FOLFOXIRI for Neoadjuvant Treatment of High-risk Locally Advanced Colorectal Cancer
To Observe the Pathological Remission Rate and Safety of FOLFOXIRI for Neoadjuvant Treatment of High-risk Locally Advanced Colorectal Cancer With a Single-arm, Open, Prospective Phase II Exploratory Clinical Study
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Anticipated)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Contact
Study Contact
- Name: Meng Qiu, Ph.D
- Phone Number: +8602885423203
- Email: qiumeng@wchscu.cn
Study Contact Backup
- Name: Weibing Leng, Ph.D
- Phone Number: +8602885423203
- Email: s103470@stu.scu.edu.cn
Study Locations
-
-
Sichuan
-
Chengdu, Sichuan, China, 610044
- Recruiting
- Sichuan University West China Hospital
-
Contact:
- Weibing Leng
- Phone Number: 18980601776
- Email: s103470@stu.scu.edu.cn
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age: 18-75 years old; Sex: Male or female;
- WHO performance status of 0, 1 or 2
- Histologically proven colorectal carcinoma (defined as cancer that is located >10 cm from the anal verge by endoscopy)
- Unequivocal radiological evidence of locally advanced cancer based on thin slice spiral CT [defined as T4a/b or (and) N2 / fused lymph nodes or (and) positive extramural vascular invasion (EMVI +) or (and) circumferential resection margin (CRM) ≤ 2mm].
- No distant metastases (distant organ or (and) distant lymph node metastases) assessed by CT scan or other radiographic examination.
- For patients with T4b, R0 resection was expected to be achieved, including the necessary combined organ resection,by MDT discussion.
- No history of 5-Fu and platinum drug allergy.
- Adequate bone marrow function: Hb>9g/dl; PLT >100 x 10^9/l; WBC >3.5 x 10^9/l and ANC ≥1.5x10^9/l.
- Adequate hepatobiliary function: ASAT (aspartate aminotransferase) and ALAT (alanine aminotransferase) of 2.5 x ULN (upper limits of normal) or less, Alkaline phosphatase of 2.5 x ULN or less, total bilirubin 1.5 x upper normal level or less.
- Adequate renal biochemistry: GFR >50 ml/min calculated by the Wright or Cockroft formula or EDTA clearance >70 ml/min.
- For female and of childbearing potential, patient must have a negative pregnancy test ≤72hours prior to initiating study treatment and agree to avoid pregnancy during and for 6 months after study treatment. For male with a partner of childbearing potential, patient must agree to use adequate, medically approved, contraceptive precautions during and for 90 days after the last dose of study treatment
- Patient able and willing to provide written informed consent for the study.
Exclusion Criteria:
- Patients with lynch syndrome
- Rectal cancer located 10 cm or less from the anal verge.
- Any patient for whom radiotherapy is advised by the MDT.
- Patient with evidence of distant metastases or peritoneal nodules (M1).
- Severe intestinal complications on initial clinical or imaging assessment: perforation, obstruction, uncontrollable bleeding.
- Another serious medical condition judged to compromise ability to tolerate neoadjuvant therapy and/or surgery.
- Pre-existing or concurrent other malignancies (including concurrent colon cancer), except for cured basal cell carcinoma of the skin and carcinoma in situ of the cervix.
- Pregnant or breastfeeding women.
- Patients with severe cardiovascular disease and diabetes mellitus that cannot be easily controlled.
- Persons with mental disorders.
- Patients with severe infections.
- Patients on thrombolytic/anticoagulant therapy, bleeding quality or coagulation disorders; or aneurysms, strokes, transient ischemic attacks, arteriovenous malformations in the past year.
- Previous history of renal disease with urine protein on urinalysis or clinically significant renal function abnormalities.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Neoadjuvant chemotherapy
4 cycles of neoadjuvant chemotherapy with FOLFOXIRI + operation + 5 cycles of adjuvant chemotherapy with XELOX
|
Oxaliplatin 85 mg/m² Q2w(2 h) before surgery rection and 130 mg/m² Q3w (2 h) after surgery
Other Names:
Irinotecan 150 mg/m² ivgtt(1.5 h) Q2w before surgery rection
Other Names:
Folinic acid 400 mg/m² ivgtt(2 h) Q2w before surgery rection
Other Names:
5-FU 2800 mg/m² civ(46 h) Q2w before surgery rection
Other Names:
Capecitabine 1000mg/m² d1-14 po Q3w after surgery rection
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Pathological response
Time Frame: up to 24 weeks
|
The rate of Tumor Regression Grade 0-1 in the resected tumour tissue
|
up to 24 weeks
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Objective Response Rate (ORR)
Time Frame: up to 24 weeks
|
Rate of patients with partial or complete response according to modified RECIST criteria.
|
up to 24 weeks
|
|
Pathologic Complete Response (PCR)
Time Frame: up to 24 weeks
|
Rate of pathological complete response in the resected tumour tissue
|
up to 24 weeks
|
|
R0 resection rate
Time Frame: up to 24 weeks
|
Resection rate, defined as patients with microscopically complete (R0) resection (ITT- population)
|
up to 24 weeks
|
|
Progression Free Survival (PFS)
Time Frame: up to 3 years
|
Progression free survival (Medium, Kaplan-Meier-estimation, ITT- population)
|
up to 3 years
|
|
Distant metastasis-free survival Metastasis-free survival
Time Frame: up to 3 years
|
distant Distant metastasis-free survival (Medium, Kaplan-Meier-estimation, ITT- population)
|
up to 3 years
|
|
Overall survival
Time Frame: up to 3 years
|
Overall survival (Kaplan-Meier-estimation, ITT- population)
|
up to 3 years
|
|
Toxicity and Compliance to study treatment
Time Frame: up to 1 years
|
Toxicity according to NCI-CTC criteria v. 4.0 Perioperative toxicity according to Clavien
|
up to 1 years
|
|
Molecular markers
Time Frame: up to 1 years
|
Evaluation of molecular predictive markers for response and toxicity
|
up to 1 years
|
|
Quality of Life to study treatment
Time Frame: up to 1 years
|
scores of Quality of Life Questionare-Core 30 of the European Organization for Research and Treatment of Cancer
|
up to 1 years
|
|
Number of patients with 30-day post-operative mortality
Time Frame: up to 24 weeks
|
up to 24 weeks
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Weibing Leng, Ph.D, Sichuan University
Study record dates
Study Major Dates
Study Start (Actual)
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 (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
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
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
- Immunosuppressive Agents
- Immunologic Factors
- Protective Agents
- Topoisomerase Inhibitors
- Micronutrients
- Vitamins
- Topoisomerase I Inhibitors
- Antidotes
- Vitamin B Complex
- Hematinics
- Fluorouracil
- Capecitabine
- Oxaliplatin
- Leucovorin
- Irinotecan
- Levoleucovorin
- Folic Acid
Other Study ID Numbers
Other Study ID Numbers
- 2021-010
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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