External-Beam Radiation Therapy, Capecitabine, and Sorafenib in Treating Patients With Locally 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 II rectal cancer, stage III rectal cancer
Eligibility Criteria
DISEASE CHARACTERISTICS:
Histologically confirmed locally advanced adenocarcinoma of the rectum (with or without nodal involvement) requiring surgery
- Stage mrT3-4, and/or mrN1-2, M0 disease
- Tumor with K-ras gene mutation as assessed locally
- No distant metastases
PATIENT CHARACTERISTICS:
- WHO performance status 0-1
- Neutrophil count ≥ 1,500/mm^3
- Platelet count ≥ 100,000/mm^3
- Hemoglobin ≥ 10.0 g/dL
- Creatinine clearance ≥ 50mL/min
- AST ≤ 2.5 times upper limit of normal (ULN)
- Total bilirubin ≤ 1.5 times ULN
- PT/INR or PTT ≤ 1.5 times ULN
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective barrier contraception during and for 12 months after completion of study therapy
- Is compliant and geographic proximity allows for proper staging and follow-up
- No other malignancy within the past 5 years except 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 clinically significant (i.e., active) cardiac disease (e.g., congestive heart failure, symptomatic coronary artery disease, or cardiac arrhythmia [even if controlled with medication]) or myocardial infarction within the past 12 months
- No uncontrolled hypertension
- No evidence or history of bleeding diathesis
- No lack of physical integrity of the upper gastrointestinal tract or malabsorption syndrome
- No serious or underlying condition (e.g., active autoimmune disease, uncontrolled diabetes, or uncontrolled infection) that, in the judgement of the investigator, could preclude the ability of the patient to participate in the study
- No known hypersensitivity to study drugs or to any other component of the study drugs
PRIOR CONCURRENT THERAPY:
- No prior treatment for rectal cancer
- No prior organ allografts
- More than 4 weeks since prior major surgery other than colostomy
- More than 30 days since prior treatment in a clinical trial
- No other concurrent experimental drugs or anticancer therapy
- No concurrent brivudine, lamivudine, ribavirin, or any other nucleoside analogue
- No concurrent drugs contraindicated for use with the study drugs
- No other concurrent radiotherapy
- No concurrent anticoagulation therapy other than low molecular weight heparin
Sites / Locations
- Szent Laszlo Korhaz
- Saint Claraspital AG
- Universitaetsspital-Basel
- Istituto Oncologico della Svizzera Italiana - Ospedale Regionale Bellinzona e Valli
- Inselspital, Bern
- Spitalzentrum Biel
- Kantonsspital Bruderholz
- Kantonsspital Graubuenden
- Hopital Cantonal Universitaire de Geneva HUG
- Kantonsspital Luzern
- OnkoZentrum Luzern at Klinik St. Anna
- Kantonsspital - St. Gallen
- SpitalSTS AG Simmental-Thun-Saanenland
- Kantonsspital Winterthur
- Onkozentrum - Klinik im Park
- Onkozentrum Hirslanden
- UniversitaetsSpital Zuerich
- Stadtspital Triemli
Arms of the Study
Arm 1
Experimental
Arm A: Sorafenib & Capecitabine & RT
Sorafenib: day 1 to 33 (5 weeks, including Saturday and Sunday) every 24 hours, immediately or within two hours after RT according to the dose escalation table during phase I, and the recommended dose during phase IIa. The intake stops at the last day of RT. On nonradiotherapy days (e.g. Saturday, Sunday), the tablets have to be taken at the same time as during the week. Capecitabine: day 1 to 33 (5 weeks, including Saturday and Sunday) according to dose escalation table during phase I, and at the recommended dose during phase IIa. The intake stops in the evening of the last day of RT. External beam RT: Monday through Friday for 5 weeks starting on day 1 (daily fraction 1.8 Gy, final dose 45 Gy) each day at the same time (e.g. 11:00 a.m. daily). Surgery: 6 weeks (± 1 week) after radiochemotherapy (RCT) has been completed