A Phase III Trial Of Irinotecan /5-FU/ Leucovorin Or Oxaliplatin /5-FU / Leucovorin With And Without Cetuximab (C225) For Patients With Untreated Metastatic Adenocarcinoma Of The Colon or Rectum
OBJECTIVES:
Primary
- Compare the survival rate of patients with previously untreated metastatic
adenocarcinoma of the colon or rectum treated with fluorouracil and leucovorin calcium
with oxaliplatin or irinotecan and with or without cetuximab.
Secondary
- Determine the level of epidermal growth factor receptor (EGFR) expression in patients
treated with these regimens.
- Determine whether expression of EGFR activity, markers of EGFR activity, and serum
levels of insulin-like growth factor-1, C-peptide, and insulin-like growth factor
binding protein 3 are independent predictors of response rate, time to tumor
progression, and survival of patients treated with these regimens.
- Correlate specific germline polymorphisms related to chemotherapy metabolism and
resistance with treatment-related toxicity, tumor response, time to tumor progression,
and survival of patients treated with these regimens.
- Correlate expression of putative prognostic markers in the tumor with tumor response,
time to tumor progression, and survival of patients treated with these regimens.
- Correlate diet, obesity, physical activity, and other lifestyle habits with
treatment-related toxicity, progression-free survival, and overall survival of patients
treated with these regimens.
OUTLINE: This is a randomized, open-label, multicenter study. Patients are stratified
according to prior adjuvant therapy (yes vs no) and prior pelvic radiotherapy (yes vs no).
Patients are randomized to 1 of 4 treatment arms.
- Arm I (FOLFIRI): Patients receive irinotecan IV over 90 minutes and leucovorin calcium
IV over 2 hours on days 1, 15, 29, and 43 and fluorouracil IV continuously over 46-48
hours beginning on days 1, 15, 29, and 43.
- Arm II (FOLFIRI and cetuximab): Patients receive FOLFIRI as in arm I and cetuximab IV
over 1-2 hours on days 1, 8, 15, 22, 29, 36, 43, and 50.
- Arm III (FOLFOX): Patients receive oxaliplatin IV over 2 hours and leucovorin calcium
IV over 2 hours on days 1, 15, 29, and 43 and fluorouracil IV continuously over 46-48
hours beginning on days 1, 15, 29, and 43.
- Arm IV (FOLFOX and cetuximab): Patients receive FOLFOX as in arm III and cetuximab IV
over 1-2 hours on days 1, 8, 15, 22, 29, 36, 43, and 50.
In all arms, courses repeat every 8 weeks in the absence of disease progression or
unacceptable toxicity.
Patients are followed every 2 months for 2 years and then every 3 months for 3 years.
PROJECTED ACCRUAL: Approximately 2,200 patients (550 per treatment arm) will be accrued for
this study within 4.6 years.
Interventional
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
Survival
3 years
No
Alan P. Venook, MD
Study Chair
University of California, San Francisco
United States: Food and Drug Administration
CDR0000350016
NCT00077233
December 2003
June 2010
Name | Location |
---|---|
Memorial Sloan-Kettering Cancer Center | New York, New York 10021 |
Walter Reed Army Medical Center | Washington, District of Columbia 20307-5000 |
University of Chicago Cancer Research Center | Chicago, Illinois 60637 |
University of Minnesota Cancer Center | Minneapolis, Minnesota 55455 |
Duke Comprehensive Cancer Center | Durham, North Carolina 27710 |
CCOP - Kansas City | Kansas City, Missouri 64131 |
CCOP - Southern Nevada Cancer Research Foundation | Las Vegas, Nevada 89106 |
CCOP - Christiana Care Health Services | Wilmington, Delaware 19899 |
CCOP - Mount Sinai Medical Center | Miami Beach, Florida 33140 |
CCOP - North Shore University Hospital | Manhasset, New York 11030 |
CCOP - Southeast Cancer Control Consortium | Winston-Salem, North Carolina 27104-4241 |
MBCCOP - Massey Cancer Center | Richmond, Virginia 23298-0037 |
CCOP - Illinois Oncology Research Association | Peoria, Illinois 61602 |
Beth Israel Deaconess Medical Center | Boston, Massachusetts 02215 |
Comprehensive Cancer Center at Wake Forest University | Winston-Salem, North Carolina 27157-1082 |
Western Pennsylvania Hospital | Pittsburgh, Pennsylvania 15224 |
Martha Jefferson Hospital | Charlottesville, Virginia 22901 |
MBCCOP - University of Illinois at Chicago | Chicago, Illinois 60612 |
CCOP - Evanston | Evanston, Illinois 60201 |
CCOP - Northern Indiana CR Consortium | South Bend, Indiana 46601 |
Holden Comprehensive Cancer Center at University of Iowa | Iowa City, Iowa 52242-1002 |
UMASS Memorial Cancer Center - University Campus | Worcester, Massachusetts 01605-2982 |
Ellis Fischel Cancer Center at University of Missouri - Columbia | Columbia, Missouri 65203 |
Siteman Cancer Center at Barnes-Jewish Hospital | Saint Louis, Missouri 63110 |
Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center | Lebanon, New Hampshire 03756-0002 |
Lineberger Comprehensive Cancer Center at University of North Carolina - Chapel Hill | Chapel Hill, North Carolina 27599-7570 |
North Shore University Hospital | Manhasset, New York 11030 |
Veterans Affairs Medical Center - Chicago (Westside Hospital) | Chicago, Illinois 60612 |
Naval Medical Center - San Diego | San Diego, California 92134-3202 |
Veterans Affairs Medical Center - San Francisco | San Francisco, California 94121 |
Baptist Hospital East - Louisville | Louisville, Kentucky 40207 |
CCOP - Syracuse Hematology-Oncology Associates of Central New York, P.C. | Syracuse, New York 13217 |
Veterans Affairs Medical Center - Minneapolis | Minneapolis, Minnesota 55417 |
Veterans Affairs Medical Center - Columbia (Truman Memorial) | Columbia, Missouri 65201 |
Veterans Affairs Medical Center - Buffalo | Buffalo, New York 14215 |
Veterans Affairs Medical Center - Syracuse | Syracuse, New York 13210 |
Veterans Affairs Medical Center - Durham | Durham, North Carolina 27705 |
Rebecca and John Moores UCSD Cancer Center | La Jolla, California 92093-0658 |
Broward General Medical Center | Fort Lauderdale, Florida 33316 |
Florida Hospital Cancer Institute | Orlando, Florida 32804 |
Dana-Farber/Harvard Cancer Center at Dana Farber Cancer Institute | Boston, Massachusetts 02115 |
Northeast Alabama Regional Medical Center | Anniston, Alabama 36207 |
Veterans Affairs Medical Center - San Diego | San Diego, California 92161 |
UCSF Comprehensive Cancer Center | San Francisco, California 94115 |
Veterans Affairs Medical Center - Washington, DC | Washington, District of Columbia 20422 |
Louis A. Weiss Memorial Hospital | Chicago, Illinois 60640 |
West Suburban Center for Cancer Care | River Forest, Illinois 60305 |
Fort Wayne Medical Oncology and Hematology, Incorporated | Fort Wayne, Indiana 46885-5099 |
Veterans Affairs Medical Center - Las Vegas | Las Vegas, Nevada 89106 |
Cooper University Hospital | Camden, New Jersey 08103 |
Queens Cancer Center of Queens Hospital | Jamaica, New York 11432 |
Veterans Affairs Medical Center - Asheville | Asheville, North Carolina 28805 |
Cape Fear Valley Health System | Fayetteville, North Carolina 28302-2000 |
FirstHealth Moore Regional Hospital | Pinehurst, North Carolina 28374 |
Lifespan: The Miriam Hospital | Providence, Rhode Island 02906 |
Veterans Affairs Medical Center - Dallas | Dallas, Texas 75216 |
Virginia Oncology Associates - Norfolk | Norfolk, Virginia 23502 |
St. Mary's Medical Center | Huntington, West Virginia 25701 |
Oklahoma University Medical Center | Oklahoma City, Oklahoma 73104 |
Mount Sinai Medical Center | New York, New York 10029 |
SUNY Upstate Medical University Hospital | Syracuse, New York 13210 |
Vermont Cancer Center at University of Vermont | Burlington, Vermont 05405-0075 |
Lombardi Cancer Center at Georgetown University Medical Center | Washington, District of Columbia 20007 |
Greenebaum Cancer Center at University of Maryland Medical Center | Baltimore, Maryland 21201 |
UNMC Eppley Cancer Center at the University of Nebraska Medical Center | Omaha, Nebraska 68198-7680 |
New Hampshire Oncology-Hematology, PA - Hooksett | Hooksett, New Hampshire 03106 |
NorthEast Oncology Associates - Concord | Concord, North Carolina 28025 |
Arthur G. James Cancer Hospital at Ohio State University | Columbus, Ohio 43210-1240 |
Oncology and Hematology Associates of Southwest Virginia, Incorporated - Roanoke | Roanoke, Virginia 24014 |
Lakeland Cancer Care Center at Lakeland Hospital - St. Joseph | Saint Joseph, Michigan 49085 |
New York Weill Cornell Cancer Center at Cornell University | New York, New York 10021 |
Zimmer Cancer Center at New Hanover Regional Medical Center | Wilmington, North Carolina 28402-9025 |
Cedars-Sinai Comprehensive Cancer Center at Cedars-Sinai Medical Center | Los Angeles, California 90048 |
Simmons Cancer Center at University of Texas Southwestern Medical Center - Dallas | Dallas, Texas 75390-9063 |
Memorial Regional Cancer Center at Memorial Regional Hospital | Hollywood, Florida 33021 |
Missouri Baptist Cancer Center | St. Louis, Missouri 63131 |
Palm Beach Cancer Institute | West Palm Beach, Florida 33401 |