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The MAX Study: Mitomycin C, Avastin and Xeloda in Patients With Untreated Metastatic Colorectal Cancer

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: NCT00294359
Recruitment Status : Completed
First Posted : February 22, 2006
Last Update Posted : August 22, 2007
Information provided by:
Australasian Gastro-Intestinal Trials Group

Brief Summary:

Although it is possible to cure bowel cancer when it is detected at an early stage, in many cases it may spread to involve other organs and in these cases is generally incurable. Chemotherapy prolongs survival and improves quality of life in such patients, but standard chemotherapy for this disease has not been defined.

There are several possible chemotherapy treatments for patients with bowel cancer, which has spread to other organs. However, these treatments are only partly effective and only work for a limited period of time. Most treatments are associated with a number of possible side effects which may have a detrimental effect on quality of life. Thus, it is imperative that more effective treatments with the lowest possible risk of side effects are developed.

Previous studies have shown that the addition of a new type of antibody treatment (bevacizumab) to an intensive combination chemotherapy regimen improved survival in patients with advanced bowel cancer and extended the time before tumours began to grow. However, intensive chemotherapy is likely to only be a suitable treatment for a proportion of patients with bowel cancer, because intensive chemotherapy causes a high rate of side effects.

This study compares a gentle chemotherapy treatment (capecitabine chemotherapy tablets given by mouth) with the combination of capecitabine and bevacizumab and the combination of capecitabine, bevacizumab and intravenous mitomycin C.

It is expected that a gentle chemotherapy treatment or a gentle chemotherapy treatment combined with bevacizumab would be an appropriate treatment for both young and fit patients as well as older and less fit patients who would not easily tolerate intensive chemotherapy.

Condition or disease Intervention/treatment Phase
Metastatic Colorectal Cancer Drug: Mitomycin C; Capecitabine; Bevacizumab Phase 2 Phase 3

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 333 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: The MAX Study: A Randomised Phase II/III Study to Evaluate the Role of Mitomycin C, Avastin and Xeloda in Patients With Untreated Metastatic Colorectal Cancer
Study Start Date : June 2005
Actual Study Completion Date : July 2007

Resource links provided by the National Library of Medicine

Primary Outcome Measures :
  1. Phase II: - treatment related toxicity
  2. Phase III: - progression free survival

Secondary Outcome Measures :
  1. Phase II: - treatment response
  2. Phase III:
  3. - treatment related toxicity
  4. - treatment response
  5. - overall survival
  6. - symptoms of disease, treatment and quality of life
  7. - cost of therapy and assessment of gain in quality-adjusted progression free survival

Information from the National Library of Medicine

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

Inclusion Criteria:

  • Histological diagnosis of colorectal cancer
  • Metastatic disease that is not resectable
  • Age > 18 years
  • Any patient in whom the investigator considers capecitabine monotherapy appropriate
  • Measurable and/or non-measurable disease as assessed by CT scan
  • ECOG performance status 0, 1 or 2. Patients with PS2 should have serum albumin >30 g/L
  • No prior chemotherapy except for adjuvant chemotherapy given in association with (i) complete resection of primary colon or rectal cancer provided there is no clinical, radiological or biochemical evidence of relapse for at least 6 months after completion of adjuvant treatment and/or (ii) complete resection of limited colorectal metastases to liver and/or lung provided there is no clinical, radiological or biochemical evidence of relapse for at least 6 months after completion of adjuvant treatment
  • Adequate bone marrow function with platelets > 100 X 109/l; neutrophils > 1.5 X 109/l i) Adequate renal function, with calculated creatinine clearance >30 ml/min (Cockcroft and Gault). For patients with creatinine clearance <50 ml/min the starting dose of capecitabine may not be greater than 2000 mg/m2/d (see Section 7.1)
  • Adequate hepatic function with serum total bilirubin < 1.5 X upper limit of normal range
  • Life expectancy of at least 12 weeks
  • No other concurrent uncontrolled medical conditions
  • No other malignant disease apart from non-melanotic skin cancer or carcinoma in situ of the uterine cervix or any other cancer treated with curative intent >2 years previously without evidence of relapse
  • Women and partners of women of childbearing potential must agree to use adequate contraception
  • Written informed consent

Exclusion Criteria:

  • Medical or psychiatric conditions that compromise the patient's ability to give informed consent or to complete the protocol
  • Patients with a lack of physical integrity of the upper gastrointestinal tract, or known malabsorption syndromes.
  • Uncontrolled hypertension
  • Active bleeding disorders within the last 3 months
  • Patients on full anticoagulation with warfarin. (Patients who require full anticoagulation and who wish to participate in the study should be converted to low molecular weight heparin). (Note: patients receiving full anticoagulation with low molecular weight heparin should have no evidence of tumour invading or abutting major blood vessels on any prior CT scan)
  • Participation in any investigational drug study within the previous 8 weeks
  • Patients with uncontrolled clinically significant cardiac disease, arrhythmias or angina pectoris
  • Patients with a history of acute myocardial infarction or cerebrovascular accident within the last 12 months
  • Regular use of aspirin (>325mg/day) or NSAIDs (low dose aspirin (<325 mg/d), or occasional use of NSAIDs is acceptable)
  • CNS metastases
  • Major surgical procedure within the last 28 days
  • Serious non-healing wound, ulcer or bone fracture
  • 24 hour urinary protein > 2g/ 24 hours ( performed if urine dipstick > 1+ )
  • Pregnancy or lactation

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): NCT00294359

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Sponsors and Collaborators
Australasian Gastro-Intestinal Trials Group
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Principal Investigator: Niall C Tebbutt, BA (Hons) BM BCh PhD MRCP FRAC Ludwig Oncology Unit, Austin Health
Publications automatically indexed to this study by Identifier (NCT Number):
Layout table for additonal information Identifier: NCT00294359    
Other Study ID Numbers: AG0501CR
First Posted: February 22, 2006    Key Record Dates
Last Update Posted: August 22, 2007
Last Verified: August 2007
Keywords provided by Australasian Gastro-Intestinal Trials Group:
colorectal neoplasm
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
Antimetabolites, Antineoplastic
Molecular Mechanisms of Pharmacological Action
Antibiotics, Antineoplastic
Alkylating Agents
Nucleic Acid Synthesis Inhibitors
Enzyme Inhibitors