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Study 20 of 884 for search of: | United States, Delaware |
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Sponsors and Collaborators: |
Cancer and Leukemia Group B National Cancer Institute (NCI) Southwest Oncology Group |
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Information provided by: | National Cancer Institute (NCI) |
ClinicalTrials.gov Identifier: | NCT00265850 |
RATIONALE: Monoclonal antibodies, such as cetuximab and 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. Cetuximab may also stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Bevacizumab may also stop the growth of tumor cells by blocking blood flow to the tumor. Drugs used in chemotherapy, such as fluorouracil, leucovorin, oxaliplatin, and irinotecan, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving monoclonal antibodies together with combination chemotherapy may kill more tumor cells. It is not yet known whether combination chemotherapy is more effective with cetuximab and/or bevacizumab in treating patients with colorectal cancer.
PURPOSE: This randomized phase III trial is studying cetuximab and/or bevacizumab when given together with combination chemotherapy to compare how well they work in treating patients with metastatic colorectal cancer.
Condition | Intervention | Phase |
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Colorectal Cancer |
Drug: bevacizumab Drug: cetuximab Drug: fluorouracil Drug: irinotecan hydrochloride Drug: leucovorin calcium Drug: oxaliplatin |
Phase III |
Study Type: | Interventional |
Study Design: | Treatment, Randomized |
Official Title: | A Phase III Trial of Irinotecan / 5-FU / Leucovorin or Oxaliplatin / 5-FU/ Leucovorin With Bevacizumab, or Cetuximab (C225), or With the Combination or Bevacizumab and Cetuximab for Patients With Untreated Metastatic Adenocarcinoma of the Colon or Rectum |
Estimated Enrollment: | 2300 |
Study Start Date: | November 2005 |
Estimated Primary Completion Date: | June 2008 (Final data collection date for primary outcome measure) |
Arms | Assigned Interventions |
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Arm I: Active Comparator
Patients receive oxaliplatin IV over 2 hours or irinotecan hydrochloride IV over 30-90 minutes; leucovorin calcium IV over 2 hours; fluorouracil IV continuously over 46-48 hours; and bevacizumab IV over 30-90 minutes on days 1, 15, 29, and 43.
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Drug: bevacizumab
Given IV
Drug: fluorouracil
Given IV
Drug: irinotecan hydrochloride
Given IV
Drug: leucovorin calcium
Given IV
Drug: oxaliplatin
Given IV
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Arm II: Experimental
Patients receive oxaliplatin or irinotecan hydrochloride, leucovorin calcium, and fluorouracil as in arm I. Patients also receive cetuximab IV over 1-2 hours on days 1, 8, 15, 22, 29, 36, 43, and 50
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Drug: cetuximab
Given IV
Drug: fluorouracil
Given IV
Drug: irinotecan hydrochloride
Given IV
Drug: leucovorin calcium
Given IV
Drug: oxaliplatin
Given IV
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Arm III: Experimental
Patients receive oxaliplatin or irinotecan hydrochloride, leucovorin calcium, fluorouracil, and bevacizumab as in arm I. Patients also receive cetuximab as in arm II.
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Drug: bevacizumab
Given IV
Drug: cetuximab
Given IV
Drug: fluorouracil
Given IV
Drug: irinotecan hydrochloride
Given IV
Drug: leucovorin calcium
Given IV
Drug: oxaliplatin
Given IV
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OBJECTIVES:
Primary
Secondary
OUTLINE: This is a randomized, open-label, multicenter study. Patients are stratified according to physician-selected chemotherapy (oxaliplatin, leucovorin calcium, and fluorouracil [FOLFOX] vs irinotecan hydrochloride, leucovorin calcium, or fluorouracil [FOLFIRI]), prior adjuvant chemotherapy (yes vs no), and prior pelvic radiotherapy (yes vs no). Patients are randomized to 1 of 3 treatment arms.
In all arms, treatment repeats every 56 days for at least 2 courses in the absence of disease progression, unacceptable toxicity, or planned surgery with curative intent.
For patients whom elective surgery is contemplated, bevacizumab must be discontinued for at least 8 weeks before surgery and may not be resumed for at least 4 weeks after surgery. Patients who undergo complete resection of metastatic disease are removed from study.
After completion of study treatment, patients are followed periodically for 5 years and then annually thereafter.
PROJECTED ACCRUAL: A total of 2,300 patients will be accrued for this study.
Ages Eligible for Study: | 18 Years and older |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
DISEASE CHARACTERISTICS:
Histologically or cytologically confirmed adenocarcinoma of the colon or rectum
Locally advanced (unresectable) or metastatic disease
Separate histological or cytological confirmation is not required from patients with a history of colorectal cancer (previously treated by surgical resection) who have now developed radiological or clinical evidence of metastatic disease, unless 1 of the following is true:
The intent of this treatment must be indicated as follows:
PATIENT CHARACTERISTICS:
Performance status
Life expectancy
Hematopoietic
Hepatic
No evidence of Gilbert's syndrome for patients assigned to receive FOLFIRI chemotherapy
Renal
Protein < 1+ by urinalysis
Cardiovascular
No arterial thromboembolic event within the past 6 months, including any of the following:
Pulmonary
Gastrointestinal
No uncontrolled, predisposing colonic or small bowel disorder (i.e., > 3 watery or soft stools daily for patients without a colostomy or ileostomy)
Neurologic
Other
PRIOR CONCURRENT THERAPY:
Biologic therapy
Chemotherapy
Endocrine therapy
Radiotherapy
Surgery
At least 2 weeks since prior minor surgery
Other
Concurrent full-dose anticoagulation (i.e., warfarin) allowed provided all of the following criteria are met:
Study Chair: | Alan P. Venook, MD | UCSF Helen Diller Family Comprehensive Cancer Center |
Study Chair: | Charles D. Blanke, MD, FACP | British Columbia Cancer Agency |
Study ID Numbers: | CDR0000455161, CALGB-C80405, SWOG-C80405 |
Study First Received: | December 14, 2005 |
Last Updated: | January 15, 2009 |
ClinicalTrials.gov Identifier: | NCT00265850 |
Health Authority: | Unspecified |
recurrent colon cancer stage III colon cancer stage III rectal cancer stage IV colon cancer |
recurrent rectal cancer stage IV rectal cancer adenocarcinoma of the colon adenocarcinoma of the rectum |
Digestive System Neoplasms Rectal Neoplasms Gastrointestinal Diseases Cetuximab Irinotecan Colonic Diseases Leucovorin Bevacizumab Intestinal Diseases Rectal Diseases Camptothecin Recurrence |
Intestinal Neoplasms Rectal neoplasm Carcinoma Calcium, Dietary Oxaliplatin Digestive System Diseases Fluorouracil Gastrointestinal Neoplasms Adenocarcinoma Rectal cancer Colorectal Neoplasms Neoplasms, Glandular and Epithelial |
Antimetabolites Neoplasms by Histologic Type Antimetabolites, Antineoplastic Vitamin B Complex Molecular Mechanisms of Pharmacological Action Immunologic Factors Antineoplastic Agents Growth Substances Physiological Effects of Drugs Enzyme Inhibitors Angiogenesis Inhibitors |
Immunosuppressive Agents Pharmacologic Actions Neoplasms Neoplasms by Site Vitamins Therapeutic Uses Growth Inhibitors Angiogenesis Modulating Agents Micronutrients Antineoplastic Agents, Phytogenic |