S0713: Oxaliplatin, Capecitabine, Cetuximab, and RT Followed By Surgery in Pts W/Stage II or III Rectal Cancer
Colorectal Cancer
About this trial
This is an interventional treatment trial for Colorectal Cancer focused on measuring adenocarcinoma of the rectum, stage IIA rectal cancer, stage IIB rectal cancer, stage IIC rectal cancer, stage IIIA rectal cancer, stage IIIB rectal cancer, stage IIIC rectal cancer
Eligibility Criteria
DISEASE CHARACTERISTICS:
Biopsy-proven primary adenocarcinoma of the rectum
- Stage II or III disease
- The distal border of the tumor must be at or below the peritoneal reflection, defined as within 12 cm of the anal verge by proctoscopic examination
- No recurrent disease
- Must have wild-type k-ras status
- Measurable and/or nonmeasurable disease
PATIENT CHARACTERISTICS:
- Zubrod performance status 0-2
- Leukocyte count ≥ 3,000/mcL
- Granulocyte count ≥ 1,500/mcL
- Platelet count ≥ 100,000/mcL
- Bilirubin ≤ 1.5 times upper limit of normal (ULN)
- Alkaline phosphatase ≤ 2.5 times ULN
- SGOT (serum glutamate oxaloacetate transaminase) or SGPT (serum glutamate pyruvate transaminase)≤ 2.5 times ULN
- Creatinine clearance > 50 mL/min
- No prior severe reaction to a monoclonal antibody
- Willing to have specimens submitted
- No peripheral neuropathy ≥ grade 2
- No known existing uncontrolled coagulopathy
No evidence of current high-grade obstruction
- At least 2 weeks since prior diverting procedure
- No history of allergy to platinum compounds or to antiemetics appropriate for administration in conjunction with protocol treatment
- No prior unanticipated severe reaction to fluoropyrimidine therapy or known sensitivity to fluorouracil or known DPD deficiency
- No active inflammatory bowel disease, malabsorption syndrome, or inability to swallow that would impair the ingestion or absorption of capecitabine
- No uncontrolled intercurrent illness
- No ongoing or active infection
- No symptomatic congestive heart failure or unstable angina pectoris
- No cardiac arrhythmia or myocardial infarction within the past 12 months
- Not pregnant or nursing
- Fertile patients must use effective contraception
- No prior malignancy allowed except for adequately treated basal cell or squamous cell skin cancer, carcinoma in situ of the cervix, or other cancer from which the patient has been disease-free for 5 years
PRIOR CONCURRENT THERAPY:
- Recovered from any recent major surgeries (e.g., coronary artery bypass graft, transurethral resection of prostate, or abdominal surgery)
- No prior chemotherapy, radiotherapy, or targeted therapy for this tumor
- More than 4 weeks since prior investigational agents
- No concurrent anti-retroviral therapy for HIV
Sites / Locations
- Providence Cancer Center at Providence Hospital
- Arizona Cancer Center at UMC Orange Grove
- Arizona Cancer Center at University Medical Center North
- Arizona Cancer Center at University of Arizona Health Sciences Center
- Alta Bates Summit Comprehensive Cancer Center
- Peninsula Medical Center
- USC/Norris Comprehensive Cancer Center and Hospital
- Sutter Health - Western Division Cancer Research Group
- Desert Regional Medical Center Comprehensive Cancer Center
- Sutter Cancer Center at Roseville Medical Center
- Sutter Cancer Center
- California Pacific Medical Center - California Campus
- Sutter Pacific Medical Foundation
- Sutter Solano Medical Center
- Memorial Hospital Cancer Center - Colorado Springs
- Poudre Valley Hospital
- Front Range Cancer Specialists
- Decatur Memorial Hospital Cancer Care Institute
- Cardinal Bernardin Cancer Center at Loyola University Medical Center
- Regional Cancer Center at Memorial Medical Center
- St. Francis Hospital and Health Centers - Beech Grove Campus
- Reid Hospital & Health Care Services
- Cancer Center of Kansas, PA - Chanute
- Cancer Center of Kansas, PA - Dodge City
- Cancer Center of Kansas - Fort Scott
- Hays Medical Center
- Hutchinson Hospital Corporation
- Cancer Center of Kansas-Independence
- Kansas City Cancer Centers - West
- Kansas Masonic Cancer Research Institute at the University of Kansas Medical Center
- Cancer Center of Kansas, PA - Kingman
- Lawrence Memorial Hospital
- Cancer Center of Kansas, PA - Liberal
- Cancer Center of Kansas, PA - Newton
- Kansas City Cancer Centers - Southwest
- Cancer Center of Kansas, PA - Parsons
- Mount Carmel Regional Cancer Center
- Cancer Center of Kansas, PA - Pratt
- Cancer Center of Kansas, PA - Salina
- Tammy Walker Cancer Center at Salina Regional Health Center
- Kansas City Cancer Center - Shawnee Mission
- St. Francis Comprehensive Cancer Center
- Cancer Center of Kansas, PA - Wellington
- Associates in Womens Health, PA - North Review
- Cancer Center of Kansas, PA - Medical Arts Tower
- Cancer Center of Kansas, PA - Wichita
- CCOP - Wichita
- Via Christi Cancer Center at Via Christi Regional Medical Center
- Wesley Medical Center
- Cancer Center of Kansas, PA - Winfield
- Alvin and Lois Lapidus Cancer Institute at Sinai Hospital
- University of Michigan Comprehensive Cancer Center
- Battle Creek Health System Cancer Care Center
- Mecosta County Medical Center
- Barbara Ann Karmanos Cancer Institute
- Josephine Ford Cancer Center at Henry Ford Hospital
- Butterworth Hospital at Spectrum Health
- CCOP - Grand Rapids
- Lacks Cancer Center at Saint Mary's Health Care
- Mercy General Health Partners
- Spectrum Health Reed City Hospital
- Munson Medical Center
- University of Mississippi Cancer Clinic
- Regional Cancer Center at Singing River Hospital
- Truman Medical Center - Hospital Hill
- Kansas City Cancer Centers - South
- Kansas City Cancer Centers - North
- Kansas City Cancer Centers - East
- Good Samaritan Cancer Center at Good Samaritan Hospital
- Interlakes Oncology/Hematology PC
- James P. Wilmot Cancer Center at University of Rochester Medical Center
- Presbyterian Cancer Center at Presbyterian Hospital
- Wayne Memorial Hospital, Incorporated
- Iredell Memorial Hospital
- McDowell Cancer Center at Akron General Medical Center
- Grandview Hospital
- Good Samaritan Hospital
- David L. Rike Cancer Center at Miami Valley Hospital
- Samaritan North Cancer Care Center
- CCOP - Dayton
- Blanchard Valley Medical Associates
- Middletown Regional Hospital
- Wayne Hospital
- Charles F. Kettering Memorial Hospital
- UVMC Cancer Care Center at Upper Valley Medical Center
- Ruth G. McMillan Cancer Center at Greene Memorial Hospital
- AnMed Cancer Center
- Roper St. Francis Cancer Center at Roper Hospital
- Bon Secours St. Francis Health System
- CCOP - Upstate Carolina
- Gibbs Regional Cancer Center at Spartanburg Regional Medical Center
- U.T. Medical Center Cancer Institute
- Southwest Regional Cancer Center - Central
- Texas Oncology, PA at Texas Oncology Cancer Center - Central
- Texas Oncology, PA at South Austin Cancer Center
- Texas Oncology, PA - Austin North
- Texas Oncology, PA - Cedar Park
- Baylor University Medical Center - Houston
- Ben Taub General Hospital
- St. Luke's Texas Cancer Institute at St. Luke's Episcopal Hospital
- Veterans Affairs Medical Center - Houston
- Texas Oncology, PA - Seton Williamson
- Texas Oncology, PA at Texas Cancer Center Round Rock
- Texas Oncology, PA - San Marcos
- American Fork Hospital
- Sandra L. Maxwell Cancer Center
- Logan Regional Hospital
- Jon and Karen Huntsman Cancer Center at Intermountain Medical Center
- Val and Ann Browning Cancer Center at McKay-Dee Hospital Center
- Utah Valley Regional Medical Center - Provo
- Dixie Regional Medical Center - East Campus
- LDS Hospital
- Island Hospital Cancer Care Center at Island Hospital
- St. Joseph Cancer Center
- Olympic Hematology and Oncology
- Highline Medical Center Cancer Center
- Swedish Medical Center - Issaquah Campus
- Columbia Basin Hematology
- Skagit Valley Hospital Cancer Care Center
- Harrison Poulsbo Hematology and Onocology
- Harborview Medical Center
- Fred Hutchinson Cancer Research Center
- Group Health Central Hospital
- Swedish Cancer Institute at Swedish Medical Center - First Hill Campus
- Polyclinic First Hill
- University Cancer Center at University of Washington Medical Center
- North Puget Oncology at United General Hospital
- Cancer Care Northwest - Spokane South
- Evergreen Hematology and Oncology, PS
- Wenatchee Valley Medical Center
Arms of the Study
Arm 1
Experimental
Chemo + Chemo and radiation + Surgery
Chemotherapy Cycle 1 (1 cycle is 35 days): Oxaliplatin, 50 mg/m^2, IV, Days 1,8,15,22,29 Cetuximab, 400 mg/m^2, IV, Day 1 Cetuximab, 250 mg/m^2, IV, Days 8,15,22,29 Capecitabine, 1650 mg/m^2/day, PO, Monday-Friday (Day 1-35) Chemotherapy+ Radiation Cycle 2: Oxaliplatin, 50 mg/m^2, IV, Days 50,57,71,78 Cetuximab, 250 mg/m^2, IV, Days 50,57,64,71,78 Capecitabine, 1650 mg/m^1, PO, Monday-Friday (Day 50-84) Radiation therapy: Planning target value 1: 4500 cGy (centigray) in 25 fractions; Planning target value 2 (stage T3 patients): Boost of 540 cGy in 3 fractions; Planning target value 2 (stage T4 patients): Boost of 900 cGy in 5 fractions. Therapeutic Surgical procedure: Resection