Cap+Bev vs Cap+Iri+Bev 1st-line Therapy in mCRC
Randomized, Open, Multicenter Phase III Study With Capecitabine Plus Bevacizumab Versus Capecitabine Plus Irinotecan Plus Bevacizumab as First-line Therapy in Patients With Metastatic Colorectal Cancer
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Anticipated)
Enrollment
Phase
Phase
- Phase 3
Contacts and Locations
Study Contact
Study Contact
- Name: Volker Heinemann, Prof. Dr.
- Phone Number: +49 89 7095 0
- Email: volker.heinemann@med.uni-muenchen.de
Study Locations
-
-
-
Munich, Germany, 81377
- Recruiting
- University of Munich - Klinikum der Universitaet Muenchen
-
Contact:
- Volker Heinemann, Prof. Dr. med.
- Phone Number: +49 89 7095 0
- Email: volker.heinemann@med.uni-muenchen.de
-
Contact:
- Clemens Giesse, Dr. med.
- Phone Number: +49 89 7095 0
- Email: clemens.giessen@med.uni-muenchen.de
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Sub-Investigator:
- Clemens Giessen, Dr. med.
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Histologically confirmed adenocarcinoma of the colon or rectum.
- Stage IV disease.
- ECOG 0-1.
- Patients considered suitable for application of chemotherapy.
- Age 18 - 75 years.
- In- or outpatient treatment.
- Estimated life expectancy > 3 months.
- Measurable index lesion according to RECIST criteria. Evaluation of tumor manifestations ≤ 2 weeks prior to treatment start.
- Effective contraception.
- Adequate hematologic function: leukocytes >= 3000/µl, neutrophils >= 1500/µl, platelets >= 100.000/µ, and hemoglobin >= 9g/dl. Bilirubin <= 1,5x upper limit of normal (ULN). ALAT and ASAT <= 2,5x ULN, in case of liver metastases <= 5x ULN. Serum creatinine <= 1,5x ULN.
- No operations within 4 weeks prior to treatment start. No cytologic biopsies within 1 week prior to treatment start. Operation sequels need to be completely healed. Major operations must not be expected at time of study begin, except for potential secondary resection of liver metastases. In case of secondary resection of liver metastases, bevacizumab must be discontinued 6-8 weeks prior to surgery.
- No relevant toxicities due to prior medical treatment at time of study entry.
Exclusion Criteria:
- primary resectable metastases
- heart failure Grade III/IV (NYHA-classification)
- Prior treatment directed against the epidermal growth factor receptor (EGFR).
- Prior treatment with bevacizumab.
- Prior chemotherapy for colorectal cancer, except for adjuvant chemotherapy dating back > 6 months prior to study entry.
- Experimental medical treatment within 30 days prior to study entry.
- Known hypersensitivity reaction to any study medication.
- Pregnant or breast feeding women (pregnancy needs to be excluded by testing of beta-HCG).
- Known or suspected cerebral metastases.
- Clinically significant coronary heart disease, myocardial infarction within the last 12 months or high risk of uncontrolled arrhythmia.
- Acute or subacute ileus, chronic inflammatory bowel disease or chronic diarrhea.
- Abdominal or tracheo-esophageal fistulas, gastrointestinal perforation within 6 months before study entry
- Symptomatic peritoneal carcinosis.
- Severe chronic wounds, ulcera or bone fracture.
- Uncontrolled hypertension.
- Severe proteinuria (nephrotic syndrome).
- Arterial thromboembolic events or hemorrhage within 6 months prior to study entry (except tumor bleeding surgically treated by tumor resection).
- Bleeding diatheses or coagulopathy.
- Full dose anticoagulation.
- Known DPD-deficiency (special screening not required).
- Known glucuronidation-deficiency (special screening not required).
- Contraindication with irinotecan
- Medical history of other malignant disease within 5 years prior to study entry, except for basalioma, and in-situ cervical carcinoma if treated with curative intent.
- Known alcohol or drug abuse.
- Medical or psychiatric condition which contradicts participation of study.
- Limited legal capacity.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: SINGLE_GROUP
- Masking: NONE
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
EXPERIMENTAL: Cap+Bev until PD followed by CAPIRI +Bev
Capecitabine + Bevacizumab In case of Progression Escalation to: Capecitabine + Irinotecan + Bevacizumab |
Capecitabine:2 x 1250 mg/m2 day 1-14 followed by 1 week pause q day 21
Bevacizumab: 7.5 mg/kg day 1 q day 21
Capecitabine: 2 x 800mg/m2 day 1-14 followed by 1 week pause q day 21
Bevacizumab: 7.5 mg/kg day 1, q day 21
|
|
ACTIVE_COMPARATOR: Capiri + Bev
Capecitabine + Irinotecan + Bevacizumab
|
Capecitabine:2 x 1250 mg/m2 day 1-14 followed by 1 week pause q day 21
Bevacizumab: 7.5 mg/kg day 1 q day 21
Capecitabine: 2 x 800mg/m2 day 1-14 followed by 1 week pause q day 21
Bevacizumab: 7.5 mg/kg day 1, q day 21
Irinotecan: 200 mg/m2 day 1 , q day 21
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
TFS
Time Frame: 9 months
|
Time of Failure Strategy
|
9 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
ORR, OS, Quality of Life, PFS-1
Time Frame: 36 months
|
36 months
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Volker Heinemann, Prof. Dr. med., University of Munich - Klinikum der Universitaet Muenchen
- Study Chair: Sebastian Stintzing, Dr. med., University of Munich - Klinikum der Universitaet Muenchen
- Study Chair: Clemens Giessen, University of Munich - Klinikum der Universitaet Muenchen
Publications and helpful links
General Publications
- Stahler A, Modest DP, Fischer von Weikersthal L, Kaiser F, Decker T, Held S, Graeven U, Schwaner I, Denzlinger C, Schenk M, Kurreck A, Heinrich K, Giessen-Jung C, Neumann J, Kirchner T, Jung A, Stintzing S, Heinemann V. First-line fluoropyrimidine plus bevacizumab followed by irinotecan-escalation versus initial fluoropyrimidine, irinotecan and bevacizumab in patients with metastatic colorectal cancer - Final survival and per-protocol analysis of the randomised XELAVIRI trial (AIO KRK 0110). Eur J Cancer. 2022 Sep;173:194-203. doi: 10.1016/j.ejca.2022.06.019. Epub 2022 Aug 5.
- Stahler A, Heinemann V, Schuster V, Heinrich K, Kurreck A, Giessen-Jung C, Fischer von Weikersthal L, Kaiser F, Decker T, Held S, Graeven U, Schwaner I, Denzlinger C, Schenk M, Neumann J, Kirchner T, Jung A, Kumbrink J, Stintzing S, Modest DP. Consensus molecular subtypes in metastatic colorectal cancer treated with sequential versus combined fluoropyrimidine, bevacizumab and irinotecan (XELAVIRI trial). Eur J Cancer. 2021 Nov;157:71-80. doi: 10.1016/j.ejca.2021.08.017. Epub 2021 Sep 8.
- Heinrich K, Modest DP, Ricard I, Fischer von Weikersthal L, Decker T, Kaiser F, Graeven U, Uhlig J, Schenk M, Freiberg-Richter J, Peuser B, Denzlinger C, Giessen-Jung C, Stahler A, Michl M, Held S, Jung A, Kirchner T, Stintzing S, Heinemann V. Gender-dependent survival benefit from first-line irinotecan in metastatic colorectal cancer. Subgroup analysis of a phase III trial (XELAVIRI-study, AIO-KRK-0110). Eur J Cancer. 2021 Apr;147:128-139. doi: 10.1016/j.ejca.2021.01.025. Epub 2021 Feb 27.
- Modest DP, Fischer von Weikersthal L, Decker T, Vehling-Kaiser U, Uhlig J, Schenk M, Freiberg-Richter J, Peuser B, Denzlinger C, Peveling Genannt Reddemann C, Graeven U, Schuch G, Schwaner I, Stahler A, Jung A, Kirchner T, Held S, Stintzing S, Giessen-Jung C, Heinemann V; XELAVIRI/AIO KRK0110 Investigators. Sequential Versus Combination Therapy of Metastatic Colorectal Cancer Using Fluoropyrimidines, Irinotecan, and Bevacizumab: A Randomized, Controlled Study-XELAVIRI (AIO KRK0110). J Clin Oncol. 2019 Jan 1;37(1):22-32. doi: 10.1200/JCO.18.00052. Epub 2018 Nov 2.
- Giessen C, von Weikersthal LF, Hinke A, Stintzing S, Kullmann F, Vehling-Kaiser U, Mayerle J, Bangerter M, Denzlinger C, Sieber M, Teschendorf C, Freiberg-Richter J, Schulz C, Modest DP, Moosmann N, Aubele P, Heinemann V. A randomized, phase III trial of capecitabine plus bevacizumab (Cape-Bev) versus capecitabine plus irinotecan plus bevacizumab (CAPIRI-Bev) in first-line treatment of metastatic colorectal cancer: the AIO KRK 0110 trial/ML22011 trial. BMC Cancer. 2011 Aug 23;11:367. doi: 10.1186/1471-2407-11-367.
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (ANTICIPATED)
Primary Completion
Study Completion (ANTICIPATED)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
First Posted
Study Record Updates
Last Update Posted (ESTIMATE)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Digestive System Diseases
- Neoplasms
- Neoplasms by Site
- Gastrointestinal Neoplasms
- Digestive System Neoplasms
- Gastrointestinal Diseases
- Colonic Diseases
- Intestinal Diseases
- Intestinal Neoplasms
- Rectal Diseases
- Colorectal Neoplasms
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Enzyme Inhibitors
- Antimetabolites, Antineoplastic
- Antimetabolites
- Antineoplastic Agents
- Topoisomerase Inhibitors
- Antineoplastic Agents, Immunological
- Angiogenesis Inhibitors
- Angiogenesis Modulating Agents
- Growth Substances
- Growth Inhibitors
- Topoisomerase I Inhibitors
- Capecitabine
- Bevacizumab
- Irinotecan
Other Study ID Numbers
Other Study ID Numbers
- ML22011
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