Capecitabine and Radiation Therapy With or Without Panitumumab in Treating Patients With Advanced Rectal Cancer
Colorectal Cancer
About this trial
This is an interventional treatment trial for Colorectal Cancer focused on measuring adenocarcinoma of the rectum, stage III rectal cancer, stage II rectal cancer
Eligibility Criteria
DISEASE CHARACTERISTICS:
Histologically confirmed advanced adenocarcinoma of the rectum with or without nodal involvement
- Stage mrT3-4 and/or mrN1-2, M0
- Tumors must express wild type K-ras gene
- No distant metastasis
PATIENT CHARACTERISTICS:
- WHO performance status 0-1
- Able to undergo surgery
- ANC ≥ 1,500/mm^3
- Platelet count ≥ 100,000/mm^3
- Hemoglobin ≥ 100 g/L
- Creatinine clearance ≥ 50 mL/min
- AST ≤ 2.5 times upper limit normal (ULN)
- Total bilirubin ≤ 1.5 times ULN
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must agree to use effective contraception during and for 12 months after completion of study
- No malignancy within the past 5 years with the exception of adequately treated cervical carcinoma in situ or localized nonmelanoma skin cancer
- No psychiatric disorder that would preclude understanding study-related information, giving informed consent, or complying with oral drug intake
- No prior existing conditions that would preclude radiotherapy
- No clinically significant (i.e., active) cardiac disease (e.g., congestive heart failure, symptomatic coronary artery disease, and cardiac arrhythmia even if controlled with medication) or myocardial infarction within the past 12 months
- No lack of physical integrity of the upper gastrointestinal tract or malabsorption syndrome
- No serious underlying medical condition that, in the judgement of the investigator, could impair the ability of the patient to participate in the trial (e.g., active autoimmune disease or uncontrolled diabetes)
- No known dihydropyrimidine dehydrogenase deficiency
- No known hypersensitivity to trial drugs or hypersensitivity to any other component of the trial drugs
PRIOR CONCURRENT THERAPY:
- More than 30 days since prior treatment in a clinical trial
- No other concurrent experimental drugs, anticancer therapy, or investigational treatments
- No prior treatment for rectal cancer
- No prior anti-EGFR antibody therapy (e.g., cetuximab) or small-molecule EGFR inhibitors (e.g., erlotinib hydrochloride)
- No concurrent treatment with brivudine, lamivudine, ribavirin, or any other nucleoside analogues
- No organ allografts
- No concurrent drugs contraindicated for use with the trial drugs
- No other concurrent anti-EGFR-targeting agents
- No other concurrent radiotherapy
Sites / Locations
- Szent Laszlo Korhaz
- Hirslanden Klinik Aarau
- Kantonspital Aarau
- Kantonsspital Baden
- Saint Claraspital AG
- Universitaetsspital-Basel
- Istituto Oncologico della Svizzera Italiana
- Inselspital Bern
- Spitalzentrum Biel
- Kantonsspital Bruderholz
- Kantonsspital Graubuenden
- Hopital Cantonal Universitaire de Geneve
- Centre Hospitalier Universitaire Vaudois
- Kantonsspital, Luzerne
- OnkoZentrum Luzern at Klinik St. Anna
- Kantonsspital Olten
- Hopital Regional de Sion-Herens-Conthey
- Kantonsspital - St. Gallen
- Regionalspital
- Kantonsspital Winterthur
- Onkozentrum
- Klinik Hirslanden
- City Hospital Triemli
- UniversitaetsSpital Zuerich
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Arm I
Arm II
Patients receive panitumumab IV over 30-90 minutes on days 1, 15, 29, 43, and 57 and oral capecitabine twice daily on days 8-40. Beginning on day 8, patients undergo daily fractions of 3-D conformal radiotherapy 5 days a week for 5 weeks. Beginning approximately 6 weeks after completion of panitumumab and chemoradiotherapy, patients undergo surgery.
Patients receive oral capecitabine twice daily on days 1-33. Patients undergo concurrent 3-D conformal radiotherapy 5 days a week for 5 weeks. Beginning 6 weeks after completion of chemoradiotherapy, patients undergo surgery.