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Neoadjuvant Cetuximab, Fluorouracil, and Pelvic Irradiation in Treating Patients With Locally Advanced or Locally Recurrent Rectal Cancer

Primary Purpose

Colorectal Cancer

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
cetuximab
fluorouracil
neoadjuvant therapy
radiation therapy
Sponsored by
Memorial Sloan Kettering Cancer Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

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

Eligibility Criteria

18 Years - 120 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

DISEASE CHARACTERISTICS: Histologically confirmed rectal adenocarcinoma meeting 1 of the following staging criteria: Locally advanced disease Resectable (uT3) disease Primary gross transmural tumor that is not adherent to adjacent pelvic structures by endorectal ultrasound Primary tethered or unresectable (cT4 or uT4) disease Primary tumor is contiguous with or adherent or fixed to adjacent pelvic structures by clinical exam and CT scan Primary surgery would likely leave residual tumor Small volume extrapelvic metastases allowed Recurrent disease after definitive resection Disease limited to the pelvis Requires combined modality treatment Epidermal growth factor receptor status-positive, -negative, or -unknown If previously treated with adjuvant fluorouracil-based chemotherapy, no disease recurrence during or within 12 months after completion of adjuvant therapy PATIENT CHARACTERISTICS: Age 18 and over Performance status ECOG 0 -1 Life expectancy Not specified Hematopoietic Absolute neutrophil count ≥ 1,500/mm^3 Hemoglobin > 8.0 g/dL Platelet count > 150,000/mm^3 Hepatic Not specified Renal Creatinine ≤ 1.5 times upper limit of normal Cardiovascular No myocardial infarction within the past 6 months No evidence of uncontrolled congestive heart failure requiring therapy Other No other malignancy within the past 5 years except adequately treated basal cell or squamous cell skin cancer or carcinoma in situ of the cervix No known severe hypersensitivity to cetuximab or any of its excipients No uncontrolled infection No high-grade bowel obstruction (bowel lumen ≤ 1 cm) unless patient has undergone protective surgical diversion or endoscopic stenting procedure No other concurrent medical or psychiatric condition or disease that would preclude study participation HIV negative Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception during and for at least 3 months after study treatment PRIOR CONCURRENT THERAPY: Biologic therapy No prior cetuximab No prior murine or chimeric monoclonal antibody therapy No prior biological response modifiers for metastatic colorectal cancer No concurrent anti-vascular endothelial growth factor/Flk-1 monoclonal antibody therapy No other concurrent antibody therapy or immunotherapy No concurrent gene therapy No concurrent vaccine therapy No concurrent angiogenesis inhibitors, including thalidomide Chemotherapy See Disease Characteristics No prior chemotherapy for metastatic colorectal cancer No other concurrent chemotherapy Endocrine therapy No concurrent hormonal therapy Radiotherapy No prior radiotherapy for metastatic colorectal cancer No prior pelvic radiotherapy No other concurrent radiotherapy Surgery See Disease Characteristics Fully recovered from prior oncologic or other major surgery Other No other prior therapy that targets the epidermal growth factor receptor pathway No other concurrent experimental therapy or drugs No concurrent matrix metalloprotease inhibitors No concurrent participation in another clinical study

Sites / Locations

  • Memorial Sloan-Kettering Cancer Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Cetuximab, Fluorouracil, and Pelvic Irradiation

Arm Description

Patients receive cetuximab IV over 1-2 hours on days 1, 8, 15, 22, 29, 36, 43, 50, 57, and 64 and fluorouracil IV continuously on days 1-42. Patients undergo whole-pelvic radiotherapy once daily on days 1-5, 8-12, 15-19, 22-26, 29-33, and 36-40. Treatment continues in the absence of disease progression or unacceptable toxicity. Approximately 1-3 weeks after completion of study treatment, patients undergo surgical resection followed by adjuvant chemotherapy off-study. Patients are followed for up to 5 years.

Outcomes

Primary Outcome Measures

Safety profile

Secondary Outcome Measures

Activity in terms of pathological complete response rate

Full Information

First Posted
June 10, 2004
Last Updated
December 21, 2015
Sponsor
Memorial Sloan Kettering Cancer Center
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00084773
Brief Title
Neoadjuvant Cetuximab, Fluorouracil, and Pelvic Irradiation in Treating Patients With Locally Advanced or Locally Recurrent Rectal Cancer
Official Title
A Pilot Clinical Trial of Preoperative Cetuximab With Concurrent Continuous Infusion Fluorouracil and Pelvic Radiation in Patients With Local-Regionally Advanced Rectal Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
December 2015
Overall Recruitment Status
Completed
Study Start Date
March 2004 (undefined)
Primary Completion Date
January 2007 (Actual)
Study Completion Date
March 2010 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Memorial Sloan Kettering Cancer Center
Collaborators
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
RATIONALE: Monoclonal antibodies such as cetuximab can locate tumor cells and either kill them or deliver tumor-killing substances to them without harming normal cells. Drugs used in chemotherapy such as fluorouracil work in different ways to stop tumor cells from dividing so they stop growing or die. Radiation therapy uses high-energy x-rays to damage tumor cells. Giving cetuximab with fluorouracil and radiation therapy may kill more tumor cells.
Detailed Description
OBJECTIVES: Primary Determine the safety profile of neoadjuvant cetuximab, fluorouracil, and pelvic irradiation in patients with locally advanced or locally recurrent rectal cancer. Secondary Determine the activity of this regimen, in terms of pathological complete response rate, in these patients. OUTLINE: This is a non-randomized, open-label, pilot study. Patients receive cetuximab IV over 1-2 hours on days 1, 8, 15, 22, 29, 36, 43, 50, 57, and 64 and fluorouracil IV continuously on days 1-42. Patients undergo whole-pelvic radiotherapy once daily on days 1-5, 8-12, 15-19, 22-26, 29-33, and 36-40. Treatment continues in the absence of disease progression or unacceptable toxicity. Approximately 1-3 weeks after completion of study treatment, patients undergo surgical resection followed by adjuvant chemotherapy off-study. Patients are followed for up to 5 years.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
28 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Cetuximab, Fluorouracil, and Pelvic Irradiation
Arm Type
Experimental
Arm Description
Patients receive cetuximab IV over 1-2 hours on days 1, 8, 15, 22, 29, 36, 43, 50, 57, and 64 and fluorouracil IV continuously on days 1-42. Patients undergo whole-pelvic radiotherapy once daily on days 1-5, 8-12, 15-19, 22-26, 29-33, and 36-40. Treatment continues in the absence of disease progression or unacceptable toxicity. Approximately 1-3 weeks after completion of study treatment, patients undergo surgical resection followed by adjuvant chemotherapy off-study. Patients are followed for up to 5 years.
Intervention Type
Biological
Intervention Name(s)
cetuximab
Intervention Type
Drug
Intervention Name(s)
fluorouracil
Intervention Type
Procedure
Intervention Name(s)
neoadjuvant therapy
Intervention Type
Radiation
Intervention Name(s)
radiation therapy
Primary Outcome Measure Information:
Title
Safety profile
Time Frame
2 years
Secondary Outcome Measure Information:
Title
Activity in terms of pathological complete response rate
Time Frame
2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
120 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically confirmed rectal adenocarcinoma meeting 1 of the following staging criteria: Locally advanced disease Resectable (uT3) disease Primary gross transmural tumor that is not adherent to adjacent pelvic structures by endorectal ultrasound Primary tethered or unresectable (cT4 or uT4) disease Primary tumor is contiguous with or adherent or fixed to adjacent pelvic structures by clinical exam and CT scan Primary surgery would likely leave residual tumor Small volume extrapelvic metastases allowed Recurrent disease after definitive resection Disease limited to the pelvis Requires combined modality treatment Epidermal growth factor receptor status-positive, -negative, or -unknown If previously treated with adjuvant fluorouracil-based chemotherapy, no disease recurrence during or within 12 months after completion of adjuvant therapy PATIENT CHARACTERISTICS: Age 18 and over Performance status ECOG 0 -1 Life expectancy Not specified Hematopoietic Absolute neutrophil count ≥ 1,500/mm^3 Hemoglobin > 8.0 g/dL Platelet count > 150,000/mm^3 Hepatic Not specified Renal Creatinine ≤ 1.5 times upper limit of normal Cardiovascular No myocardial infarction within the past 6 months No evidence of uncontrolled congestive heart failure requiring therapy Other No other malignancy within the past 5 years except adequately treated basal cell or squamous cell skin cancer or carcinoma in situ of the cervix No known severe hypersensitivity to cetuximab or any of its excipients No uncontrolled infection No high-grade bowel obstruction (bowel lumen ≤ 1 cm) unless patient has undergone protective surgical diversion or endoscopic stenting procedure No other concurrent medical or psychiatric condition or disease that would preclude study participation HIV negative Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception during and for at least 3 months after study treatment PRIOR CONCURRENT THERAPY: Biologic therapy No prior cetuximab No prior murine or chimeric monoclonal antibody therapy No prior biological response modifiers for metastatic colorectal cancer No concurrent anti-vascular endothelial growth factor/Flk-1 monoclonal antibody therapy No other concurrent antibody therapy or immunotherapy No concurrent gene therapy No concurrent vaccine therapy No concurrent angiogenesis inhibitors, including thalidomide Chemotherapy See Disease Characteristics No prior chemotherapy for metastatic colorectal cancer No other concurrent chemotherapy Endocrine therapy No concurrent hormonal therapy Radiotherapy No prior radiotherapy for metastatic colorectal cancer No prior pelvic radiotherapy No other concurrent radiotherapy Surgery See Disease Characteristics Fully recovered from prior oncologic or other major surgery Other No other prior therapy that targets the epidermal growth factor receptor pathway No other concurrent experimental therapy or drugs No concurrent matrix metalloprotease inhibitors No concurrent participation in another clinical study
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Leonard B. Saltz, MD
Organizational Affiliation
Memorial Sloan Kettering Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Memorial Sloan-Kettering Cancer Center
City
New York
State/Province
New York
ZIP/Postal Code
10021
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Neoadjuvant Cetuximab, Fluorouracil, and Pelvic Irradiation in Treating Patients With Locally Advanced or Locally Recurrent Rectal Cancer

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