Preoperative Chemoradiation Followed by Chemotherapy for Locally Advanced Rectal Cancer (PREPARE)
A Randomized Phase II Trial of Preoperative Chemoradiation (Preop CRT) Followed by CapOx (Capecitabine Plus Oxaliplatin) Versus Preop CRT Alone for Locally Advanced Rectal Cancer (LARC)
Studienübersicht
Status
Status
Bedingungen
Bedingungen
Intervention / Behandlung
Intervention / Behandlung
Detaillierte Beschreibung
Studientyp
Studientyp
Einschreibung (Tatsächlich)
Einschreibung
Phase
Phase
- Phase 2
Kontakte und Standorte
Studienorte
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Anyang, Korea, Republik von
- Hallym University Sacred Heart Hospital
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Gangneung, Korea, Republik von
- Gangneung Asan Hospital
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Seoul, Korea, Republik von, 03722
- Severance Hospital
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Seoul, Korea, Republik von, 05505
- Asan Medical Center
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Seoul, Korea, Republik von, 06973
- Chung-Ang University Hospital
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Gyeonggi-do
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Goyang, Gyeonggi-do, Korea, Republik von, 410-769
- National Cancer Center
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Seongnam, Gyeonggi-do, Korea, Republik von, 13620
- Seoul National University Bundang Hospital
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Teilnahmekriterien
Zulassungskriterien
Zulassungskriterien
Studienberechtigtes Alter
Akzeptiert gesunde Freiwillige
Studienberechtigte Geschlechter
Beschreibung
Inclusion Criteria:
- histologically confirmed adenocarcinoma of the rectum
- distal margin of tumor located from 0 to 12 cm from anal verge measured by digital rectal examination
high risk clinical stage II or III in MRI (satisfying at least one of the followings)
- circumferential resection margin < 1 mm involved
- low-lying tumor below anal verge 3 cm
- T3 > 5 mm extramural spread
- T4 (involving surrounding structures or peritoneum)
- cN2 (4 or more mixed signal intensity or irregularly bordered node or tumor deposit)
- age 20 years or more
- ECOG (Eastern Cooperative Oncology Group) performance status 0-2
- No prior chemotherapy, radiotherapy to pelvis
- Adequate bone marrow function
- Adequate renal function
- Adequate hepatic function
- patients must sign the informed consent indicating that they were aware of the investigational nature of the study in keeping with the policy of the hospital
Exclusion Criteria:
- malignant disease of the rectum other than adenocarcinoma or arisen from chronic inflammatory bowel disease
- any unresected synchronous colon cancer
- any distant metastases
- intestinal obstruction or impending obstruction, but decompressing colostomy is permitted
- any previous or concurrent malignancy withih 5 years other than non-melanoma skin cancer / in situ cancer of uterine cervix / early gastric cancer / thyroid cancer of low risk
- any other morbidity or situation with relative contraindication for chemoradiotherapy
- patients with history of significant gastric or small bowel resection, or malabsorption syndrome, or other lack of integrity of the upper gastrointestinal tract that may compromise the absorption of capecitabine
- pregnant or lactating women or patients of childbearing potential not predicting adequate contraception
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Behandlung
- Zuteilung: Zufällig
- Interventionsmodell: Parallele Zuordnung
- Maskierung: Keine (Offenes Etikett)
Anzahl der Arme
Waffen und Interventionen
Teilnehmergruppe / ArmTeilnehmergruppe / Arm |
Intervention / BehandlungIntervention / Behandlung |
|---|---|
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Experimental: chemoradiation followed by CapOx
preoperative chemoradiation 50.4Gy with capecitabine or 5-fluorouracil/leucovorin (pelvic radiation capecitabine 5-fluorouracil) followed by 2 cycles of chemotherapy (Capecitabine Oxaliplatin - CapOx) and surgery (total mesorectal excision)
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after completion of chemoradiation, two cycles of capecitabine (850mg/m2 twice daily from D1 evening to D15 morning) and oxaliplatin (100mg/m2 on D1) will be administered every 3 weeks.
Andere Namen:
50.4Gy of pelvic radiation with capecitabine or 5-fluorouracil
Andere Namen:
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Aktiver Komparator: chemoradiation
preoperative chemoradiation 50.4Gy with capecitabine or 5-fluorouracil/leucovorin (pelvic radiation capecitabine 5-fluorouracil) followed by rest for 8 weeks and surgery (total mesorectal excision)
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50.4Gy of pelvic radiation with capecitabine or 5-fluorouracil
Andere Namen:
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Was misst die Studie?
Primäre Ergebnismessungen
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
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downstaging rate
Zeitfenster: expected average of 15 weeks after start of study treatment
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downstaging rate is defined as the proportion of patients with ypStage (pathologic stage after preoperative treatment) 0 or I (from pathologic findings after preoperative treatment and surgery) out of all patients who were assigned to each arm.
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expected average of 15 weeks after start of study treatment
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Sekundäre Ergebnismessungen
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
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pathologic response
Zeitfenster: expected average of 15 weeks after start of study treatment
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pathologic response is assessed by Dworak's grading system from postoperative specimen.
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expected average of 15 weeks after start of study treatment
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radiologic response rate
Zeitfenster: expected average of 14 weeks after start of study treatment
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radiologic response will be assessed according to RECIST (Response Evaluation Criteria in Solid Tumors) guideline 1.1
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expected average of 14 weeks after start of study treatment
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toxicity profile
Zeitfenster: expected average of 35 weeks after start of study treatment
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Toxicities or any adverse events during study treatment, surgery and follow-up period will be assessed according to NCI CTCAE (Common Terminology Criteria for Adverse Events) version 4.0
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expected average of 35 weeks after start of study treatment
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pattern of failure
Zeitfenster: 3 years after surgery
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if any recurrent lesion is noticed, anatomic sites of recurrent lesions and the date and the name of exam or imaging study (physical exam, CT or MRI…) will be recorded in case report form.
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3 years after surgery
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local control rate
Zeitfenster: 3 years after surgery
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Local recurrence is defined as tumor recurrence confined in radiation field (pelvic cavity).
Cumulative incidence of local recurrence will be suggested.
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3 years after surgery
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relapse-free survival
Zeitfenster: 3 years after surgery
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Time from date of operation to date of recurrence of disease or deaths due to recurrence or progression of disease.
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3 years after surgery
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Disease-free survival
Zeitfenster: 3 years after surgery
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time from date of operation to date of recurrence of disease, a new occurrence of secondary colorectal cancer, a new occurrence of other malignancy, or deaths from any cause.
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3 years after surgery
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overall survival
Zeitfenster: 3 years after surgery
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time from date of operation to date of death due to any cause.
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3 years after surgery
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quality of life
Zeitfenster: before study treatment, 7 weeks after completion of chemoradiation, and at 4 weeks after surgery
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quality of life will be measured with FACT-C
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before study treatment, 7 weeks after completion of chemoradiation, and at 4 weeks after surgery
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Mitarbeiter und Ermittler
Sponsor
Sponsor
Mitarbeiter
Mitarbeiter
Ermittler
Ermittler
- Studienstuhl: Sun Young Kim, MD, Asan Medical Center
Publikationen und hilfreiche Links
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn
Studienbeginn
Primärer Abschluss (Tatsächlich)
Primärer Abschluss
Studienabschluss (Voraussichtlich)
Studienabschluss
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Schätzen)
Zuerst gepostet
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes Update gepostet
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Schlüsselwörter
Zusätzliche relevante MeSH-Bedingungen
- Erkrankungen des Verdauungssystems
- Neubildungen
- Neubildungen nach Standort
- Gastrointestinale Neubildungen
- Neoplasmen des Verdauungssystems
- Magen-Darm-Erkrankungen
- Darmerkrankungen
- Darmtumoren
- Rektale Erkrankungen
- Kolorektale Neubildungen
- Rektale Neoplasien
- Physiologische Wirkungen von Arzneimitteln
- Molekulare Mechanismen der pharmakologischen Wirkung
- Antimetaboliten, antineoplastisch
- Antimetaboliten
- Antineoplastische Mittel
- Immunsuppressive Mittel
- Immunologische Faktoren
- Fluorouracil
- Capecitabin
- Oxaliplatin
Andere Studien-ID-Nummern
Andere Studien-ID-Nummern
- KCSG CO14-03
Plan für individuelle Teilnehmerdaten (IPD)
Planen Sie, individuelle Teilnehmerdaten (IPD) zu teilen?
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