Colon CancerNCT00826800
Neoadjuvant FOLFOX Plus Bevacizumab Chemotherapy in Patients With Locally Advanced Colon Cancer
A study testing FOLFOX and bevacizumab in people with Colon Cancer, run by Memorial Sloan Kettering Cancer Center at 5 sites in United States.
Trial summary
The purpose of this study is to see if giving chemo-therapy for colon cancer before surgery can shrink the cancer and lead to a higher rate of cure than operating first and then giving chemotherapy. Read more about this study
- Who is it for?
- Ages 18 to 90 years
- Conditions the study is for
- Colon Cancer
- What is being tested?
- FOLFOX and bevacizumab
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 2 participants
- Where
- 5 sitesUnited States
- Study dates
- Feb 2009to Jan 2011
- Phase
- Interventional
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 90 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- NOTE: Patients may sign consent and be registered for this protocol prior to completion of assessment of criteria 6.1.1 and 6.1.2, (assuming all other eligibility criteria are met) so that endocolonic ultrasound and biopsy may be performed on study; as these procedures may be necessary to determine TNM staging and/or histopathology; however criteria 6.1.1 and 6.1.2 must be successfully met prior to patient receiving chemotherapy on this trial.
- 6.1.1 Clinical T1N1-2/T2N1-2/T3N0/T3N1-2/T4Ni-N2 adenocarcinomas of the colon determined by endocolonic ultrasound (ECUS) performed at MSKCC.
- 6.1.2 Colonoscopy with endoscopic biopsy of tumor at MSKCC for disease confirmation and correlative studies. Pathological confirmation of adenocarcinoma or poorly differentiated carcinoma as the primary histology.
- CT or MRI scans (done within 30 days of registration) of the Chest, Abdomen and Pelvis all without clear evidence of distant metastatic (M1) disease.
- Candidates for systemic therapy with FOLFOX and bevacizumab based on the opinion of the primary treating medical oncologist.
- Candidates for complete surgical resection prior to administration of any therapy.
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- Performance status of ECOG 0 or 1.
- Patients must be of age ≥18 years.
- ANC ≥ 1.5 cells/mm3, PLT >150,000/mm3.
- Serum creatinine < or = to 1.5 OR creatinine clearance (measured or calculated) greater than 60 ml/min.
Who cannot join
- Primary tumor clearly unresectable.
- Tumors with neuroendocrine histology.
- Patients with tumors that require placement of an endocolonic stent prior to treatment initiation.
- Patients with a history of stroke or TIA.
- Patients with history of thrombotic episodes such as deep venous thrombosis, pulmonary embolus, MI, or CVA occurring more than 12 months prior to enrollment may be considered for protocol participation provided that they are on stable doses of anticoagulant therapy. Similarly, patients anticoagulated for atrial fibrillation or other conditions may participate provided that they are on stable dose of anticoagulant therapy. Clinicians must note the higher risk of bevacizumab therapy amongst patients with history of thromboembolic disorders and consideration for participation is at the discretion of the treating physician.
- No other experimental therapies (including chemotherapy, radiation, hormonal treatment, antibody therapy, immunotherapy, gene therapy, vaccine therapy, angiogenesis inhibitors, matrix metalloprotease inhibitors, thalidomide, anti-VEGF/Flk-1 monoclonal antibody or other experimental drugs) of any kind are permitted while the patient is receiving study treatment.
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- Women of childbearing potential (WOCBP) who are unwilling or unable to use an acceptable method to avoid pregnancy for the entire study period and for up to 6 months after the study. Subjects who are men must also agree to use effective contraception.
- Note: Women of childbearing potential (WOCBP) must be using an adequate method of contraception to avoid pregnancy throughout the study and for up to 6 months after the study in such a manner that the risk of pregnancy is minimized.
- WOCBP include any female who has experienced menarche and who has not undergone successful surgical sterilization (hysterectomy, bilateral tubal ligation or bilateral oophorectomy) or is not postmenopausal [defined as amenorrhea ≥ 12 consecutive months; or women on hormone replacement therapy (HRT) with documented serum follicle stimulating hormone (FSH) level > 35mIU/mL]. Even women who are using oral, implanted or injectable contraceptive hormones or mechanical products such as an intrauterine device or barrier methods (diaphragm, condoms, spermicides) to prevent pregnancy or practicing abstinence or where partner is sterile (e.g., vasectomy), should be considered to be of child bearing potential.
- WOCBP must have a negative serum or urine pregnancy test (minimum sensitivity 25 IU/L or equivalent units of HCG) within 72 hours prior to the start of study medication.
- Women who are pregnant or breast feeding. Note: women with a positive pregnancy test on enrollment or prior to study drug administration will be removed from study.
- Patients with any other concurrent medical or psychiatric condition or disease which, in the investigator's judgment, would make the patient inappropriate for entry into this study.
- Patients with a history in the past five years of a prior malignancy, except for adequately treated basal cell or squamous cell skin cancer or in situ cervical cancer. Inadequately controlled, persistent (on more than one occasion) hypertension (defined as systolic blood pressure >150 mmHg and/or diastolic blood pressure > 100 mmHg).
- Prior history of hypertensive crisis or hypertensive encephalopathy.
- New York Heart Association (NYHA) Grade II or greater congestive heart failure
- Significant vascular disease (e.g., aortic aneurysm, requiring surgical repair or recent peripheral arterial thrombosis) within 6 months prior to Day 1
- Evidence of bleeding diathesis or significant coagulopathy (in the absence of therapeutic anticoagulation)
- History of abdominal fistula or gastrointestinal perforation within 6 months prior to Day 1
- Serious, non-healing wound, active ulcer, or untreated bone fracture (adjuvant trials: bone fractures must be healed
- Proteinuria as demonstrated by a UPC ratio ≥ 1.0 at screening
- Known hypersensitivity to any component of bevacizumab
Trial locations and contacts
5 sites in 1 country.
5 sites in 1 country
United States5 sites
Memorial Sloan-Kettering at Basking Ridge
Basking Ridge, New Jersey, 07920
Memorial Sloan-Kettering Cancer Center @ Suffolk
Commack, New York, 11725
Memorial Sloan-Kettering Cancer Center
New York, New York, 10065
Memorial Sloan-Kettering Cancer Center at Mercy Medical Center
Rockville Centre, New York, 11570
Memoral Sloan Kettering Cancer Center@Phelps
Sleepy Hollow, New York
About this study
Official title: A Pilot Study of Neoadjuvant FOLFOX Plus Bevacizumab Chemotherapy in Patients With Locally Advanced Colon Cancer
The purpose of this study is to see if giving chemo-therapy for colon cancer before surgery can shrink the cancer and lead to a higher rate of cure than operating first and then giving chemotherapy. Standard treatment for colon cancer is to first operate, and then, if the tumor is advanced, give chemotherapy for about 6 months. However, surgery delays the time until chemotherapy can start, since the body needs time to heal from the operation. During this time any cancer cells that remain in the body that were not removed by the operation may be allowed to grow. Giving chemotherapy first could attack the cancer cells right from the start, not only at the tumor site that we know of, but also at the site of any cancer cells that may have spread to other parts of the body. Another possible reason why giving chemo therapy first might work better is that the blood vessels that feed the cancer cells are intact before surgery and thus chemotherapy can travel directly to the cancer.
This study will also use the drug bevacizumab, in addition to the standard chemotherapy. Bevacizumab has been on the market since 2004 for colon cancer that has spread to other organs, but its use in earlier stage colon cancer, as planned in this trial, is still under study.
- Conditions
- Colon Cancer
- Being tested
- FOLFOX and bevacizumab
- Keywords
- BEVACIZUMAB (AVASTIN), FLUOROURACIL, LEUCOVORIN, OXALIPLATIN, Chemotherapy
- Medical subject headings
- Colonic Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
FOLFOX and bevacizumabDrug
The patient will receive six treatments, two weeks apart. On each treatment day you will get Oxaliplatin, 5-FU,Leucovorin. On the first four treatments you will also get Bevacizumab (Avastin). These drugs are given through a Mediport. They will be given in an outpatient chemotherapy unit. Each tx will take about 4 hours. A pump for the 5-FU is worn around your waist. This drug is given over 2 days. Part II: Colon Cancer Surgery is standard practice, and is not a research procedure.Part III: Post-operative Re-Evaluation and Recovery The doctor will decide on the type of chemotherapy based on how the patient responded to the first chemotherapy. The plan will be for the patient to get 6 more doses of FOLFOX, without any further bevacizumab, unless your doctor finds a reason to do otherwise.
| Study group | Role | What they receive |
|---|---|---|
| Neoadjuvant FOLFOX Plus Bevacizumab | Experimental | FOLFOX and bevacizumab will be given to colon cancer patients for 4 cycles over 8 weeks; an additional 2 cycles of FOLFOX without bevacizumab will be given for a total of 12 weeks of pre-operative chemotherapy.Restaging will be performed within 3 weeks of the 6th chemotherapy cycle. Colon surgery will be performed between weeks 3 and 6 subsequent to the 6th cycle of FOLFOX. Patients receiving preoperative chemotherapy without radiation will wait a minimum of 3 weeks from their last dose of chemotherapy, and 6 weeks from their last dose of bevacizumab, before proceeding to surgery. Specifically, it is intended that patients will undergo surgery between 3-6 weeks from completion of their neoadjuvant therapy as deemed clinically appropriate by their surgeon and medical oncologist. This permits a 7-10 week interval between the 4th bevacizumab administration and colon surgery. Receives: Drug: FOLFOX and bevacizumab |
What is being measured
The primary outcome is the main question the study is designed to answer.
To Determine the Pathologic Complete Response (Path CR) Rate in Patients With Locally Advanced (Stage II or III) Colon Cancer to FOLFOX-bevacizumab Administered as Neoadjuvant.
Measured: 3 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted22 Jan 2009 (estimated)
- Study startFeb 2009
- Primary completionJan 2011
- Study completionJan 2011
Why it stopped: Lack of accrual
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for Colon CancerStudies of the same condition, open and under way.
- More trials run by Memorial Sloan Kettering Cancer CenterThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 2 participants (actual)
Sponsor and investigators
- Lead sponsor
- Memorial Sloan Kettering Cancer Center
- Sponsor type
- University, hospital or other
- Collaborators
- Genentech, Inc.
- Responsible party
- Sponsor
- Investigators
- Leonard Saltz, MD, Principal investigator, Memorial Sloan Kettering Cancer Center
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00826800
- Sponsor's protocol ID
- 08-162
- Status last verified
- Apr 2015
- First submitted
- 20 Jan 2009
- Last updated
- 15 Apr 2015
- Results posted
- Yes, on ClinicalTrials.gov
Study at a glance
From the registry record, last updated by the sponsor on 15 Apr 2015. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Pilot Study of Neoadjuvant FOLFOX Plus Bevacizumab Chemotherapy in Patients With Locally Advanced Colon Cancer
- ClinicalTrials.gov ID
- NCT00826800
- Acronym / sponsor ID
- 08-162
- Conditions
- Colon Cancer
- Keywords
- BEVACIZUMAB (AVASTIN), FLUOROURACIL, LEUCOVORIN, OXALIPLATIN, Chemotherapy
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: Lack of accrual
- Enrolment
- 2 participants (actual)
- Lead sponsor
- Memorial Sloan Kettering Cancer CenterUniversity, hospital or other
- Collaborators
- Genentech, Inc.
- Study start
- Feb 2009
- Primary completion
- Jan 2011 (actual)
- Study completion
- Jan 2011 (actual)
- First posted
- 22 Jan 2009 (estimated)
- Results
- Posted 15 Apr 2015
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this study is to see if giving chemo-therapy for colon cancer before surgery can shrink the cancer and lead to a higher rate of cure than operating first and then giving chemotherapy. Standard treatment for colon cancer is to first operate, and then, if the tumor is advanced, give chemotherapy for about 6 months. However, surgery delays the time until chemotherapy can start, since the body needs time to heal from the operation. During this time any cancer cells that remain in the body that were not removed by the operation may be allowed to grow. Giving chemotherapy first could attack the cancer cells right from the start, not only at the tumor site that we know of, but also at the site of any cancer cells that may have spread to other parts of the body. Another possible reason why giving chemo therapy first might work better is that the blood vessels that feed the cancer cells are intact before surgery and thus chemotherapy can travel directly to the cancer.
This study will also use the drug bevacizumab, in addition to the standard chemotherapy. Bevacizumab has been on the market since 2004 for colon cancer that has spread to other organs, but its use in earlier stage colon cancer, as planned in this trial, is still under study.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Neoadjuvant FOLFOX Plus Bevacizumab | Experimental | Drug: FOLFOX and bevacizumabFOLFOX and bevacizumab will be given to colon cancer patients for 4 cycles over 8 weeks; an additional 2 cycles of FOLFOX without bevacizumab will be given for a total of 12 weeks of pre-operative chemotherapy.Restaging will be performed within 3 weeks of the 6th chemotherapy cycle. Colon surgery will be performed between weeks 3 and 6 subsequent to the 6th cycle of FOLFOX. Patients receiving preoperative chemotherapy without radiation will wait a minimum of 3 weeks from their last dose of chemotherapy, and 6 weeks from their last dose of bevacizumab, before proceeding to surgery. Specifically, it is intended that patients will undergo surgery between 3-6 weeks from completion of their neoadjuvant therapy as deemed clinically appropriate by their surgeon and medical oncologist. This permits a 7-10 week interval between the 4th bevacizumab administration and colon surgery. |
Who may qualify
- Ages
- 18 to 90 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (10 listed)
- NOTE: Patients may sign consent and be registered for this protocol prior to completion of assessment of criteria 6.1.1 and 6.1.2, (assuming all other eligibility criteria are met) so that endocolonic ultrasound and biopsy may be performed on study; as these procedures may be necessary to determine TNM staging and/or histopathology; however criteria 6.1.1 and 6.1.2 must be successfully met prior to patient receiving chemotherapy on this trial.
- 6.1.1 Clinical T1N1-2/T2N1-2/T3N0/T3N1-2/T4Ni-N2 adenocarcinomas of the colon determined by endocolonic ultrasound (ECUS) performed at MSKCC.
- 6.1.2 Colonoscopy with endoscopic biopsy of tumor at MSKCC for disease confirmation and correlative studies. Pathological confirmation of adenocarcinoma or poorly differentiated carcinoma as the primary histology.
- CT or MRI scans (done within 30 days of registration) of the Chest, Abdomen and Pelvis all without clear evidence of distant metastatic (M1) disease.
- Candidates for systemic therapy with FOLFOX and bevacizumab based on the opinion of the primary treating medical oncologist.
Key exclusion criteria (21 listed)
- Primary tumor clearly unresectable.
- Tumors with neuroendocrine histology.
- Patients with tumors that require placement of an endocolonic stent prior to treatment initiation.
- Patients with a history of stroke or TIA.
- Patients with history of thrombotic episodes such as deep venous thrombosis, pulmonary embolus, MI, or CVA occurring more than 12 months prior to enrollment may be considered for protocol participation provided that they are on stable doses of anticoagulant therapy. Similarly, patients anticoagulated for atrial fibrillation or other conditions may participate provided that they are on stable dose of anticoagulant therapy. Clinicians must note the higher risk of bevacizumab therapy amongst patients with history of thromboembolic disorders and consideration for participation is at the discretion of the treating physician.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| FOLFOX and bevacizumabThe patient will receive six treatments, two weeks apart. On each treatment day you will get Oxaliplatin, 5-FU,Leucovorin. On the first four treatments you will also get Bevacizumab (Avastin). These drugs are given through a Mediport. They will be given in an outpatient chemotherapy unit. Each tx will take about 4 hours. A pump for the 5-FU is worn around your waist. This drug is given over 2 days. Part II: Colon Cancer Surgery is standard practice, and is not a research procedure.Part III: Post-operative Re-Evaluation and Recovery The doctor will decide on the type of chemotherapy based on how the patient responded to the first chemotherapy. The plan will be for the patient to get 6 more doses of FOLFOX, without any further bevacizumab, unless your doctor finds a reason to do otherwise. | Drug | Neoadjuvant FOLFOX Plus Bevacizumab |
Primary outcome
To Determine the Pathologic Complete Response (Path CR) Rate in Patients With Locally Advanced (Stage II or III) Colon Cancer to FOLFOX-bevacizumab Administered as Neoadjuvant.
Time frame: 3 years
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 15 Apr 2015.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Memorial Sloan-Kettering Cancer CenterLink provided by the sponsor.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Leonard Saltz, MD principal investigator
Memorial Sloan Kettering Cancer Center
5 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing FOLFOX and bevacizumab in people with Colon Cancer, run by Memorial Sloan Kettering Cancer Center at 5 sites in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 10 inclusion and 21 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: stopped early, as of the sponsor's last update on 15 Apr 2015. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 5 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Yes. Results are posted in the registry (first posted 15 Apr 2015). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
To Determine the Pathologic Complete Response (Path CR) Rate in Patients With Locally Advanced (Stage II or III) Colon Cancer to FOLFOX-bevacizumab Administered as Neoadjuvant. (time frame: 3 years). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Apr 2015.