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Xeloda and Bevacizumab to Treat Rectal Cancer (xeberecto)

Primary Purpose

Rectal Cancer

Status
Completed
Phase
Phase 2
Locations
Spain
Study Type
Interventional
Intervention
Bevacizumab
capecitabine (Xeloda)
Rectal Radiotherapy
Sponsored by
Institut Català d'Oncologia
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Rectal Cancer focused on measuring rectum, adenocarcinoma, neoadjuvant, bevacizumab, capecitabine, radiotherapy, locally, advanced, resectable, resectable locally advanced adenocarcinoma of the rectum, xeberecto

Eligibility Criteria

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

Inclusion Criteria:

  1. The patient has given written informed consent prior to any study related procedure
  2. Male and female aged 18 to 75 years
  3. ECOG performance status 0 or 1
  4. Histologically confirmed diagnostic of adenocarcinoma of the rectum < 15 cm from anal verge
  5. Clinical stage of T3, T4 with/without regional lymph node metastases, without metastatic disease
  6. Disease evaluable by imaging techniques
  7. No tumour haemorrhage in the week prior to start of study treatment
  8. External derivation in symptomatic occlusive tumours
  9. Not prior cancer treatment
  10. Adequate bone marrow, hepatic and renal function, defined as:

    1. White blood cells ≥ 4 x 109 /l
    2. Absolute neutrophil count ≥ 1.5 x 109 /l
    3. Platelets ≥ 100 x 109 /l
    4. Haemoglobin ≥10 g/dl
    5. Bilirubin < 1.25 x upper limit of normal
    6. Aspartate transaminase and alanine transaminase < 2.5 x upper limit of normal
    7. Serum creatinine ≤ 106 µmol/l
  11. Less than 10% weight loss

Exclusion Criteria:

  1. Rectal cancer no amenable to resection
  2. Any other malignancy which has been active or treated within the past 5 years , with the exception of in situ carcinoma of the cervix and non-melanoma skin lesions adequately treated
  3. Pregnant or breast-feeding women
  4. Women oh childbearing potential unless effective methods of contraception are used
  5. No prior or concurrent significant medical conditions, including any of the following:

    • Cerebrovascular disease (including transient ischemic attack and stroke) within the past year
    • Cardiovascular disease, including the following:
    • Myocardial infarction within the past year
    • Uncontrolled hypertension while receiving chronic medication
    • Unstable angina
    • New York Heart Association class II-IV congestive heart failure
    • Serious cardiac arrhythmia requiring medication
  6. Major trauma within the past 28 days
  7. Serious nonhealing wound, ulcer, or bone fracture
  8. Evidence of bleeding diathesis or coagulopathy
  9. No lack of physical integrity of the upper gastrointestinal tract, malabsorption syndrome, or inability to take oral medication
  10. No evidence of other disease, metabolic dysfunction, physical examination finding, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates use of an investigational drug
  11. No known dihydropyrimidine dehydrogenase deficiency
  12. Major surgery in the 4 weeks prior to the start of study treatment
  13. No concurrent chronic, daily treatment with aspirin (> 325 mg/day)
  14. More than 10 days since prior use of full-dose oral or parenteral anticoagulants for therapeutic purposes
  15. No participation in another clinical trial with any investigational drug within 30 days prior to randomization or during study participation
  16. No other medical history or condition that, in the opinion of the investigator, would preclude study participation

Sites / Locations

  • Institut Català d'Oncologia-L'Hospitalet

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Bevacizumab & capecitabine & radiotheraphy

Arm Description

Bevacizumab 4 cycles each 15 days, the first 10 mg/kg and the rest of cycles with 5 mg/kg. Radiotherapy 45 Gy starting on Bevacizumab 2nd cycle during 5 weeks, 1.8 Gy per day, 5 days at week. Capecitabine 900 mg/m2 two times a day concomitant during radiotherapy period.

Outcomes

Primary Outcome Measures

Pathologic complete response rate. % patients with pathologic complete response (absence of tumoral cells in the resected piece)

Secondary Outcome Measures

Overall clinical response
To determine the downstaging caused by treatment
relapse free survival
Quantify the local control grade: R0 resections in surgery
Local relapse and distant relapse rates
To determine the security profile of this neoadjuvant treatment (radio- chemotherapy)
Surgery complication rate
To determine the angiogenic profile changes in tumour.

Full Information

First Posted
February 18, 2009
Last Updated
August 28, 2017
Sponsor
Institut Català d'Oncologia
Collaborators
Hoffmann-La Roche
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1. Study Identification

Unique Protocol Identification Number
NCT00847119
Brief Title
Xeloda and Bevacizumab to Treat Rectal Cancer
Acronym
xeberecto
Official Title
ESTUDIO FASE II DE BEVACIZUMAB EN COMBINACIÓN CON CAPECITABINA Y RADIOTERAPIA COMO TRATAMIENTO PREOPERATORIO EN PACIENTES CON CÁNCER RECTAL LOCALMENTE AVANZADO RESECABLE
Study Type
Interventional

2. Study Status

Record Verification Date
August 2017
Overall Recruitment Status
Completed
Study Start Date
September 2007 (undefined)
Primary Completion Date
June 2011 (Actual)
Study Completion Date
February 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Institut Català d'Oncologia
Collaborators
Hoffmann-La Roche

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The project objective is to evaluate the efficacy of the neoadjuvant treatment with bevacizumab, capecitabine and radiotherapy, in patients with rectal adenocarcinoma resectable locally advanced (stage T3 or T4), with or without presence of ganglionar metastases and without distant metastases.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Rectal Cancer
Keywords
rectum, adenocarcinoma, neoadjuvant, bevacizumab, capecitabine, radiotherapy, locally, advanced, resectable, resectable locally advanced adenocarcinoma of the rectum, xeberecto

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Bevacizumab & capecitabine & radiotheraphy
Arm Type
Experimental
Arm Description
Bevacizumab 4 cycles each 15 days, the first 10 mg/kg and the rest of cycles with 5 mg/kg. Radiotherapy 45 Gy starting on Bevacizumab 2nd cycle during 5 weeks, 1.8 Gy per day, 5 days at week. Capecitabine 900 mg/m2 two times a day concomitant during radiotherapy period.
Intervention Type
Biological
Intervention Name(s)
Bevacizumab
Intervention Description
Bevacizumab 4 cycles each 15 days, the first 10 mg/kg and the rest of cycles with 5 mg/kg.
Intervention Type
Drug
Intervention Name(s)
capecitabine (Xeloda)
Intervention Description
Capecitabine 900 mg/m2 two times a day concomitant during radiotherapy period
Intervention Type
Radiation
Intervention Name(s)
Rectal Radiotherapy
Intervention Description
Radiotherapy in rectum 45 Gy starting on Bevacizumab 2nd cycle during 5 weeks, 1.8 Gy per day, 5 days at week.
Primary Outcome Measure Information:
Title
Pathologic complete response rate. % patients with pathologic complete response (absence of tumoral cells in the resected piece)
Time Frame
Surgery date
Secondary Outcome Measure Information:
Title
Overall clinical response
Time Frame
Surgery date
Title
To determine the downstaging caused by treatment
Time Frame
Surgery date
Title
relapse free survival
Time Frame
Time of radiological evidence of relapse.
Title
Quantify the local control grade: R0 resections in surgery
Time Frame
Surgery date
Title
Local relapse and distant relapse rates
Time Frame
Relapse date
Title
To determine the security profile of this neoadjuvant treatment (radio- chemotherapy)
Time Frame
From date of register to surgery date
Title
Surgery complication rate
Time Frame
During surgery admission.
Title
To determine the angiogenic profile changes in tumour.
Time Frame
15 days, 6 weeks and 4 months

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: The patient has given written informed consent prior to any study related procedure Male and female aged 18 to 75 years ECOG performance status 0 or 1 Histologically confirmed diagnostic of adenocarcinoma of the rectum < 15 cm from anal verge Clinical stage of T3, T4 with/without regional lymph node metastases, without metastatic disease Disease evaluable by imaging techniques No tumour haemorrhage in the week prior to start of study treatment External derivation in symptomatic occlusive tumours Not prior cancer treatment Adequate bone marrow, hepatic and renal function, defined as: White blood cells ≥ 4 x 109 /l Absolute neutrophil count ≥ 1.5 x 109 /l Platelets ≥ 100 x 109 /l Haemoglobin ≥10 g/dl Bilirubin < 1.25 x upper limit of normal Aspartate transaminase and alanine transaminase < 2.5 x upper limit of normal Serum creatinine ≤ 106 µmol/l Less than 10% weight loss Exclusion Criteria: Rectal cancer no amenable to resection Any other malignancy which has been active or treated within the past 5 years , with the exception of in situ carcinoma of the cervix and non-melanoma skin lesions adequately treated Pregnant or breast-feeding women Women oh childbearing potential unless effective methods of contraception are used No prior or concurrent significant medical conditions, including any of the following: Cerebrovascular disease (including transient ischemic attack and stroke) within the past year Cardiovascular disease, including the following: Myocardial infarction within the past year Uncontrolled hypertension while receiving chronic medication Unstable angina New York Heart Association class II-IV congestive heart failure Serious cardiac arrhythmia requiring medication Major trauma within the past 28 days Serious nonhealing wound, ulcer, or bone fracture Evidence of bleeding diathesis or coagulopathy No lack of physical integrity of the upper gastrointestinal tract, malabsorption syndrome, or inability to take oral medication No evidence of other disease, metabolic dysfunction, physical examination finding, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates use of an investigational drug No known dihydropyrimidine dehydrogenase deficiency Major surgery in the 4 weeks prior to the start of study treatment No concurrent chronic, daily treatment with aspirin (> 325 mg/day) More than 10 days since prior use of full-dose oral or parenteral anticoagulants for therapeutic purposes No participation in another clinical trial with any investigational drug within 30 days prior to randomization or during study participation No other medical history or condition that, in the opinion of the investigator, would preclude study participation
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ramon Salazar, Phd
Organizational Affiliation
Institut Català d'Oncologia
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Margarita Garcia, MD
Organizational Affiliation
Institut Català d'Oncologia
Official's Role
Study Chair
Facility Information:
Facility Name
Institut Català d'Oncologia-L'Hospitalet
City
L'Hospitalet del Llobregat
State/Province
Barcelona
ZIP/Postal Code
08907
Country
Spain

12. IPD Sharing Statement

Citations:
PubMed Identifier
25886275
Citation
Garcia M, Martinez-Villacampa M, Santos C, Navarro V, Teule A, Losa F, Pisa A, Cambray M, Soler G, Lema L, Kreisler E, Figueras A, Juan XS, Vinals F, Biondo S, Salazar R. Phase II study of preoperative bevacizumab, capecitabine and radiotherapy for resectable locally-advanced rectal cancer. BMC Cancer. 2015 Feb 26;15:59. doi: 10.1186/s12885-015-1052-0.
Results Reference
result

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Xeloda and Bevacizumab to Treat Rectal Cancer

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