Cetuximab, Leucovorin, Oxaliplatin, and Fluorouracil With or Without Bevacizumab in Treating Patients With Resectable Liver Metastases From Colorectal Cancer

This is an interventional treatment trial for Colorectal Cancer focused on measuring liver metastases, stage IV colon cancer, stage IV rectal cancer, recurrent colon cancer, recurrent rectal cancer Read More

DISEASE CHARACTERISTICS:

• Diagnosis of metastatic colorectal cancer, meeting all of the following criteria:

  • Metachronous or synchronous liver metastases

    • Metastases potentially completely resectable

      • No requirement for resection combined with cryotherapy or radiofrequency ablation
  • Must have undergone complete resection (R0) of the primary tumor within the past 4 weeks
• Measurable liver metastases

• No evidence of extrahepatic disease

  • 1 or 2 resectable lung metastases allowed

PATIENT CHARACTERISTICS:

• WHO performance status 0-1
• Absolute neutrophil count > 1,500/mm³
• Platelet count > 100,000/mm³
• Hemoglobin > 9 g/dL
• WBC > 3,000/mm³
• Creatinine < 1.5 times upper limit of normal (ULN)
• Bilirubin < 1.5 times ULN
• AST and ALT < 5 times ULN
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception
• No significant proteinuria (i.e., protein > 500 mg/24-hour urine collection)
• No known allergy to any of the study drugs (including excipients) or any related compound, including hypersensitivity to Chinese hamster ovary cell products or other recombinant human or humanized antibodies
• No bleeding diathesis or coagulopathy
• No peripheral neuropathy > grade 1
• No serious nonhealing wound, ulcer, or bone fracture

• No clinically significant cardiovascular disease, including any of the following:

  • Uncontrolled hypertension
  • New York Heart Association class II-IV congestive heart failure
  • Unstable angina pectoris within the past 12 months
  • Peripheral vascular disease ≥ grade 2
  • Serious cardiac arrhythmia requiring medication
  • Myocardial infarction within the past 12 months
  • Cerebrovascular accident or transient ischemic attack within the past 12 months
• No symptomatic diverticulitis or known gastroduodenal ulceration
• No significant traumatic injury within the past 4 weeks
• No known alcohol or drug abuse
• No psychological, familial, social, or geographical condition that would preclude study compliance
• No other significant disease that would preclude study participation

PRIOR CONCURRENT THERAPY:

• See Disease Characteristics
• No prior chemotherapy for metastatic disease
• At least 1 month since prior major surgical procedure or open biopsy
• More than 30 days since prior participation in another clinical study

• Prior adjuvant chemotherapy for primary cancer allowed provided the following criteria are met:

  • At least 12 months since prior oxaliplatin-containing adjuvant therapy
  • No persistent neuropathy
• No prior therapy targeting the epidermal growth factor receptor or vascular endothelial growth factor (VEGF)/VEGF receptor
• No concurrent regular use of acetylsalicylic acid (> 325 mg/day) or other nonsteroidal anti-inflammatory drugs
• No concurrent full-dose anticoagulation
• No concurrent prophylactic hematopoietic growth factors
• No concurrent allopurinol