IXO+A in mCRC With Liver-only Metastases

June 4, 2013 updated by: Ottawa Hospital Research Institute

A Single-arm Phase II Downsizing Study of Irinotecan, Capecitabine and Oxaliplatin (IXO) and Bevacizumab as First-line Treatment to Assess Conversion to Resectability of Liver-only Metastases in Colorectal Cancer Patients With Initially Unresectable Metastases

The percentage of patients with defined unresectable metastatic disease who will benefit from a first-line treatment enabling secondary complete metastasectomy is unknown but limited. Definition of optimized treatment algorithms is difficult due to very inhomogeneous patient populations.

This open label, multicentre Phase II study primarily aims to assess the resection rate achievable in a selected patient population with initially unresectable metastatic disease limited to the liver only in order to evaluate feasibility, safety and efficacy with regards to secondary resection of hepatic lesions in these patients.

The trial aims to enrol only patients meeting defined criteria of unresectability with regards to their hepatic lesions and will exclude patients with extrahepatic lesions in order to examine the most appropriate, highly active treatment regimen for this group of unresectable patients with the highest probability of a successful secondary metastasectomy with curative intent. The trial will be conducted in highly specialized centres with a track record of successful interdisciplinary treatment approaches in the field of metastatic colorectal cancer to allow the precise assessment of the peri-operative safety parameters as well as an evaluation of the surgical treatment approaches.

The IXO regimen selected for this study has shown in a phase I/II study promising efficacy and a favourable safety profile. Bevacizumab has demonstrated a significant survival benefit in combination with chemotherapy in metastatic colorectal cancer. Therefore the study will allow evaluation of its potential benefit in combination with the two most active current chemotherapy regimens in the first-line and post-operative treatment setting.

Study Overview

Status

Withdrawn

Conditions

Intervention / Treatment

Study Type

Interventional

Phase

  • Phase 2

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Canada
    • Ontario
      • Ottawa, Ontario, Canada, K1H 8L6
        • The Ottawa Hospital Cancer Center
      • Toronto, Ontario, Canada, M4N 3M5
        • Sunnybrook Health Sciences Centre
      • Toronto, Ontario, Canada, M5T 2S8
        • University Health Network
    • Quebec
      • Montreal, Quebec, Canada, H3A 1A1
        • McGill University Health Centre

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Primary colorectal cancer with unresectable metastatic lesion(s)
  • At least one measurable lesion, confirmed by CT scan
  • Male and female patients, aged ≥ 18 years
  • ECOG performance score of 0 or 1 (within 1 week of study treatment start)
  • Written informed consent
  • Adequate general condition, cardiopulmonary functions and performance status
  • Liver metastases no initially foreseen R0 resection of all hepatic lesions, but deemed potentially resectable after response to downsizing therapy

Exclusion Criteria:

  • Extrahepatic metastatic disease
  • Prior systemic or local treatment for metastatic disease, prior therapy with a biologic agent, prior adjuvant or neo-adjuvant chemotherapy, prior radiotherapy to the liver, other concurrent chemotherapy
  • Inadequate bone marrow, liver, renal function, uncontrolled hypertension
  • Pregnancy or lactation

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: IXO+A
IXO regimen with Avastin
Drug: irinotecan, capecitabine, oxaliplatin (IXO) and bevacizumab
IXO plus bevacizumab regimen is given every 3 weeks (Q3W), in the following order: Bevacizumab (A): 7.5 mg/kg via IV infusion, day 1 Oxaliplatin (O): 100 mg/m2 via 2-hour IV infusion, day 1 Irinotecan (I): 160 mg/m2 via 1-hour IV infusion, day 1 Capecitabine (X): 950 mg/m2 twice daily PO, days 2 - 15

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
conversion to resectability during downsizing therapy with IXO+A patients with initially unresectable liver-only metastases associated with colorectal cancer
Time Frame: after 8 IXO+A cycles
after 8 IXO+A cycles

Secondary Outcome Measures

Outcome Measure
Time Frame
Recurrence-free survival (RFS)
Time Frame: Every 2 cycles
Every 2 cycles
Progression-free survival (PFS)
Time Frame: Every 2 cycles
Every 2 cycles
Time to response (TTR)
Time Frame: Every 2 cycles
Every 2 cycles
Overall survival (OS)
Time Frame: Every 2 cycles
Every 2 cycles
Pathological complete response (pCR) rate
Time Frame: assessed post-operatory
assessed post-operatory
Overall response rate (ORR)
Time Frame: Every 2 cycles
Every 2 cycles
Number of participants with Adverse Events as a measure of Safety and Tolerability
Time Frame: Every 3 weeks
Every 3 weeks
Surgical safety (frequency of surgical complications)
Time Frame: assessed post-operatory
assessed post-operatory
Pathological changes in the non-tumoural liver following therapy with IXO+A
Time Frame: assessed post-operatory
assessed post-operatory
R0, R1, R2 resection rate after up to 8 cycles of downsizing therapy with IXO+A
Time Frame: assessed post-operatory
assessed post-operatory

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Ottawa Hospital Research Institute

Collaborators

Sanofi
Hoffmann-La Roche

Investigators

  • Study Chair: Jean Maroun, MD, The Ottawa Hospital Cancer Centre

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

March 1, 2011

Primary Completion (Actual)

February 1, 2012

Study Completion (Actual)

February 1, 2012

Study Registration Dates

First Submitted

February 8, 2011

First Submitted That Met QC Criteria

February 9, 2011

First Posted (Estimate)

February 11, 2011

Study Record Updates

Last Update Posted (Estimate)

June 5, 2013

Last Update Submitted That Met QC Criteria

June 4, 2013

Last Verified

June 1, 2013

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • OTT 10-01

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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