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Bevacizumab Plus Fluorouracil and Leucovorin in Treating Patients With Locally Advanced or Metastatic Stage IV Colorectal Cancer That Has Progressed After Standard Chemotherapy

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00066846
Recruitment Status : Completed
First Posted : August 7, 2003
Last Update Posted : June 20, 2013
Information provided by:
National Cancer Institute (NCI)

Brief Summary:

RATIONALE: Bevacizumab may stop the growth of tumor cells by blocking the enzymes necessary for cancer cell growth. Drugs used in chemotherapy such as fluorouracil and leucovorin use different ways to stop tumor cells from dividing so they stop growing or die. Combining bevacizumab with fluorouracil and leucovorin may kill more tumor cells.

PURPOSE: Phase II trial to study the effectiveness of combining bevacizumab with fluorouracil and leucovorin in treating patients who have locally advanced or metastatic stage IV colorectal cancer that has progressed after standard chemotherapy.

Condition or disease Intervention/treatment Phase
Colorectal Cancer Biological: bevacizumab Drug: fluorouracil Drug: leucovorin calcium Phase 2

Detailed Description:


  • Determine the response rate of patients treated with bevacizumab, fluorouracil, and leucovorin calcium for stage IV colorectal cancer that has progressed after standard chemotherapy.
  • Determine the time to progression and overall survival of patients treated with this regimen.
  • Determine the safety of administering "bolus" and continuous infusion fluorouracil and leucovorin calcium in patients treated with this regimen.

OUTLINE: This is an open-label, multicenter study. Patients receive 1 of 2 treatment regimens.

  • Regimen I: Patients receive bevacizumab IV on days 1, 15, 29, and 42 (every 2 weeks) and leucovorin calcium (CF) IV over 2 hours and fluorouracil (5-FU) IV bolus on days 1, 8, 15, 22, 29, and 36.
  • Regimen II: Patients receive bevacizumab as in regimen I and CF IV over 2 hours and 5-FU IV bolus followed by a continuous infusion over 22 hours on days 1, 2, 15, 16, 29, 30, 43, and 44.

For both regimens, courses repeat every 8 weeks in the absence of disease progression or unacceptable toxicity.

Patients are followed for tumor response and survival.

PROJECTED ACCRUAL: Various NCI-designated Clinical Cancer Centers and other medical institutions across the United States will participate in this study. A total of 35-125 patients will be accrued for this study within 3 months.

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Study Type : Interventional  (Clinical Trial)
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Multicenter Study of the Anti-VEGF Monoclonal Antibody Bevacizumab (Avastin®) Plus 5-Fluorouracil/Leucovorin in Patients With Metastatic Colorectal Cancers That Have Progressed After Standard Chemotherapy
Study Start Date : August 2003
Actual Study Completion Date : July 2007

Resource links provided by the National Library of Medicine

Information from the National Library of Medicine

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, Learn About Clinical Studies.

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No


  • Histologically or cytologically confirmed colorectal adenocarcinoma

    • Stage IV (metastatic) disease
    • Not curable by surgery or radiotherapy
  • Must have received prior standard chemotherapy regimens, including oxaliplatin and irinotecan, and meet both of the following criteria:

    • Disease progression during or after irinotecan-based chemotherapy for metastatic disease OR relapsed disease within 6 months after adjuvant irinotecan-based therapy
    • Disease progression during or after oxaliplatin-based chemotherapy for metastatic disease OR relapsed disease within 6 months after adjuvant oxaliplatin-based therapy
  • No brain metastases



  • 18 and over

Performance status

  • ECOG 0-2 OR
  • Karnofsky 60-100%

Life expectancy

  • Not specified


  • Absolute granulocyte count at least 1,500/mm^3
  • Platelet count at least 100,000/mm^3
  • Hemoglobin at least 9 g/dL (transfusion allowed)
  • No evidence of bleeding diathesis or coagulopathy


  • Bilirubin no greater than 1.5 mg/dL
  • AST less than 5 times upper limit of normal (ULN)
  • Alkaline phosphatase less than 5 times ULN
  • PT and INR no greater than 1.5 times ULN
  • PTT no greater than ULN


  • Creatinine no greater than 1.5 times ULN
  • Proteinuria less than grade 1 OR
  • Proteinuria less than 500 mg/24 hours


  • No prior stroke
  • No uncontrolled high blood pressure
  • No symptomatic congestive heart failure
  • No unstable angina pectoris
  • No cardiac arrhythmia
  • No myocardial infarction within the past 6 months
  • No New York Heart Association class III or IV heart disease
  • No thromboembolism within the past 6 months


  • Chemonaive
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception during and for at least 3 months after study participation
  • No significant traumatic injury within the past 6 weeks
  • No prior allergic reaction attributed to compounds of similar chemical or biological composition to bevacizumab or other study agents
  • No active infection
  • No psychiatric illness or social situation that would preclude study compliance
  • No serious nonhealing wound (including wounds healing by secondary intention), ulcer, or bone fracture
  • No CNS disease, including either of the following:

    • Primary brain tumor
    • Seizures not controlled with standard medical therapy


Biologic therapy

  • At least 8 weeks since prior monoclonal antibody therapy
  • No prior bevacizumab


  • See Disease Characteristics

Endocrine therapy

  • Not specified


  • At least 4 weeks since prior major radiotherapy (e.g., chest or bone palliative radiotherapy)


  • More than 6 weeks since prior major surgical procedure or open biopsy
  • More than 7 days since prior fine needle aspiration or core biopsy
  • No concurrent surgery


  • Recovered from prior therapy
  • At least 3 weeks since prior cytotoxic agents
  • No concurrent therapeutic anticoagulation

    • Prophylactic anticoagulation of venous access devices allowed provided PT/INR or PTT criteria are met
  • No concurrent chronic aspirin (greater than 325 mg/day) or nonsteroidal anti-inflammatory drugs
  • No concurrent combination antiretroviral therapy for HIV-positive patients
  • No other concurrent investigational or commercial agents for the malignancy

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00066846

Show Show 33 study locations
Sponsors and Collaborators
National Cancer Institute (NCI)
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Principal Investigator: Helen X. Chen, MD NCI - Investigational Drug Branch
Publications of Results:
Layout table for additonal information Identifier: NCT00066846    
Other Study ID Numbers: CDR0000320506
First Posted: August 7, 2003    Key Record Dates
Last Update Posted: June 20, 2013
Last Verified: April 2004
Keywords provided by National Cancer Institute (NCI):
adenocarcinoma of the colon
adenocarcinoma of the rectum
stage IV rectal cancer
recurrent rectal cancer
stage IV colon cancer
recurrent colon cancer
Additional relevant MeSH terms:
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Colorectal Neoplasms
Intestinal Neoplasms
Gastrointestinal Neoplasms
Digestive System Neoplasms
Neoplasms by Site
Digestive System Diseases
Gastrointestinal Diseases
Colonic Diseases
Intestinal Diseases
Rectal Diseases
Antineoplastic Agents, Immunological
Antineoplastic Agents
Angiogenesis Inhibitors
Angiogenesis Modulating Agents
Growth Substances
Physiological Effects of Drugs
Growth Inhibitors
Calcium-Regulating Hormones and Agents
Molecular Mechanisms of Pharmacological Action
Antimetabolites, Antineoplastic
Immunosuppressive Agents
Immunologic Factors