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FLOX in Combination With Cetuximab in First-line Treatment of Colorectal Cancer

Primary Purpose

Metastatic Colorectal Cancer

Status
Completed
Phase
Phase 3
Locations
Norway
Study Type
Interventional
Intervention
FLOX (5-fluorouracil/folinic acid/oxaliplatin)
FLOX (5-fluorouracil/folinic acid/oxaliplatin) and Cetuximab
FLOX (5-fluorouracil and folinic acid and oxaliplatin) intermittently and maintenance cetuximab
Sponsored by
The Nordic Colorectal Cancer Biomodulation Group
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Metastatic Colorectal Cancer focused on measuring Metastatic colorectal cancer, FLOX, Cetuximab

Eligibility Criteria

18 Years - 74 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Histology and staging disease: Histological proven adenocarcinoma of the colon or rectum; At least one measurable metastatic disease If only one metastatic lesion and no S-CEA elevation, histology is mandatory; Availability of tumour sample for EGFR assessment. General conditions: Age >18 and < 75 years; WHO performance status: life expectancy of more than 3 months; Adequate haematological function Adequate renal and hepatic functions Written informed consent Exclusion Criteria: Prior therapy: No prior chemotherapy for advanced/metastatic disease; No adjuvant chemotherapy the last 6 months before inclusion; No previous oxaliplatin; Prior or current history: No current indication for resection with a curative intent; No evidence of CNS metastasis; No current infection, unresolved bowel obstruction or subobstruction, uncontrolled Crohn's disease or ulcerative colitis; No current history of chronic diarrhoea; No peripheral neuropathy; No other serious illness or medical conditions (including contraindication to 5 FU e.g.: angor, myocardial infarction within 6 months, contraindications to monoclonal antibodies); No past or concurrent history of malignant neoplasm other than colorectal adenocarcinoma within the past five years, except curatively treated non melanoma skin cancer or in situ carcinoma of the cervix; Concomitant treatments: No concomitant (or within 4 weeks before randomisation) administration of any other experimental drug under investigation; No concurrent treatment with any other anti-cancer therapy; Other: Not pregnant, no breast feeding Fertile patients must use adequate contraceptives Not include patients clearly intending to withdraw from the study if not randomised in the willing arm or patients who cannot be regularly followed up for psychological, social, familiar or geographic reasons.

Sites / Locations

  • The Nordic Colorectal Cancer Biomodulation Group

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Active Comparator

Experimental

Experimental

Arm Label

A

B

C

Arm Description

FLOX: 5-fluorouracil/folinic acid/oxaliplatin; Nordic Regimen; given continuosly

FLOX: 5-fluorouracil/folinic acid/oxaliplatin and cetuximab

FLOX given intermittently and maintenance cetuximab

Outcomes

Primary Outcome Measures

To compare efficacy, as measured by time to disease progression, of treatment with cetuximab in combination with the FLOX regimen compared to FLOX alone, in first- line treatment of patients with metastatic cororectal cancer

Secondary Outcome Measures

To measure response rates, response duration, secondary surgical curative resection frequency, safety profile, overall survival and quality of life in the treatment groups.

Full Information

First Posted
September 2, 2005
Last Updated
January 13, 2011
Sponsor
The Nordic Colorectal Cancer Biomodulation Group
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1. Study Identification

Unique Protocol Identification Number
NCT00145314
Brief Title
FLOX in Combination With Cetuximab in First-line Treatment of Colorectal Cancer
Official Title
5-Fluorouracil/Folinate/Oxaliplatin (Eloxatin) (FLOX Regimen), Given Continuously or Intermittently, in Combination With Cetuximab (Erbitux), in First-line Treatment of Metastatic Colorectal Cancer. A Phase III Multicenter Trial.
Study Type
Interventional

2. Study Status

Record Verification Date
January 2011
Overall Recruitment Status
Completed
Study Start Date
May 2005 (undefined)
Primary Completion Date
May 2009 (Actual)
Study Completion Date
August 2010 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
The Nordic Colorectal Cancer Biomodulation Group

4. Oversight

5. Study Description

Brief Summary
The main objective of this trial is to explore the effect of combining an established chemotherapy regimen (FLOX), based on 5-fluorouracil, folinic acid, and oxaliplatin (Eloxatin®), with the EGF receptor antibody cetuximab (Erbitux®) in first-line treatment of metastatic colorectal cancer. The trial will investigate two regimens of FLOX plus cetuximab, in which FLOX is given continuously or intermittently, compared to standard FLOX without cetuximab.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metastatic Colorectal Cancer
Keywords
Metastatic colorectal cancer, FLOX, Cetuximab

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
571 (Actual)

8. Arms, Groups, and Interventions

Arm Title
A
Arm Type
Active Comparator
Arm Description
FLOX: 5-fluorouracil/folinic acid/oxaliplatin; Nordic Regimen; given continuosly
Arm Title
B
Arm Type
Experimental
Arm Description
FLOX: 5-fluorouracil/folinic acid/oxaliplatin and cetuximab
Arm Title
C
Arm Type
Experimental
Arm Description
FLOX given intermittently and maintenance cetuximab
Intervention Type
Drug
Intervention Name(s)
FLOX (5-fluorouracil/folinic acid/oxaliplatin)
Intervention Description
FLOX every 2nd week
Intervention Type
Drug
Intervention Name(s)
FLOX (5-fluorouracil/folinic acid/oxaliplatin) and Cetuximab
Intervention Description
FLOX every 2nd week Cetuximab weekly
Intervention Type
Drug
Intervention Name(s)
FLOX (5-fluorouracil and folinic acid and oxaliplatin) intermittently and maintenance cetuximab
Intervention Description
FLOX every 2nd week for 8 cycles. Stop of FLOX until progression then FLOX is reintroduced. Cetuximab weekly.
Primary Outcome Measure Information:
Title
To compare efficacy, as measured by time to disease progression, of treatment with cetuximab in combination with the FLOX regimen compared to FLOX alone, in first- line treatment of patients with metastatic cororectal cancer
Time Frame
Every 4th cycle
Secondary Outcome Measure Information:
Title
To measure response rates, response duration, secondary surgical curative resection frequency, safety profile, overall survival and quality of life in the treatment groups.
Time Frame
Every 2nd week (safety profile)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
74 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histology and staging disease: Histological proven adenocarcinoma of the colon or rectum; At least one measurable metastatic disease If only one metastatic lesion and no S-CEA elevation, histology is mandatory; Availability of tumour sample for EGFR assessment. General conditions: Age >18 and < 75 years; WHO performance status: life expectancy of more than 3 months; Adequate haematological function Adequate renal and hepatic functions Written informed consent Exclusion Criteria: Prior therapy: No prior chemotherapy for advanced/metastatic disease; No adjuvant chemotherapy the last 6 months before inclusion; No previous oxaliplatin; Prior or current history: No current indication for resection with a curative intent; No evidence of CNS metastasis; No current infection, unresolved bowel obstruction or subobstruction, uncontrolled Crohn's disease or ulcerative colitis; No current history of chronic diarrhoea; No peripheral neuropathy; No other serious illness or medical conditions (including contraindication to 5 FU e.g.: angor, myocardial infarction within 6 months, contraindications to monoclonal antibodies); No past or concurrent history of malignant neoplasm other than colorectal adenocarcinoma within the past five years, except curatively treated non melanoma skin cancer or in situ carcinoma of the cervix; Concomitant treatments: No concomitant (or within 4 weeks before randomisation) administration of any other experimental drug under investigation; No concurrent treatment with any other anti-cancer therapy; Other: Not pregnant, no breast feeding Fertile patients must use adequate contraceptives Not include patients clearly intending to withdraw from the study if not randomised in the willing arm or patients who cannot be regularly followed up for psychological, social, familiar or geographic reasons.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Kjell M. Tveit, MD, PhD
Organizational Affiliation
Professor at Ullevål University Hospital, Norway
Official's Role
Principal Investigator
Facility Information:
Facility Name
The Nordic Colorectal Cancer Biomodulation Group
City
Oslo
ZIP/Postal Code
NO-0407
Country
Norway

12. IPD Sharing Statement

Citations:
PubMed Identifier
31046124
Citation
Hamfjord J, Guren TK, Dajani O, Johansen JS, Glimelius B, Sorbye H, Pfeiffer P, Lingjaerde OC, Tveit KM, Kure EH, Pallisgaard N, Spindler KG. Total circulating cell-free DNA as a prognostic biomarker in metastatic colorectal cancer before first-line oxaliplatin-based chemotherapy. Ann Oncol. 2019 Jul 1;30(7):1088-1095. doi: 10.1093/annonc/mdz139.
Results Reference
derived
PubMed Identifier
26261061
Citation
Kjersem JB, Thomsen M, Guren T, Hamfjord J, Carlsson G, Gustavsson B, Ikdahl T, Indrebo G, Pfeiffer P, Lingjaerde O, Tveit KM, Wettergren Y, Kure EH. AGXT and ERCC2 polymorphisms are associated with clinical outcome in metastatic colorectal cancer patients treated with 5-FU/oxaliplatin. Pharmacogenomics J. 2016 Jun;16(3):272-9. doi: 10.1038/tpj.2015.54. Epub 2015 Aug 11.
Results Reference
derived
PubMed Identifier
24884501
Citation
Kjersem JB, Skovlund E, Ikdahl T, Guren T, Kersten C, Dalsgaard AM, Yilmaz MK, Fokstuen T, Tveit KM, Kure EH. FCGR2A and FCGR3A polymorphisms and clinical outcome in metastatic colorectal cancer patients treated with first-line 5-fluorouracil/folinic acid and oxaliplatin +/- cetuximab. BMC Cancer. 2014 May 19;14:340. doi: 10.1186/1471-2407-14-340.
Results Reference
derived
PubMed Identifier
23167843
Citation
Kjersem JB, Ikdahl T, Guren T, Skovlund E, Sorbye H, Hamfjord J, Pfeiffer P, Glimelius B, Kersten C, Solvang H, Tveit KM, Kure EH. Let-7 miRNA-binding site polymorphism in the KRAS 3'UTR; colorectal cancer screening population prevalence and influence on clinical outcome in patients with metastatic colorectal cancer treated with 5-fluorouracil and oxaliplatin +/- cetuximab. BMC Cancer. 2012 Nov 20;12:534. doi: 10.1186/1471-2407-12-534.
Results Reference
derived

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FLOX in Combination With Cetuximab in First-line Treatment of Colorectal Cancer

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