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Metastatic Colorectal CancerPhase 3NCT01219920

FOLFOXIRI Compared With FOLFIRI for Metastatic Colorectal Cancer

A Phase 3 study testing FOLFIRI and FOLFOXIRI in people with Metastatic Colorectal Cancer, run by Gruppo Oncologico del Nord-Ovest at 48 sites in Italy.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

The purpose of the study is to evaluate if the exposure to all the three active cytotoxic agents (FOLFOXIRI regimen) is superior in terms of response rate to conventional chemotherapy with the FOLFIRI regimen as first-line treatment of metastatic colorectal cancer patients. Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
Metastatic Colorectal Cancer
What is being tested?
FOLFIRI and FOLFOXIRI
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
244 participants
Where
48 sitesItaly
Study dates
Nov 2001to Nov 2009
Phase
Phase 3
Are there results?
None posted in the registry

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 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • adenocarcinoma of the colon or rectum
  • unresectable metastatic disease
  • age 18 to 75 years
  • Eastern Cooperative Oncology Group (ECOG) performance status of 2 or lower if age 70 years or younger or ECOG performance status of 0 if age 71 to 75 years measurable disease according to WHOcriteria
  • leukocyte count of at least 3,500/mm3, neutrophils count of at least 1,500/mm3, platelet count of at least 100,000/mm3
  • serum creatinine of 1.3 mg/dL or less
  • serum bilirubin less than 1.5 mg/dL and AST, ALT, and alkaline phosphatase 2.5 x normal values or less (</= 5 if liver metastases)
  • previous fluoropyrimidine-based adjuvant chemotherapy was allowed if ended more than 6 months before random assignment

Who cannot join

  • previous palliative chemotherapy for metastatic disease
  • previous chemotherapy including irinotecan or oxaliplatin
  • symptomatic cardiac disease, myocardial infarction in the last 24 months or uncontrolled arrhythmia
  • active infections
  • inflammatory bowel disease
  • total colectomy

Trial locations and contacts

48 sites in 1 country.

48 sites in 1 country

Italy48 sites
  • Ospedale Civile Ss. Antonio E Biagio Di Alessandria - Alessandria (Al) Oncologia Medica

    Alessandria, 15100

  • A.O. Universitaria Ospedali Riuniti - Ospedale Umberto I Di Ancona - Ancona (An) Oncologia Medica

    Ancona, 60100

  • Ausl Della Valle D' Aosta (Ao) - Aosta (Ao) Oncologia Medica

    Aosta, 11100

  • P.O. Zona Aretina - Ospedale S. Donato Di Arezzo - Arezzo (Ar) Oncologia Medica

    Arezzo, 52100

  • Azienda Ospedale 'G.Rummo' - Benevento (Bn) Oncologia Medica

    Benevento, 82100

  • Ospedale Degli Infermi Di Biella - Biella (Bi) Oncologia Medica

    Biella, 13900

  • Ospedale S. Orsola F.B.F. - Brescia - Brescia (Bs) Oncologia Medica

    Brescia, 25122

  • Stabilimento "Perrino" - Brindisi - Brindisi (Br) Oncologia Medica

    Brindisi, 72100

  • Azienda Ospedaliera S. Elia - Caltanissetta (Cl) Oncologia Medica

    Caltanissetta, 93100

  • Ospedale Versilia - Camaiore (Lu) Oncologia Medica

    Camaiore, 55043

  • Ospedale Cecina - Cecina (Li) Oncologia Medica

    Cecina, 57023

  • Istituti Ospitalieri - Cremona - Cremona (Cr) Oncologia Medica

    Cremona, 26100

  • Azienda Ospedaliera S. Croce E Carle Di Cuneo - Cuneo (Cn) Oncologia Medica

    Cuneo, 12100

  • Ausl 11 Di Empoli (Fi) - Empoli (Fi) Oncologia Medica

    Empoli, 50053

  • Asur - Zona Territoriale 6 Di Fabriano (An) - Fabriano (An) Oncologia Medica

    Fabriano, 60044

  • Ospedale Santa Croce Fano - Fano (Pu) Oncologia Medica

    Fano, 61032

  • Ausl 10 Di Firenze - Firenze (Fi) Oncologia Medica

    Florence, 50122

  • A.O. Universitaria Careggi Di Firenze Oncologia Medica

    Florence, 50134

  • E.O. Ospedali Galliera - Genova (Ge) Oncologia Medica

    Genova, 16128

  • Irccs Istituto Nazionale Per La Ricerca Sul Cancro (Ist) - Genova (Ge) Oncologia Medica

    Genova, 16132

  • Ospedale Sant'Andrea La Spezia - La Spezia (Sp) Oncologia Medica

    La Spezia, 19100

  • Ausl Le Di Lecce - Lecce (Le) Oncologia Chirurgica

    Lecce, 73100

  • Ospedale Per Acuti "Mater Salutis" Legn. - Legnago (Vr) Oncologia Medica

    Legnano, 37045

  • U.O. Oncologia Medica, Ospedale Civile

    Livorno, 57123

  • Presidio Ospedaliero Piana Di Lucca - Lucca (Lu) Oncologia Medica

    Lucca, 55100

  • Irccs Fondazione Centro S. Raffaele Del Monte Tabor - Milano (Mi) Oncologia Medica

    Milan, 20132

  • Ospedale Ca' Granda-Niguarda - Milano - Milano (Mi) Oncologia Medica

    Milan, 20162

  • Ospedale Civile Di Mirano - Mirano (Ve) Oncologia Medica

    Mirano, 30035

  • A.O. Universitaria Federico Ii Di Napoli Oncologia Medica

    Naples, 80131

  • A.O. Universitaria Maggiore Della Carita' Di Novara Oncologia Medica

    Novara, 28100

  • A.O. Universitaria Di Parma Oncologia Medica

    Parma, 43100

  • Asl 1 Di Citta' Di Castello (Pg) - Citta' Di Castello (Pg) Oncologia Medica

    Perugia, 06012

  • A.O. Di Perugia - Ospedale S. Maria Della Misericordia (Ex Silvestrini) - Perugia (Pg) Oncologia Medica

    Perugia, 06156

  • Azienda Ospedaliera San Salvatore - Pesaro (Pu) Oncologia Medica

    Pesaro, 61100

  • Ospedale Piombino - Piombino (Li) Oncologia Medica

    Piombino, 57025

  • Ausl 5 Di Pisa - Pisa (Pi) Oncologia Medica

    Pisa, 56100

  • A.O. Universitaria Pisana - Pisa (Pi) Oncologia Medica

    Pisa, 56126

  • A.O. Universitaria Pisana Oncologia Medica

    Pisa, 56126

  • Ausl 3 Di Pistoia - Pistoia (Pt) Oncologia Medica

    Pistoia, 51100

  • Ospedali Riuniti Di Pistoia - Pistoia (Pt) Oncologia Medica

    Pistoia, 51100

  • Ospedale Di S. Maria Nuova - Reggio Nell'Emilia

    Reggio Emilia, 42100

  • Policlinico Universitario Campus Bio-Medico Di Roma Oncologia Medica

    Roma, 00128

  • Policlinico Umberto I Di Roma Oncologia Medica

    Roma, 00161

  • Policlinico Universitario Gemelli Di Roma Oncologia Medica

    Roma, 00168

  • A.O. Universitaria Senese Oncologia Medica

    Siena, 53100

  • Ausl 7 Di Siena - Siena (Si) Oncologia Medica

    Siena, 53100

  • Ospedale Civile - Sondrio - Sondrio (So) Oncologia Medica

    Sondrio, 23100

  • A.O. Universitaria S. Giovanni Battista-Molinette Di Torino Oncologia Medica

    Torino, 10134

Other trials in Italy

About this study

Official title: Phase III Trial of Infusional Fluorouracil, Leucovorin, Oxaliplatin and Irinotecan (FOLFOXIRI) Compared With Infusional Fluorouracil, Leucovorin and Irinotecan (FOLFIRI) as First-line Treatment for Metastatic Colorectal Cancer

The purpose of the study is to evaluate if the exposure to all the three active cytotoxic agents (FOLFOXIRI regimen) is superior in terms of response rate to conventional chemotherapy with the FOLFIRI regimen as first-line treatment of metastatic colorectal cancer patients.

Read the detailed description

Survival of patients with metastatic colorectal cancer is correlated with the proportion of patients who receive all the three active drugs in the course of the disease, but not with the proportion of patients who receive any second-line therapy. In a sequential strategy, not all patients who progress after first-line chemotherapy are able to receive second-line treatment. Moreover, there is a correlation between the response rate to chemotherapy and the postchemotherapy radical resection rate of metastases.

Therefore, a way to improve the outcome of metastatic colorectal cancer patients could be to administer a first-line regimen containing the three active agents.

Being tested
FOLFIRI, FOLFOXIRI
Keywords
Metastatic colorectal cancer, Phase III, FOLFOXIRI, FOLFIRI
Medical subject headings
Colorectal Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • FOLFIRIDrug

    Also called Campto, l-lederfolin, 5-FU

    Irinotecan 180 mg/sqm on day 1 Leucovorin 100 mg/sqm on day 1 and day 2 5-fluorouracil 400 mg/sqm bolus followed by 5-fluorouracil 600 mg/sqm 22-hour continuous infusion on day 1 and day 2 Repeated every 2 weeks

  • FOLFOXIRIDrug

    Also called Campto, Eloxatin, l-leucovorin, 5FU

    Irinotecan 165 mg/sqm on day 1 Oxaliplatin 85 mg/sqm on day 1 Leucovorin 200 mg/sqm on day 1 5-fluorouracil 3200 mg/sqm 48-hour continuous infusion starting on day 1 Repeated every 2 weeks

Study groups in NCT01219920
Study groupRoleWhat they receive
FOLFIRIActive comparatorIrinotecan 180 mg/sqm on day 1 Leucovorin 100 mg/sqm on day 1 and day 2 5-fluorouracil 400 mg/sqm bolus followed by 5-fluorouracil 600 mg/sqm 22-hour continuous infusion on day 1 and day 2 Repeated every 2 weeks
Receives: Drug: FOLFIRI
FOLFOXIRIExperimentalIrinotecan 165 mg/sqm on day 1 Oxaliplatin 85 mg/sqm on day 1 Leucovorin 200 mg/sqm on day 1 5-fluorouracil 3200 mg/sqm 48-hour continuous infusion starting on day 1 Repeated every 2 weeks
Receives: Drug: FOLFOXIRI

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Response rate (RR)

    Responses are evaluated every 8 weeks according to WHO criteria. The determination of responses and progression was initially based on investigator-reported measurements; computed tomography scans of all responding patients and of patients with stable disease were subsequently subjected to external review by an independent panel.

    Measured: Responses are evaluated every 8 weeks according to WHO criteria and reviewed by an independent panel at the end of treatment (6 months)

Secondary outcomes (5)
  1. Progression-free survival (PFS)

    PFS is defined as the length of time from random assignment to disease progression or to death resulting from any cause, whichever occurred first, or to last contact.

    Measured: Progressions are evaluated every 8 weeks according to WHO criteria and reviewed by an independent panel at the end of follow up (36 months)

  2. Overall survival (OS)

    OS is defined as the length of time from random assignment to death or to last contact.

    Measured: For survival analysis participants are followed until death

  3. Postchemotherapy radical (R0) surgical resection rate of metastases

    Percentage of patients who undergo radical (R0) resection of metastases after achieving objective response to chemotherapy.

    Measured: Postchemotherapy radical (R0) surgical resection rate of metastases were evaluated every 8 weeks during treatment and during follow up (36 months)

  4. Number of Participants with Adverse Events as a Measure of Safety and Tolerability

    During the full lenght of first-line treatment, number of enrolled patients reporting adverse events is recorded. Adverse events are evaluated according to National Cancer Institute Common Toxicity Criteria version 2.0.

    Measured: Number of Participants with Adverse Events as a Measure of Safety and Tolerability were evaluated every 2 weeks during treatment and every 8 weeks during follow up (36 months)

  5. Quality of life (QoL)

    Quality of life is assessed at the beginning of each treatment cycle using the Quality of Life Questionnaire of the European Organisation for Research and Treatment of Cancer (version 2.0).

    The QLQ-C30 questionnaire was analyzed with the global health status/quality-of-life scale as the primary end point and the other 10 scales as secondary end points.

    Measured: Quality of life was evaluated every 2 weeks during treatment and every 8 weeks during follow up (36 months)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted13 Oct 2010 (estimated)
  2. Study startNov 2001
  3. Primary completionNov 2005
  4. Study completionNov 2009

Resources

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 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
244 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01219920
Sponsor's protocol ID
ASL601LIOM03
Other IDs
2007-002886-11
Status last verified
Mar 2015
First submitted
8 Oct 2010
Last updated
11 Mar 2015
Results posted
No
Data monitoring committee
Yes

Publications

  • Falcone A, Ricci S, Brunetti I, Pfanner E, Allegrini G, Barbara C, Crino L, Benedetti G, Evangelista W, Fanchini L, Cortesi E, Picone V, Vitello S, Chiara S, Granetto C, Porcile G, Fioretto L, Orlandini C, Andreuccetti M, Masi G; Gruppo Oncologico Nord Ovest. Phase III trial of infusional fluorouracil, leucovorin, oxaliplatin, and irinotecan (FOLFOXIRI) compared with infusional fluorouracil, leucovorin, and irinotecan (FOLFIRI) as first-line treatment for metastatic colorectal cancer: the Gruppo Oncologico Nord Ovest. J Clin Oncol. 2007 May 1;25(13):1670-6. doi: 10.1200/JCO.2006.09.0928.

    PubMed 17470860
  • Masi G, Vasile E, Loupakis F, Bursi S, Ricci S, Petrini I, Fontana A, Allegrini G, Falcone A. Triplet combination of fluoropyrimidines, oxaliplatin, and irinotecan in the first-line treatment of metastatic colorectal cancer. Clin Colorectal Cancer. 2008 Jan;7(1):7-14. doi: 10.3816/CCC.2008.n.002.

    PubMed 18279572
  • Masi G, Loupakis F, Pollina L, Vasile E, Cupini S, Ricci S, Brunetti IM, Ferraldeschi R, Naso G, Filipponi F, Pietrabissa A, Goletti O, Baldi G, Fornaro L, Andreuccetti M, Falcone A. Long-term outcome of initially unresectable metastatic colorectal cancer patients treated with 5-fluorouracil/leucovorin, oxaliplatin, and irinotecan (FOLFOXIRI) followed by radical surgery of metastases. Ann Surg. 2009 Mar;249(3):420-5. doi: 10.1097/SLA.0b013e31819a0486.

    PubMed 19247029
  • Cremolini C, Loupakis F, Masi G, Lonardi S, Granetto C, Mancini ML, Chiara S, Moretto R, Rossini D, Vitello S, Allegrini G, Tonini G, Bergamo F, Tomasello G, Ronzoni M, Buonadonna A, Bustreo S, Barbara C, Boni L, Falcone A. FOLFOXIRI or FOLFOXIRI plus bevacizumab as first-line treatment of metastatic colorectal cancer: a propensity score-adjusted analysis from two randomized clinical trials. Ann Oncol. 2016 May;27(5):843-9. doi: 10.1093/annonc/mdw052. Epub 2016 Feb 9.

    PubMed 26861604

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing FOLFIRI and FOLFOXIRI in people with Metastatic Colorectal Cancer, run by Gruppo Oncologico del Nord-Ovest at 48 sites in Italy.

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 8 inclusion and 6 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: finished, as of the sponsor's last update on 11 Mar 2015. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 48 sites in Italy. 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.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

Response rate (RR) (time frame: Responses are evaluated every 8 weeks according to WHO criteria and reviewed by an independent panel at the end of treatment (6 months)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01219920, which also lists 4 linked publications.

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 11 Mar 2015.

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