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Combination Chemotherapy and Bevacizumab With or Without Bevacizumab Maintenance Therapy in Treating Patients With Metastatic Colorectal Cancer

This study is ongoing, but not recruiting participants.
Sponsor:
Information provided by (Responsible Party):
Federation Francophone de Cancerologie Digestive
ClinicalTrials.gov Identifier:
NCT00952029
First received: August 1, 2009
Last updated: March 3, 2014
Last verified: March 2014
  Purpose

RATIONALE: Drugs used in chemotherapy, such as irinotecan hydrochloride, leucovorin calcium, and fluorouracil, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Bevacizumab may stop the growth of colorectal cancer by blocking blood flow to the tumor. It is not yet known whether giving more than one drug (combination chemotherapy) is more effective when given with or without bevacizumab in treating patients with metastatic colorectal cancer.

PURPOSE: This randomized phase III trial is studying giving combination chemotherapy with or without bevacizumab to see how well it works in treating patients with metastatic colorectal cancer.


Condition Intervention Phase
Colorectal Cancer
Biological: bevacizumab
Drug: FOLFIRI regimen
Drug: fluorouracil
Drug: irinotecan hydrochloride
Drug: leucovorin calcium
Phase 2
Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Multicenter Phase III Randomized Study of FOLFIRI Plus Bevacizumab Following or Not by a Maintenance Therapy With Bevacizumab in Patients With Non-Pretreated Metastatic Colorectal Cancer

Resource links provided by NLM:


Further study details as provided by Federation Francophone de Cancerologie Digestive:

Primary Outcome Measures:
  • Disease-control duration [ Time Frame: one year after last patient included ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Objective response rate [ Time Frame: one year after last patient is included ] [ Designated as safety issue: No ]
  • Rate of non-hematologic grade 3-4 toxicities (except alopecia) [ Time Frame: one year after last patient is included ] [ Designated as safety issue: Yes ]
  • Overall toxicity rate [ Time Frame: one year after last patient is included ] [ Designated as safety issue: Yes ]
  • Duration of chemotherapy-free interval [ Time Frame: one year after last patient is included ] [ Designated as safety issue: No ]
  • Progression-free survival [ Time Frame: one year after last patient is included ] [ Designated as safety issue: No ]
  • Overall survival [ Time Frame: one and 2 year after last patient is included ] [ Designated as safety issue: No ]
  • Time-to-treatment failure [ Time Frame: one year after last patient is included ] [ Designated as safety issue: No ]
  • Quality of life as assessed by EORTC QLQ-C30 [ Time Frame: one year after last patient is included ] [ Designated as safety issue: No ]
  • Geriatric evaluation [ Time Frame: one year after last patient is included ] [ Designated as safety issue: No ]

Estimated Enrollment: 492
Study Start Date: March 2010
Estimated Study Completion Date: July 2016
Estimated Primary Completion Date: July 2015 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Maintenance with bevacizumab
FOLFIRI + Avastin and during the chemotherapy-free interval maintenance with bevacizumab
Biological: bevacizumab Drug: FOLFIRI regimen Drug: fluorouracil Drug: irinotecan hydrochloride Drug: leucovorin calcium
Active Comparator: No maintenance with bevacizumab
FOLFIRI + Avastin and during the chemotherapy-free interval NO maintenance
Biological: bevacizumab Drug: FOLFIRI regimen Drug: fluorouracil Drug: irinotecan hydrochloride Drug: leucovorin calcium

Detailed Description:

OBJECTIVES:

Primary

  • Compare disease-control duration in patients with metastatic colorectal cancer receiving FOLFIRI chemotherapy in combination with bevacizumab with or without bevacizumab maintenance therapy.

Secondary

  • Determine objective response rate.
  • Determine non-hematologic grade 3-4 (except alopecia) toxicity rate.
  • Determine overall toxicity rate.
  • Determine duration of chemotherapy-free interval.
  • Determine progression-free survival.
  • Determine overall survival.
  • Determine time-to-treatment failure.
  • Determine quality of life (EORTC QLQ-C30).
  • Complete geriatric evaluation.

OUTLINE: This is a multicenter study. Patients are stratified according to cancer center, primary tumor (resected vs unresected), and Köhne criteria (low vs intermediate vs high). Patients are randomized to 1 of 2 treatment arms.

  • Arm A: Patients receive FOLFIRI chemotherapy comprising irinotecan hydrochloride IV over 90 minutes and leucovorin calcium IV over 2 hours on day 1 and fluorouracil IV over 46 hours on days 1-2. Chemotherapy treatment repeats every 2 weeks for 12 courses. Patients also receive bevacizumab IV over 30-90 minutes once every 2 weeks during chemotherapy. Patients then receive bevacizumab maintenance therapy once every 2 weeks during the chemotherapy-free interval.
  • Arm B: Patients receive FOLFIRI chemotherapy and bevacizumab as in arm A. Patients receive no treatment during the chemotherapy-free interval.

In all arms, the chemotherapy treatment and the chemotherapy-free interval treatment repeats in the absence of disease progression during the chemotherapy portion or unacceptable toxicity. Patients who progress during the chemotherapy-free interval will receive 12 more courses of chemotherapy.

All patients complete quality of life questionnaires (QLQ-30) and patients ≥ 75 also complete the geriatric questionnaire at baseline and every 8 weeks during study treatment.

After completion of study treatment, patients are followed up every 8 weeks.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Histologically confirmed colorectal cancer

    • Metastatic disease
  • Not a candidate for curative surgery
  • At least 1 tumor target measurable by RECIST criteria
  • No metastasis potentially resectable after receiving chemotherapy
  • No occlusive tumors
  • No macronodular peritoneal carcinomatosis
  • No known or suspected CNS metastases

PATIENT CHARACTERISTICS:

  • OMS status 0-2
  • Life expectancy ≥ 3 months
  • ANC ≥ 1,500/mm^3
  • Platelet count ≥ 100,000/mm^3
  • Hemoglobin ≥ 9 g/dL
  • Total bilirubin ≤ 1.5 times upper limit of normal (ULN)
  • Alkaline phosphatase ≤ 2.5 times ULN (≤ 5 times ULN in the presence of hepatic metastases)
  • Creatinine ≤ 1.5 times ULN
  • Proteinuria ≤1 g
  • Not pregnant or nursing
  • No gastroduodenal ulcer, wound, or fractured bone
  • No acute or subacute intestinal occlusion or history of inflammatory bowel disease or large resection of small bowel
  • No clinically relevant coronary artery disease or a history of a myocardial infarction within the last 6 months
  • No uncontrolled hypertension while receiving chronic medication
  • No other malignancy within the past 5 years except for basal cell carcinoma of the skin or pre-invasive carcinoma of the cervix
  • No medical or psychological condition which, in the opinion of the investigator, would not permit the patient to complete the study

PRIOR CONCURRENT THERAPY:

  • See Patient Characteristics
  • No prior chemotherapy for metastatic disease

    • Adjuvant chemotherapy allowed provided it was completed > 6 months ago
  • No prior irinotecan or other antiangiogenic therapy
  • At least 4 weeks since surgery (except for diagnostic biopsy) or irradiation
  • No other drugs not allowed for medical reasons
  • Concurrent oral anticoagulants (e.g., coumadin, warfarin) allowed provided the INR is closely monitored

    • A change of anticoagulants to low-molecular weight heparin is preferred
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00952029

Locations
France
Hopital Bichat - Claude Bernard
Paris, France, 75018
Sponsors and Collaborators
Federation Francophone de Cancerologie Digestive
Investigators
Principal Investigator: Thomas Aparicio Hopital Avicenne BOBIGNY
  More Information

Additional Information:
No publications provided

Responsible Party: Federation Francophone de Cancerologie Digestive
ClinicalTrials.gov Identifier: NCT00952029     History of Changes
Other Study ID Numbers: CDR0000636983, FFCD-PRODIGE-9, FFCD-0802, EU-20912, EU-21030, EUDRACT-2008-007928-25, EUDRACT-2009-017996-11
Study First Received: August 1, 2009
Last Updated: March 3, 2014
Health Authority: France: Agence Nationale de Sécurité du Médicament et des produits de santé

Keywords provided by Federation Francophone de Cancerologie Digestive:
stage IV colon cancer
stage IV rectal cancer

Additional relevant MeSH terms:
Colorectal Neoplasms
Colonic Diseases
Digestive System Diseases
Digestive System Neoplasms
Gastrointestinal Diseases
Gastrointestinal Neoplasms
Intestinal Diseases
Intestinal Neoplasms
Neoplasms
Neoplasms by Site
Rectal Diseases
Bevacizumab
Fluorouracil
Irinotecan
Levoleucovorin
Angiogenesis Inhibitors
Angiogenesis Modulating Agents
Antidotes
Antimetabolites
Antimetabolites, Antineoplastic
Antineoplastic Agents
Antineoplastic Agents, Phytogenic
Enzyme Inhibitors
Growth Inhibitors
Growth Substances
Immunologic Factors
Immunosuppressive Agents
Molecular Mechanisms of Pharmacological Action
Pharmacologic Actions
Physiological Effects of Drugs

ClinicalTrials.gov processed this record on November 24, 2014