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AzTrials

Colon CancerPhase 2ECKINOXENCT01675999

Trial of Neoadjuvant Chemotherapy in Locally Advanced Colon Cancer

A Phase 2 study testing Perioperative simplified FOLFOX-4 chemotherapy, Perioperative FOLFOX4+Cetuximab chemotherapy and Surgery followed by FOLFOX4 chemotherapy in people with Colon Cancer and Locally Advanced Malignant Neoplasm, run by Assistance Publique - Hôpitaux de Paris at 1 site in France.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

In patients with locally advanced colon cancer (high risk stage II and stage III), curative surgery followed by adjuvant FOLFOX-4 chemotherapy has become the standard of care. However, for 30-40% of these patients, the current curative treatment strategy of surgical excision followed by adjuvant chemotherapy fails… Read more about this study

Who is it for?
Ages 18 to 76 years
What is being tested?
Perioperative simplified FOLFOX-4 chemotherapy, Perioperative FOLFOX4+Cetuximab chemotherapy and Surgery followed by FOLFOX4 chemotherapy
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
186 participants
Where
1 siteFrance
Study dates
May 2012to Feb 2021
Phase
Phase 2
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 76 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Pathologically confirmed colon adenocarcinoma (≥ 15 cm from the anal verge)
  • Assessment of RAS status of the primary colon cancer on biopsies (WT or mutated)
  • Colon cancer classified: poor prognosis T3 (T3 bad) - T4 and/ or N2 by abdominal CT scan.
  • Non metastatic colon cancer (lung, liver, peritoneal)
  • Non complicated primary tumor (obstruction, perforation, bleeding), patients with cancer treated by stomie de derivation may be included in the study.
  • DPD deficency
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  • Absence of synchronous colorectal cancer
  • Age ≥ 18 years and < 76 years
  • ECOG performance status 0-1
  • No prior chemotherapy within the last 5 years
  • No prior abdominal or pelvic irradiation within the last 5 years
  • Life expectancy of 5 years or more
  • No history of colorectal cancer within the last 5 years
  • Patients with childbearing potential should use effective contraception during the study and the following 6 months
  • White blood cell count of 3 x 109/L or more with neutrophils of1.5 x 109/L or more, platelet count of 100 x 109/L or more, hemoglobin of 9 g/dL (5,6 mmol/l) or more
  • Total bilirubin of 1.5 x ULN (upper limit of normal) or less
  • ASAT and ALAT of 2.5 x ULN or less
  • Alkaline phosphatase of 1.5 x ULN or less
  • Serum creatinine of 1.5 x ULN or less
  • Signed written informed consent obtained prior to any study specific screening procedures

Who cannot join

  • contra-indication to iodinated contrast medium injection including allergy to iodinated contrast medium and renal insufficiency proscribing iodinated injection
  • Age > 70 years
  • Rectal cancer located within 15 cm from the anal verge by endoscopy or under the peritoneal reflection at surgery or having received radiation therapy prior to surgery
  • Complicated primary colon cancer (obstruction, bleeding, perforation)
  • Synchronous colorectal cancer
  • Metastatic spread at baseline assessment (lung, liver, peritoneal)
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  • History or current evidence on physical examination of central nervous system disease or peripheral neuropathy ≥ grade 1 Common Toxicity Criteria for Adverse Events (CTCAE) v.3.0
  • Known hypersensitivity reaction to any of the components of study treatments
  • Presence of inflammatory bowel disease
  • HNPCC syndrome or polyposis
  • Major surgical procedure, open biopsy or significant traumatic injury within 28 days prior to study treatment start. Incompletely healed wounds or anticipation of the need for major surgical procedure during the course of the study
  • Clinically relevant coronary artery disease or history of myocardial infarction in the last 12 months, or high risk of uncontrolled arrhythmia
  • Pregnancy (absence to be confirmed by ß-hCG test) or breast-feeding period
  • Previous malignancy in the last 5 years
  • Medical, geographical, sociological, psychological or legal conditions that would not permit the patient to complete the study or sign informed consent
  • Any significant disease which, in the investigator's opinion, would exclude the patient from the study.

Trial locations and contacts

1 site in 1 country.

France1 site, 1 recruiting
  • Hopital Henri Mondor

    Paris, 94010

    Mehdi KAROUI, PH, +33 (0) 1 42 17 56 11, mehdi.karoui@gmail.com

    Recruiting

Other trials in France

About this study

Official title: PRODIGE 22-ECKINOXE : Randomized Phase II Trial of Neoadjuvant FOLFOX 4 Versus FOLFOX 4 With Cetuximab Versus Immediate Surgery in Locally Advanced Colon Cancer

In patients with locally advanced colon cancer (high risk stage II and stage III), curative surgery followed by adjuvant FOLFOX-4 chemotherapy has become the standard of care. However, for 30-40% of these patients, the current curative treatment strategy of surgical excision followed by adjuvant chemotherapy fails either to clear locoregional spread or to eradicate distant micrometastases, leading to disease recurrence. Preoperative chemotherapy is an attractive concept for locally advanced colon cancer and has the potential to impact upon both of these causes of failure. Optimum systemic therapy at the earliest possible opportunity may be more effective at eradicating distant metastases than the same treatment given after the delay and immunological stress of surgery. Added to this, shrinking the primary tumor before surgery may reduce the risk of incomplete surgical excision, and the risk of tumor cell shedding during surgery.

ECKINOXE is a multicenter randomized phase II trial designed to evaluate efficacy (response rate) and feasibility (safety, tolerance) of these two chemotherapy regimens (FOLFOX-4 alone and FOLFOX-4+Cetuximab) in a neoadjuvant strategy in patients with locally advanced colon cancer. Control arm includes patients for whom standard treatment comprises surgery followed by adjuvant FOLFOX-4 chemotherapy. This phase II study will assess the feasibility of a neoadjuvant strategy in these patients and determine which neoadjuvant regimen is the most effective in terms of response rate.

Read the detailed description

See Synopsis below

Being tested
Perioperative simplified FOLFOX-4 chemotherapy, Perioperative FOLFOX4+Cetuximab chemotherapy, Surgery followed by FOLFOX4 chemotherapy
Keywords
Neoadjuvant chemotherapy, Locally advanced malignant neoplasm, colon cancer
Medical subject headings
Colonic Neoplasms

What participants receive

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

  • Perioperative simplified FOLFOX-4 chemotherapyOther

    Preoperative chemotherapy

  • Perioperative FOLFOX4+Cetuximab chemotherapyOther

    Preoperative chemotherapy

  • Surgery followed by FOLFOX4 chemotherapyOther

    Preoperative chemotherapy

Study groups in NCT01675999
Study groupRoleWhat they receive
1ExperimentalPerioperative simplified FOLFOX-4 chemotherapy - Simplified FOLFOX-4 (IV oxaliplatin given over 120 min at a dose of 85 mg/m2 on day 1 followed by IV leucovorin 400 mg/m2 over 2h, IV bolus 5-FU 400 mg/m2 and IV infusional 5-FU 2400 mg/m2 over 46h) for 4 cycles followed by colectomy (3 to 5 weeks after) followed by simplified FOLFOX-4 (8 cycles).
Receives: Other: Perioperative simplified FOLFOX-4 chemotherapy
2ExperimentalPerioperative FOLFOX4+Cetuximab chemotherapy Simplified FOLFOX-4 (IV oxaliplatin given over 120 min at a dose of 85 mg/m2 on day 1 followed by IV leucovorin 400 mg/m2 over 2h, IV bolus 5-FU 400 mg/m2 and IV infusional 5-FU 2400 mg/m2 over 46h)+ Cetuximab (IV 500 mg/m2 every 2 weeks) for 4 cycles followed by colectomy (3 to 5 weeks after), followed by simplified FOLFOX-4 + Cetuximab (8 cycles).
Receives: Other: Perioperative FOLFOX4+Cetuximab chemotherapy
3OtherSurgery followed by FOLFOX4 chemotherapy No preoperative chemotherapy Colectomy (maximum 4 weeks after randomization) followed by simplified FOLFOX-4 (IV oxaliplatin given over 120 min at a dose of 85 mg/m2 on day 1 followed by IV leucovorin 400 mg/m2 over 2h, IV bolus 5-FU 400 mg/m2 and IV infusional 5-FU 2400 mg/m2 over 46h) for 12 cycles.
Receives: Other: Surgery followed by FOLFOX4 chemotherapy

What is being measured

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

  1. Histological tumor response in the primary tumor according to the simplified Tumor Regression Grade (TRG) of Ryan

    This primary outcome will be evaluated on the surgical specimens: Immediately after surgery (arm C) or after neoadjuvant chemotherapy (4 cycles) and surgery (arms A and B)

    Measured: 2 years

Secondary outcomes (8)
  1. Safety and tolerability and efficacy of the neoadjuvant chemotherapy

    • Tolerability of the neoadjuvant therapies. SAFETY ISSUE
    • Postoperative morbidity at 60 days. SAFETY ISSUE

    Measured: 9 years

  2. •Disease free survival and regression free survival at 3 years

    Measured: 3 years

  3. •Overall survival at 6 and 7 years

    Measured: 6 and 7 years

  4. •Quality of life (EORTC QLQ-C30, QLQ-CR29)

    Measured: 5 years

  5. •Quality and radicality of the surgical excision

    Measured: 2 years

  6. •Accuracy of pre-treatment CT scan staging and evaluation of radiological response to chemotherapy

    Measured: 2 years

  7. •Correlation between radiological and histological response

    Measured: 2 years

  8. •Evaluation of another histopathological grade

    Measured: 2 years

Timeline

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

  1. First posted30 Aug 2012 (estimated)
  2. Study startMay 2012
  3. Primary completionMay 2012
  4. Study completionFeb 2021 (estimated)

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 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Single group
Masking
None (open label)
Enrolment
186 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01675999
Sponsor's protocol ID
P100131
Acronym
ECKINOXE
Status last verified
Jan 2012
First submitted
2 Feb 2012
Last updated
15 Jan 2016
Results posted
No
Data monitoring committee
Yes

Publications

  • Karoui M, Gallois C, Piessen G, Legoux JL, Barbier E, De Chaisemartin C, Lecaille C, Bouche O, Ammarguellat H, Brunetti F, Prudhomme M, Regimbeau JM, Glehen O, Lievre A, Portier G, Hartwig J, Goujon G, Romain B, Lepage C, Taieb J; for PRODIGE 22 investigators/Collaborators. Does neoadjuvant FOLFOX chemotherapy improve the prognosis of high-risk Stage II and III colon cancers? Three years' follow-up results of the PRODIGE 22 phase II randomized multicentre trial. Colorectal Dis. 2021 Jun;23(6):1357-1369. doi: 10.1111/codi.15585. Epub 2021 Mar 10.

    PubMed 33580623
  • Karoui M, Rullier A, Piessen G, Legoux JL, Barbier E, De Chaisemartin C, Lecaille C, Bouche O, Ammarguellat H, Brunetti F, Prudhomme M, Regimbeau JM, Glehen O, Lievre A, Portier G, Hartwig J, Goujon G, Romain B, Lepage C, Taieb J; for PRODIGE 22 investigators/collaborators. Perioperative FOLFOX 4 Versus FOLFOX 4 Plus Cetuximab Versus Immediate Surgery for High-Risk Stage II and III Colon Cancers: A Phase II Multicenter Randomized Controlled Trial (PRODIGE 22). Ann Surg. 2020 Apr;271(4):637-645. doi: 10.1097/SLA.0000000000003454.

    PubMed 31356278
  • Karoui M, Rullier A, Luciani A, Bonnetain F, Auriault ML, Sarran A, Monges G, Trillaud H, Le Malicot K, Leroy K, Sobhani I, Bardier A, Moreau M, Brindel I, Seitz JF, Taieb J. Neoadjuvant FOLFOX 4 versus FOLFOX 4 with Cetuximab versus immediate surgery for high-risk stage II and III colon cancers: a multicentre randomised controlled phase II trial--the PRODIGE 22--ECKINOXE trial. BMC Cancer. 2015 Jul 10;15:511. doi: 10.1186/s12885-015-1507-3.

    PubMed 26156156

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Perioperative simplified FOLFOX-4 chemotherapy, Perioperative FOLFOX4+Cetuximab chemotherapy and Surgery followed by FOLFOX4 chemotherapy in people with Colon Cancer and Locally Advanced Malignant Neoplasm, run by Assistance Publique - Hôpitaux de Paris at 1 site in France.

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 20 inclusion and 16 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: status not confirmed, as of the sponsor's last update on 15 Jan 2016. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in France. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

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

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Mehdi karoui, PH (+33 (0) 1 42 17 56 11, mehdi.karoui@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Histological tumor response in the primary tumor according to the simplified Tumor Regression Grade (TRG) of Ryan (time frame: 2 years). 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 NCT01675999, which also lists 3 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 15 Jan 2016.

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