- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03259035
NEO: Neoadjuvant Chemotherapy, Excision and Observation for Early Rectal Cancer
April 8, 2024 updated by: Canadian Cancer Trials Group
The purpose of this study is to find out the effects of chemotherapy followed by less invasive surgery on patients and their early rectal cancer.
The approach of this trial will be considered a success if at least 65% of participants are able to keep the rectum.
Study Overview
Status
Active, not recruiting
Conditions
Intervention / Treatment
Study Type
Interventional
Enrollment (Actual)
58
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
-
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British Columbia
-
Vancouver, British Columbia, Canada, V6Z 1Y6
- St. Paul's Hospital
-
Vancouver, British Columbia, Canada, V5Z 4E6
- BCCA - Vancouver Cancer Centre
-
-
Manitoba
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Winnipeg, Manitoba, Canada, R3E 0V9
- CancerCare Manitoba
-
-
Nova Scotia
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Halifax, Nova Scotia, Canada, B3H 1V7
- QEII Health Sciences Centre
-
-
Ontario
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Kingston, Ontario, Canada, K7L 2V7
- Kingston Health Sciences Centre
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Ottawa, Ontario, Canada, K1H 8L6
- Ottawa Hospital Research Institute
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Sudbury, Ontario, Canada, P3E 5J1
- Health Sciences North
-
-
Quebec
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Montreal, Quebec, Canada, H4A 3J1
- The Research Institute of the McGill University
-
-
-
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California
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Orange, California, United States, 92868
- UC Irvine Medical Center
-
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Massachusetts
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Boston, Massachusetts, United States, 02115
- Dana-Farber Cancer Institute
-
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Washington
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Seattle, Washington, United States, 97101
- Virginia Mason Medical Center
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-
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
16 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- Histologically confirmed invasive well-moderately differentiated rectal adenocarcinoma diagnosed within 90 days prior to enrollment.
Tumour stage cT1-T3abN0 based on pelvic MRI
- cT1N0- tumour invasion into submucosa, no radiographic evidence of mesorectal nodal metastasis, tumour deposits or vascular invasion.
- cT2N0 - tumour invasion into muscularis propria, no radiographic evidence of mesorectal nodal metastasis, tumour deposits or vascular invasion.
- cT3a,bN0- tumour invasion through the muscularis propria no more than 5 mm into the subserosa/perirectal tissue and clear of the circumferential radial margin (CRM). Absence of radiographic evidence of mesorectal nodal metastasis, tumour deposits or lymphovascular invasion.
Note: If the tumour is not visualized in the MRI but there is histological confirmation of rectal adenocarcinoma the patient is eligible.
- cN0 stage based on pelvic MRI. Any nodes ≥ 10 mm in longest dimension are considered malignant, regardless of nodal morphology. For pelvic nodes < 10 mm in longest dimension, if nodes are seen and are deemed to be morphologically benign in the opinion of the radiologist and surgeon, the patient is eligible. Patients with visible pelvic sidewall nodes are excluded
- M0 stage based on no evidence of metastatic disease by CT imaging.
- Mid to low-lying tumour eligible for local tumour excision in the opinion of the treating surgeon.
- Age of at least 18 years.
- Medically fit to undergo radical surgery as per treating surgeon's discretion
- No contraindications to protocol chemotherapy.
Adequate normal organ and marrow function as defined below (must be done within 30 days prior to enrolment):
- ANC ≥ 1.5 x 109/L
- platelet count ≥100 x 109/L
- bilirubin < 1.5 ULN, excluding Gilbert's syndrome
- Calculated creatinine clearance of ≥ 50 ml/min.
- Clearance to be calculated using Cockcroft formula: Males: 1.23 x (140 - age) x weight (kg) - serum creatinine (μmol/l) ; Females: 1.05 x (140 - age) x weight (kg) - serum creatinine (μmol/l)
- The patient must have an ECOG performance status of 0, 1.
- Patient is able (i.e. sufficiently fluent) and willing to complete the quality of life and health utility questionnaires.
- Patient consent must be appropriately obtained in accordance with applicable local and regulatory requirements. Each patient must sign a consent form prior to enrollment in the trial to document their willingness to participate.
- Must be accessible for treatment and follow up. Patients registered on this trial must be treated with chemotherapy and followed at the enrolling centre.
- Protocol treatment is to begin within 5 working days of patient enrollment.
- Women/men of childbearing potential must have agreed to use a highly effective contraceptive method during and for 6 months after completion of chemotherapy.
Exclusion Criteria:
- Patient has pathologic high risk factors on either the initial biopsy specimen report or follow-up biopsy (if done): high histologic grade, mucinous histology, lymphatic or vascular invasion.
- History of other malignancies, except: adequately treated non-melanoma skin cancer, curatively treated in-situ cancer of the cervix, or other solid tumours curatively treated with no evidence of disease for ≥ 5 years.
- Synchronous cancer.
- Prior treatment for rectal cancer.
- Previous pelvic radiation for any reason.
- Patients with known dihydropyrimidine dehydrogenase deficiency
- Treatment with other investigational drugs or anti-cancer therapy within 28 days prior to enrolment.
- Clinically significant (i.e. active) cardiovascular disease for example cerebro vascular accidents (< 6 months prior to enrolment), myocardial infarction (< 6 months prior to enrolment), unstable angina, New York Heart Association (NYHA) grade II or higher, congestive heart failure, serious cardiac arrhythmia requiring medication.
- Any contra-indications to undergo MRI imaging.
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: chemotherapy (FOLFOX or CAPOX) followed by tumour excision
|
6 cycles of q2weekly FOLFOX, or
4 cycles of q3weekly CAPOX
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Measurement of organ preservation rate
Time Frame: 3 years
|
The primary endpoint of this study is the protocol specified organ preservation rate, defined as the proportion of patients with tumour downstaging to ypT0/T1good N0 and who avoid radical surgery.
The 95% confidence interval for the organ preservation rate will be calculated
|
3 years
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Locoregional Relapse Rate (LRR)
Time Frame: 3 years
|
3 years
|
Distant Relapse Rate (DRR) estimated based on Kaplan-Meier method
Time Frame: 3 years
|
3 years
|
Disease Free Survival (DFS) estimated based on Kaplan-Meier method
Time Frame: 3 years
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3 years
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Rate of post-operative complications
Time Frame: 3 years
|
3 years
|
Number and severity of adverse events using CTCAE V5
Time Frame: 3 years
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3 years
|
Quality of Life using QLQ-C30
Time Frame: 3 years
|
3 years
|
Cost effectiveness using the EQ-5D-5L questionnaire
Time Frame: 3 years
|
3 years
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Study Chair: Hagen Kennecke, Virginia Mason Medical Centre, WA USA
- Study Chair: Carl Brown, St. Paul's Hospital, Vancouver BC
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
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 (Actual)
June 29, 2018
Primary Completion (Actual)
April 8, 2024
Study Completion (Estimated)
June 30, 2025
Study Registration Dates
First Submitted
August 21, 2017
First Submitted That Met QC Criteria
August 21, 2017
First Posted (Actual)
August 23, 2017
Study Record Updates
Last Update Posted (Actual)
April 9, 2024
Last Update Submitted That Met QC Criteria
April 8, 2024
Last Verified
April 1, 2023
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- CO28
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Yes
Studies a U.S. FDA-regulated device product
No
product manufactured in and exported from the U.S.
No
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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-
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-
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