Fluorouracil, Semustine, and Vincristine Compared With BCG in Treating Patients With Dukes' B or Dukes' C Colon Cancer That Has Been Removed By Surgery - Full Text View

Purpose

RATIONALE: Drugs used in chemotherapy, such as vincristine, fluorouracil, and semustine, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Biological therapies, such as BCG, may stimulate the immune system in different ways and stop tumor cells from growing. It is not yet known whether combination chemotherapy is more effective than BCG in treating colon cancer that has been removed by surgery.

PURPOSE: This randomized phase III clinical trial is studying giving fluorouracil together with semustine and vincristine to see how well they work compared with giving BCG in treating patients with Dukes' B or Dukes' C colon cancer that has been removed by surgery.

Condition	Intervention	Phase
Colorectal Cancer	Drug: BCG vaccine Drug: fluorouracil Drug: semustine Drug: vincristine sulfate Procedure: biological therapy	Phase III

MedlinePlus related topics:

Cancer Colorectal Cancer

ChemIDplus related topics:

Vincristine sulfate Vincristine Fluorouracil BCG Vaccine Semustine

U.S. FDA Resources

Study Type:	Interventional
Study Design:	Treatment

Official Title:	A Clinical Trial to Evaluate Postoperative Immunotherapy and Postoperative Systemic Chemotherapy in the Management of Resectable Colon Cancer

Further study details as provided by National Cancer Institute (NCI):

Study Start Date:

September 1977

Detailed Description:

OBJECTIVES: I. Obtain information to define subsets of colon cancer patients at high risk of recurrence. II. Correlate pathologic and biologic parameters with disease-free interval and survival. III. Determine the value of surgical and ancillary techniques in management of colon cancer. IV. Compare disease-free interval and survival after curative resection vs. chemotherapy with 5-fluorouracil/methyl-CCNU/vincristine vs. BCG immunotherapy. V. Relate the total lymphocyte count to the course of the disease. VI. Determine the feasibility of conducting a trial employing immunotherapy in a surgical adjuvant setting. VII. Identify appropriate future protocols based on data generated in the study.

OUTLINE: Randomized study for patients with Dukes Stage B and C disease only. All patients with Dukes A and D lesions enter Arm I. Arm I: No therapy following surgery. Arm II: 3-Drug Combination Chemotherapy. 5-Fluorouracil, 5-FU, NSC-19893; Methyl-CCNU, MeCCNU, NSC-95441; Vincristine, VCR, NSC-67574. Arm III: Immunotherapy. BCG-Pasteur, BCG, NSC-B116328.

PROJECTED ACCRUAL: Protocol closed February 1984.

Eligibility

Ages Eligible for Study:	up to 79 Years
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

DISEASE CHARACTERISTICS: See General Eligibility Criteria

PATIENT CHARACTERISTICS: See General Eligibility Criteria

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00427570

Sponsors and Collaborators

National Surgical Adjuvant Breast and Bowel Project (NSABP)

National Cancer Institute (NCI)

Investigators


Study Chair:	Norman Wolmark, MD	Allegheny Cancer Center at Allegheny General Hospital

More Information

Clinical trial summary from the National Cancer Institute's PDQ® database This link exits the ClinicalTrials.gov site

Publications of Results:

Smith RE, Colangelo L, Wieand HS, Begovic M, Wolmark N. Randomized trial of adjuvant therapy in colon carcinoma: 10-year results of NSABP protocol C-01. J Natl Cancer Inst. 2004 Aug 4;96(15):1128-32.

Wolmark N, Fisher B, Rockette H, Redmond C, Wickerham DL, Fisher ER, Jones J, Glass A, Lerner H, Lawrence W, et al. Postoperative adjuvant chemotherapy or BCG for colon cancer: results from NSABP protocol C-01. J Natl Cancer Inst. 1988 Mar 2;80(1):30-6.

Wolmark N, Fisher B, Rockette H, et al.: Adjuvant therapy in carcinoma of the colon: five year results of NSABP protocol C-01. [Abstract] Proceedings of the American Society of Clinical Oncology 6: A-358, 92, 1987.

Weese JL, Starling JR, Ottery FD, et al.: Should omentectomy be part of colectomy for colon cancer? [Abstract] Proceedings of the American Society of Clinical Oncology 4: C-358, 92, 1985.

Other Publications:

Kim GP, Colangelo LH, Wieand HS, Paik S, Kirsch IR, Wolmark N, Allegra CJ; National Cancer Institute. Prognostic and predictive roles of high-degree microsatellite instability in colon cancer: a National Cancer Institute-National Surgical Adjuvant Breast and Bowel Project Collaborative Study. J Clin Oncol. 2007 Mar 1;25(7):767-72. Epub 2007 Jan 16.

Kim GP, Colangelo L, Wieand H, et al.: Prognostic and predictive roles of high-degree microsatellite instability (MSI-H) in colon cancer: National Cancer Institute (NCI)-National Surgical Adjuvant Bowel Project (NSABP) collaborative study. [Abstract] American Society of Clinical Oncology 2005 Gastrointestinal Cancers Symposium, 27-29 January 2005, Miami, Florida. A-227, 2005.

Allegra CJ, Paik S, Colangelo LH, Parr AL, Kirsch I, Kim G, Klein P, Johnston PG, Wolmark N, Wieand HS. Prognostic value of thymidylate synthase, Ki-67, and p53 in patients with Dukes' B and C colon cancer: a National Cancer Institute-National Surgical Adjuvant Breast and Bowel Project collaborative study. J Clin Oncol. 2003 Jan 15;21(2):241-50.

Fisher ER, Colangelo L, Wieand S, Fisher B, Wolmark N. Lack of influence of cytokeratin-positive mini micrometastases in "Negative Node" patients with colorectal cancer: findings from the national surgical adjuvant breast and bowel projects protocols R-01 and C-01. Dis Colon Rectum. 2003 Aug;46(8):1021-5; discussion 1025-6.

Wolmark N, Colangelo L, Wieand S. National Surgical Adjuvant Breast and Bowel Project trials in colon cancer. Semin Oncol. 2001 Feb;28(1 Suppl 1):9-13.

Dignam JJ, Colangelo L, Tian W, Jones J, Smith R, Wickerham DL, Wolmark N. Outcomes among African-Americans and Caucasians in colon cancer adjuvant therapy trials: findings from the National Surgical Adjuvant Breast and Bowel Project. J Natl Cancer Inst. 1999 Nov 17;91(22):1933-40.

Mamounas E, Wieand S, Wolmark N, Bear HD, Atkins JN, Song K, Jones J, Rockette H. Comparative efficacy of adjuvant chemotherapy in patients with Dukes' B versus Dukes' C colon cancer: results from four National Surgical Adjuvant Breast and Bowel Project adjuvant studies (C-01, C-02, C-03, and C-04) J Clin Oncol. 1999 May;17(5):1349-55.

Wolmark N, Fisher B, Wieand HS, Henry RS, Lerner H, Legault-Poisson S, Deckers PJ, Dimitrov N, Gordon PH, Jochimsen P, et al. The prognostic significance of preoperative carcinoembryonic antigen levels in colorectal cancer. Results from NSABP (National Surgical Adjuvant Breast and Bowel Project) clinical trials. Ann Surg. 1984 Apr;199(4):375-82.

Wolmark N, Fisher ER, Wieand HS, Fisher B. The relationship of depth of penetration and tumor size to the number of positive nodes in Dukes C colorectal cancer. Cancer. 1984 Jun 15;53(12):2707-12.

Wolmark N, Cruz I, Redmond CK, Fisher B, Fisher ER. Tumor size and regional lymph node metastasis in colorectal cancer. A preliminary analysis from the NSABP clinical trials. Cancer. 1983 Apr 1;51(7):1315-22.

Wolmark N, Wieand HS, Rockette HE, Fisher B, Glass A, Lawrence W, Lerner H, Cruz AB, Volk H, Shibata H, et al. The prognostic significance of tumor location and bowel obstruction in Dukes B and C colorectal cancer. Findings from the NSABP clinical trials. Ann Surg. 1983 Dec;198(6):743-52.

Study ID Numbers:	CDR0000071312, NSABP-C-01
First Received:	January 18, 2007
Last Updated:	August 23, 2008
ClinicalTrials.gov Identifier:	NCT00427570
Health Authority:	United States: Federal Government

Keywords provided by National Cancer Institute (NCI):

stage II colon cancer

stage III colon cancer

Study placed in the following topic categories:

BCG Vaccine

Digestive System Neoplasms

Gastrointestinal Diseases

Colonic Diseases

Vincristine

Intestinal Diseases

Rectal Diseases

Intestinal Neoplasms

Digestive System Diseases

Fluorouracil

Gastrointestinal Neoplasms

Semustine

Colonic Neoplasms

Colorectal Neoplasms

Additional relevant MeSH terms:

Antimetabolites

Antimetabolites, Antineoplastic

Immunologic Factors

Molecular Mechanisms of Pharmacological Action

Antineoplastic Agents

Mitosis Modulators

Physiological Effects of Drugs

Adjuvants, Immunologic

Antimitotic Agents

Immunosuppressive Agents

Pharmacologic Actions

Neoplasms

Neoplasms by Site

Therapeutic Uses

Tubulin Modulators

Antineoplastic Agents, Alkylating

Antineoplastic Agents, Phytogenic

Alkylating Agents

ClinicalTrials.gov processed this record on September 23, 2008

Sponsors and Collaborators:	National Surgical Adjuvant Breast and Bowel Project (NSABP) National Cancer Institute (NCI)
Information provided by:	National Cancer Institute (NCI)
ClinicalTrials.gov Identifier:	NCT00427570