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Yttrium Microspheres With Cetuximab Plus Irinotecan for Patients With Advanced Colorectal Cancer Mets to Liver
This study is not yet open for participant recruitment.
Verified by M.D. Anderson Cancer Center, December 2008
Sponsors and Collaborators: M.D. Anderson Cancer Center
Sirtex Medical
Information provided by: M.D. Anderson Cancer Center
ClinicalTrials.gov Identifier: NCT00766220
  Purpose

Primary Objective:

To determine the progression free survival for patients treated with the combination of liver directed therapy with SIR-Sphere followed by systemic chemotherapy with a combination of cetuximab with irinotecan for patients who have previously been treated.

Secondary Objectives:

  1. To determine response rate, overall progression-free survival, and overall survival.
  2. To evaluate toxicities and tolerability.

Condition Intervention Phase
Colon Cancer
Colorectal Cancer
Drug: SIR-spheres Agent Administration
Drug: Cetuximab
Drug: Irinotecan
Procedure: Blood vessel study
Phase II

MedlinePlus related topics: Cancer Colorectal Cancer
Drug Information available for: Irinotecan Irinotecan hydrochloride Cetuximab X-Rays
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Randomized, Single Blind (Subject), Single Group Assignment, Safety/Efficacy Study
Official Title: Phase II Randomized Study of SIR-Spheres, Yttrium Microspheres With Cetuximab Plus Irinotecan for Patients With Advanced Colorectal Cancer Metastases to the Liver

Further study details as provided by M.D. Anderson Cancer Center:

Primary Outcome Measures:
  • To find effects of liver injected SIR-spheres followed by systemic chemotherapy with combination of cetuximab and irinotecan compared to systemic therapy alone in patients with colon cancer metastasized to liver [ Time Frame: 2 Years ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • To study the safety of this treatment and how well it controls the disease [ Time Frame: 2 Years ] [ Designated as safety issue: Yes ]

Estimated Enrollment: 45
Study Start Date: January 2009
Estimated Primary Completion Date: October 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
1: Active Comparator
SIR-Spheres with Cetuximab + Irinotecan Therapy
Drug: SIR-spheres Agent Administration
SIR-Spheres, resin microspheres containing pure Beta emitter Yttrium-90, given through femoral catheter over 10 minutes
Drug: Cetuximab
Once a week by IV over 2 hours
Drug: Irinotecan
Once every 3 weeks by IV over 90 minutes
Procedure: Blood vessel study
X-Ray dye injected in artery through groin catheter to view arteries to liver and surrounding areas.
2: Active Comparator
Cetuximab + Irinotecan Therapy
Drug: Cetuximab
Once a week by IV over 2 hours
Drug: Irinotecan
Once every 3 weeks by IV over 90 minutes
Procedure: Blood vessel study
X-Ray dye injected in artery through groin catheter to view arteries to liver and surrounding areas.

  Show Detailed Description

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Patients must have histologically or cytologically confirmed adenocarcinoma of the colon or rectum. Histology from the hepatic metastasis is not mandatory if the morphological appearances on cross sectional imaging and tumor markers (CEA) are indicative of a colorectal primary.
  2. Patients must have measurable disease, defined as at least one lesion that can be accurately measured in two dimensions (longest diameter to be recorded) as greater than or equal to 20 mm with conventional techniques or as greater than or equal to 10 mm with spiral CT scan.
  3. Patients must have radiological evidence of disease progression of disease within 6 months of their most recent dose of chemotherapeutic regimens that should include irinotecan.
  4. Age greater than or equal to 18 years.
  5. ECOG performance status less than or equal to 2.
  6. Patients must have normal organ and marrow function as defined below within 30 days of receiving the investigational agent: - leukocytes greater than or equal to 3,000/mL - absolute neutrophil count greater than or equal to 1,500/mL - platelets greater than or equal to 100,000/mL - total bilirubin less than or equal to 1.5 times upper limits of normal institutional limits - AST(SGOT) less than or equal to 2.5 X 46 IU/L and ALT(SGPT) less than or equal to 2.5 X 56 IU/L - Creatinine less than or equal to 1.5 times upper limits of normal institutional limits
  7. Patients with a prior history of non-colorectal cancer who have no active disease may be eligible if they are disease free for greater than or equal to 12 months prior to treatment.
  8. The effects of SIR-Spheres, irinotecan or cetuximab on the developing human fetus at the recommended therapeutic dose are unknown. For this reason and because radiation as well as other therapeutic agents used in this trial are known to be teratogenic, women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while in this study, she should inform her treating physician immediately.
  9. Ability to understand and the willingness to sign a written informed consent document.
  10. Patients without evidence of local disease recurrence from colorectal cancer are eligible
  11. Patients with extrahepatic disease confined to the lung is permitted if < 4 lesions are depicted on CTand all are < 3 cm in size
  12. Patients with brain mets are eligible for this trial if those patients who have had the area surgically resected or irradiated and have no evidence of active disease as demonstrated by MRI of the brain. Patients must have no evidence of residual neurological dysfunction as per baseline neurological exam. Patients with untreated brain metastases will be considered ineligible.

Exclusion Criteria:

  1. Patients who have had chemotherapy within 4 weeks (6 weeks for nitrosoureas or mitomycin C) prior to entering the study or those who have not recovered from adverse events due to agents administered more than 4 weeks earlier will be excluded. Patients who have had hepatic external beam radiotherapy will be excluded.
  2. Patients may not be receiving any other investigational agents.
  3. History of allergic reactions attributed to compounds of similar chemical or biologic composition to SIR-Spheres, irinotecan or cetuximab or other agents used in the study.
  4. Evidence of ascites, biopsy proven cirrhosis or portal hypertension suggested by the presence of characteristic imaging features on cross sectional imaging or esophageal varicosities demonstrated on endoscopy or barium swallow. A diagnostic study to rule out the presence of portal hypertension will not be required unless the findings on cross sectional imaging are suggestive but not confirmatory.
  5. Hepatic arterial anatomy that would prevent catheterization and the administration of SIR-Spheres into the liver.
  6. >20% hepatopulmonary shunting on a Technetium99-MAA nuclear scan
  7. Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection requiring hospital admission or antibiotics,symptomatic congestive heart failure (class III and IV), unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations would exclude patients from this study.
  8. Contraindications to angiography and selective visceral catheterization: History of severe allergy or intolerance to any contrast media, or atropine. Bleeding diathesis, not correctable by usual forms of therapy that would include medical coagulopathy but not limited to the administration of blood products.
  9. Nuclear Medicine scan demonstrates evidence of potential delivery of greater than 16.5 mCi (30 Gy absorbed dose) of radiation to the lungs with SIR-Sphere administration.
  10. Evidence of any detectable Tc-99 MAA flow to the stomach or duodenum, after application of established angiographic techniques to stop such flow.
  11. Utilization of capecitabine for the 6 weeks preceding SIR-Sphere therapy and indefinitely following SIR-Sphere therapy as per manufacturer's recommendations due to the increased risk of radiation hepatitis.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00766220

Contacts
Contact: Ravi Murthy, MD 713-745-0312

Locations
United States, Texas
UT MD Anderson Cancer Center
Houston, Texas, United States, 77030
Sponsors and Collaborators
M.D. Anderson Cancer Center
Sirtex Medical
Investigators
Principal Investigator: Ravi Murthy, MD UT MD Anderson Cancer Center
  More Information

MD Anderson Cancer Center website  This link exits the ClinicalTrials.gov site

Responsible Party: UT MD Anderson Cancer Center ( Ravi Murthy, MD/Associate Professor )
Study ID Numbers: 2004-0779
Study First Received: October 1, 2008
Last Updated: December 1, 2008
ClinicalTrials.gov Identifier: NCT00766220  
Health Authority: United States: Institutional Review Board

Keywords provided by M.D. Anderson Cancer Center:
colon
liver
Colorectal cancer
Colorectal cancer metastases to the liver
metastases to the liver
colorectal cancer mets to liver
colon cancer metastasized to liver
Yttrium microspheres
SIR-Spheres
cetuximab
irinotecan
Yttrium 90
cetuximab plus irinotecan
liver directed therapy

Study placed in the following topic categories:
Digestive System Neoplasms
Gastrointestinal Diseases
Colonic Diseases
Irinotecan
Cetuximab
Intestinal Diseases
Rectal Diseases
Intestinal Neoplasms
Digestive System Diseases
Neoplasm Metastasis
Gastrointestinal Neoplasms
Colonic Neoplasms
Colorectal Neoplasms

Additional relevant MeSH terms:
Neoplasms
Neoplasms by Site
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Therapeutic Uses
Enzyme Inhibitors
Antineoplastic Agents, Phytogenic
Pharmacologic Actions

ClinicalTrials.gov processed this record on January 16, 2009