Full Text View
Tabular View
No Study Results Posted
Related Studies
Combination Chemotherapy and Bevacizumab as First-Line Therapy in Treating Patients With Metastatic Colorectal Cancer
This study is currently recruiting participants.
Verified by National Cancer Institute (NCI), December 2008
First Received: July 19, 2008   Last Updated: February 14, 2009   History of Changes
Sponsored by: Gruppo Oncologico del Nord-Ovest
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00719797
  Purpose

RATIONALE: Drugs used in chemotherapy, such as irinotecan, oxaliplatin, leucovorin, and fluorouracil, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. 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.

Giving combination chemotherapy together with bevacizumab may kill more tumor cells.

PURPOSE: This randomized phase III trial is comparing two combination chemotherapy regimens given together with bevacizumab to see how well they work as first-line therapy in treating patients with metastatic colorectal cancer that cannot be removed by surgery.


Condition Intervention Phase
Colorectal Cancer
Biological: bevacizumab
Drug: fluorouracil
Drug: irinotecan hydrochloride
Drug: leucovorin calcium
Drug: oxaliplatin
Phase III

MedlinePlus related topics: Cancer Colorectal Cancer Surgery
Drug Information available for: Fluorouracil Leucovorin Citrovorum factor Oxaliplatin Irinotecan U 101440E Irinotecan hydrochloride Bevacizumab Leucovorin Calcium Folinic acid calcium salt pentahydrate
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Randomized, Open Label
Official Title: A Phase III Randomized Trial of FOLFOXIRI + Bevacizumab Versus FOLFIRI + Bevacizumab as First- Line Treatment for Metastatic 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 response rate [ Designated as safety issue: No ]
  • Duration of response [ Designated as safety issue: No ]
  • Secondary R0 surgery rates of metastases [ Designated as safety issue: No ]
  • Overall survival [ Designated as safety issue: No ]
  • Surrogate markers predictive of bevacizumab activity [ Designated as safety issue: No ]

Estimated Enrollment: 450
Study Start Date: July 2008
Estimated Primary Completion Date: November 2012 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Arm I (FOLFOXIRI): Experimental

Patients receive irinotecan hydrochloride IV over 1 hour, oxaliplatin IV over 2 hours, leucovorin calcium IV over 2 hours, and bevacizumab IV on day

1. Patients also receive fluorouracil IV continuously over 48 hours beginning on day 1.

Biological: bevacizumab
Given IV
Drug: fluorouracil
Given IV
Drug: irinotecan hydrochloride
Given IV
Drug: leucovorin calcium
Given IV
Drug: oxaliplatin
Given IV
Arm II (FOLFIRI): Experimental
Patients receive irinotecan hydrochloride IV over 1 hour, leucovorin calcium IV over 2 hours, and bevacizumab IV on day 1. Patients also receive fluorouracil IV continuously over 48 hours beginning on day 1.
Biological: bevacizumab
Given IV
Drug: fluorouracil
Given IV
Drug: irinotecan hydrochloride
Given IV
Drug: leucovorin calcium
Given IV

Detailed Description:

OBJECTIVES:

Primary

  • To compare the progression-free survival of bevacizumab in combination with oxaliplatin, irinotecan hydrochloride, fluorouracil, and leucovorin calcium (FOLFOXIRI) versus bevacizumab in combination with irinotecan hydrochloride, fluorouracil, and leucovorin calcium (FOLFIRI) in patients with unresectable, metastatic colorectal cancer.

Secondary

  • To evaluate the safety profile, including long-term adverse events of these regimens in these patients.
  • To compare the overall response rate, duration of response, and secondary R0 surgery rates of metastases and overall survival between treatment arms.
  • To evaluate potential surrogate markers predictive of bevacizumab activity.

OUTLINE: This is a multicenter study. Patients are stratified according to ECOG performance status (0 vs 1-2), prior adjuvant chemotherapy (yes vs no), and participating center. Patients are randomized to 1 of 2 treatment arms.

  • Arm I (FOLFOXIRI): Patients receive irinotecan hydrochloride IV over 1 hour, oxaliplatin IV over 2 hours, leucovorin calcium IV over 2 hours, and bevacizumab IV on day 1. Patients also receive fluorouracil IV continuously over 48 hours beginning on day 1.
  • Arm II (FOLFIRI): Patients receive irinotecan hydrochloride IV over 1 hour, leucovorin calcium IV over 2 hours, and bevacizumab IV on day 1. Patients also receive fluorouracil IV continuously over 48 hours beginning on day 1. In both arms, treatment repeats every 2 weeks for up to 12 courses. Treatment with bevacizumab, fluorouracil, and leucovorin calcium continues in the absence of disease progression or unacceptable toxicity.

Patients undergo serum extraction and blood sample collection periodically for genotyping studies. Patients also undergo collection of tumoral sections from paraffin embedded primary and/or metastatic lesions periodically for immunohistochemical analyses.

After completion of study treatment, patients are followed every 8 weeks.

  Eligibility

Ages Eligible for Study:   18 Years to 75 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Histologically confirmed colorectal cancer

    • Unresectable metastatic disease
  • Measurable disease, defined as ≥ 1 measurable lesion according to RECIST criteria
  • No prior chemotherapy for metastatic disease
  • No untreated brain metastases, spinal cord compression, or primary brain tumors
  • No history or evidence of CNS disease by physical examination unless adequately treated (e.g., uncontrolled seizure despite standard medical therapy or history of stroke)

PATIENT CHARACTERISTICS:

Inclusion criteria:

  • ECOG performance status (PS) 0-2 (≤ 70 years of age) OR ECOG PS 0 (71-75 years of age)
  • Life expectancy ≥ 12 weeks
  • Neutrophils ≥ 1.5 x 10^9/L
  • Platelet count ≥ 100 x 10^9/L
  • Hemoglobin > 9 g/dL
  • Total bilirubin ≤ 1.5 times upper limit of normal (ULN)
  • AST and ALT ≤ 2.5 times ULN (≤ 5 times ULN if f liver metastases present)
  • Alkaline phosphatase ≤ 2.5 times ULN (≤ 5 times ULN if liver metastases present)
  • Creatinine clearance > 50 mL/min OR serum creatinine ≤ 1.5 times ULN
  • Proteinuria < 2+ by dipstick OR urine protein ≤ 1 g by 24-hr urine collection
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception

Exclusion criteria:

  • Serious, nonhealing wound, ulcer, or bone fracture
  • Evidence of bleeding diathesis or coagulopathy
  • Uncontrolled hypertension
  • Clinically significant (i.e., active) cardiovascular disease, including any of the following:

    • Cerebrovascular accidents within the past 6 months
    • Myocardial infarction within the past 6 months
    • Unstable angina
    • New York Heart Association class II-IV congestive heart failure
    • Serious cardiac arrhythmia requiring medication
  • Known allergy to Chinese hamster ovary cell proteins or any of the components of the study medications
  • Other co-existing malignancy or malignancy diagnosed within the past 5 years, except for basal cell or squamous cell carcinoma, or carcinoma in situ of the cervix
  • Symptomatic peripheral neuropathy ≥ grade 1 according to the NCI Common Toxicity Criteria
  • Lack of physical integrity of the upper gastrointestinal tract
  • Malabsorption syndrome
  • Inability to take oral medication
  • Significant traumatic injury within the past 28 days

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • More than 4 weeks since prior radiotherapy
  • More than 10 days since prior and no concurrent ongoing treatment with anticoagulants for therapeutic purposes
  • More than 28 days since prior and no concurrent major surgical procedure
  • More than 28 days since prior open biopsy
  • More than 30 days since prior investigational agents
  • No concurrent chronic daily high-dose acetylsalicylic acid (> 325 mg/day)
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00719797

Locations
Italy
A. Perrino Hospital Recruiting
Brindisi, Italy, 72100
Contact: Contact Person     39-831-537-508        
Arcispedale S. Maria Nuova Recruiting
Reggio Emilia, Italy, 42100
Contact: Contact Person     39-522-29-66-23        
Azienda Istituti Ospitalieri Recruiting
Cremona, Italy, 26100
Contact: Contact Person     39-372-40-51-11        
Azienda Ospedaliera di Firenze Recruiting
Florence, Italy, 50011
Contact: Contact Person     39-552-49-64-76        
Azienda Ospedaliera Maggiore Della Carita Recruiting
Novara, Italy, 28100
Contact: Contact Person     39-32-13-73-32-82        
Azienda Ospedaliera Universitaria Senese Recruiting
Siena, Italy, 53100
Contact: Contact Person     39-577-58-51-11        
Azienda Sanitaria Ospedale San Giovanni Battista Molinette di Torino Recruiting
Turin, Italy, 10126
Contact: Contact Person     39-11-63-31-633        
Azienda Usl 8 Arezzo Recruiting
Arezzo, Italy, 52100
Contact: Contact Person     39-575-2551        
Azienda USL12 Versilia Recruiting
Lido di Camaiore, Italy, 55043
Contact: Contact Person     39-584-60-51-0        
Universita Politecnica Delle Marche Recruiting
Ancona, Italy, 60100
Contact: Contact Person     39-71-220-2318        
Civic Hospital of Carrara Recruiting
Carrara, Italy, 54033
Contact: Contact Person     39-585-7671        
Istituto Nazionale per la Ricerca sul Cancro Recruiting
Genoa, Italy, 16132
Contact: Contact Person     39-10-56-001        
Istituto Scientifico H. San Raffaele Recruiting
Milan, Italy, 20132
Contact: Contact Person     39-2-26-43-27-54        
Misericordia e Dolce Hospital Recruiting
Prato, Italy, 59100
Contact: Contact Person     39-574-43-47-66        
Ospedale Pistoia Recruiting
Pistoia, Italy, Pistoia
Contact: Contact Person     39-573-3521        
Ospedale Santa Croce Recruiting
Cuneo, Italy, 12100
Contact: Contact Person     39-171-44-13-09        
Ospendale S. Andrea EST Recruiting
La Spezia, Italy, 19100
Contact: Contact Person     39-187-53-33-15        
Presidio Ospedaliero di Livorno Recruiting
Livorno, Italy, 57100
Contact: Contact Person     39-58-622-3189        
Centro di Riferimento Oncologico - Aviano Recruiting
Aviano, Italy, 33081
Contact: Contact Person     39-43-46-59-111        
Sponsors and Collaborators
Gruppo Oncologico del Nord-Ovest
Investigators
Principal Investigator: Alfredo Falcone, MD Presidio Ospedaliero di Livorno
  More Information

Additional Information:
No publications provided

Study ID Numbers: CDR0000598582, GONO-TRIBE, ASL608LIOM04, EUDRACT:2008-001537-10
Study First Received: July 19, 2008
Last Updated: February 14, 2009
ClinicalTrials.gov Identifier: NCT00719797     History of Changes
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
stage IV rectal cancer
stage IV colon cancer
stage III rectal cancer
stage III colon cancer

Study placed in the following topic categories:
Antimetabolites
Immunologic Factors
Gastrointestinal Diseases
Rectal Neoplasms
Colonic Diseases
Irinotecan
Leucovorin
Bevacizumab
Rectal Diseases
Oxaliplatin
Vitamins
Micronutrients
Digestive System Neoplasms
Vitamin B Complex
Rectal Neoplasm
Trace Elements
Intestinal Diseases
Angiogenesis Inhibitors
Immunosuppressive Agents
Intestinal Neoplasms
Camptothecin
Calcium, Dietary
Rectal Cancer
Digestive System Diseases
Fluorouracil
Gastrointestinal Neoplasms
Antineoplastic Agents, Phytogenic
Colorectal Neoplasms

Additional relevant MeSH terms:
Antimetabolites
Antimetabolites, Antineoplastic
Molecular Mechanisms of Pharmacological Action
Immunologic Factors
Gastrointestinal Diseases
Antineoplastic Agents
Physiological Effects of Drugs
Colonic Diseases
Irinotecan
Leucovorin
Bevacizumab
Rectal Diseases
Oxaliplatin
Neoplasms by Site
Vitamins
Therapeutic Uses
Growth Inhibitors
Angiogenesis Modulating Agents
Micronutrients
Vitamin B Complex
Digestive System Neoplasms
Growth Substances
Enzyme Inhibitors
Intestinal Diseases
Angiogenesis Inhibitors
Immunosuppressive Agents
Intestinal Neoplasms
Camptothecin
Pharmacologic Actions
Neoplasms

ClinicalTrials.gov processed this record on May 07, 2009