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Pre-op Rectal ChemoRad +/- Cetuximab

Primary Purpose

Rectal Cancer

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Cetuximab
5-fluorouracil
Pelvic irradiation
Sponsored by
US Oncology Research
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Rectal Cancer

Eligibility Criteria

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

Inclusion Criteria:

Note: Please see Section 8.1 for the necessary "Prestudy Assessments".

A patient will be eligible for inclusion in this study if s/he meets all of the following criteria:

  • Has a histologically confirmed diagnosis of newly diagnosed adenocarcinoma of the rectum (tumor within 15 cm of the anal verge). Location of tumor (lower 1/3rd vs. middle or upper 1/3rd) and pre-treatment nodal status (N0 vs. N1 or N2) will be recorded in the eCRF. Patients with only non-measurable disease are eligible as long as they meet the other disease requirements in this criterion as well as all other eligibility criteria.
  • Has tumor that is locally advanced (T3/T4 or lymph node positive) by preoperative assessment with CT or MRI imaging or transrectal ultrasonography.
  • Has no evidence of distant metastases by radiographic staging
  • Has an ECOG Performance Status (PS) 0-1
  • Is greater than 18 years of age
  • Has adequate marrow and organ system function as assessed by the following lab values:

White blood cell (WBC) count See protocol for specific details Absolute neutrophil count (ANC) See protocol for specific details Hemoglobin See protocol for specific details Total bilirubin See protocol for specific details AST and ALT See protocol for specific details Serum creatinine See protocol for specific details Platelet count See protocol for specific details

  • Sexually active women of childbearing potential must use an effective method of birth control during the course of the study, in a manner such that risk of failure is minimized.

Prior to study enrollment, women of childbearing potential (WOCBP) must be advised of the importance of avoiding pregnancy during trial participation and the potential risk factors for an unintentional pregnancy. In addition, men enrolled on this study should understand the risks to any sexual partner of childbearing potential and should practice an effective method of birth control.

All WOCBP MUST have a negative pregnancy test within 3 weeks prior to registration (confirmed within 7 days prior to first receiving investigational product). If the pregnancy test is positive, the patient must not receive investigational product and must not be enrolled in the study.

In addition, all WOCBP should be instructed to contact the Investigator immediately if they suspect they might be pregnant (eg, missed or late menstrual period) at any time during study participation.

The Investigator must immediately notify BMS in the event of a confirmed pregnancy in a patient participating in the study.

  • Has signed a Patient Informed Consent Form
  • Has signed a Patient Authorization Form

Exclusion Criteria:

  • A patient will be excluded from this study if s/he meets any of the following criteria:
  • Has another disease similar to one being studied (ie, colon cancer)
  • Has evidence of distant metastases by radiographic staging
  • Has had prior treatment for the current disease
  • Has had prior stem cell or bone marrow transplant or any organ transplant with the exception of corneal transplant or cadaver bone graft
  • Has a history of hypersensitivity to any of study treatments
  • Has had a prior severe infusion reaction to a monoclonal antibody
  • Has received prior therapy, at any time, which specifically and directly targets the EGFR pathway
  • Has a significant history of uncontrolled cardiac disease; ie, uncontrolled hypertension, unstable angina, recent myocardial infarction (within prior 6 months), uncontrolled congestive heart failure, or cardiomyopathy with decreased ejection fraction
  • Has evidence of CNS involvement (CNS imaging is not required for study enrollment unless clinically suspected CNS disease is present.)
  • Has a serious uncontrolled intercurrent medical or psychiatric illness, including serious infection or Gilbert's Syndrome
  • Has a history of other malignancy within the last 5 years (except cured basal cell carcinoma of skin and carcinoma in situ of uterine cervix), which could affect the diagnosis or assessment of any of the study drugs. Patients, who have received prior radiotherapy to any regional site other than the pelvis, as long as all other inclusion criteria are met, could be considered for enrollment after discussion with Dr. McCollum.
  • Is a pregnant or nursing woman
  • Is unable to comply with requirements of study

Sites / Locations

  • Oncology Associates D.B.A. Hematology Oncology Physicians & Extenders
  • Melbourne Internal Medicine Associates
  • Advanced Medical Specialties
  • Cancer Centers of Florida, P.A.
  • Cancer Care & Hematology Specialists of Chicagoland, PC
  • Central Indiana Cancer Centers
  • Kansas City Cancer Centers-Southwest
  • Alliance Hematology Oncology PA
  • Missouri Cance Associates
  • St. Joseph Oncology, Inc.
  • Comprehensive Cancer Centers of Nevada
  • New York Oncology Hematology, P.C.
  • Cancer Centers of North Carolina
  • Willamette Valley Cancer Center
  • Texas Oncology - Amarillo
  • Texas Oncology Cance Center
  • Mamie McFaddin Ward Cancer Center
  • Texas Cancer Center at Medical City
  • Methodist Charlton Cancer Ctr.
  • Texas Oncology, P.A.
  • Texas Cancer Center
  • El Paso Cancer Treatment Ctr
  • Texas Oncology, P.A.
  • Lake Vista Cancer Center
  • Longview Cance Center
  • Allison Cancer Center
  • Texas Oncology-Odessa
  • Paris Regional Cancer Center
  • HOAST - Medical Dr.
  • Texas Cancer Center - Sherman
  • Texas Oncology Cancer Center-Sugar Land
  • Tyler Cancer Center
  • Texas Oncology Cancer Care and Research
  • Texas Oncology, P.A.
  • Texoma Cancer Center
  • Virginia Oncology Associates
  • Highline Medical Oncology
  • Cancer Care Northwest-South
  • Northwest Cancer Specialists-Vancouver
  • Yakima Valley Mem Hosp/North Star Lodge
  • Raleigh Regional Cancer Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Chemoradiotherapy plus Cetuximab

Chemoradiotherapy alone

Arm Description

Pelvic irradiation plus 5-fluorouracil plus cetuximab

Pelvic irradiation plus 5-fluorouracil

Outcomes

Primary Outcome Measures

Percentage of Pathologic Response Rate (pCR) With 95% Confidence Interval.
A pathologic complete response (pCR) is defined as no pathologic evidence of invasive disease at the primary site in the bowel wall or in examined mesorectal tissue and/or lymph nodes.

Secondary Outcome Measures

To Determine Objective Response Rate (ORR) Based on RECIST Local Recurrence-free Survival in These Patient Groups; Overall and Recurrence-free Survival in These Cohorts.
Complete Response (CR): Disappearance of all target lesions. Partial Response (PR): At least a 30% decrease in the sum of the LD of target lesions taking as reference the baseline sum LD.
5- Year Overall Survival (OS) Rate
Overall survival is measured from the date of randomization to the date of death for a dead patient. If a patient is still alive or is lost to follow up, the patient will be censored at the date of last contact.
Recurrence-free Survival (RFS) Rate at 5 Years
RFS is measured from the date of randomization to the date of first documented disease recurrence or date of death, whichever comes first. If a patient neither recurrences nor dies, this patient will be censored at the date of last contact.
KRAS Mutation Rate
Percentage of Participants with KRAS mutation.

Full Information

First Posted
September 7, 2007
Last Updated
September 15, 2016
Sponsor
US Oncology Research
Collaborators
Bristol-Myers Squibb, Eli Lilly and Company
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1. Study Identification

Unique Protocol Identification Number
NCT00527111
Brief Title
Pre-op Rectal ChemoRad +/- Cetuximab
Official Title
A Randomized Phase II Trial of Pre-operative Chemoradiotherapy With or Without Cetuximab (ERBITUX(R)) in Locally-advanced Adenocarcinoma of the Rectum
Study Type
Interventional

2. Study Status

Record Verification Date
September 2016
Overall Recruitment Status
Completed
Study Start Date
February 2007 (undefined)
Primary Completion Date
January 2015 (Actual)
Study Completion Date
January 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
US Oncology Research
Collaborators
Bristol-Myers Squibb, Eli Lilly and Company

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this research study is to find out what effects (good and bad) cetuximab has on rectal cancer.
Detailed Description
Rectal cancer remains a significant cause of morbidity and mortality in the United States. Standard treatment for patients with locally advanced rectal cancer generally includes combined chemotherapy and radiotherapy administered either before (neoadjuvant) or after (adjuvant) definitive surgical resection. Published data from Germany has suggested advantages to a neoadjuvant strategy. Currently, the standard concurrent chemoradiotherapy regimen in the United States is pelvic irradiation administered concurrently with 5-fluorouracil (5-FU) given as a protracted venous infusion. However, local recurrence remains a problem. Recently completed randomized trials of chemoradiotherapy have demonstrated local recurrence rates between 8-17% even with currently accepted standard chemoradiotherapy and adequate surgical management. Several recent trials have explored the use of radiotherapy and cetuximab with good results. Because of the non-overlapping toxicity profiles and the potentially diverse and complimentary mechanisms of action, the combination of chemotherapy plus ERBITUX given concurrently with pelvic radiotherapy may improve on the outcomes seen with current standards for patients with locally advanced adenocarcinoma of the rectum.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Rectal Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
139 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Chemoradiotherapy plus Cetuximab
Arm Type
Experimental
Arm Description
Pelvic irradiation plus 5-fluorouracil plus cetuximab
Arm Title
Chemoradiotherapy alone
Arm Type
Active Comparator
Arm Description
Pelvic irradiation plus 5-fluorouracil
Intervention Type
Drug
Intervention Name(s)
Cetuximab
Other Intervention Name(s)
Erbitux
Intervention Type
Drug
Intervention Name(s)
5-fluorouracil
Other Intervention Name(s)
5-FU
Intervention Type
Radiation
Intervention Name(s)
Pelvic irradiation
Other Intervention Name(s)
Radiotherapy
Primary Outcome Measure Information:
Title
Percentage of Pathologic Response Rate (pCR) With 95% Confidence Interval.
Description
A pathologic complete response (pCR) is defined as no pathologic evidence of invasive disease at the primary site in the bowel wall or in examined mesorectal tissue and/or lymph nodes.
Time Frame
5 years
Secondary Outcome Measure Information:
Title
To Determine Objective Response Rate (ORR) Based on RECIST Local Recurrence-free Survival in These Patient Groups; Overall and Recurrence-free Survival in These Cohorts.
Description
Complete Response (CR): Disappearance of all target lesions. Partial Response (PR): At least a 30% decrease in the sum of the LD of target lesions taking as reference the baseline sum LD.
Time Frame
5 years
Title
5- Year Overall Survival (OS) Rate
Description
Overall survival is measured from the date of randomization to the date of death for a dead patient. If a patient is still alive or is lost to follow up, the patient will be censored at the date of last contact.
Time Frame
5 years
Title
Recurrence-free Survival (RFS) Rate at 5 Years
Description
RFS is measured from the date of randomization to the date of first documented disease recurrence or date of death, whichever comes first. If a patient neither recurrences nor dies, this patient will be censored at the date of last contact.
Time Frame
5 years
Title
KRAS Mutation Rate
Description
Percentage of Participants with KRAS mutation.
Time Frame
5 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Note: Please see Section 8.1 for the necessary "Prestudy Assessments". A patient will be eligible for inclusion in this study if s/he meets all of the following criteria: Has a histologically confirmed diagnosis of newly diagnosed adenocarcinoma of the rectum (tumor within 15 cm of the anal verge). Location of tumor (lower 1/3rd vs. middle or upper 1/3rd) and pre-treatment nodal status (N0 vs. N1 or N2) will be recorded in the eCRF. Patients with only non-measurable disease are eligible as long as they meet the other disease requirements in this criterion as well as all other eligibility criteria. Has tumor that is locally advanced (T3/T4 or lymph node positive) by preoperative assessment with CT or MRI imaging or transrectal ultrasonography. Has no evidence of distant metastases by radiographic staging Has an ECOG Performance Status (PS) 0-1 Is greater than 18 years of age Has adequate marrow and organ system function as assessed by the following lab values: White blood cell (WBC) count See protocol for specific details Absolute neutrophil count (ANC) See protocol for specific details Hemoglobin See protocol for specific details Total bilirubin See protocol for specific details AST and ALT See protocol for specific details Serum creatinine See protocol for specific details Platelet count See protocol for specific details Sexually active women of childbearing potential must use an effective method of birth control during the course of the study, in a manner such that risk of failure is minimized. Prior to study enrollment, women of childbearing potential (WOCBP) must be advised of the importance of avoiding pregnancy during trial participation and the potential risk factors for an unintentional pregnancy. In addition, men enrolled on this study should understand the risks to any sexual partner of childbearing potential and should practice an effective method of birth control. All WOCBP MUST have a negative pregnancy test within 3 weeks prior to registration (confirmed within 7 days prior to first receiving investigational product). If the pregnancy test is positive, the patient must not receive investigational product and must not be enrolled in the study. In addition, all WOCBP should be instructed to contact the Investigator immediately if they suspect they might be pregnant (eg, missed or late menstrual period) at any time during study participation. The Investigator must immediately notify BMS in the event of a confirmed pregnancy in a patient participating in the study. Has signed a Patient Informed Consent Form Has signed a Patient Authorization Form Exclusion Criteria: A patient will be excluded from this study if s/he meets any of the following criteria: Has another disease similar to one being studied (ie, colon cancer) Has evidence of distant metastases by radiographic staging Has had prior treatment for the current disease Has had prior stem cell or bone marrow transplant or any organ transplant with the exception of corneal transplant or cadaver bone graft Has a history of hypersensitivity to any of study treatments Has had a prior severe infusion reaction to a monoclonal antibody Has received prior therapy, at any time, which specifically and directly targets the EGFR pathway Has a significant history of uncontrolled cardiac disease; ie, uncontrolled hypertension, unstable angina, recent myocardial infarction (within prior 6 months), uncontrolled congestive heart failure, or cardiomyopathy with decreased ejection fraction Has evidence of CNS involvement (CNS imaging is not required for study enrollment unless clinically suspected CNS disease is present.) Has a serious uncontrolled intercurrent medical or psychiatric illness, including serious infection or Gilbert's Syndrome Has a history of other malignancy within the last 5 years (except cured basal cell carcinoma of skin and carcinoma in situ of uterine cervix), which could affect the diagnosis or assessment of any of the study drugs. Patients, who have received prior radiotherapy to any regional site other than the pelvis, as long as all other inclusion criteria are met, could be considered for enrollment after discussion with Dr. McCollum. Is a pregnant or nursing woman Is unable to comply with requirements of study
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Andrew D McCollum, MD
Organizational Affiliation
US Oncology Research
Official's Role
Principal Investigator
Facility Information:
Facility Name
Oncology Associates D.B.A. Hematology Oncology Physicians & Extenders
City
Tucson
State/Province
Arizona
ZIP/Postal Code
85704
Country
United States
Facility Name
Melbourne Internal Medicine Associates
City
Melbourne
State/Province
Florida
ZIP/Postal Code
32901
Country
United States
Facility Name
Advanced Medical Specialties
City
Miami
State/Province
Florida
ZIP/Postal Code
33133
Country
United States
Facility Name
Cancer Centers of Florida, P.A.
City
Ocoee
State/Province
Florida
ZIP/Postal Code
34761
Country
United States
Facility Name
Cancer Care & Hematology Specialists of Chicagoland, PC
City
Niles
State/Province
Illinois
ZIP/Postal Code
60714
Country
United States
Facility Name
Central Indiana Cancer Centers
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
76227
Country
United States
Facility Name
Kansas City Cancer Centers-Southwest
City
Overland Park
State/Province
Kansas
ZIP/Postal Code
66210
Country
United States
Facility Name
Alliance Hematology Oncology PA
City
Westminster
State/Province
Maryland
ZIP/Postal Code
21157
Country
United States
Facility Name
Missouri Cance Associates
City
Columbia
State/Province
Missouri
ZIP/Postal Code
65201
Country
United States
Facility Name
St. Joseph Oncology, Inc.
City
St. Joseph
State/Province
Missouri
ZIP/Postal Code
64507
Country
United States
Facility Name
Comprehensive Cancer Centers of Nevada
City
Las Vegas
State/Province
Nevada
ZIP/Postal Code
89169
Country
United States
Facility Name
New York Oncology Hematology, P.C.
City
Albany
State/Province
New York
ZIP/Postal Code
12206
Country
United States
Facility Name
Cancer Centers of North Carolina
City
Raleigh
State/Province
North Carolina
ZIP/Postal Code
27607
Country
United States
Facility Name
Willamette Valley Cancer Center
City
Eugene
State/Province
Oregon
ZIP/Postal Code
97401
Country
United States
Facility Name
Texas Oncology - Amarillo
City
Amarillo
State/Province
Texas
ZIP/Postal Code
79106
Country
United States
Facility Name
Texas Oncology Cance Center
City
Austin
State/Province
Texas
ZIP/Postal Code
78731
Country
United States
Facility Name
Mamie McFaddin Ward Cancer Center
City
Beaumont
State/Province
Texas
ZIP/Postal Code
77702
Country
United States
Facility Name
Texas Cancer Center at Medical City
City
Dallas
State/Province
Texas
ZIP/Postal Code
75230
Country
United States
Facility Name
Methodist Charlton Cancer Ctr.
City
Dallas
State/Province
Texas
ZIP/Postal Code
75237
Country
United States
Facility Name
Texas Oncology, P.A.
City
Dallas
State/Province
Texas
ZIP/Postal Code
75246
Country
United States
Facility Name
Texas Cancer Center
City
Denton
State/Province
Texas
ZIP/Postal Code
76210
Country
United States
Facility Name
El Paso Cancer Treatment Ctr
City
El Paso
State/Province
Texas
ZIP/Postal Code
79915
Country
United States
Facility Name
Texas Oncology, P.A.
City
Fort Worth
State/Province
Texas
ZIP/Postal Code
76104
Country
United States
Facility Name
Lake Vista Cancer Center
City
Lewisville
State/Province
Texas
ZIP/Postal Code
75067
Country
United States
Facility Name
Longview Cance Center
City
Longview
State/Province
Texas
ZIP/Postal Code
75601
Country
United States
Facility Name
Allison Cancer Center
City
Midland
State/Province
Texas
ZIP/Postal Code
79701
Country
United States
Facility Name
Texas Oncology-Odessa
City
Odessa
State/Province
Texas
ZIP/Postal Code
79761
Country
United States
Facility Name
Paris Regional Cancer Center
City
Paris
State/Province
Texas
ZIP/Postal Code
75460
Country
United States
Facility Name
HOAST - Medical Dr.
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States
Facility Name
Texas Cancer Center - Sherman
City
Sherman
State/Province
Texas
ZIP/Postal Code
75090
Country
United States
Facility Name
Texas Oncology Cancer Center-Sugar Land
City
Sugar Land
State/Province
Texas
ZIP/Postal Code
77479
Country
United States
Facility Name
Tyler Cancer Center
City
Tyler
State/Province
Texas
ZIP/Postal Code
75702
Country
United States
Facility Name
Texas Oncology Cancer Care and Research
City
Waco
State/Province
Texas
ZIP/Postal Code
76712
Country
United States
Facility Name
Texas Oncology, P.A.
City
Webster
State/Province
Texas
ZIP/Postal Code
77598
Country
United States
Facility Name
Texoma Cancer Center
City
Wichita Falls
State/Province
Texas
ZIP/Postal Code
76310
Country
United States
Facility Name
Virginia Oncology Associates
City
Norfolk
State/Province
Virginia
ZIP/Postal Code
23502
Country
United States
Facility Name
Highline Medical Oncology
City
Burien
State/Province
Washington
ZIP/Postal Code
98166
Country
United States
Facility Name
Cancer Care Northwest-South
City
Spokane
State/Province
Washington
ZIP/Postal Code
99202
Country
United States
Facility Name
Northwest Cancer Specialists-Vancouver
City
Vancouver
State/Province
Washington
ZIP/Postal Code
98684
Country
United States
Facility Name
Yakima Valley Mem Hosp/North Star Lodge
City
Yakima
State/Province
Washington
ZIP/Postal Code
98902
Country
United States
Facility Name
Raleigh Regional Cancer Center
City
Beckley
State/Province
West Virginia
ZIP/Postal Code
25801
Country
United States

12. IPD Sharing Statement

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Pre-op Rectal ChemoRad +/- Cetuximab

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