Combination Chemotherapy and Bevacizumab as First-Line Therapy in Treating Patients With Metastatic Colorectal Cancer (TRIBE)
Colorectal Cancer
About this trial
This is an interventional treatment trial for Colorectal Cancer focused on measuring stage IV rectal cancer, stage IV colon cancer, stage III rectal cancer, stage III colon cancer
Eligibility Criteria
DISEASE CHARACTERISTICS:
Histologically confirmed colorectal cancer
- Unresectable metastatic disease
- Measurable disease, defined as ≥ 1 measurable lesion according to RECIST criteria
- No prior chemotherapy for metastatic disease
- No untreated brain metastases, spinal cord compression, or primary brain tumors
- No history or evidence of CNS disease by physical examination unless adequately treated (e.g., uncontrolled seizure despite standard medical therapy or history of stroke)
PATIENT CHARACTERISTICS:
Inclusion criteria:
- ECOG performance status (PS) 0-2 (≤ 70 years of age) OR ECOG PS 0 (71-75 years of age)
- Life expectancy ≥ 12 weeks
- Neutrophils ≥ 1.5 x 10^9/L
- Platelet count ≥ 100 x 10^9/L
- Hemoglobin > 9 g/dL
- Total bilirubin ≤ 1.5 times upper limit of normal (ULN)
- AST and ALT ≤ 2.5 times ULN (≤ 5 times ULN if f liver metastases present)
- Alkaline phosphatase ≤ 2.5 times ULN (≤ 5 times ULN if liver metastases present)
- Creatinine clearance > 50 mL/min OR serum creatinine ≤ 1.5 times ULN
- Proteinuria < 2+ by dipstick OR urine protein ≤ 1 g by 24-hr urine collection
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
Exclusion criteria:
- Serious, nonhealing wound, ulcer, or bone fracture
- Evidence of bleeding diathesis or coagulopathy
- Uncontrolled hypertension
Clinically significant (i.e., active) cardiovascular disease, including any of the following:
- Cerebrovascular accidents within the past 6 months
- Myocardial infarction within the past 6 months
- Unstable angina
- New York Heart Association class II-IV congestive heart failure
- Serious cardiac arrhythmia requiring medication
- Known allergy to Chinese hamster ovary cell proteins or any of the components of the study medications
- Other co-existing malignancy or malignancy diagnosed within the past 5 years, except for basal cell or squamous cell carcinoma, or carcinoma in situ of the cervix
- Symptomatic peripheral neuropathy ≥ grade 1 according to the NCI Common Toxicity Criteria
- Lack of physical integrity of the upper gastrointestinal tract
- Malabsorption syndrome
- Inability to take oral medication
- Significant traumatic injury within the past 28 days
PRIOR CONCURRENT THERAPY:
- See Disease Characteristics
- More than 4 weeks since prior radiotherapy
- More than 10 days since prior and no concurrent ongoing treatment with anticoagulants for therapeutic purposes
- More than 28 days since prior and no concurrent major surgical procedure
- More than 28 days since prior open biopsy
- More than 30 days since prior investigational agents
- No concurrent chronic daily high-dose acetylsalicylic acid (> 325 mg/day)
Sites / Locations
- Ospedale Civile Ss. Antonio E Biagio Di Alessandria - Alessandria (Al) Oncologia Medica
- A.O. Universitaria Ospedali Riuniti - Ospedale Umberto I Di Ancona - Ancona (An) Oncologia Medica
- P.O. Zona Aretina - Ospedale S. Donato Di Arezzo - Arezzo (Ar) Oncologia Medica
- Irccs Centro Di Riferimento Oncologico (Cro) - Aviano (Pn) Oncologia Medica
- Ospedale S. Orsola F.B.F. - Brescia - Brescia (Bs) Oncologia Medica
- Istituto Ospedaliero Fondazione Poliambulanza Di Brescia - Brescia (Bs) Oncologia Medica
- Stabilimento "Perrino" - Brindisi - Brindisi (Br) Oncologia Medica
- Azienda Ospedaliera S. Elia - Caltanissetta (Cl) Oncologia Medica
- Ausl 1 Di Massa E Carrara - Carrara (Ms) Oncologia Medica
- Ospedale Cecina - Cecina (Li) Oncologia Medica
- Istituti Ospitalieri - Cremona - Cremona (Cr) Oncologia Medica
- Azienda Ospedaliera S. Croce E Carle Di Cuneo - Cuneo (Cn) Oncoematologia
- Ausl 11 Di Empoli (Fi) - Empoli (Fi) Oncologia Medica
- U.S.L.N.6 -Ospedale Civile 'E.Profili'-F - Fabriano (An) Oncologia Medica
- Ausl 10 Di Firenze - Firenze (Fi) Oncologia Medica
- Irccs Istituto Nazionale Per La Ricerca Sul Cancro (Ist) - Genova (Ge) Oncologia Medica
- Ausl Le Di Lecce - Lecce (Le) Oncologia Medica
- Aulss 21 Di Legnago (Vr) - Legnago (Vr) Oncologia Medica
- Ausl 12 Di Viareggio (Lu) - Lido Di Camaiore (Lu) Oncologia Medica
- Ospedale Livorno - Livorno (Li), Oncologia Medica
- Presidio Ospedaliero Piana Di Lucca - Lucca (Lu) Oncologia Medica
- Irccs Fondazione Centro S. Raffaele Del Monte Tabor - Milano (Mi) Oncologia Medica
- Ospedale Ca' Granda-Niguarda - Milano - Milano (Mi) Oncologia Medica
- S.Gerardo - Monza - Monza (Mi) Oncologia Medica
- A.O. Universitaria Federico Ii Di Napoli Oncologia Medica
- A.O. Universitaria Maggiore Della Carita' Di Novara Oncologia Medica
- A.O. Universitaria Di Parma Oncologia Medica
- Asl 1 Di Citta' Di Castello (Pg) - Citta' Di Castello (Pg) Oncologia Medica
- A.O. Di Perugia - Ospedale S. Maria Della Misericordia (Ex Silvestrini) - Perugia (Pg) Oncologia Medica
- Azienda Ospedaliera San Salvatore - Pesaro (Pu) Oncologia Medica
- Ospedale Della Valdinievole - Pescia (Pt) Oncologia Medica
- Ospedale Piombino - Piombino (Li) Oncologia Medica
- A.O. Universitaria Pisana Oncologia Medica
- Ausl 5 Di Pisa - Pisa (Pi) Oncologia Medica
- Alfredo Falcone A.O. Universitaria Pisana - Pisa (Pi) Oncologia Medica
- Ausl 3 Di Pistoia - Pistoia (Pt) Oncologia Medica
- Ausl 4 Di Prato - Prato (Po) Oncologia Medica
- Ospedale Di S. Maria Nuova - Reggio Nell'Emilia (Re) Oncologia Medica
- Policlinico Universitario Campus Bio-Medico Di Roma Oncologia Medica
- Policlinico Umberto I Di Roma Oncologia Medica
- Policlinico Universitario Gemelli Di Roma Oncologia Medica
- A.O. Universitaria Senese Oncologia Medica
- Ospedale Civile - Sondrio - Sondrio (So) Oncologia Medica
- A.O. Universitaria S. Giovanni Battista-Molinette Di Torino Oncologia Medica
Arms of the Study
Arm 1
Arm 2
Experimental
Experimental
Arm I (FOLFOXIRI)
Arm II (FOLFIRI)
Patients receive irinotecan hydrochloride IV over 1 hour, oxaliplatin IV over 2 hours, leucovorin calcium IV over 2 hours, and bevacizumab IV on day 1. Patients also receive fluorouracil IV continuously over 48 hours beginning on day 1.
Patients receive irinotecan hydrochloride IV over 1 hour, leucovorin calcium IV over 2 hours, and bevacizumab IV on day 1. Patients also receive fluorouracil IV continuously over 48 hours beginning on day 1.