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Oxaliplatin, Irinotecan, and Capecitabine in Treating Patients With Advanced or Metastatic Colorectal Cancer That Cannot Be Removed By Surgery

Primary Purpose

Colorectal Cancer

Status
Completed
Phase
Phase 1
Locations
Switzerland
Study Type
Interventional
Intervention
Capecitabine
irinotecan hydrochloride
oxaliplatin
Sponsored by
Swiss Group for Clinical Cancer Research
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Colorectal Cancer focused on measuring stage III colon cancer, stage IV colon cancer, stage III rectal cancer, stage IV rectal cancer

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

DISEASE CHARACTERISTICS: Histologically or cytologically confirmed unresectable advanced or metastatic colorectal cancer Measurable disease (phase II only) At least 1 unidimensionally measurable lesion ≥ 20 mm by conventional techniques OR ≥ 10 mm by spiral CT scan or MRI No presence or history of CNS metastases PATIENT CHARACTERISTICS: Age 18 to 70 Performance status WHO 0-1 Life expectancy Not specified Hematopoietic Absolute neutrophil count ≥ 1,500/mm^3 Platelet count ≥ 100,000/mm^3 Hepatic Bilirubin ≤ 1.25 times upper limit of normal (ULN) (1.5 times ULN if liver metastases are present) AST and ALT ≤ 3 times ULN (5 times ULN if liver metastases are present) Renal Creatinine clearance > 60 mL/min Cardiovascular No New York Heart Association class III-IV congestive heart failure No symptomatic coronary artery disease No uncontrolled cardiac arrhythmia No myocardial infarction within the past year No other clinically significant cardiac disease Immunologic No active autoimmune disease No uncontrolled infection No prior severe reaction to fluoropyrimidine therapy or known hypersensitivity to fluorouracil No known hypersensitivity to any component of study drugs Other Not pregnant or nursing Negative pregnancy test Patients must use effective contraception during and for 1 year after study participation No other malignancy within the past 5 years except adequately treated carcinoma in situ of the cervix or localized nonmelanoma skin cancer No peripheral neuropathy > grade 1 of any origin (e.g., alcohol or diabetes) No nausea, vomiting, or malabsorption syndrome that would preclude ingestion or absorption of oral medication No psychiatric disability that would preclude study compliance No uncontrolled diabetes No other serious underlying medical condition that would preclude study participation No known dihydropyrimidine dehydrogenase deficiency PRIOR CONCURRENT THERAPY: Biologic therapy No concurrent prophylactic hematopoietic growth factors Chemotherapy More than 6 months since prior adjuvant fluoropyrimidine chemotherapy No other prior chemotherapy Endocrine therapy Not specified Radiotherapy No concurrent radiotherapy Concurrent radiotherapy of a single painful lesion allowed Surgery Not specified Other More than 30 days since prior clinical trial participation No other concurrent experimental drugs No other concurrent anticancer therapy No concurrent sorivudine or its chemically-related analogues (e.g., lamivudine)

Sites / Locations

  • Kantonsspital Graubuenden
  • Hopital Cantonal Universitaire de Geneve
  • Hirslanden Klinik Aarau
  • City Hospital Triemli

Arms of the Study

Arm 1

Arm Type

Active Comparator

Arm Label

Arm A

Arm Description

Oxaliplatin, Irinotecan, and Capecitabine

Outcomes

Primary Outcome Measures

capecitabine + oxaliplatin + irinotecan dose finding
Determine the maximum tolerated dose and recommended phase II dose of capecitabine administered in combination with oxaliplatin and irinotecan in patients with unresectable advanced or metastatic colorectal cancer. (Phase I)
Efficacy of Oxaliplatin, Irinotecan, and Capecitabine
Determine the efficacy of this regimen in these patients (Phase II)

Secondary Outcome Measures

Objective response (CR or PR) as measured after completion of study treatment
Adverse events as measured after completion of study treatment
Time to progression
Time to treatment failure as measured after completion of study treatment
Overall survival

Full Information

First Posted
September 20, 2005
Last Updated
June 2, 2012
Sponsor
Swiss Group for Clinical Cancer Research
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1. Study Identification

Unique Protocol Identification Number
NCT00217711
Brief Title
Oxaliplatin, Irinotecan, and Capecitabine in Treating Patients With Advanced or Metastatic Colorectal Cancer That Cannot Be Removed By Surgery
Official Title
Oxaliplatin, Irinotecan, and Capecitabine as a Combination Regimen for First-Line Treatment of Advanced or Metastatic Colorectal Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
June 2012
Overall Recruitment Status
Completed
Study Start Date
May 2005 (undefined)
Primary Completion Date
August 2007 (Actual)
Study Completion Date
October 2011 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Swiss Group for Clinical Cancer Research

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
RATIONALE: Drugs used in chemotherapy, such as oxaliplatin, irinotecan, and capecitabine, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more tumor cells. PURPOSE: This phase I/II trial is studying the side effects and best dose of capecitabine when given together with oxaliplatin and irinotecan and to see how well they work in treating patients with advanced or metastatic colorectal cancer that cannot be removed by surgery.
Detailed Description
OBJECTIVES: Primary Determine the maximum tolerated dose and recommended phase II dose of capecitabine administered in combination with oxaliplatin and irinotecan in patients with unresectable advanced or metastatic colorectal cancer. (Phase I) Determine the efficacy of this regimen in these patients. (Phase II) Secondary Determine the tolerability of this regimen in these patients. (Phase II) OUTLINE: This is a multicenter, phase I dose-escalation study of capecitabine followed by a phase II study. Phase I: Patients receive oxaliplatin IV over 2 hours on days 1 and 15, irinotecan IV over 1 hour on days 8 and 22, and oral capecitabine twice daily on days 1-29. Treatment repeats every 5 weeks for up to 6 courses in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of capecitabine until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. Phase II: Patients receive capecitabine at the MTD and irinotecan and oxaliplatin as in phase I. After completion of study treatment, patients are followed every 2 months for 1 year and then every 4 months thereafter. PROJECTED ACCRUAL: A total of 23-32 patients (3-12 for the phase I portion and 20 for the phase II portion) will be accrued for this study within 2.75 years

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Colorectal Cancer
Keywords
stage III colon cancer, stage IV colon cancer, stage III rectal cancer, stage IV rectal cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
23 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm A
Arm Type
Active Comparator
Arm Description
Oxaliplatin, Irinotecan, and Capecitabine
Intervention Type
Drug
Intervention Name(s)
Capecitabine
Intervention Description
capecitabine
Intervention Type
Drug
Intervention Name(s)
irinotecan hydrochloride
Intervention Description
irinotecan hydrochloride
Intervention Type
Drug
Intervention Name(s)
oxaliplatin
Intervention Description
oxaliplatin
Primary Outcome Measure Information:
Title
capecitabine + oxaliplatin + irinotecan dose finding
Description
Determine the maximum tolerated dose and recommended phase II dose of capecitabine administered in combination with oxaliplatin and irinotecan in patients with unresectable advanced or metastatic colorectal cancer. (Phase I)
Time Frame
30 days
Title
Efficacy of Oxaliplatin, Irinotecan, and Capecitabine
Description
Determine the efficacy of this regimen in these patients (Phase II)
Time Frame
2 months
Secondary Outcome Measure Information:
Title
Objective response (CR or PR) as measured after completion of study treatment
Time Frame
2 months
Title
Adverse events as measured after completion of study treatment
Time Frame
2 months
Title
Time to progression
Time Frame
life-long
Title
Time to treatment failure as measured after completion of study treatment
Time Frame
life-long
Title
Overall survival
Time Frame
life-long

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically or cytologically confirmed unresectable advanced or metastatic colorectal cancer Measurable disease (phase II only) At least 1 unidimensionally measurable lesion ≥ 20 mm by conventional techniques OR ≥ 10 mm by spiral CT scan or MRI No presence or history of CNS metastases PATIENT CHARACTERISTICS: Age 18 to 70 Performance status WHO 0-1 Life expectancy Not specified Hematopoietic Absolute neutrophil count ≥ 1,500/mm^3 Platelet count ≥ 100,000/mm^3 Hepatic Bilirubin ≤ 1.25 times upper limit of normal (ULN) (1.5 times ULN if liver metastases are present) AST and ALT ≤ 3 times ULN (5 times ULN if liver metastases are present) Renal Creatinine clearance > 60 mL/min Cardiovascular No New York Heart Association class III-IV congestive heart failure No symptomatic coronary artery disease No uncontrolled cardiac arrhythmia No myocardial infarction within the past year No other clinically significant cardiac disease Immunologic No active autoimmune disease No uncontrolled infection No prior severe reaction to fluoropyrimidine therapy or known hypersensitivity to fluorouracil No known hypersensitivity to any component of study drugs Other Not pregnant or nursing Negative pregnancy test Patients must use effective contraception during and for 1 year after study participation No other malignancy within the past 5 years except adequately treated carcinoma in situ of the cervix or localized nonmelanoma skin cancer No peripheral neuropathy > grade 1 of any origin (e.g., alcohol or diabetes) No nausea, vomiting, or malabsorption syndrome that would preclude ingestion or absorption of oral medication No psychiatric disability that would preclude study compliance No uncontrolled diabetes No other serious underlying medical condition that would preclude study participation No known dihydropyrimidine dehydrogenase deficiency PRIOR CONCURRENT THERAPY: Biologic therapy No concurrent prophylactic hematopoietic growth factors Chemotherapy More than 6 months since prior adjuvant fluoropyrimidine chemotherapy No other prior chemotherapy Endocrine therapy Not specified Radiotherapy No concurrent radiotherapy Concurrent radiotherapy of a single painful lesion allowed Surgery Not specified Other More than 30 days since prior clinical trial participation No other concurrent experimental drugs No other concurrent anticancer therapy No concurrent sorivudine or its chemically-related analogues (e.g., lamivudine)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Razvan Popescu, MD
Organizational Affiliation
Centre Hospitalier Universitaire Vaudois
Official's Role
Study Chair
Facility Information:
Facility Name
Kantonsspital Graubuenden
City
Chur
ZIP/Postal Code
CH-7000
Country
Switzerland
Facility Name
Hopital Cantonal Universitaire de Geneve
City
Geneva
ZIP/Postal Code
CH-1211
Country
Switzerland
Facility Name
Hirslanden Klinik Aarau
City
Lausanne
ZIP/Postal Code
CH-1011
Country
Switzerland
Facility Name
City Hospital Triemli
City
Zurich
ZIP/Postal Code
CH-8063
Country
Switzerland

12. IPD Sharing Statement

Citations:
PubMed Identifier
20523092
Citation
von Moos R, Roth A, Ruhstaller T, Widmer L, Uhlmann C, Cathomas R, Koberle D, Simcock M, Lanz D, Popescu R. Oxaliplatin, irinotecan and capecitabine (OCX) for first-line treatment of advanced/metastatic colorectal cancer: a phase I trial (SAKK 41/03). Onkologie. 2010;33(6):295-9. doi: 10.1159/000313598. Epub 2010 May 14.
Results Reference
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Oxaliplatin, Irinotecan, and Capecitabine in Treating Patients With Advanced or Metastatic Colorectal Cancer That Cannot Be Removed By Surgery

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