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Bevacizumab Plus Fluorouracil and Leucovorin in Treating Patients With Locally Advanced or Metastatic Stage IV Colorectal Cancer That Has Progressed After Standard Chemotherapy

Primary Purpose

Colorectal Cancer

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
bevacizumab
fluorouracil
leucovorin calcium
Sponsored by
National Cancer Institute (NCI)
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Colorectal Cancer focused on measuring adenocarcinoma of the colon, adenocarcinoma of the rectum, stage IV rectal cancer, recurrent rectal cancer, stage IV colon cancer, recurrent colon cancer

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

DISEASE CHARACTERISTICS: Histologically or cytologically confirmed colorectal adenocarcinoma Stage IV (metastatic) disease Not curable by surgery or radiotherapy Must have received prior standard chemotherapy regimens, including oxaliplatin and irinotecan, and meet both of the following criteria: Disease progression during or after irinotecan-based chemotherapy for metastatic disease OR relapsed disease within 6 months after adjuvant irinotecan-based therapy Disease progression during or after oxaliplatin-based chemotherapy for metastatic disease OR relapsed disease within 6 months after adjuvant oxaliplatin-based therapy No brain metastases PATIENT CHARACTERISTICS: Age 18 and over Performance status ECOG 0-2 OR Karnofsky 60-100% Life expectancy Not specified Hematopoietic Absolute granulocyte count at least 1,500/mm^3 Platelet count at least 100,000/mm^3 Hemoglobin at least 9 g/dL (transfusion allowed) No evidence of bleeding diathesis or coagulopathy Hepatic Bilirubin no greater than 1.5 mg/dL AST less than 5 times upper limit of normal (ULN) Alkaline phosphatase less than 5 times ULN PT and INR no greater than 1.5 times ULN PTT no greater than ULN Renal Creatinine no greater than 1.5 times ULN Proteinuria less than grade 1 OR Proteinuria less than 500 mg/24 hours Cardiovascular No prior stroke No uncontrolled high blood pressure No symptomatic congestive heart failure No unstable angina pectoris No cardiac arrhythmia No myocardial infarction within the past 6 months No New York Heart Association class III or IV heart disease No thromboembolism within the past 6 months Other Chemonaive Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception during and for at least 3 months after study participation No significant traumatic injury within the past 6 weeks No prior allergic reaction attributed to compounds of similar chemical or biological composition to bevacizumab or other study agents No active infection No psychiatric illness or social situation that would preclude study compliance No serious nonhealing wound (including wounds healing by secondary intention), ulcer, or bone fracture No CNS disease, including either of the following: Primary brain tumor Seizures not controlled with standard medical therapy PRIOR CONCURRENT THERAPY: Biologic therapy At least 8 weeks since prior monoclonal antibody therapy No prior bevacizumab Chemotherapy See Disease Characteristics Endocrine therapy Not specified Radiotherapy At least 4 weeks since prior major radiotherapy (e.g., chest or bone palliative radiotherapy) Surgery More than 6 weeks since prior major surgical procedure or open biopsy More than 7 days since prior fine needle aspiration or core biopsy No concurrent surgery Other Recovered from prior therapy At least 3 weeks since prior cytotoxic agents No concurrent therapeutic anticoagulation Prophylactic anticoagulation of venous access devices allowed provided PT/INR or PTT criteria are met No concurrent chronic aspirin (greater than 325 mg/day) or nonsteroidal anti-inflammatory drugs No concurrent combination antiretroviral therapy for HIV-positive patients No other concurrent investigational or commercial agents for the malignancy

Sites / Locations

  • Providence Alaska Medical Center
  • Jonsson Comprehensive Cancer Center, UCLA
  • USC/Norris Comprehensive Cancer Center and Hospital
  • University of Colorado Cancer Center at University of Colorado Health Sciences Center
  • Yale Comprehensive Cancer Center
  • Lombardi Cancer Center
  • CCOP - Atlanta Regional
  • Robert H. Lurie Comprehensive Cancer Center, Northwestern University
  • Loyola University Medical Center
  • Holden Comprehensive Cancer Center
  • Siouxland Hematology-Oncology
  • CCOP - Wichita
  • Cancer Care of Maine
  • Saint Joseph Mercy Health System
  • St. Mary's/Duluth Clinic Cancer Center
  • University of Mississippi Medical Center
  • CCOP - Montana Cancer Consortium
  • Southern Nevada Cancer Research Foundation
  • Norris Cotton Cancer Center
  • Roswell Park Cancer Institute
  • New York Weill Cornell Cancer Center at Cornell University
  • Duke Comprehensive Cancer Center
  • Comprehensive Cancer Center at Wake Forest University
  • Meritcare Roger Maris Cancer Center
  • Ireland Cancer Center
  • University of Oklahoma Health Sciences Center
  • Abramson Cancer Center of the University of Pennsylvania
  • Kimmel Cancer Center of Thomas Jefferson University - Philadelphia
  • Sioux Valley Clinics - Oncology
  • Fletcher Allen Health Care - University Health Center Campus
  • Massey Cancer Center
  • CCOP - Virginia Mason Research Center
  • Seattle Cancer Care Alliance

Outcomes

Primary Outcome Measures

Secondary Outcome Measures

Full Information

First Posted
August 6, 2003
Last Updated
June 18, 2013
Sponsor
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00066846
Brief Title
Bevacizumab Plus Fluorouracil and Leucovorin in Treating Patients With Locally Advanced or Metastatic Stage IV Colorectal Cancer That Has Progressed After Standard Chemotherapy
Official Title
A Multicenter Study of the Anti-VEGF Monoclonal Antibody Bevacizumab (Avastin®) Plus 5-Fluorouracil/Leucovorin in Patients With Metastatic Colorectal Cancers That Have Progressed After Standard Chemotherapy
Study Type
Interventional

2. Study Status

Record Verification Date
April 2004
Overall Recruitment Status
Completed
Study Start Date
August 2003 (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
July 2007 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
RATIONALE: Bevacizumab may stop the growth of tumor cells by blocking the enzymes necessary for cancer cell growth. Drugs used in chemotherapy such as fluorouracil and leucovorin use different ways to stop tumor cells from dividing so they stop growing or die. Combining bevacizumab with fluorouracil and leucovorin may kill more tumor cells. PURPOSE: Phase II trial to study the effectiveness of combining bevacizumab with fluorouracil and leucovorin in treating patients who have locally advanced or metastatic stage IV colorectal cancer that has progressed after standard chemotherapy.
Detailed Description
OBJECTIVES: Determine the response rate of patients treated with bevacizumab, fluorouracil, and leucovorin calcium for stage IV colorectal cancer that has progressed after standard chemotherapy. Determine the time to progression and overall survival of patients treated with this regimen. Determine the safety of administering "bolus" and continuous infusion fluorouracil and leucovorin calcium in patients treated with this regimen. OUTLINE: This is an open-label, multicenter study. Patients receive 1 of 2 treatment regimens. Regimen I: Patients receive bevacizumab IV on days 1, 15, 29, and 42 (every 2 weeks) and leucovorin calcium (CF) IV over 2 hours and fluorouracil (5-FU) IV bolus on days 1, 8, 15, 22, 29, and 36. Regimen II: Patients receive bevacizumab as in regimen I and CF IV over 2 hours and 5-FU IV bolus followed by a continuous infusion over 22 hours on days 1, 2, 15, 16, 29, 30, 43, and 44. For both regimens, courses repeat every 8 weeks in the absence of disease progression or unacceptable toxicity. Patients are followed for tumor response and survival. PROJECTED ACCRUAL: Various NCI-designated Clinical Cancer Centers and other medical institutions across the United States will participate in this study. A total of 35-125 patients will be accrued for this study within 3 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Colorectal Cancer
Keywords
adenocarcinoma of the colon, adenocarcinoma of the rectum, stage IV rectal cancer, recurrent rectal cancer, stage IV colon cancer, recurrent colon cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Masking
None (Open Label)

8. Arms, Groups, and Interventions

Intervention Type
Biological
Intervention Name(s)
bevacizumab
Intervention Type
Drug
Intervention Name(s)
fluorouracil
Intervention Type
Drug
Intervention Name(s)
leucovorin calcium

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically or cytologically confirmed colorectal adenocarcinoma Stage IV (metastatic) disease Not curable by surgery or radiotherapy Must have received prior standard chemotherapy regimens, including oxaliplatin and irinotecan, and meet both of the following criteria: Disease progression during or after irinotecan-based chemotherapy for metastatic disease OR relapsed disease within 6 months after adjuvant irinotecan-based therapy Disease progression during or after oxaliplatin-based chemotherapy for metastatic disease OR relapsed disease within 6 months after adjuvant oxaliplatin-based therapy No brain metastases PATIENT CHARACTERISTICS: Age 18 and over Performance status ECOG 0-2 OR Karnofsky 60-100% Life expectancy Not specified Hematopoietic Absolute granulocyte count at least 1,500/mm^3 Platelet count at least 100,000/mm^3 Hemoglobin at least 9 g/dL (transfusion allowed) No evidence of bleeding diathesis or coagulopathy Hepatic Bilirubin no greater than 1.5 mg/dL AST less than 5 times upper limit of normal (ULN) Alkaline phosphatase less than 5 times ULN PT and INR no greater than 1.5 times ULN PTT no greater than ULN Renal Creatinine no greater than 1.5 times ULN Proteinuria less than grade 1 OR Proteinuria less than 500 mg/24 hours Cardiovascular No prior stroke No uncontrolled high blood pressure No symptomatic congestive heart failure No unstable angina pectoris No cardiac arrhythmia No myocardial infarction within the past 6 months No New York Heart Association class III or IV heart disease No thromboembolism within the past 6 months Other Chemonaive Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception during and for at least 3 months after study participation No significant traumatic injury within the past 6 weeks No prior allergic reaction attributed to compounds of similar chemical or biological composition to bevacizumab or other study agents No active infection No psychiatric illness or social situation that would preclude study compliance No serious nonhealing wound (including wounds healing by secondary intention), ulcer, or bone fracture No CNS disease, including either of the following: Primary brain tumor Seizures not controlled with standard medical therapy PRIOR CONCURRENT THERAPY: Biologic therapy At least 8 weeks since prior monoclonal antibody therapy No prior bevacizumab Chemotherapy See Disease Characteristics Endocrine therapy Not specified Radiotherapy At least 4 weeks since prior major radiotherapy (e.g., chest or bone palliative radiotherapy) Surgery More than 6 weeks since prior major surgical procedure or open biopsy More than 7 days since prior fine needle aspiration or core biopsy No concurrent surgery Other Recovered from prior therapy At least 3 weeks since prior cytotoxic agents No concurrent therapeutic anticoagulation Prophylactic anticoagulation of venous access devices allowed provided PT/INR or PTT criteria are met No concurrent chronic aspirin (greater than 325 mg/day) or nonsteroidal anti-inflammatory drugs No concurrent combination antiretroviral therapy for HIV-positive patients No other concurrent investigational or commercial agents for the malignancy
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Helen X. Chen, MD
Organizational Affiliation
NCI - Investigational Drug Branch
Official's Role
Principal Investigator
Facility Information:
Facility Name
Providence Alaska Medical Center
City
Anchorage
State/Province
Alaska
ZIP/Postal Code
99519-6604
Country
United States
Facility Name
Jonsson Comprehensive Cancer Center, UCLA
City
Los Angeles
State/Province
California
ZIP/Postal Code
90024
Country
United States
Facility Name
USC/Norris Comprehensive Cancer Center and Hospital
City
Los Angeles
State/Province
California
ZIP/Postal Code
90033-0804
Country
United States
Facility Name
University of Colorado Cancer Center at University of Colorado Health Sciences Center
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80010
Country
United States
Facility Name
Yale Comprehensive Cancer Center
City
New Haven
State/Province
Connecticut
ZIP/Postal Code
06520-8028
Country
United States
Facility Name
Lombardi Cancer Center
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20007
Country
United States
Facility Name
CCOP - Atlanta Regional
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30342-1701
Country
United States
Facility Name
Robert H. Lurie Comprehensive Cancer Center, Northwestern University
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
Loyola University Medical Center
City
Maywood
State/Province
Illinois
ZIP/Postal Code
60153
Country
United States
Facility Name
Holden Comprehensive Cancer Center
City
Iowa City
State/Province
Iowa
ZIP/Postal Code
52242-1009
Country
United States
Facility Name
Siouxland Hematology-Oncology
City
Sioux City
State/Province
Iowa
ZIP/Postal Code
51101-1733
Country
United States
Facility Name
CCOP - Wichita
City
Wichita
State/Province
Kansas
ZIP/Postal Code
67214-3882
Country
United States
Facility Name
Cancer Care of Maine
City
Bangor
State/Province
Maine
ZIP/Postal Code
04401
Country
United States
Facility Name
Saint Joseph Mercy Health System
City
Ann Arbor
State/Province
Michigan
ZIP/Postal Code
48106
Country
United States
Facility Name
St. Mary's/Duluth Clinic Cancer Center
City
Duluth
State/Province
Minnesota
ZIP/Postal Code
55805
Country
United States
Facility Name
University of Mississippi Medical Center
City
Jackson
State/Province
Mississippi
ZIP/Postal Code
39216-4505
Country
United States
Facility Name
CCOP - Montana Cancer Consortium
City
Billings
State/Province
Montana
ZIP/Postal Code
59101
Country
United States
Facility Name
Southern Nevada Cancer Research Foundation
City
Las Vegas
State/Province
Nevada
ZIP/Postal Code
89106
Country
United States
Facility Name
Norris Cotton Cancer Center
City
Lebanon
State/Province
New Hampshire
ZIP/Postal Code
03756-0002
Country
United States
Facility Name
Roswell Park Cancer Institute
City
Buffalo
State/Province
New York
ZIP/Postal Code
14263-0001
Country
United States
Facility Name
New York Weill Cornell Cancer Center at Cornell University
City
New York
State/Province
New York
ZIP/Postal Code
10021
Country
United States
Facility Name
Duke Comprehensive Cancer Center
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27710
Country
United States
Facility Name
Comprehensive Cancer Center at Wake Forest University
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27157-1082
Country
United States
Facility Name
Meritcare Roger Maris Cancer Center
City
Fargo
State/Province
North Dakota
ZIP/Postal Code
58122
Country
United States
Facility Name
Ireland Cancer Center
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44106-5065
Country
United States
Facility Name
University of Oklahoma Health Sciences Center
City
Oklahoma City
State/Province
Oklahoma
ZIP/Postal Code
73104
Country
United States
Facility Name
Abramson Cancer Center of the University of Pennsylvania
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
Kimmel Cancer Center of Thomas Jefferson University - Philadelphia
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19107-5541
Country
United States
Facility Name
Sioux Valley Clinics - Oncology
City
Sioux Falls
State/Province
South Dakota
ZIP/Postal Code
57104
Country
United States
Facility Name
Fletcher Allen Health Care - University Health Center Campus
City
Burlington
State/Province
Vermont
ZIP/Postal Code
05401
Country
United States
Facility Name
Massey Cancer Center
City
Richmond
State/Province
Virginia
ZIP/Postal Code
23298-0037
Country
United States
Facility Name
CCOP - Virginia Mason Research Center
City
Seattle
State/Province
Washington
ZIP/Postal Code
98101
Country
United States
Facility Name
Seattle Cancer Care Alliance
City
Seattle
State/Province
Washington
ZIP/Postal Code
98109
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
16849749
Citation
Chen HX, Mooney M, Boron M, Vena D, Mosby K, Grochow L, Jaffe C, Rubinstein L, Zwiebel J, Kaplan RS. Phase II multicenter trial of bevacizumab plus fluorouracil and leucovorin in patients with advanced refractory colorectal cancer: an NCI Treatment Referral Center Trial TRC-0301. J Clin Oncol. 2006 Jul 20;24(21):3354-60. doi: 10.1200/JCO.2005.05.1573.
Results Reference
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Bevacizumab Plus Fluorouracil and Leucovorin in Treating Patients With Locally Advanced or Metastatic Stage IV Colorectal Cancer That Has Progressed After Standard Chemotherapy

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