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Capecitabine,Oxaliplatin & Erbitux Given Throughout Multi-Modal Therapy for Locally Advanced Rectal Adenocarcinoma

Primary Purpose

Rectal Cancer

Status
Terminated
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Capecitabine, Oxaliplatin and Cetuximab
Radiation
Sponsored by
Abramson Cancer Center at Penn Medicine
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Rectal Cancer focused on measuring Adjuvant therapy, Rectal cancer, Capecitabine, Oxaliplatin, Cetuximab, Erbitux

Eligibility Criteria

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

Inclusion Criteria: Histologically confirmed nonmetastatic, measurable, locally advanced (T3 or T4) rectal adenocarcinoma If available, tumor tissue must be sent for investigational immunohistochemical evaluations of EGFR status The distal border of the tumor must be at or below the peritoneal reflection (defined a with 12 cm of the anal verge by proctoscopy) Transmural penetration of the tumor demonstrated by CT + endorectal ultrasound or MRI ECOG PS 0-2 No prior chemotherapy, biologic therapy or radiation therapy Age >= 18 years old Laboratory values: ANC >= 1500/mm3; Platelets >= 100,000/mm3; Hgb >= 9 g/dL; Estimated CrCl > 50 mL/min; Serum bilirubin <= 1.5 x ULN; AST and ALT <= 3.0 x ULN; Negative proteinuria based on dip stick reading Patients must either be not of child bearing potential or have a negative pregnancy test upon study enrollment. Patients must agree to continue contraception for 30 days from the date of the last study drug administration. Exclusion Criteria: Pregnant or lactating woman. Women of childbearing potential with either a positive or no pregnancy test upon study enrollment. Women/men of childbearing potential not using a reliable and appropriate contraceptive method. Patients must agree to continue contraception for 30 days from the date of the last study administration. Life expectancy < 3 months Serious, uncontrolled, concurrent infection(s) Concurrent use of chemotherapy not indicated in the study protocol or any other investigational agents and patients who have received investigational drugs < 4 weeks prior to randomization. Prior therapy which specifically and directly targets the EGFR pathway. Prior severe infusion reaction to a monoclonal antibody Any prior therapy with Oxaliplatin Prior pelvic irradiation for any reason Prior unanticipated severe reaction to fluoropyrimidine therapy, or known sensitivity to 5-fluorouracil or known DPD deficiency Treatment for other carcinomas within the last five years, except cured non-melanoma skin and treated in-situ cervical cancer Participation in any investigational drug study within 4 weeks preceding the start of the study treatment Major surgery within 4 weeks of the study treatment, without complete recovery Known, existing uncontrolled coagulopathy Unwillingness to give written informed consent Unwillingness to participate or inability to comply with the protocol for the duration of the study Known allergy or hypersensitivity to platinum-containing drugs Peripheral sensory neuropathy with functional impairment Interstitial pneumonia or extensive and symptomatic interstitial fibrosis of the lung Pleural effusions or ascites that causes respiratory compromise Acute hepatitis or known HIV Any of the following concurrent severe and/or uncontrolled medical conditions which could compromise participation in the study: uncontrolled high blood pressure, history of labile hypertension, or history of poor compliance with anti-hypertensive regimen; unstable angina pectoris; symptomatic congestive heart failure; myocardial infarction < 6 months prior to randomization; serious uncontrolled cardiac arrhythmia; uncontrolled diabetes; active or uncontrolled infection; impairment of gastrointestinal function or GI disease that may significantly alter the absorption of Capecitabine. Evidence of CNS metastases or history of uncontrolled seizures, central nervous system disorders or psychiatric disability judged by the investigator to be clinically significant, precluding informed consent, or interfering with compliance of oral drug intake.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    Arm 1

    Arm Description

    Capecitabine, Oxaliplatin and Cetuximab

    Outcomes

    Primary Outcome Measures

    Pathologic complete response

    Secondary Outcome Measures

    Sphincter function
    Type of surgery
    Disease free survival

    Full Information

    First Posted
    July 14, 2006
    Last Updated
    April 6, 2020
    Sponsor
    Abramson Cancer Center at Penn Medicine
    Collaborators
    Bristol-Myers Squibb, Roche Pharma AG
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    1. Study Identification

    Unique Protocol Identification Number
    NCT00353457
    Brief Title
    Capecitabine,Oxaliplatin & Erbitux Given Throughout Multi-Modal Therapy for Locally Advanced Rectal Adenocarcinoma
    Official Title
    Phase II Study of Capecitabine, Oxaliplatin and Cetuximab Given Throughout Multi-Modal Therapy for Locally Advanced Rectal Adenocarcinoma
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    April 2020
    Overall Recruitment Status
    Terminated
    Why Stopped
    new studies were finding that Erbitux was not beneficial
    Study Start Date
    February 2006 (Actual)
    Primary Completion Date
    June 2011 (Actual)
    Study Completion Date
    June 2011 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Abramson Cancer Center at Penn Medicine
    Collaborators
    Bristol-Myers Squibb, Roche Pharma AG

    4. Oversight

    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    This is a phase II study of induction chemotherapy (capecitabine, oxaliplatin and cetuximab (erbitux)) followed by capecitabine, oxaliplatin, cetuximab and radiotherapy followed by surgery followed by adjuvant capecitabine, oxaliplatin and cetuximab for locally advanced resectable rectal cancer.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Rectal Cancer
    Keywords
    Adjuvant therapy, Rectal cancer, Capecitabine, Oxaliplatin, Cetuximab, Erbitux

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 2
    Interventional Study Model
    Single Group Assignment
    Masking
    None (Open Label)
    Allocation
    N/A
    Enrollment
    6 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Arm 1
    Arm Type
    Experimental
    Arm Description
    Capecitabine, Oxaliplatin and Cetuximab
    Intervention Type
    Drug
    Intervention Name(s)
    Capecitabine, Oxaliplatin and Cetuximab
    Intervention Description
    Capecitabine 825mg/m2 po BID D1-15 of 21 x2 cycles (Cyle 1 and 2), Capecitabine 825mg/m2 po BID weekly Sun PM-Fri AM x2 cycles (cycle 3 and 4), Capecitabine 825mg/m2 po BID D1-15 of 21 x4 cycles (cycle 5,6,7,8) Oxaliplatin 130mg/m2 IV Day 1 every 3 weeks x2 cycles (Cycle 1 and 2), Oxaliplatin 50mg/m2 IV weekly every Monday x2 cycles (Cycle 3 and 4), Oxaliplatin 130mg/m2 IV day 1 every 3 weeks x4 cycles (Cycles 5,6,7,8) Cetuximab 400mg/m2 IV cycle 1 day1, Cetuximab 250mg/m2 Day 1,8,15 of 21 for cycles 1-8
    Intervention Type
    Radiation
    Intervention Name(s)
    Radiation
    Intervention Description
    45 Gy in 25 fractions, 3-fraction boost 5.4 Gy
    Primary Outcome Measure Information:
    Title
    Pathologic complete response
    Time Frame
    After neoadjuvant treatment
    Secondary Outcome Measure Information:
    Title
    Sphincter function
    Time Frame
    After surgery
    Title
    Type of surgery
    Time Frame
    At time of surgery
    Title
    Disease free survival
    Time Frame
    From time of study entry until first documented relapse

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Histologically confirmed nonmetastatic, measurable, locally advanced (T3 or T4) rectal adenocarcinoma If available, tumor tissue must be sent for investigational immunohistochemical evaluations of EGFR status The distal border of the tumor must be at or below the peritoneal reflection (defined a with 12 cm of the anal verge by proctoscopy) Transmural penetration of the tumor demonstrated by CT + endorectal ultrasound or MRI ECOG PS 0-2 No prior chemotherapy, biologic therapy or radiation therapy Age >= 18 years old Laboratory values: ANC >= 1500/mm3; Platelets >= 100,000/mm3; Hgb >= 9 g/dL; Estimated CrCl > 50 mL/min; Serum bilirubin <= 1.5 x ULN; AST and ALT <= 3.0 x ULN; Negative proteinuria based on dip stick reading Patients must either be not of child bearing potential or have a negative pregnancy test upon study enrollment. Patients must agree to continue contraception for 30 days from the date of the last study drug administration. Exclusion Criteria: Pregnant or lactating woman. Women of childbearing potential with either a positive or no pregnancy test upon study enrollment. Women/men of childbearing potential not using a reliable and appropriate contraceptive method. Patients must agree to continue contraception for 30 days from the date of the last study administration. Life expectancy < 3 months Serious, uncontrolled, concurrent infection(s) Concurrent use of chemotherapy not indicated in the study protocol or any other investigational agents and patients who have received investigational drugs < 4 weeks prior to randomization. Prior therapy which specifically and directly targets the EGFR pathway. Prior severe infusion reaction to a monoclonal antibody Any prior therapy with Oxaliplatin Prior pelvic irradiation for any reason Prior unanticipated severe reaction to fluoropyrimidine therapy, or known sensitivity to 5-fluorouracil or known DPD deficiency Treatment for other carcinomas within the last five years, except cured non-melanoma skin and treated in-situ cervical cancer Participation in any investigational drug study within 4 weeks preceding the start of the study treatment Major surgery within 4 weeks of the study treatment, without complete recovery Known, existing uncontrolled coagulopathy Unwillingness to give written informed consent Unwillingness to participate or inability to comply with the protocol for the duration of the study Known allergy or hypersensitivity to platinum-containing drugs Peripheral sensory neuropathy with functional impairment Interstitial pneumonia or extensive and symptomatic interstitial fibrosis of the lung Pleural effusions or ascites that causes respiratory compromise Acute hepatitis or known HIV Any of the following concurrent severe and/or uncontrolled medical conditions which could compromise participation in the study: uncontrolled high blood pressure, history of labile hypertension, or history of poor compliance with anti-hypertensive regimen; unstable angina pectoris; symptomatic congestive heart failure; myocardial infarction < 6 months prior to randomization; serious uncontrolled cardiac arrhythmia; uncontrolled diabetes; active or uncontrolled infection; impairment of gastrointestinal function or GI disease that may significantly alter the absorption of Capecitabine. Evidence of CNS metastases or history of uncontrolled seizures, central nervous system disorders or psychiatric disability judged by the investigator to be clinically significant, precluding informed consent, or interfering with compliance of oral drug intake.
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Daniel G Haller, M.D.
    Organizational Affiliation
    Abramson Cancer Center of University of Pennsylvania
    Official's Role
    Principal Investigator
    First Name & Middle Initial & Last Name & Degree
    James M Metz, M.D.
    Organizational Affiliation
    Abramson Cancer Center of University of Pennsylvania
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Learn more about this trial

    Capecitabine,Oxaliplatin & Erbitux Given Throughout Multi-Modal Therapy for Locally Advanced Rectal Adenocarcinoma

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