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Combination Chemotherapy and Cetuximab as First-Line Therapy in Treating Patients With Advanced and/or Metastatic Colorectal Cancer
This study is currently recruiting participants.
Verified by National Cancer Institute (NCI), December 2008
First Received: March 19, 2008   Last Updated: March 28, 2009   History of Changes
Sponsored by: Medical Research Council
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00640081
  Purpose

RATIONALE: Drugs used in chemotherapy 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 cetuximab, 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. It is not yet known whether giving combination chemotherapy together with intermittent cetuximab is more effective than combination chemotherapy given together with continuous cetuximab in treating colorectal cancer.

PURPOSE: This randomized phase II trial is studying giving combination chemotherapy together with intermittent cetuximab to see how well it works compared to combination chemotherapy given together with continuous cetuximab as first-line therapy in treating patients with advanced or metastatic colorectal cancer.


Condition Intervention Phase
Colorectal Cancer
Biological: cetuximab
Drug: capecitabine
Drug: fluorouracil
Drug: leucovorin calcium
Drug: oxaliplatin
Other: immunohistochemistry staining method
Other: laboratory biomarker analysis
Phase II

MedlinePlus related topics: Cancer Colorectal Cancer
Drug Information available for: Fluorouracil Leucovorin Citrovorum factor Oxaliplatin Capecitabine Cetuximab Leucovorin Calcium Folinic acid calcium salt pentahydrate
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Randomized, Open Label
Official Title: A Two-Arm Phase II Randomised Trial of Intermittent Chemotherapy Plus Continuous Cetuximab and of Intermittent Chemotherapy Plus Intermittent Cetuximab in First Line Treatment of Metastatic Colorectal Cancer

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

Primary Outcome Measures:
  • Failure-free survival at 10 months [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Safety of cetuximab reintroduction, in terms of risk of grade 3-4 allergic reactions [ Designated as safety issue: Yes ]
  • Proportion of patients achieving disease control (complete response plus partial response plus stable disease) at 24 weeks [ Designated as safety issue: No ]
  • Overall survival [ Designated as safety issue: No ]
  • Progression-free survival [ Designated as safety issue: No ]
  • Response rates at 12, 24, and 36 weeks [ Designated as safety issue: No ]
  • Toxicity of each treatment regimen by NCI CTCAE v3.0 [ Designated as safety issue: Yes ]

Estimated Enrollment: 136
Study Start Date: July 2007
Estimated Primary Completion Date: June 2008 (Final data collection date for primary outcome measure)
  Show Detailed Description

  Eligibility

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

DISEASE CHARACTERISTICS:

  • Diagnosis of colorectal adenocarcinoma, defined by 1 of the following:

    • Prior or current histologically confirmed primary adenocarcinoma of colon or rectum with clinical or radiological evidence of advanced and/or metastatic disease
    • Histologically and cytologically confirmed metastatic adenocarcinoma with clinical and/or radiological evidence of colorectal primary tumor
  • Unidimensionally measurable disease by RECIST criteria
  • Inoperable metastatic or locoregional disease

    • Potentially resectable liver metastases allowed provided the following criteria are met:

      • Fewer than 4 unilobar liver metastases, each < 4 cm in size and without major vascular involvement
      • No combination chemotherapy allowed prior to the planned resection of operable liver metastases
  • No brain metastases

PATIENT CHARACTERISTICS:

  • WHO performance status 0-2
  • Must be considered fit to undergo combination chemotherapy
  • ANC ≥ 1,500/mm³
  • Platelet count ≥ 100,000/mm³
  • Serum bilirubin ≤ 1.25 times upper limit of normal (ULN)
  • Alkaline phosphatase ≤ 5 times ULN
  • AST or ALT ≤ 2.5 times ULN
  • Creatinine clearance ≥ 50mL/min OR glomerular filtration rate ≥ 50 mL/min
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • No severe uncontrolled concurrent medical illness (including poorly controlled angina or myocardial infarction within the past 12 weeks) likely to interfere with protocol treatments
  • No psychiatric or neurological condition that would preclude study compliance with oral medication or giving informed consent
  • No partial or complete bowel obstruction
  • No preexisting neuropathy > grade 1
  • No prior or current malignant disease which, in the judgement of the treating investigator, is likely to interfere with COIN-B treatment or assessment of response
  • No patients with known hypersensitivity reactions to any of the components of the study treatments
  • No proven dihydropyrimidine dehydrogenase deficiency (DPD) or personal or family history of DPD

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • No prior systemic palliative chemotherapy for metastatic disease
  • No prior oxaliplatin
  • More than 1 month since prior adjuvant chemotherapy comprising fluorouracil (with or without leucovorin calcium), capecitabine, or irinotecan hydrochloride
  • More than 1 month since prior chemoradiotherapy comprising fluorouracil (with or without leucovorin calcium) or capecitabine for rectal cancer
  • No ongoing requirement for contraindicated concurrent medication
  • No concurrent enrollment in any type of study other than observational studies
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00640081

Locations
United Kingdom, England
Bradford Royal Infirmary Recruiting
Bradford, England, United Kingdom, BD9 6RJ
Contact: Contact Person     44-1274-364-273     chris.bradley@bradfordhospitals.nhs.uk    
Charing Cross Hospital Recruiting
London, England, United Kingdom, W6 8RF
Contact: Contact Person     44-208-846-1732     charles.lowdell@imperial.nhs.uk    
Cheltenham General Hospital Recruiting
Cheltenham, England, United Kingdom, GL53 7AN
Contact: Contact Person     44-845-422-3510     kimbenstead@glos.nhs.uk    
Churchill Hospital Recruiting
Oxford, England, United Kingdom, OX3 7LJ
Contact: Contact Person     44-1865-225-681     andrew.weaver@orh.nhs.uk    
Peterborough Hospitals Trust Recruiting
Peterborough, England, United Kingdom, PE3 6DA
Contact: Contact Person     4-1733-874-095     Karen.McAdam@pbh-tr.nhs.uk    
Essex County Hospital Recruiting
Colchester, England, United Kingdom, C03 3NB
Contact: Contact Person     44-1206-744-438     bruce.sizer@colchesterhospital.nhs.uk    
Hammersmith Hospital Recruiting
London, England, United Kingdom, W12 OHS
Contact: Contact Person     44-208-383-3057     wasan@cancer.org.uk    
Dorset County Hospital Recruiting
Dorset, England, United Kingdom, DT1 2JY
Contact: Contact Person     44-1305-251-150     rjo2004@btinternet.com    
Princess Royal Hospital at Hull and East Yorkshire NHS Trust Recruiting
Hull, England, United Kingdom, HU8 9HE
Contact: Contact Person     44-1482-676-703     anthony.maraveyas@hey.nhs.uk    
St. Luke's Cancer Centre at Royal Surrey County Hospital Recruiting
Guildford, England, United Kingdom, GU2 7XX
Contact: Contact Person     44-1483-406-874     gary.middleton@royalsurrey.nhs.uk    
St. Mary's Hospital Recruiting
London, England, United Kingdom, W2 1NY
Contact: Contact Person     44-207-886-1132     s.cleator@imperial.ac.uk    
University Hospital of North Staffordshire Recruiting
Stoke-On-Trent, England, United Kingdom, ST4 7LN
Contact: Contact Person     44-1782-554-176     fawzi.adab@uhns.nhs.uk    
United Kingdom, Wales
Wrexham Maelor Hospital Recruiting
Wrexham, Wales, United Kingdom, LL13 7TD
Contact: Contact Person     44-1745-445-161     simon.gollins@cd-tr.wales.nhs.uk    
Singleton Hospital Recruiting
Swansea, Wales, United Kingdom, SA2 8QA
Contact: Contact Person     44-1792-285-318     john.wagstaff@swansea-tr.wales.nhs.uk    
Velindre Cancer Center at Velindre Hospital Recruiting
Cardiff, Wales, United Kingdom, CF14 2TL
Contact: Contact Person     44-2920-615-888     tim.maughan@velindre-tr.wales.nhs.uk    
Glan Clwyd Hospital Recruiting
Rhyl, Wales, United Kingdom, LL 18 5UJ
Contact: Contact Person     44-1745-445-715     simon.gollins@cd-tr.wales.nhs.uk    
Sponsors and Collaborators
Medical Research Council
Investigators
Principal Investigator: Harpreet S. Wasan Hammersmith Hospital
  More Information

Additional Information:
No publications provided

Study ID Numbers: CDR0000589635, MRC-CTU-COIN-B/CR11, EUDRACT:2006-003049-17, ISRCTN38375681, EU-20828, MERCK-MRC-CTU-COIN-B/CR11
Study First Received: March 19, 2008
Last Updated: March 28, 2009
ClinicalTrials.gov Identifier: NCT00640081     History of Changes
Health Authority: Unspecified

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

Study placed in the following topic categories:
Antimetabolites
Immunologic Factors
Gastrointestinal Diseases
Rectal Neoplasms
Colonic Diseases
Leucovorin
Rectal Diseases
Oxaliplatin
Vitamins
Micronutrients
Capecitabine
Digestive System Neoplasms
Vitamin B Complex
Cetuximab
Rectal Neoplasm
Trace Elements
Intestinal Diseases
Immunosuppressive Agents
Intestinal Neoplasms
Recurrence
Calcium, Dietary
Rectal Cancer
Digestive System Diseases
Fluorouracil
Gastrointestinal Neoplasms
Adenocarcinoma
Colorectal Neoplasms

Additional relevant MeSH terms:
Antimetabolites
Antimetabolites, Antineoplastic
Molecular Mechanisms of Pharmacological Action
Immunologic Factors
Gastrointestinal Diseases
Antineoplastic Agents
Colonic Diseases
Physiological Effects of Drugs
Leucovorin
Rectal Diseases
Oxaliplatin
Neoplasms by Site
Vitamins
Therapeutic Uses
Micronutrients
Capecitabine
Vitamin B Complex
Digestive System Neoplasms
Growth Substances
Cetuximab
Intestinal Diseases
Immunosuppressive Agents
Intestinal Neoplasms
Pharmacologic Actions
Neoplasms
Digestive System Diseases
Fluorouracil
Gastrointestinal Neoplasms
Colorectal Neoplasms

ClinicalTrials.gov processed this record on May 06, 2009