsten Götze, PD Dr.
- Recruiting
Markus-Krankenhaus Frankfurt
Frankfurt
Silvan Becker, Dr.
- Recruiting
Universitätsklinikum Frankfurt
Frankfurt
Christine Koch, Dr.
- Recruiting
Universitätsklinikum Freiburg
Freiburg im Breisgau
Michael Quante, Prof. Dr.
- Recruiting
Gemeinschaftspraxis internistische Onkologie Fürth
Fürth
Jochen Wilke, Dr.
- Recruiting
Niels-Stensen Kliniken Georgsmarienhütte
Georgsmarienhütte
Jens Atzpodien, Prof. Dr.
- Recruiting
Praxis Hämatologie Onkologie Gießen
Giessen
Georg Schließer, Dr.
- Recruiting
Universitätsmedizin Göttingen
Göttingen
Yong-Jun Peter Jo, Dr.
- Recruiting
Universitätsklinikum Halle
Halle
Mascha Binder, Prof. Dr.
- Recruiting
Universitätsklinikum Hamburg-Eppendorf
Hamburg
Marianne Sinn, PD Dr.
- Recruiting
Medizinische Hochschule Hannover
Hanover
Arndt Vogel, Prof. Dr.
- Recruiting
St. Anna Hospital Herne
Herne
Vera Heuer, Dr.
- Recruiting
Universitätsklinikum des Saarlandes
Homburg
Matthias Glanemann, Prof. Dr.
- Withdrawn
Klinikum Ingolstadt GmbH
Ingolstadt
- Recruiting
Universitätsklinikum Jena
Jena
Udo Lindig, Dr.
- Recruiting
Klinikum Landshut
Landshut
Christian Bogner, Dr.
- Recruiting
VK&K Studien Landshut
Landshut
Florian Kaiser, Dr.
- Active, not recruiting
Studienzentrum UnterEms Leer
Leer
- Recruiting
Universitätsklinikum Leipzig
Leipzig
Ulrich Hacker, Prof. Dr.
- Recruiting
Klinikum Leverkusen
Leverkusen
Andrea Heider, Dr.
- Recruiting
Klinikum Lippe
Lippe
Christian Constantin, Dr.
- Recruiting
Klinikum Ludwigsburg
Ludwigsburg
Stefan Angermeier, Dr.
- Recruiting
Klinikum Magdeburg
Magdeburg
Christoph Kahl, Prof. Dr.
- Recruiting
Universitätsmedizin Mainz
Mainz
Markus Möhler, Prof. Dr.
- Recruiting
OnkoNet Marburg GmbH
Marburg
Christina Balser, Dr.
- Recruiting
Philipps-Universität Marburg
Marburg
Jorge Riera, Dr.
- Recruiting
Johannes Wesling Klinikum Minden
Minden
Hans-Joachim Tischler, Dr.
- Withdrawn
Kliniken Maria Hilf Mönchengladbach
Mönchengladbach
- Recruiting
Klinikum der Universität München
München
Victoria Probst, Dr.
- Recruiting
Klinikum rechts der Isar TU München
München
Sylvie Lorenzen, Prof. Dr.
- Recruiting
München Klinik Bogenhausen
München
Martin Fuchs, Dr.
- Recruiting
München Klinik Neuperlach
München
Meinolf Karthaus, Prof. Dr.
- Recruiting
Gemeinschaftspraxis Münster
Münster
Christian Lerchenmüller, Dr.
- Recruiting
Universitätsklinikum Münster
Münster
Klaus Wethmar, Dr. Dr.
- Recruiting
Friedrich-Ebert-Krankenhaus Neumünster
Neumünster
Siegfried Haas, Dr.
- Recruiting
Lukaskrankenhaus Neuss
Neuss
Ulf Reinhart, Dr.
- Recruiting
Klinikum Nürnberg
Nuremberg
Gabriele Siegler, Dr.
- Withdrawn
Pi.Tri-Studien GmbH Offenburg
Offenburg
- Recruiting
Klinikum Passau
Passau
Thomas Südhoff, Prof. Dr.
- Recruiting
Schwerpunktpraxis Penzberg
Penzberg
Michael Sandherr, PD Dr.
- Recruiting
Ernst von Bergmann Klinikum Potsdam
Potsdam
Matthias Paland, Dr.
- Recruiting
Studienzentrum Onkologie Ravensburg
Ravensburg
Tobias Dechow, Prof. Dr.
- Recruiting
Krankenhaus Barmherzige Brüder Regensburg
Regensburg
Anke Schlenska-Lange, Dr.
- Recruiting
Universitätsklinikum Regensburg
Regensburg
Hans Jürgen Schlitt, Prof. Dr.
- Recruiting
Kreiskliniken Reutlingen
Reutlingen
Stefan Kubicka, Prof. Dr.
- Recruiting
Mathias Spital Rheine
Rheine
Sebastian Bröckling, Dr.
- Recruiting
RoMed Klinikum Rosenheim
Rosenheim
Gerhard Gerhard Puchtler, Dr.
- Recruiting
Universitätsmedizin Rostock
Rostock
Ulrich Langenkamp, Dr.
- Recruiting
DIAK Klinikum Schwäbisch Hall
Schwäbisch Hall
Thomas Geer, Dr.
- Recruiting
Marienkrankenhaus Siegen
Siegen
Elisabeth Mack, Dr.
- Recruiting
Klinikum Stuttgart
Stuttgart
Wolfram Bohle, Dr.
- Withdrawn
Marienhospital Stuttgart
Stuttgart
- Recruiting
Krankenhaus der Barmherzigen Brüder Trier
Trier
Iordanis Deligiannis, Dr.
- Recruiting
Universitätsklinikum Ulm
Ulm
Thomas J. Ettrich, Dr.
- Recruiting
Klinikum Wetzlar
Wetzlar
Birgitta Killing, Dr.
- Withdrawn
Onkologisches Zentrum Wolfsburg-Helmstedt
Wolfsburg
- Recruiting
Petrus-Krankenhaus Wuppertal
Wuppertal
Matthias Sandmann, Dr.
- Recruiting
Gemeinschaftspraxis Würzburg
Würzburg
Björn Schöttker, Dr.
About this study
Official title: Post-resection/Ablation Chemotherapy in Patients With Metastatic Colorectal Cancer Prospective, Randomized, Open, Multicenter Phase III Trial to Investigate the Efficacy of Active Post-resection/Ablation Therapy in Patients With Metastatic Colorectal Cancer
This is an open-label, randomized, controlled, multicenter, phase III study with two parallel arms. Patients with metastatic colorectal cancer after definite interventional therapy of all lesions are randomized in a 2:1 fashion (favoring active therapy) to investigate the efficacy, patient reported quality of life and safety of mFOLFOXIRI/mFOLFOX-6 as additive treatment (Arm A) versus active follow-up/surveillance (Arm B).
Read the detailed description
The trial will consist of both a clinical and translational part. During the study, re-assessments (radiologic assessment, blood and QoL) will be conducted for all trial subject of the trial every 3 months. Tumor biopsies will be collected at screening (baseline sample) and in case of relapse of disease if a new tumor sample is obtained.
The objective of the re-assessments is detection of relapse either radiologically or within the translational material (blood samples with ctDNA dynamics and tumor - if available from relapses). CT scans of thorax/abdomen and/or MRI scans will be performed every 3 months within the 2 years after randomization. After the first two relapse-free years, intervals should be stretched to 6 months in the third and following years after study start. Structured follow-up for up to 60 months after randomization should be maintained for both arms.
Patients in Arm A receive additive study drug intervention (mFOLFOXIRI or mFOLFOX-6) for up to six months (12 cycles) after randomization with additional clinical and safety assessments.
- Conditions
- Colorectal Cancer
- Being tested
- mFOLFOX6, mFOLFOXIRI, FOLFIRI, CAPOX
- Keywords
- Colorectal Cancer
- Medical subject headings
- Colorectal Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
mFOLFOX6Drug
Also called Folinic acid, Oxaliplatin, 5-fluorouracil (FU)
Oxaliplatin: 85 mg/m², 2h IV infusion on d1 Folinic acid: 400 mg/m², 1-2 h IV infusion on d1 5-FU: (optional: 400 mg/m² bolus, 2-5 min IV infusion), 2400 mg/m², 46 h IV infusion on d1 Cycles are repeated on day 15. A total of up to 12 cycles are administered.
mFOLFOXIRIDrug
Also called Folinic acid, Oxaliplatin, 5-FU, Irinotecan
Oxaliplatin: 85 mg/m², 2h IV infusion on d1 Irinotecan: 150 mg/m², 90 min IV infusion on d1 Folinic acid: 400 mg/m², 1-2 h IV infusion on d1 5-FU: 2400 mg/m², 46 h IV infusion on d1 Cycles are repeated on day 15. A total of up to 12 cycles are administered.
FOLFIRIDrug
Also called Folinic acid, 5-FU
Folinic acid: 400mg/m², 1-2h IV Infusion on d1 5-FU: 2400 mg/m², 46 h IV infusion on d1 Irinotecan: 180 mg/m², 90-120 min IV infusion on d1 Cycles are repeated on day 15. A total of up to 12 cycles is administered.
CAPOXDrug
Also called Capecitaine, Oxaliplatin
Capecitabine: 1000 mg/m², oral 1-0-1 on d1-14 Oxaliplatin: 130 mg/m², 3h IV infusion on d1 Cycles are repeated on day 22. A total of up to 8 cycles isadministered.
| Study group | Role | What they receive |
|---|---|---|
| Treatment | Experimental | Active treatment with mFOLFOXIRI or mFOLFOX6 or FOLFIRI q2w or CAPOX q3w up to six months followed by structured Follow-up for up to five years after randomization Receives: Drug: mFOLFOX6; Drug: mFOLFOXIRI; Drug: FOLFIRI; Drug: CAPOX |
| Control | No intervention | Structured Follow-up for up to five years after randomization |
What is being measured
The primary outcome is the main question the study is designed to answer.
Progression-free survival (PFS) time
time from randomization to death or evidence of disease relapse/progression (whatever occurs first)
Measured: 24 months
Secondary outcomes (4)
Overall survival (OS)
time from randomization to the date of death of any cause
Measured: at least 5 years after randomization
Control ol lesions
Local or distant control of lesions according to ablative technique (surgery vs. ablation vs. radiation)
Measured: up to 5 years after randomization
(Serious) Adverse Events
Type, incidence, severity, and causal relationship to active chemotherapy of non-serious adverse events and serious adverse events (severity evaluated according to CTCAE version 5.0)
Measured: up to 2 years after randomization
Quality of life (QoL)
Quality of life (QoL) as assessed with the QoL questionnaire EQ-5D-5L
Measured: up to 5 years after randomization
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted17 Aug 2021
- Study start6 Dec 2021
- Primary completionNov 2027 (estimated)
- Study completionNov 2030 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Colorectal CancerStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Model description
- open-label, randomized, controlled, multicenter, phase III study with two parallel arms
- Masking
- None (open label)
- Enrolment
- 507 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Dominik Paul Modest
- Sponsor type
- University, hospital or other
- Collaborators
- German Research Foundation, Institut für Klinische Krebsforschung IKF GmbH at Krankenhaus Nordwest
- Responsible party
- Sponsor-investigator, Dominik Paul Modest, Charite University, Berlin, Germany
- Investigators
- Dominik Modest, Prof. Dr., Principal investigator, Charite University, Berlin, Germany
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05008809
- Sponsor's protocol ID
- FIRE-9 - PORT
- Other IDs
- AIO-KRK-0418, 2020-006144-18
- Status last verified
- Dec 2025
- First submitted
- 6 Aug 2021
- Last updated
- 12 Dec 2025
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Raschzok N, Stintzing S, Heinemann V, Rauch G, Ricke J, Guckenberger M, Kurreck A, Alig AHS, Stahler A, Bullinger L, Schmelzle M, Schoning W, Lurje G, Krenzien F, Haase O, Rau B, Gebauer B, Sauer IM, Pratschke J, Modest DP. FIRE-9 - PORT / AIO-KRK-0418: a prospective, randomized, open, multicenter Phase III trial to investigate the efficacy of adjuvant/additive chemotherapy in patients with definitely-treated metastatic colorectal cancer. BMC Cancer. 2022 Apr 2;22(1):359. doi: 10.1186/s12885-022-09422-6.
PubMed 35366831
Study at a glance
From the registry record, last updated by the sponsor on 12 Dec 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Post-resection/Ablation Chemotherapy in Patients With Metastatic Colorectal Cancer Prospective, Randomized, Open, Multicenter Phase III Trial to Investigate the Efficacy of Active Post-resection/Ablation Therapy in Patients With Metastatic Colorectal Cancer
- ClinicalTrials.gov ID
- NCT05008809
- Acronym / sponsor ID
- FIRE-9 - PORT
- Conditions
- Colorectal Cancer
- Keywords
- Colorectal Cancer
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 507 participants (estimated)
- Lead sponsor
- Dominik Paul ModestUniversity, hospital or other
- Collaborators
- German Research Foundation, Institut für Klinische Krebsforschung IKF GmbH at Krankenhaus Nordwest
- Study start
- 6 Dec 2021 (actual)
- Primary completion
- Nov 2027 (estimated)
- Study completion
- Nov 2030 (estimated)
- First posted
- 17 Aug 2021 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This is an open-label, randomized, controlled, multicenter, phase III study with two parallel arms. Patients with metastatic colorectal cancer after definite interventional therapy of all lesions are randomized in a 2:1 fashion (favoring active therapy) to investigate the efficacy, patient reported quality of life and safety of mFOLFOXIRI/mFOLFOX-6 as additive treatment (Arm A) versus active follow-up/surveillance (Arm B).
Detailed description
The trial will consist of both a clinical and translational part. During the study, re-assessments (radiologic assessment, blood and QoL) will be conducted for all trial subject of the trial every 3 months. Tumor biopsies will be collected at screening (baseline sample) and in case of relapse of disease if a new tumor sample is obtained.
The objective of the re-assessments is detection of relapse either radiologically or within the translational material (blood samples with ctDNA dynamics and tumor - if available from relapses). CT scans of thorax/abdomen and/or MRI scans will be performed every 3 months within the 2 years after randomization. After the first two relapse-free years, intervals should be stretched to 6 months in the third and following years after study start. Structured follow-up for up to 60 months after randomization should be maintained for both arms.
Patients in Arm A receive additive study drug intervention (mFOLFOXIRI or mFOLFOX-6) for up to six months (12 cycles) after randomization with additional clinical and safety assessments.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
- Model description
- open-label, randomized, controlled, multicenter, phase III study with two parallel arms
| Arm | Type | Receives |
|---|---|---|
| Treatment | Experimental | Drug: mFOLFOX6, Drug: mFOLFOXIRI, Drug: FOLFIRI, Drug: CAPOXActive treatment with mFOLFOXIRI or mFOLFOX6 or FOLFIRI q2w or CAPOX q3w up to six months followed by structured Follow-up for up to five years after randomization |
| Control | No intervention | –Structured Follow-up for up to five years after randomization |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (22 listed)
- Patient's signed informed consent.
- Patient's age ≥18 years at the time of signing the informed consent.
- Histologically confirmed adenocarcinoma of the colon or rectum.
- Resected (R0 or R1) and/or effectively treated metastases (all techniques allowed) of colorectal cancer within 3-10 weeks before randomization (earlier randomisation allowed if at least 3 weeks interval between intervention and treatment start is guaranteed) AND resected primary tumor (synchronous or metachronous). In cases of synchronous metastases the interval of 3-10 weeks might be calculated following the removal of the primary tumor if this intervention was the last to address all tumor lesions.
- Absence of significant active wound healing complications (if applicable) at randomization. Resolved wound healing complications after resection/ablation are acceptable for inclusion into the trial.
Key exclusion criteria (33 listed)
- Treatment of metastases greater than 3 cm with radio-frequency/microwave ablation within 24 months prior to study entry if applicable.
- Treatment of metastases greater than 5 cm with radiation (stereotactic/ brachytherapy) within 24 months prior to study entry if applicable.
- Any previous systemic therapy is allowed for inclusion into the trial. However, if previous oxaliplatin-containing chemotherapy at any time for metastatic or localized disease was carried out, the inclusion into the trial is permitted under the condition, that
- New York Heart Association Class III or greater heart failure by clinical judgement.
- Myocardial infarction within 6 months prior to randomization; percutaneous transluminal coronary angioplasty (PTCA) with or without stenting within 6 months prior to randomization.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| mFOLFOX6Also: Folinic acid, Oxaliplatin, 5-fluorouracil (FU)Oxaliplatin: 85 mg/m², 2h IV infusion on d1 Folinic acid: 400 mg/m², 1-2 h IV infusion on d1 5-FU: (optional: 400 mg/m² bolus, 2-5 min IV infusion), 2400 mg/m², 46 h IV infusion on d1 Cycles are repeated on day 15. A total of up to 12 cycles are administered. | Drug | Treatment |
| mFOLFOXIRIAlso: Folinic acid, Oxaliplatin, 5-FU, IrinotecanOxaliplatin: 85 mg/m², 2h IV infusion on d1 Irinotecan: 150 mg/m², 90 min IV infusion on d1 Folinic acid: 400 mg/m², 1-2 h IV infusion on d1 5-FU: 2400 mg/m², 46 h IV infusion on d1 Cycles are repeated on day 15. A total of up to 12 cycles are administered. | Drug | Treatment |
| FOLFIRIAlso: Folinic acid, 5-FUFolinic acid: 400mg/m², 1-2h IV Infusion on d1 5-FU: 2400 mg/m², 46 h IV infusion on d1 Irinotecan: 180 mg/m², 90-120 min IV infusion on d1 Cycles are repeated on day 15. A total of up to 12 cycles is administered. | Drug | Treatment |
| CAPOXAlso: Capecitaine, OxaliplatinCapecitabine: 1000 mg/m², oral 1-0-1 on d1-14 Oxaliplatin: 130 mg/m², 3h IV infusion on d1 Cycles are repeated on day 22. A total of up to 8 cycles isadministered. | Drug | Treatment |
Primary outcome
Progression-free survival (PFS) time
Time frame: 24 months
time from randomization to death or evidence of disease relapse/progression (whatever occurs first)
4 secondary outcomes
Overall survival (OS)
Time frame: at least 5 years after randomization
Control ol lesions
Time frame: up to 5 years after randomization
(Serious) Adverse Events
Time frame: up to 2 years after randomization
Quality of life (QoL)
Time frame: up to 5 years after randomization
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 12 Dec 2025.
- Derived from this study: PubMed 35366831Raschzok N, Stintzing S, Heinemann V, Rauch G, Ricke J, Guckenberger M, Kurreck A, Alig AHS, Stahler A, Bullinger L, Schmelzle M, Schoning W, Lurje G, Krenzien F, Haase O, Rau B, Gebauer B, Sauer IM, Pratschke J, Modest DP. FIRE-9 - PORT / AIO-KRK-0418: a prospective, randomized, open, multicenter Phase III trial to investigate the efficacy of adjuvant/additive chemotherapy in patients with definitely-treated metastatic colorectal cancer. BMC Cancer. 2022 Apr 2;22(1):359. doi: 10.1186/s12885-022-09422-6.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Dominik Modest, Prof. Dr. principal investigator
Charite University, Berlin, Germany
79 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing mFOLFOX6, mFOLFOXIRI and FOLFIRI in people with Colorectal Cancer, run by Dominik Paul Modest at 79 sites in Germany.
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 22 inclusion and 33 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: looking for participants now, as of the sponsor's last update on 12 Dec 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 79 sites in Germany. 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?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Dominik Modest, Prof. Dr. (+49 30 450 ext. 553222, dominik.modest@charite.de), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Progression-free survival (PFS) time (time frame: 24 months). 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 NCT05008809, 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 12 Dec 2025.