- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03487939
Neoadjuvant FOLFOXIRI Chemotherapy in Resectable Liver Metastasis of Colorectal Cancer
Neoadjuvant FOLFOXIRI Chemotherapy in Resectable Liver Metastasis of Colorectal Cancer:an Open-label, Single-arm, Multicenter Phase II Study
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
For the patients Neoadjuvant FOLFOX chemotherapy is recommended for the resectable liver metastasis colorectal cancer. Neoadjuvant chemotherapy could suppress tumor, reduce metastasis, inhibit recurrence and improve long-term prognosis. Moreover, neoadjuvant chemotherapy could provide evidence about tumor response to drugs for the adjuvant chemotherapy. Furthermore, according to the biological behavior of tumors observed by neoadjuvant chemotherapy, unnecessarily excessive surgery could be avoided. However, some studies suggested that drug efficiency was consistent with resection rate. And FOLFOXIRI has been observed efficacy in the treatment of metastatic colorectal cancer with manageable toxicities. Therefore, we evaluate the efficacy and safety of neoadjuvant FOLFOXIRI chemotherapy in the patients with resectable liver metastasis of colorectal cancer to achieve higher resection rate and longer survival.
In this prospective study, 30 patients with resectable colorectal liver metastases were treated with neoadjuvant FOLFOXIRI chemotherapy. After 4 cycles of neoadjuvant chemotherapy, the liver metastases will be removed. If there are primary bowel lesions, they will be resected together. Safety profile was recorded based on NCI Common Terminology Criteria for Adverse Events version 4.0 (NCI-CTCAE v4.0). Objective response was evaluated by Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1). Before treatment and after 4 cycles of neoadjuvant chemotherapy, we will evaluate tumor metabolic response via FDG-PET and monitor the dynamic changes of peripheral blood ctDNA.
Study Type
Enrollment (Anticipated)
Phase
- Phase 2
Contacts and Locations
Study Contact
- Name: Yuanhe Wang, Doctor
- Phone Number: 18900918737
- Email: wangyuanhe@sina.com
Study Locations
-
-
Liaoning
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Shenyang, Liaoning, China, 110000
- Recruiting
- Liaoning Cancer Hospital
-
Contact:
- Yuanhe Wang
- Phone Number: 18900918737
- Email: wangyuanhe@sina.com
-
Principal Investigator:
- Jingdong Zhang
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria
- Age: 18-75years old
- Histologically confirmed colorectal cancer with liver metastasis (all patients should have the pathological report of colorectal cancer). The chances of hepatocellular carcinoma or metastasis from other primary lesions should be excluded.
- It was confirmed by imaging that the liver metastases and the primary intestinal lesions were all resectable.
- Radical resection of colorectal cancer after adjuvant chemotherapy complete 1 years later with liver metastases.
- There is at least one measurable objective tumor of the tumor (according to the 1.1 version of RECIST standard).
- Liver metastases can be excised by R0 and sufficient normal liver tissue can be retained
- ECOG status: 0~1
- Adequate bone marrow, hepatic and renal function as assessed by the following laboratory requirements conducted within 7 days of starting study treatment:
Neutrophil count≥1.5×10^9/L Platelet count≥90×10^9/L Hemoglobin≥90g/L Total bilirubin (TBI) ≤ 1.5 * ULN Alanine aminotransferase (ALT)≤2.5 * ULN Aspartate aminotransferase (AST)≤2.5 * ULN Alkaline phosphatase (ALP)≤2.5 * ULN
- Signed informed consent; able to comply with study and/or follow- up procedures
Exclusion Criteria:
- Hypersensitivity to fluorouracil, oxaliplatin or irinotecan.
- In addition to liver metastases, there are other parts of metastasis
- Cardiovascular disease that would preclude study treatment or follow-up; New York Heart Association class III or IV heart disease; Active ischemic heart disease; Myocardial infarction within the past 6 months; Symptomatic arrhythmia Uncontrolled hypertension. Unexplained syncope occurred within 3 months
- Gastric ulcers or duodenal ulcers for the treatment of resistance;
- 3 or 4 grade gastrointestinal bleeding / bleeding;
- Gastrointestinal perforation / fistula;
- Abdominal abscess;
- Infectious or inflammatory bowel disease
- HIV infection and/or active hepatitis B virus infection
- Pregnant or lactating women. Fertile patients must use effective contraception
- Any serious acute or chronic disease that can not be involved in the study or to influence the interpretation of the results of the study
- Other intervention clinical trials were combined at the same time.
- Nerve or mental abnormality affecting cognitive ability
- Other malignancy except effectively treated squamous cell or basal cell skin cancer,
- Other situations that the researchers think should be excluded.
Study Plan
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: FOLFOXIRI
Patients received 4 cycles of neoadjuvant FOLFOXIRI chemotherapy before surgical resection.
|
IRINOTECAN 150 mg/m^2 IV over 1-h, day 1 + OXALIPLATIN 85 mg/m^2 IV over 2-h, day 1 + L-LEUCOVORIN 200 mg/m^2 IV over 2-h, day 1 + 5-FLUOROURACIL 2800 mg/m^2 IV 48-h continuous infusion, starting on day 1 administered every two weeks for 4 cycles (2 months).
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The ratio of tumor downstaging to stage 0 and stage I
Time Frame: 2 years
|
Tumor downstaging from stage II or III to pathologic complete response (stage 0) and stage I
|
2 years
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Tumor regression grade (TRG)
Time Frame: 2 years
|
The level of tumor regression under pathological examination
|
2 years
|
Disease free survival
Time Frame: 3 years
|
Estimated from the date of surgery to the date of recurrence.
|
3 years
|
Overall survival time
Time Frame: 3 years
|
Estimated from the date of enrollment to death from any cause.
|
3 years
|
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0
Time Frame: 3 years
|
The grade of toxicity will be assessed using the NCI-CTCAE version 4.0.
|
3 years
|
ctDNA assessment and relation to clinical outcome
Time Frame: 3 years
|
The relationship between ctDNA and survival will be evaluated.
|
3 years
|
SUVmax assessment and relation to clinical outcome
Time Frame: At the beginning of Cycle 1 and the end of Cycle 4 (each cycle is 14 days)
|
Tumor metabolic response through FDG-PET examination before and after 4 cycles of neoadjuvant FOLFOXIRI chemotherapy
|
At the beginning of Cycle 1 and the end of Cycle 4 (each cycle is 14 days)
|
Quality of life (QLQ C30)
Time Frame: Every 2 weeks after the first treatment until 3 years
|
Scores according to EORTC QLQ-C30 scoring manual
|
Every 2 weeks after the first treatment until 3 years
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
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
- Topoisomerase Inhibitors
- Topoisomerase I Inhibitors
- Fluorouracil
- Oxaliplatin
- Irinotecan
Other Study ID Numbers
- LGIOG-2017-03
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.
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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