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Oxaliplatin, Fluorouracil, Leucovorin and ABT-869 or Bevacizumab as Second-Line Therapy in Treating Patients With Locally Recurrent or Metastatic Colorectal Cancer
This study is not yet open for participant recruitment.
Verified by National Cancer Institute (NCI), October 2008
Sponsors and Collaborators: Vanderbilt-Ingram Cancer Center
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00788411
  Purpose

RATIONALE: Drugs used in chemotherapy, such as oxaliplatin, fluorouracil, and leucovorin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. ABT-869 may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Monoclonal antibodies, such as bevacizumab, can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Bevacizumab may also stop the growth of colorectal cancer by blocking blood flow to the tumor. It is not yet known whether combination chemotherapy is more effective when given together with ABT-869 or bevacizumab in treating patients with colorectal cancer.

PURPOSE: This randomized phase II trial is studying oxaliplatin, fluorouracil, and leucovorin given together with ABT-869 to see how well it works compared with oxaliplatin, fluorouracil, and leucovorin given together with bevacizumab as second-line therapy in treating patients with locally recurrent or metastatic colorectal cancer.


Condition Intervention Phase
Colorectal Cancer
Drug: bevacizumab
Drug: fluorouracil
Drug: leucovorin calcium
Drug: multitargeted receptor tyrosine kinase inhibitor ABT-869
Drug: oxaliplatin
Phase II

MedlinePlus related topics: Cancer Colorectal Cancer
Drug Information available for: Leucovorin Calcium Citrovorum factor Folinic acid calcium salt pentahydrate Leucovorin Bevacizumab Fluorouracil Oxaliplatin Calcium gluconate Tyrosine
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Randomized, Open Label, Active Control
Official Title: An Open-Label, Randomized Phase 2 Study of ABT-869 in Combination With mFOLFOX6 (Oxaliplatin, 5-Fluorouracil, and Folinic Acid) Versus Bevacizumab in Combination With mFOLFOX6 as Second-Line Treatment of Subjects With Advanced Colorectal Cancer

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

Primary Outcome Measures:
  • Progression-free survival [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Overall survival [ Designated as safety issue: No ]
  • 12-month survival rate [ Designated as safety issue: No ]
  • Time to disease progression [ Designated as safety issue: No ]
  • Objective response rate [ Designated as safety issue: No ]
  • Best response rate [ Designated as safety issue: No ]
  • Maximum percent reduction in tumor size [ Designated as safety issue: No ]
  • Duration of response [ Designated as safety issue: No ]
  • Safety and tolerability [ Designated as safety issue: Yes ]
  • Quality of life [ Designated as safety issue: No ]
  • Performance status [ Designated as safety issue: No ]

Estimated Enrollment: 90
Study Start Date: October 2008
Estimated Primary Completion Date: April 2013 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Arm A: Experimental
Patients receive oxaliplatin IV over 120 minutes and leucovorin calcium IV over 120 minutes on day 1 and fluorouracil IV bolus followed by continuously IV over 46-48 hours on days 1 and 2 (mFOLFOX6). They also receive oral ABT-869 on days 1-14. Courses repeat every 14 days in the absence of disease progression or unacceptable toxicity.
Drug: fluorouracil
Given IV
Drug: leucovorin calcium
Given IV
Drug: multitargeted receptor tyrosine kinase inhibitor ABT-869
Given orally
Drug: oxaliplatin
Given IV
Arm B: Experimental
Patients receive mFOLFOX6 as in arm A and bevacizumab IV over 30-90 minutes on day 1. Courses repeat every 14 days in the absence of disease progression or unacceptable toxicity.
Drug: bevacizumab
Given IV
Drug: fluorouracil
Given IV
Drug: leucovorin calcium
Given IV
Drug: oxaliplatin
Given IV

Detailed Description:

OBJECTIVES:

Primary

  • To assess if the addition of oral ABT-869 vs bevacizumab to mFOLFOX6 (oxaliplatin, fluorouracil, and leucovorin calcium) as second-line treatment can prolong progression-free survival of patients with advanced colorectal cancer.

Secondary

  • To evaluate overall survival and additional efficacy endpoints as well as the safety and tolerability of the regimens in these patients.

Tertiary

  • To evaluate quality of life and performance status in these patients.

OUTLINE: This is a multicenter study.

Patients are stratified according to prior radiotherapy (yes vs no). Patients are randomized to 1 of 2 treatment arms.

  • Arm A: Patients receive oxaliplatin IV over 120 minutes and leucovorin calcium IV over 120 minutes on day 1 and fluorouracil IV bolus followed by continuously IV over 46-48 hours on days 1 and 2 (mFOLFOX6). They also receive oral ABT-869 on days 1-14. Courses repeat every 14 days in the absence of disease progression or unacceptable toxicity.
  • Arm B: Patients receive mFOLFOX6 as in arm A and bevacizumab IV over 30-90 minutes on day 1. Courses repeat every 14 days in the absence of disease progression or unacceptable toxicity.

Quality of life is assessed periodically by FACT-C questionnaire. After completion of study therapy, patients are followed periodically for 5 years.

  Eligibility

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

DISEASE CHARACTERISTICS:

  • Diagnosed with adenocarcinoma of the colon or rectum
  • Metastatic disease or locally recurrent disease that is not amenable to surgical resection with curative intent
  • Measurable disease, defined as ≥ 1 unidimensionally measurable lesion on a CT scan as defined by RECIST criteria
  • Must have received 1 prior chemotherapy regimen containing irinotecan or a fluoropyrimidine for locally recurrent or metastatic disease AND have experienced progressive disease during or following the prior chemotherapy treatment
  • No symptomatic or untreated brain or meningeal metastases

    • Must have CT scan if there is clinical suspicion of CNS
    • Patients with treated brain metastases that are radiographically or clinically stable for ≥ 4 weeks after therapy and have no evidence of cavitation or hemorrhage in the brain lesion are eligible provided that they are asymptomatic and do not require corticosteroids

PATIENT CHARACTERISTICS:

  • ECOG performance status 0-1
  • ANC ≥ 1,500/mm³
  • Platelets ≥ 100,000/mm³
  • Hemoglobin ≥ 9.0 g/dL
  • Serum creatinine ≤ 2.0 mg/dL
  • AST and ALT ≤ 1.5 times upper limit of normal (ULN) (≤ 5.0 times ULN if liver metastases present)
  • Bilirubin ≤ 1.5 mg/dL
  • PTT ≤ 1.5 times ULN
  • INR ≤ 1.5
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception during and for up to 2 months after completion of therapy
  • No history of hypersensitivity to recombinant murine monoclonal antibodies, oxaliplatin, other platinum-containing compounds, fluorouracil, or leucovorin calcium
  • Proteinuria CTC grade ≤ 1 at baseline as measured by a urine protein:creatinine ratio of ≤ 1 by a 24-hour urine collection
  • No history of or concurrent clinically significant cancer-related events of bleeding (e.g., gross hemoptysis defined as bright red blood of ≤ ½ teaspoon or 2.5 mL per episode within the past 3 months) or other clinically significant signs of bleeding
  • No symptomatic or persistent, uncontrolled hypertension, defined as diastolic blood pressure (BP) > 100 mm Hg or systolic BP > 150 mm Hg
  • No history of myocardial infarction, stroke, or transient ischemic attack within the past 6 months
  • No history of abdominal fistula or gastrointestinal perforation within the past 6 months
  • No documented left ventricular ejection fraction < 50%
  • No known autoimmune disease with renal involvement (e.g., lupus)
  • No clinically significant uncontrolled condition(s) including, but not limited to, any of the following:

    • Active uncontrolled infection
    • Symptomatic congestive heart failure
    • Unstable angina pectoris or cardiac arrhythmia
    • History of adrenal insufficiency
    • Psychiatric illness/social situation that would limit compliance with study requirements
  • No active ulcerative colitis, Crohn's disease, celiac disease, or any other conditions that interfere with absorption
  • No other active malignancy within the past 5 years except cervical cancer in situ, in situ carcinoma of the bladder, or nonmelanoma carcinoma of the skin
  • No medical condition that, in the opinion of the study investigator, places patients at an unacceptably high risk for toxicities

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • Recovered to ≤ grade 1 clinically significant adverse effects/toxicities of the previous therapy
  • More than 28 days since prior major surgery
  • More than 21 days since prior cytotoxic chemotherapy (i.e., alkylating agents, microtubule inhibitors, anti-metabolites)
  • More than 21 days since prior and no concurrent non-cytotoxic anticancer therapy (e.g., investigational agents, immunotherapy, anticancer traditional Chinese medicine/herbal remedies, hormonal therapy, targeted agents [i.e., erlotinib hydrochloride, imatinib mesylate], or biologic therapy)

    • Concurrent hormone replacement therapy or hormonal contraceptives allowed
  • More than 14 days since prior and no concurrent radiotherapy
  • At least 1 week since prior steroids
  • Prior adjuvant treatment for colorectal cancer allowed
  • No prior treatment with bevacizumab or a tyrosine kinase inhibitor targeting VEGF or PDGF
  • No prior treatment for colorectal cancer with oxaliplatin in the metastatic setting
  • No concurrent combination antiretroviral therapy for HIV
  • No concurrent therapeutic anticoagulation therapy

    • Low-dose anticoagulation (e.g., warfarin) for catheter coagulation prophylaxis allowed
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00788411

Sponsors and Collaborators
Vanderbilt-Ingram Cancer Center
Investigators
Principal Investigator: Jordan D. Berlin, MD Vanderbilt-Ingram Cancer Center
  More Information

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

Responsible Party: Vanderbilt-Ingram Cancer Center ( Jordan D. Berlin )
Study ID Numbers: CDR0000618193, VU-VICC-GI-0831, ABBOTT-M10-300, IRB#080551, EudraCT-2007-007081-38
Study First Received: November 7, 2008
Last Updated: November 7, 2008
ClinicalTrials.gov Identifier: NCT00788411  
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
adenocarcinoma of the colon
adenocarcinoma of the rectum
recurrent colon cancer
stage III colon cancer
stage IV colon cancer
recurrent rectal cancer
stage III rectal cancer
stage IV rectal cancer

Study placed in the following topic categories:
Digestive System Neoplasms
Rectal Neoplasms
Gastrointestinal Diseases
Colonic Diseases
Leucovorin
Bevacizumab
Intestinal Diseases
Rectal Diseases
Recurrence
Intestinal Neoplasms
Rectal neoplasm
Calcium, Dietary
Oxaliplatin
Digestive System Diseases
Fluorouracil
Gastrointestinal Neoplasms
Adenocarcinoma
Rectal cancer
Colorectal Neoplasms

Additional relevant MeSH terms:
Antimetabolites
Antimetabolites, Antineoplastic
Vitamin B Complex
Molecular Mechanisms of Pharmacological Action
Immunologic Factors
Antineoplastic Agents
Growth Substances
Physiological Effects of Drugs
Angiogenesis Inhibitors
Immunosuppressive Agents
Pharmacologic Actions
Neoplasms
Neoplasms by Site
Therapeutic Uses
Vitamins
Growth Inhibitors
Angiogenesis Modulating Agents
Micronutrients

ClinicalTrials.gov processed this record on January 16, 2009