- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00911170
PAVES: Pegfilgrastim Anti-vascular Endothelial Growth Factor (VEGF) Evaluation Study
A Phase 3, Randomized, Double-blind, Placebo-controlled Study of Pegfilgrastim Admininstered to Subjects With Newly Diagnosed, Locally-advanced or Metastatic Colorectal Cancer Treated With Bevacizumab & Either 5-fluorouracil, Oxaliplatin, Leucovorin (FOLFOX) or 5-fluorouracil, Irinotecan, Leucovorin (FOLFIRI)
This is a phase 3, randomized, double-blind, placebo-controlled multi-center study evaluating the efficacy of pegfilgrastim to reduce the incidence of febrile neutropenia (FN) in patients with newly diagnosed, locally-advanced or metastatic colorectal cancer receiving first-line treatment with bevacizumab and either 5-fluorouracil, Oxaliplatin, Leucovorin (FOLFOX) or 5-fluorouracil, Irinotecan, Leucovorin (FOLFIRI).
This study will also investigate the effect of adding pegfilgrastim to bevacizumab and either FOLFOX or FOLFIRI by evaluating overall survival, progression-free survival, and overall response rate in each arm at regular intervals over a maximum of 60 months follow-up.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Actual)
Phase
- Phase 3
Contacts and Locations
Study Locations
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Tasmania
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Hobart, Tasmania, Australia, 7000
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Victoria
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Ballarat, Victoria, Australia, 3350
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Coburg, Victoria, Australia, 3058
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Footscray, Victoria, Australia, 3011
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Frankston, Victoria, Australia, 3199
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Aalst, Belgium, 9300
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Roeselare, Belgium, 8800
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Verviers, Belgium, 4800
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Sofia, Bulgaria, 1784
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Sofia, Bulgaria, 1756
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Sofia, Bulgaria, 1606
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Varna, Bulgaria, 9000
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Ontario
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Brampton, Ontario, Canada, L6R 3J7
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London, Ontario, Canada, N6A 4L6
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Sault Ste. Marie, Ontario, Canada, P6A 5K7
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Sudbury, Ontario, Canada, P3E 5J1
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Toronto, Ontario, Canada, M6R 1B5
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Quebec
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Laval, Quebec, Canada, H7M 3L9
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Levis, Quebec, Canada, G6V 3Z1
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Montreal, Quebec, Canada, H4J 1C5
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Montreal, Quebec, Canada, H2W 1S6
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Horovice, Czechia, 268 31
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Nova Ves pod Plesi, Czechia, 262 04
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Olomouc, Czechia, 775 20
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Znojmo, Czechia, 669 02
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Amiens, France, 80000
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Bordeaux Cedex, France, 33076
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Cahors Cedex, France, 46005
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Lille cedex 01, France, 59037
- Research Site
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Rouen, France, 76000
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Budapest, Hungary, 1125
- Research Site
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Budapest, Hungary, 1097
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Debrecen, Hungary, 4012
- Research Site
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Gyor, Hungary, 9023
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Gyula, Hungary, 5700
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Kaposvar, Hungary, 7400
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Kecskemet, Hungary, 6000
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Szeged, Hungary, 6720
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Szolnok, Hungary, 5004
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Cork, Ireland
- Research Site
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Dublin, Ireland, 8
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Dublin, Ireland, 24
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Dublin, Ireland, 7
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Dublin, Ireland, 9
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Galway, Ireland
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Waterford, Ireland
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Benevento, Italy, 82100
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Palermo, Italy, 90100
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Roma (RM), Italy, 00133
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Rozzano (MI), Italy, 20089
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Taormina (ME), Italy, 98039
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Daugavpils, Latvia, 5417
- Research Site
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Riga, Latvia, 1079
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Riga, Latvia, 1002
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Colima, Mexico, 28030
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Toluca, Mexico, 50080
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San Luis P
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San Luis Potosi, San Luis P, Mexico, 78200
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Gdansk, Poland, 80-952
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Lodz, Poland, 93-509
- Research Site
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Olsztyn, Poland, 10-228
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Suwalki, Poland, 16-400
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Warszawa, Poland, 04-125
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Bucharest, Romania, 022328
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Bucharest, Romania, 022338
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Cluj Napoca, Romania, 400015
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Sibiu, Romania, 550245
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Chelyabinsk, Russian Federation, 454087
- Research Site
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Kazan, Russian Federation, 420029
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Moscow, Russian Federation, 115478
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Saint Petersburg, Russian Federation, 197022
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Samara, Russian Federation, 443031
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Yaroslavl, Russian Federation, 150054
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Bratislava, Slovakia, 833 10
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Kosice, Slovakia, 041 91
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Rimavska Sobota, Slovakia, 979 01
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Trnava, Slovakia, 917 75
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Dnipropetrovsk, Ukraine, 49102
- Research Site
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Donetsk, Ukraine, 83092
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Ivano-Frankivsk, Ukraine, 76018
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Kyiv, Ukraine, 03115
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Lviv, Ukraine, 79031
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Uzhgorod, Ukraine, 88000
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Alabama
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Muscle Shoals, Alabama, United States, 35661
- Research Site
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Arkansas
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Jonesboro, Arkansas, United States, 72401
- Research Site
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California
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Anaheim, California, United States, 92801
- Research Site
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Beverly Hills, California, United States, 90211
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Modesto, California, United States, 95355
- Research Site
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San Diego, California, United States, 92161
- Research Site
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Connecticut
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Greenwich, Connecticut, United States, 06830
- Research Site
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Delaware
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Dover, Delaware, United States, 19901
- Research Site
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Florida
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Gainesville, Florida, United States, 32605
- Research Site
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Loxahatchee Groves, Florida, United States, 33470
- Research Site
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Port Saint Lucie, Florida, United States, 34952
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Tamarac, Florida, United States, 33321
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Hawaii
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Honolulu, Hawaii, United States, 96813
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Illinois
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Gurnee, Illinois, United States, 60031
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Maywood, Illinois, United States, 60153
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Quincy, Illinois, United States, 62301
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Rockford, Illinois, United States, 61108
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Indiana
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New Albany, Indiana, United States, 47150
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South Bend, Indiana, United States, 46617
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Iowa
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Council Bluffs, Iowa, United States, 51503
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Sioux City, Iowa, United States, 51101
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Waterloo, Iowa, United States, 50702
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Waterloo, Iowa, United States, 50701
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Kansas
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Hutchinson, Kansas, United States, 67502
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Kentucky
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Hazard, Kentucky, United States, 41701
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Lexington, Kentucky, United States, 40503
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Paducah, Kentucky, United States, 42001
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Louisiana
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Shreveport, Louisiana, United States, 71103
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Maryland
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Bethesda, Maryland, United States, 20817
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Cumberland, Maryland, United States, 21502
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Randallstown, Maryland, United States, 21133
- Research Site
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Towson, Maryland, United States, 21204
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Massachusetts
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Boston, Massachusetts, United States, 02135
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Boston, Massachusetts, United States, 02130
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Missouri
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Jefferson City, Missouri, United States, 65109
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Kansas City, Missouri, United States, 64118
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Saint Louis, Missouri, United States, 63136
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Springfield, Missouri, United States, 65807
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Montana
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Billings, Montana, United States, 59101
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Nebraska
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Grand Island, Nebraska, United States, 68803
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Kearney, Nebraska, United States, 68845
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Omaha, Nebraska, United States, 68131
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New Hampshire
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Portsmouth, New Hampshire, United States, 03801
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New Jersey
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Little Silver, New Jersey, United States, 07739
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Somerville, New Jersey, United States, 08876
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New Mexico
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Albuquerque, New Mexico, United States, 87131
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New York
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Lake Success, New York, United States, 11042
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Nyack, New York, United States, 10960
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North Carolina
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Asheville, North Carolina, United States, 28801
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Hickory, North Carolina, United States, 28602
- Research Site
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High Point, North Carolina, United States, 27262
- Research Site
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Winston-Salem, North Carolina, United States, 27103
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Ohio
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Canton, Ohio, United States, 44708
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Cincinnati, Ohio, United States, 45219
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Massillon, Ohio, United States, 44646
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Middletown, Ohio, United States, 45042
- Research Site
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Pennsylvania
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Lancaster, Pennsylvania, United States, 17605
- Research Site
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Langhorne, Pennsylvania, United States, 19047
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Reading, Pennsylvania, United States, 19605
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Upland, Pennsylvania, United States, 19013
- Research Site
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West Reading, Pennsylvania, United States, 19611
- Research Site
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Willow Grove, Pennsylvania, United States, 19090
- Research Site
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South Carolina
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Hilton Head Island, South Carolina, United States, 29926
- Research Site
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Myrtle Beach, South Carolina, United States, 29572
- Research Site
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Tennessee
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Nashville, Tennessee, United States, 37203
- Research Site
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Texas
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Bryan, Texas, United States, 77802
- Research Site
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Corpus Christi, Texas, United States, 78405
- Research Site
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Corpus Christi, Texas, United States, 78412
- Research Site
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Virginia
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Abingdon, Virginia, United States, 24211
- Research Site
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Lynchburg, Virginia, United States, 24501
- Research Site
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Washington
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Kennewick, Washington, United States, 99336
- Research Site
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Spokane, Washington, United States, 99220
- Research Site
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
Disease-related:
- Histologically or cytologically-confirmed adenocarcinoma of the colon or rectum
- Locally-advanced or metastatic disease by radiographic evaluation
- Measurable disease
- Has not previously received chemotherapy for locally-advanced or metastatic colorectal cancer. Patient may have received adjuvant therapy for primary colorectal cancer provided that at least 6 months have elapsed from the time the adjuvant therapy was concluded and recurrent/metastatic disease was documented.
- Eastern Cooperative Oncology Group (ECOG) Performance status 0-2
Demographic:
- Age of 18 years or over
Laboratory:
Adequate organ and marrow function as defined below:
- Absolute neutrophil count at least 1.5 x 10^9/L
- Platelet count at least 100 x 10^9/L
- Bilirubin ≤ 1.5 times upper limit of normal
- Aspartate aminotransferase and alanine aminotransferase ≤ 2.5 x upper limit of normal or Aspartate aminotransferase and alanine aminotransferase ≤ 5.0 x upper limit of normal if attributable to liver metastasis
- An in-range international normalized ratio (INR) (in-range is usually defined as between 2 and 3) for patients on a stable dose of oral anticoagulant or stable dose of low molecular weight heparin
- Has no active bleeding or pathological condition that carries high risk of bleeding (eg, tumor involving major vessels or known varices). If a suspicion of bleeding diathesis exists, a bleeding time should be performed
- Creatinine ≤ 1.5 times upper limit of normal
General:
- Written informed consent obtained
- Afebrile on day 1 of cycle 1
- Must be able and willing to comply with study and/or follow-up procedures
Exclusion Criteria:
Disease-Related:
- Known brain metastases
- History of another primary malignancy less than/equal to 5 years prior to randomization, with the exception of non-melanoma skin cancer, carcinoma in situ of uterine cervix, and prostatic intraepithelial neoplasia without evidence of prostate cancer
- Prior major surgical procedure less than 28 days prior to day 1 of cycle 1 chemotherapy dosing; anticipated need for major surgical procedure during the 4 cycle treatment period of the study
- Fine needle aspirations or core biopsies within 7 days prior to day 1 of cycle 1 chemotherapy dosing
- Serious nonhealing wound, ulcer, or bone fracture, or history of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within 6 months prior to day 1 of cycle 1
- Uncontrolled high blood pressure, history of labile hypertension, uncontrolled congestive heart failure, unstable angina within the past 3 months, myocardial infarction or history of stroke within the past 12 months, unstable symptomatic arrhythmia requiring medication, or clinically significant peripheral vascular disease
- History of clinically significant bleeding within 6 months prior to randomization
- History of arterial or venous thromboembolism within 6 months prior to randomization
- History of other disease including uncontrolled diabetes, serious active or uncontrolled infection, metabolic dysfunction; physical examination finding, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates the use of the prescribed therapy or that might affect the interpretation of the results of the study or render the subject at high risk from treatment complications
Laboratory:
- Proteinuria > 1+, or total quantitative protein > 500 mg protein/day as determined by 24-hr urine collection
Medications:
- Prior radiotherapy unless treatment was limited to the target lesion and only 1 measurable lesion was treated. Progression of the irradiated lesion must be demonstrated. Patients may not have received prior radiotherapy to greater than 25% of bone marrow. Radiation must have concluded ≥ 4 weeks prior to enrollment. Prior radio-sensitizing chemoradiation will be allowed as long as it was concluded ≥ 4 weeks prior to enrollment.
- Radiotherapy to non-target lesions for pain control will be allowed
- Prior bevacizumab use or other agents targeting VEGF
- Concurrent use of other biological agents
- Use of systemic anti-infectives for active infection, during the 3 calendar days before starting study chemotherapy and bevacizumab or planned during the study treatment period
General:
- Current, recent (within 4 weeks of the first infusion of this study), or planned participation (during the study treatment period) in an experimental therapeutics study other than this protocol
- Female participants who are pregnant or lactating or men and women of reproductive potential not willing to employ an effective method of birth control during treatment and for 20 weeks for women, and 30 weeks for men after discontinuing study treatment
- History of allergic reactions attributed to compounds of similar chemical or biologic composition to bevacizumab, irinotecan, 5-fluorouracil (5-FU), oxaliplatin, or leucovorin, including known sensitivity to E. Coli derived products (eg, Filgrastim, HUMULIN insulin, L-asparaginase)
- Known dihydropyrimidine dehydrogenase deficiency
Study Plan
How is the study designed?
Design Details
- Primary Purpose: SUPPORTIVE_CARE
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: DOUBLE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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PLACEBO_COMPARATOR: Placebo
Participants received standard chemotherapy (FOLFOX or FOLFIRI) on Days 1-2, and bevacizumab 5 mg/kg intravenous (IV) infusion on Day 1 of each 14-day cycle plus placebo subcutaneous injection once per cycle, for a maximum of 4 cycles, 24 hours after chemotherapy (Day 4).
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Administered as a single subcutaneous injection using a pre-filled syringe.
5 mg/kg by intravenous (IV) infusion on day 1 of each 14-day cycle.
Other Names:
Each participant received one of the following chemotherapy regimens at the discretion of treating physician: FOLFOX: Oxaliplatin, leucovorin, and 5-fluorouracil; FOLFIRI: Irinotecan, leucovorin and 5-flurouracil. |
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PLACEBO_COMPARATOR: Pegfilgrastim
Participants received standard chemotherapy (FOLFOX or FOLFIRI) on Days 1-2 and bevacizumab 5 mg/kg intravenous (IV) infusion on Day 1 of each 14-day cycle plus pegfilgrastim 6 mg administered as a single subcutaneous injection once per cycle, for a maximum of 4 cycles, 24 hours after chemotherapy (Day 4).
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5 mg/kg by intravenous (IV) infusion on day 1 of each 14-day cycle.
Other Names:
Each participant received one of the following chemotherapy regimens at the discretion of treating physician: FOLFOX: Oxaliplatin, leucovorin, and 5-fluorouracil; FOLFIRI: Irinotecan, leucovorin and 5-flurouracil.
Administered as a single 6 mg subcutaneous injection using a pre-filled syringe.
There will be no dosage adjustments for investigational product.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Percentage of Participants With Grade 3/4 Febrile Neutropenia Across the First 4 Cycles of Chemotherapy
Time Frame: Approximately 2 months duration (Daily for 4 cycles of treatment; 2 weeks per cycle)
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Grade 3/4 febrile neutropenia (FN) is defined as: • A temperature ≥ 38.0°C (≥ 100.4°F) and absolute neutrophil count (ANC) < 1.0 × 10^9/L, where ANC was measured the same day or within ± 1 calendar day of a temperature ≥ 38.0°C (≥ 100.4°F), or • An ANC < 1.0 × 10^9/L in combination with: - documented sepsis or infection, OR - neutropenia-related hospitalization where ANC was measured the same day or within ± 1 calendar day.
Participants monitored their oral temperatures and maintained diaries to record their temperature twice per day: once in the morning and once in the evening, as well as whenever they suspect they had fever throughout the first 4 cycles of chemotherapy treatment.
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Approximately 2 months duration (Daily for 4 cycles of treatment; 2 weeks per cycle)
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Overall Survival
Time Frame: From randomization to the data cut-off date of 8 June 2012. Median time on study was 11.6 months and the maximum was 27.6 months.
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Median time from randomization to date of death caclulated using the Kaplan-Meier method.
Participants were censored on the date of last contact (i.e., the date the participant was last known to be alive) if they were not known to have died.
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From randomization to the data cut-off date of 8 June 2012. Median time on study was 11.6 months and the maximum was 27.6 months.
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Progression Free Survival
Time Frame: From randomization to the data cut-off date of 8 June 2012. Median time on study was 11.6 months and the maximum was 27.6 months.
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Time from randomization to date of radiological disease progression or death from any cause, whichever event occurs first, calculated using the Kaplan-Meier method.
Participants without either event by the analysis data cutoff date were censored on the date of their last evaluable disease assessment.
Disease progression based on the investigator's assessment of radiographic scans using the Response Evaluation Criteria in Solid Tumors (RECIST) v1.1.
Clinical progression without radiological assessment was not be considered a disease progression in this analysis.
Progression defined as at least a 20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study recorded since the treatment started or the appearance of one or more new lesions and/or unequivocal progression of existing non-target lesions.
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From randomization to the data cut-off date of 8 June 2012. Median time on study was 11.6 months and the maximum was 27.6 months.
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Time to Progression
Time Frame: From randomization to the data cut-off date of 8 June 2012. Median time on study was 11.6 months and the maximum was 27.6 months.
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Time from randomization to date of radiological disease progression calculated using the Kaplan-Meier method.
Participants without progression were censored on the date of their last radiographic tumor assessment.
Disease progression based on the investigator's assessment of scans using the RECIST v1.1.
Clinical progression without radiological assessment was not considered a disease progression.
Progression defined as at least a 20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study recorded since the treatment started or the appearance of one or more new lesions and/or unequivocal progression of existing non-target lesions.
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From randomization to the data cut-off date of 8 June 2012. Median time on study was 11.6 months and the maximum was 27.6 months.
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Percentage of Participants With an Objective Response
Time Frame: From randomization to the data cut-off date of 8 June 2012. Median time on study was 11.6 months and the maximum was 27.6 months.
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The percentage of participants with a complete response (CR) or partial response (PR) defined by the RECIST v1.1 criteria at any time during the study.
Response was be determined by the investigator's assessment of radiographic scans.
CR: Disappearance of all non-nodal target lesions and the disappearance of all non-nodal non-target lesions, and no new lesions.
All nodal lesions must have reduction of short axis to < 10 mm.
PR: At least a 30% decrease in the sum of the diameters of target lesions, taking as reference the baseline sum diameters and no new lesions and/or unequivocal progression of existing non-target lesions, or, the disappearance of all non-nodal target lesions with persistence of one or more non-target lesion(s).
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From randomization to the data cut-off date of 8 June 2012. Median time on study was 11.6 months and the maximum was 27.6 months.
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Percentage of Participants With Grade 4 Febrile Neutropenia Across the First 4 Cycles of Chemotherapy
Time Frame: Approximately 2 months duration (Daily for 4 cycles of treatment; 2 weeks per cycle)
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Grade 4 febrile neutropenia (FN) is defined as:
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Approximately 2 months duration (Daily for 4 cycles of treatment; 2 weeks per cycle)
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Percentage of Participants With Grade 3/4 Neutropenia Across the First 4 Cycles of Chemotherapy
Time Frame: Approximately 2 months duration (Daily for 4 cycles of treatment; 2 weeks per cycle)
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Grade 3/4 severe neutropenia is defined as neutropenia with absolute neutrophil count (ANC) <1.0 x 10^9/L.
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Approximately 2 months duration (Daily for 4 cycles of treatment; 2 weeks per cycle)
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Percentage of Participants With Grade 4 Neutropenia Across the First 4 Cycles of Chemotherapy
Time Frame: Approximately 2 months duration (Daily for 4 cycles of treatment; 2 weeks per cycle)
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Grade 4 severe neutropenia is defined as neutropenia with absolute neutrophil count (ANC) <0.5 x 10^9/L.
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Approximately 2 months duration (Daily for 4 cycles of treatment; 2 weeks per cycle)
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Number of Participants With Adverse Events (AEs)
Time Frame: Approximately 8 weeks (4 treatment cycles)
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A serious adverse event (SAE) is defined as an adverse event that - is fatal; - is life threatening (places the participant at immediate risk of death); - requires inpatient hospitalization or prolongation of existing hospitalization; - results in persistent or significant disability/incapacity; - is a congenital anomaly/birth defect; - other significant medical hazard.
AEs were assessed for severity according to National Cancer Institute, Common Terminology Criteria for Adverse Events, Version 3.0, based on this general guideline: Grade 1 = Mild AE; Grade 2 = Moderate AE; Grade 3 = Severe AE; Grade 4 = Life-threatening or disabling AE; Grade 5 = Death related to AE.
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Approximately 8 weeks (4 treatment cycles)
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Collaborators and Investigators
Sponsor
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ACTUAL)
Study Completion (ACTUAL)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Digestive System Diseases
- Neoplasms
- Neoplasms by Site
- Hematologic Diseases
- Gastrointestinal Neoplasms
- Digestive System Neoplasms
- Gastrointestinal Diseases
- Colonic Diseases
- Intestinal Diseases
- Intestinal Neoplasms
- Rectal Diseases
- Agranulocytosis
- Leukopenia
- Leukocyte Disorders
- Colorectal Neoplasms
- Neutropenia
- Physiological Effects of Drugs
- Antineoplastic Agents
- Antineoplastic Agents, Immunological
- Angiogenesis Inhibitors
- Angiogenesis Modulating Agents
- Growth Substances
- Growth Inhibitors
- Bevacizumab
Other Study ID Numbers
- 20080259
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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Clinical Trials on Placebo
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SamA Pharmaceutical Co., LtdUnknownAcute Bronchitis | Acute Upper Respiratory Tract InfectionKorea, Republic of
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National Institute on Drug Abuse (NIDA)CompletedCannabis UseUnited States
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AstraZenecaParexel; Spandauer Damm 130; 14050; Berlin, GermanyCompletedMale Subjects With Type II Diabetes (T2DM)Germany
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AkesoNot yet recruitingAtopic DermatitisChina
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Heptares Therapeutics LimitedCompletedPharmacokinetics | Safety IssuesUnited Kingdom
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GlaxoSmithKlineCompletedPulmonary Disease, Chronic ObstructiveUnited Kingdom, Netherlands
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Shijiazhuang Yiling Pharmaceutical Co. LtdXuanwu Hospital, BeijingCompleted
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GlaxoSmithKlineCompletedInfections, BacterialUnited States
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Chong Kun Dang PharmaceuticalUnknownHypertension | DyslipidemiasKorea, Republic of