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Clinical Trial to Evaluate Safety and Efficacy of Hyperthermic Intra-peritoneal Chemotherapy (HIPEC) With Mitomycin C Used During Surgery for Treatment of Locally Advanced Colorectal Carcinoma (HIPECT4)

Primary Purpose

Colorectal Cancer

Status
Active
Phase
Phase 3
Locations
Spain
Study Type
Interventional
Intervention
MITOMYCIN-C 30 mg
Proactive cytoreductive surgery
Sponsored by
Maimónides Biomedical Research Institute of Córdoba
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Colorectal Cancer focused on measuring HIPEC

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male and female patients between the ages of 18 and 75 years;
  2. Adenocarcinoma of the colon, sigma and colon-sigma joint which represent cT4a/b in line with The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual;
  3. Lymph node involvement: N0, the presence of N1/2 according to the 7th edition of the AJCC is allowed, provided that they can be resectable;
  4. Metastatic extent: M0;
  5. Karnofsky index >70 or Performance status ≤2;
  6. Informed consent properly completed.

Exclusion Criteria:

  1. Presence of metastases (M1), in case of liver or peritoneal metastases at the time of surgery, the patient will be excluded from the trial and treated according to their new stage.
  2. Presence of unresectability criteria;
  3. Urgent intervention due to obstruction or perforation if there is tumor removal, prior interventions will be accepted as referrals without primary tumor removal or drainage of collections prior to scheduled surgery.
  4. Extraperitoneal rectal cáncer (avoiding alterations for neoadyuvance);
  5. Coexistence of another malignant neoplastic disease (synchronous tumors of the colon and upper rectum are accepted as long as the stage is equal to or less than the treated tumor).
  6. Severely altered liver, kidney and cardiovascular function;
  7. Intolerance to treatment;
  8. Administration of chemotherapy before the trial (use of neoadyuvance is discarded);
  9. Pregnant or breastfeeding women.

Sites / Locations

  • Hospital de Sant Joan Despí. Moisès Broggi
  • Hospital Provincial de Castellón
  • Hospital Universitario Son Espases
  • Hospital Universitario de Gran Canaria "Dr. Negrín"
  • Hospital Universitario Nuestra Señora de Candelaria
  • Hospital Universitario Príncipe de Asturias
  • Hospital Universitario de Fuenlabrada
  • Hospital Universitario Torrecárdenas
  • Hospital Universitario de Badajoz
  • Hospital General Universitario de Ciudad Real
  • Hospital Universitario Reina Sofía
  • MD Anderson Cancer Center
  • Hospital Universitario Fundación Jiménez Díaz
  • Hospital Universitario La Paz
  • Hospital Universitario HM Sanchinarro
  • Hospital General Universitario Reina Sofía
  • Hospital Regional Universitario de Málaga
  • Instituto Valenciano de Oncología
  • Hospital Clínico Universitario de Valencia

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Proactive cytoreductive surgery + HIPEC

Proactive cytoreductive surgery

Arm Description

Tumoral cytoreductive surgery + apendicectomy + total omentectomy + round hepatic ligament + oophorectomy (postmenopausian women) plus HIPEC (Mytomicin C - 60 minutes).

Tumoral cytoreductive surgery + apendicectomy + total omentectomy + round hepatic ligament + oophorectomy (postmenopausian women).

Outcomes

Primary Outcome Measures

Locoregional Control (LC)
Time elapsed from the surgical intervention clinical up to the date the patient is free of clinical and radiological locoregional recurrence

Secondary Outcome Measures

Overall survival
Evaluate the effect of the addition of HIPEC with Mitomycin C to cytoreductive surgery in 12 months and 3 years overall survival rate (%OS).
Disease Free Survival
Evaluate the effect of addition of HIPEC with Mitomycin C to cytoreductive surgery in 12 months and 3 years disease free survival rate (% DFS).
Evaluation of the morbidity and mortality related with the treatment
Evaluate the safety (treatment-related morbidity and mortality) of addition of HIPEC with Mitomycin C to cytoreductive surgery in locally advanced colo-rectal cancer. It will be measured by the incidence rate of adverse events and deaths.
HIPEC technique operating time
Average operating time calculation.
HIPEC technique length of hospital stay
Average length of hospital stay calculation.
HIPEC technique re-admission rate
Average re-admission rate calculation.
HIPEC technique laparoscopic vs laparotomy approach
With this outcome it will be calculated the frequency of both surgery techniques and if it has any impact on the locoregional control of the disease.
HIPEC technique open vs. closed HIPEC technique
With this outcome it will be calculated the frequency of both surgery techniques and if it has any impact on the locoregional control of the disease.
Quality of life questionnaire QLQ-C30
With this outcome it will be calculated the effect on the quality of life of patients using questionnaire QLQ-C30.
Quality of life questionnaires QLQ-CR29
With this outcome it will be calculated the effect on the quality of life of patients using questionnaire QLQ-CR29.

Full Information

First Posted
November 9, 2015
Last Updated
September 27, 2023
Sponsor
Maimónides Biomedical Research Institute of Córdoba
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1. Study Identification

Unique Protocol Identification Number
NCT02614534
Brief Title
Clinical Trial to Evaluate Safety and Efficacy of Hyperthermic Intra-peritoneal Chemotherapy (HIPEC) With Mitomycin C Used During Surgery for Treatment of Locally Advanced Colorectal Carcinoma
Acronym
HIPECT4
Official Title
Multicentre, Randomized Clinical Trial to Evaluate Safety and Efficacy of Hyperthermic Intra-peritoneal Chemotherapy (HIPEC) With Mitomycin C Used During Surgery for Treatment of Locally Advanced Colorectal Carcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
September 2022
Overall Recruitment Status
Active, not recruiting
Study Start Date
November 16, 2015 (Actual)
Primary Completion Date
March 2024 (Anticipated)
Study Completion Date
March 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Maimónides Biomedical Research Institute of Córdoba

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to determine whether Hyperthermic Intra-peritoneal Chemotherapy (HIPEC) with Mitomycin C used during surgery for treatment of locally advanced colorectal carcinoma is effective in the treatment of locally advanced colorectal carcinoma.
Detailed Description
The purpose of this study is to determine whether Hyperthermic Intra-peritoneal Chemotherapy (HIPEC) with Mitomycin C used during surgery for treatment of locally advanced colorectal carcinoma is effective in the treatment of locally advanced colorectal carcinoma. The Hyperthermic Intra-peritoneal Chemotherapy (HIPEC) is expected to be an effective treatment with minimal side effects, it has already provided clear benefits in terms of overall survival in patients with advanced cancer. This is an attractive option for the healthcare professionals who face daily to peritoneal recurrence after performing complex surgeries, however its application is difficult due to the cost and resources increase. This leads to the necessity of administering the treatment within a clinical trials and in order to obtain a significant power this clinical trials will be multicenter and it will be performed in several Oncological surgery Units highly specialised and with extensive experience in colorectal carcinoma.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Colorectal Cancer
Keywords
HIPEC

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
200 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Proactive cytoreductive surgery + HIPEC
Arm Type
Experimental
Arm Description
Tumoral cytoreductive surgery + apendicectomy + total omentectomy + round hepatic ligament + oophorectomy (postmenopausian women) plus HIPEC (Mytomicin C - 60 minutes).
Arm Title
Proactive cytoreductive surgery
Arm Type
Active Comparator
Arm Description
Tumoral cytoreductive surgery + apendicectomy + total omentectomy + round hepatic ligament + oophorectomy (postmenopausian women).
Intervention Type
Drug
Intervention Name(s)
MITOMYCIN-C 30 mg
Intervention Description
Proactive cytoreductive surgery: Tumoral cytoreductive surgery + apendicectomy + total omentectomy + round hepatic ligament + oophorectomy (postmenopausian women) plus HIPEC with Mytomicin C for 60 minutes.
Intervention Type
Procedure
Intervention Name(s)
Proactive cytoreductive surgery
Intervention Description
Proactive cytoreductive surgery: Tumoral cytoreductive surgery + apendicectomy + total omentectomy + round hepatic ligament + oophorectomy (postmenopausian women)
Primary Outcome Measure Information:
Title
Locoregional Control (LC)
Description
Time elapsed from the surgical intervention clinical up to the date the patient is free of clinical and radiological locoregional recurrence
Time Frame
3 years
Secondary Outcome Measure Information:
Title
Overall survival
Description
Evaluate the effect of the addition of HIPEC with Mitomycin C to cytoreductive surgery in 12 months and 3 years overall survival rate (%OS).
Time Frame
12 months and 36 months after surgery
Title
Disease Free Survival
Description
Evaluate the effect of addition of HIPEC with Mitomycin C to cytoreductive surgery in 12 months and 3 years disease free survival rate (% DFS).
Time Frame
12 months and 36 months after surgery
Title
Evaluation of the morbidity and mortality related with the treatment
Description
Evaluate the safety (treatment-related morbidity and mortality) of addition of HIPEC with Mitomycin C to cytoreductive surgery in locally advanced colo-rectal cancer. It will be measured by the incidence rate of adverse events and deaths.
Time Frame
36 months after surgery
Title
HIPEC technique operating time
Description
Average operating time calculation.
Time Frame
36 months after surgery
Title
HIPEC technique length of hospital stay
Description
Average length of hospital stay calculation.
Time Frame
36 months after surgery
Title
HIPEC technique re-admission rate
Description
Average re-admission rate calculation.
Time Frame
36 months after surgery
Title
HIPEC technique laparoscopic vs laparotomy approach
Description
With this outcome it will be calculated the frequency of both surgery techniques and if it has any impact on the locoregional control of the disease.
Time Frame
36 months after surgery
Title
HIPEC technique open vs. closed HIPEC technique
Description
With this outcome it will be calculated the frequency of both surgery techniques and if it has any impact on the locoregional control of the disease.
Time Frame
36 months after surgery
Title
Quality of life questionnaire QLQ-C30
Description
With this outcome it will be calculated the effect on the quality of life of patients using questionnaire QLQ-C30.
Time Frame
At baseline, 1 month after surgery, 6 months after surgery, 12 months after surgery, 24 months after surgery and 36 months after surgery
Title
Quality of life questionnaires QLQ-CR29
Description
With this outcome it will be calculated the effect on the quality of life of patients using questionnaire QLQ-CR29.
Time Frame
At baseline, 1 month after surgery, 6 months after surgery, 12 months after surgery, 24 months after surgery and 36 months after surgery

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male and female patients between the ages of 18 and 75 years; Adenocarcinoma of the colon, sigma and colon-sigma joint which represent cT4a/b in line with The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual; Lymph node involvement: N0, the presence of N1/2 according to the 7th edition of the AJCC is allowed, provided that they can be resectable; Metastatic extent: M0; Karnofsky index >70 or Performance status ≤2; Informed consent properly completed. Exclusion Criteria: Presence of metastases (M1), in case of liver or peritoneal metastases at the time of surgery, the patient will be excluded from the trial and treated according to their new stage. Presence of unresectability criteria; Urgent intervention due to obstruction or perforation if there is tumor removal, prior interventions will be accepted as referrals without primary tumor removal or drainage of collections prior to scheduled surgery. Extraperitoneal rectal cáncer (avoiding alterations for neoadyuvance); Coexistence of another malignant neoplastic disease (synchronous tumors of the colon and upper rectum are accepted as long as the stage is equal to or less than the treated tumor). Severely altered liver, kidney and cardiovascular function; Intolerance to treatment; Administration of chemotherapy before the trial (use of neoadyuvance is discarded); Pregnant or breastfeeding women.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Álvaro Arjona Sánchez, MD
Organizational Affiliation
Hospital Universitario Reina Sofía
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hospital de Sant Joan Despí. Moisès Broggi
City
Sant Joan Despí
State/Province
Barcelona
ZIP/Postal Code
08970
Country
Spain
Facility Name
Hospital Provincial de Castellón
City
Castellón De La Plana
State/Province
Castellón
ZIP/Postal Code
12002
Country
Spain
Facility Name
Hospital Universitario Son Espases
City
Palma De Mallorca
State/Province
Islas Baleares
Country
Spain
Facility Name
Hospital Universitario de Gran Canaria "Dr. Negrín"
City
Las Palmas De Gran Canaria
State/Province
Islas Canarias
ZIP/Postal Code
35019
Country
Spain
Facility Name
Hospital Universitario Nuestra Señora de Candelaria
City
Santa Cruz De Tenerife
State/Province
Islas Canarias
ZIP/Postal Code
38010
Country
Spain
Facility Name
Hospital Universitario Príncipe de Asturias
City
Alcalá De Henares
State/Province
Madrid
Country
Spain
Facility Name
Hospital Universitario de Fuenlabrada
City
Fuenlabrada
State/Province
Madrid
ZIP/Postal Code
28942
Country
Spain
Facility Name
Hospital Universitario Torrecárdenas
City
Almería
ZIP/Postal Code
04009
Country
Spain
Facility Name
Hospital Universitario de Badajoz
City
Badajoz
ZIP/Postal Code
06080
Country
Spain
Facility Name
Hospital General Universitario de Ciudad Real
City
Ciudad Real
ZIP/Postal Code
13005
Country
Spain
Facility Name
Hospital Universitario Reina Sofía
City
Córdoba
ZIP/Postal Code
14004
Country
Spain
Facility Name
MD Anderson Cancer Center
City
Madrid
ZIP/Postal Code
28033
Country
Spain
Facility Name
Hospital Universitario Fundación Jiménez Díaz
City
Madrid
ZIP/Postal Code
28040
Country
Spain
Facility Name
Hospital Universitario La Paz
City
Madrid
ZIP/Postal Code
28046
Country
Spain
Facility Name
Hospital Universitario HM Sanchinarro
City
Madrid
ZIP/Postal Code
28050
Country
Spain
Facility Name
Hospital General Universitario Reina Sofía
City
Murcia
ZIP/Postal Code
30003
Country
Spain
Facility Name
Hospital Regional Universitario de Málaga
City
Málaga
Country
Spain
Facility Name
Instituto Valenciano de Oncología
City
Valencia
ZIP/Postal Code
46009
Country
Spain
Facility Name
Hospital Clínico Universitario de Valencia
City
Valencia
ZIP/Postal Code
46010
Country
Spain

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
The individual participant data will be available. Individual parcicipant data that underlie the results reportes in this article, after deidenttification (text, tables, figures and appendices) The other documents that will be available: study protocol, Statistical Analysis Plan, Informed Consent Form. The data will be available beginning 9 months and ending 36 months following article publication. With whom? Researchers who provide a methodologically sound proposal. For what types of analyses? for individual participant data meta-analysis.
IPD Sharing Time Frame
The data will be available beginning 9 months and ending 36 months following article publication.
IPD Sharing Access Criteria
To obtain the data, a proposal must be sent to uicec@imibic.org. To gain access, data requestors will need to sign a data access agreement.
Citations:
PubMed Identifier
29439668
Citation
Arjona-Sanchez A, Barrios P, Boldo-Roda E, Camps B, Carrasco-Campos J, Concepcion Martin V, Garcia-Fadrique A, Gutierrez-Calvo A, Morales R, Ortega-Perez G, Perez-Viejo E, Prada-Villaverde A, Torres-Melero J, Vicente E, Villarejo-Campos P, Sanchez-Hidalgo JM, Casado-Adam A, Garcia-Martin R, Medina M, Caro T, Villar C, Aranda E, Cano-Osuna MT, Diaz-Lopez C, Torres-Tordera E, Briceno-Delgado FJ, Rufian-Pena S. HIPECT4: multicentre, randomized clinical trial to evaluate safety and efficacy of Hyperthermic intra-peritoneal chemotherapy (HIPEC) with Mitomycin C used during surgery for treatment of locally advanced colorectal carcinoma. BMC Cancer. 2018 Feb 13;18(1):183. doi: 10.1186/s12885-018-4096-0.
Results Reference
derived

Learn more about this trial

Clinical Trial to Evaluate Safety and Efficacy of Hyperthermic Intra-peritoneal Chemotherapy (HIPEC) With Mitomycin C Used During Surgery for Treatment of Locally Advanced Colorectal Carcinoma

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