Questa pagina è stata tradotta automaticamente e l'accuratezza della traduzione non è garantita. Si prega di fare riferimento al Versione inglese per un testo di partenza.

Test della chemioterapia con pompa in aggiunta alla chemioterapia standard rispetto alla sola chemioterapia standard per i pazienti con metastasi epatiche colorettali non resecabili: lo studio PUMP

21 settembre 2026 aggiornato da: ECOG-ACRIN Cancer Research Group

Uno studio randomizzato di fase III sulla terapia sistemica con o senza infusione arteriosa epatica per metastasi epatiche colorettali non resecabili: lo studio PUMP

This phase III trial compares hepatic arterial infusion (HAI) (pump chemotherapy) in addition to standard of care chemotherapy versus standard of care chemotherapy alone in treating patients with colorectal cancer that has spread to the liver (liver metastases) and cannot be removed by surgery (unresectable). HAI uses a catheter to carry a tumor-killing chemotherapy drug called floxuridine directly into the liver. HAI is already approved by the Food and Drug Administration (FDA) for use in metastatic colorectal cancer to the liver, but it is only available at a small number of hospitals, and most of the time it is not used until standard chemotherapy stops working. Standard chemotherapy drugs work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Adding HAI to standard chemotherapy may be effective in shrinking or stabilizing unresectable colorectal liver metastases.

Panoramica dello studio

Stato

Reclutamento

Condizioni

Intervento / Trattamento

Descrizione dettagliata

PRIMARY OBJECTIVE:

I. To determine if patients with persistently unresectable colorectal liver metastases (CRLM) after treatment with first-line chemotherapy have improved overall survival (OS) with hepatic arterial infusion (HAI) and systemic chemotherapy versus systemic chemotherapy alone.

SECONDARY OBJECTIVES:

I. To determine whether there is a direct association between hepatic progression free survival (hPFS) and overall survival (OS) when patients are treated with HAI combined with systemic chemotherapy for unresectable CRLM.

II To determine the impact on progression free survival (overall, hepatic and extrahepatic) for patients with unresectable CRLM treated with HAI in combination with systemic chemotherapy.

III. To determine objective response rate (ORR) in the liver, defined as the proportion of patients achieving complete or partial response by Response Evaluation Criteria is Solid Tumors (RECIST) 1.1.

IV. To determine the rate of conversion to resectable disease, defined as the proportion of patients who successfully convert from unresectable to resectable status and undergo R0/R1 resection/ablation.

V. To determine the rate in which patients are intended to be treated with HAI but are deemed ineligible at the time of planned pump insertion due to detection of occult extrahepatic disease or unsuitable arterial anatomy (Intra-Operative Ineligibility, IOI).

VI. To determine the extent to which patient and disease-specific factors correlate with short- and long-term risk of HAI-specific complications.

OUTLINE: Patients are randomized to 1 of 2 arms.

ARM A: Patients undergo surgery to place the HAI pump within 6 weeks of randomization, followed by single photon emission computed tomography/computed tomography (SPECT/CT) on study. Patients then receive floxuridine via the HAI pump within 12 weeks of randomization on study. Patients also receive one of the following standard chemotherapy regimens per the treating physician within 16 weeks of randomization: FOLFOX (fluorouracil intravenously [IV], oxaliplatin IV, and leucovorin IV), FOLFIRI (fluorouracil IV, irinotecan IV, and leucovorin IV), or OX/IRI (oxaliplatin IV and irinotecan IV) with or without cetuximab IV and/or panitumumab IV on days 1 and 15 of each cycle. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients may have leucovorin omitted from their regimen per institutional standards. Patients also undergo CT and/or magnetic resonance imaging (MRI) scans throughout the trial.

ARM B: Patients receive one of the following standard chemotherapy regimens per the treating physician within 6 weeks of randomization: FOLFOXIRI (fluorouracil IV, oxaliplatin IV, irinotecan IV, and leucovorin IV), FOLFOX IV, FOLFIRI IV, or OX/IRI IV with or without cetuximab IV, panitumumab IV, and/or bevacizumab IV on days 1 and 15 of each cycle. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients may receive capecitabine orally (PO) in substitution for fluorouracil at the discretion of the investigator and may have leucovorin omitted from their regimen per institutional standards. Patients also undergo CT and/or MRI scans throughout the trial.

After completion of treatment, patients follow up every 3 months for 2 years and then every 6 months for an additional 3 years.

Tipo di studio

Interventistico

Iscrizione (Stimato)

408

Fase

  • Fase 3

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Luoghi di studio

  • Stati Uniti
    • Alabama
      • Birmingham, Alabama, Stati Uniti, 35233
        • Ritirato
        • University of Alabama at Birmingham Cancer Center
    • Arizona
      • Gilbert, Arizona, Stati Uniti, 85234
        • Reclutamento
        • Banner MD Anderson Cancer Center
        • Contatto:
          • Site Public Contact
          • Numero di telefono: 602-747-9738
        • Investigatore principale:
          • Rajesh Ramanathan
      • Phoenix, Arizona, Stati Uniti, 85006
        • Reclutamento
        • Banner-University Medical Center Phoenix
        • Contatto:
        • Investigatore principale:
          • Rajesh Ramanathan
      • Sun City, Arizona, Stati Uniti, 85351
        • Reclutamento
        • Banner Boswell Medical Center
        • Contatto:
        • Investigatore principale:
          • Rajesh Ramanathan
    • Colorado
      • Aurora, Colorado, Stati Uniti, 80045
        • Reclutamento
        • UCHealth University of Colorado Hospital
        • Contatto:
          • Site Public Contact
          • Numero di telefono: 720-848-0650
        • Investigatore principale:
          • Alexis D. Leal
    • Florida
      • Aventura, Florida, Stati Uniti, 33180
        • Reclutamento
        • UM Sylvester Comprehensive Cancer Center at Aventura
        • Investigatore principale:
          • Jashodeep Datta
        • Contatto:
          • Site Public Contact
          • Numero di telefono: 954-461-2180
      • Coral Gables, Florida, Stati Uniti, 33146
        • Reclutamento
        • UM Sylvester Comprehensive Cancer Center at Coral Gables
        • Investigatore principale:
          • Jashodeep Datta
        • Contatto:
          • Site Public Contact
          • Numero di telefono: 305-243-2647
      • Deerfield Beach, Florida, Stati Uniti, 33442
        • Reclutamento
        • UM Sylvester Comprehensive Cancer Center at Deerfield Beach
        • Investigatore principale:
          • Jashodeep Datta
        • Contatto:
          • Site Public Contact
          • Numero di telefono: 305-243-2647
      • Hollywood, Florida, Stati Uniti, 33021
        • Reclutamento
        • UM Sylvester Comprehensive Cancer Center at Hollywood
        • Investigatore principale:
          • Jashodeep Datta
        • Contatto:
          • Site Public Contact
          • Numero di telefono: 305-243-2647
      • Miami, Florida, Stati Uniti, 33136
        • Reclutamento
        • University of Miami Miller School of Medicine-Sylvester Cancer Center
        • Investigatore principale:
          • Jashodeep Datta
        • Contatto:
          • Site Public Contact
          • Numero di telefono: 305-243-2647
      • Miami, Florida, Stati Uniti, 33176
        • Reclutamento
        • UM Sylvester Comprehensive Cancer Center at Kendall
        • Investigatore principale:
          • Jashodeep Datta
        • Contatto:
          • Site Public Contact
          • Numero di telefono: 305-243-2647
      • Plantation, Florida, Stati Uniti, 33324
        • Reclutamento
        • UM Sylvester Comprehensive Cancer Center at Plantation
        • Investigatore principale:
          • Jashodeep Datta
        • Contatto:
          • Site Public Contact
          • Numero di telefono: 305-243-2647
    • Georgia
      • Atlanta, Georgia, Stati Uniti, 30322
        • Reclutamento
        • Emory University Hospital/Winship Cancer Institute
        • Contatto:
          • Site Public Contact
          • Numero di telefono: 404-778-1868
        • Investigatore principale:
          • Olumide B. Gbolahan
      • Atlanta, Georgia, Stati Uniti, 30342
        • Reclutamento
        • Emory Saint Joseph's Hospital
        • Investigatore principale:
          • Olumide B. Gbolahan
        • Contatto:
          • Site Public Contact
          • Numero di telefono: 404-851-7115
    • Illinois
      • Chicago, Illinois, Stati Uniti, 60637
        • Reclutamento
        • University of Chicago Comprehensive Cancer Center
        • Contatto:
        • Investigatore principale:
          • Ryan Merkow
      • Chicago, Illinois, Stati Uniti, 60611
        • Reclutamento
        • Northwestern University
        • Contatto:
        • Investigatore principale:
          • Shishir K. Maithel
      • Chicago, Illinois, Stati Uniti, 60641
        • Reclutamento
        • Northwestern Medicine Cancer Center Old Irving Park
        • Investigatore principale:
          • Shishir K. Maithel
        • Contatto:
      • Shiloh, Illinois, Stati Uniti, 62269
        • Ritirato
        • Memorial Hospital East
    • Indiana
      • Carmel, Indiana, Stati Uniti, 46032
        • Reclutamento
        • IU Health North Hospital
        • Contatto:
          • Site Public Contact
          • Numero di telefono: 317-278-5632
          • Email: iutrials@iu.edu
        • Investigatore principale:
          • Anita Turk
      • Indianapolis, Indiana, Stati Uniti, 46202
        • Reclutamento
        • Indiana University/Melvin and Bren Simon Cancer Center
        • Contatto:
          • Site Public Contact
          • Numero di telefono: 317-278-5632
          • Email: iutrials@iu.edu
        • Investigatore principale:
          • Anita Turk
    • Kentucky
      • Lexington, Kentucky, Stati Uniti, 40536
        • Reclutamento
        • University of Kentucky/Markey Cancer Center
        • Investigatore principale:
          • Michael J. Cavnar
        • Contatto:
          • Site Public Contact
          • Numero di telefono: 859-257-3379
    • Michigan
      • Ann Arbor, Michigan, Stati Uniti, 48109
        • Reclutamento
        • University of Michigan Rogel Cancer Center
        • Investigatore principale:
          • Benjamin D. Ferguson
        • Contatto:
      • Grand Rapids, Michigan, Stati Uniti, 49503
        • Reclutamento
        • Corewell Health Grand Rapids Hospitals - Butterworth Hospital
        • Contatto:
        • Investigatore principale:
          • Kathleen Y. Butler
    • Minnesota
      • Minneapolis, Minnesota, Stati Uniti, 55455
        • Reclutamento
        • University of Minnesota/Masonic Cancer Center
        • Contatto:
          • Site Public Contact
          • Numero di telefono: 612-624-2620
        • Investigatore principale:
          • Ajay Prakash
      • Rochester, Minnesota, Stati Uniti, 55905
        • Reclutamento
        • Mayo Clinic in Rochester
        • Contatto:
          • Site Public Contact
          • Numero di telefono: 855-776-0015
        • Investigatore principale:
          • Cornelius A. Thiels
    • Missouri
      • City of Saint Peters, Missouri, Stati Uniti, 63376
        • Ritirato
        • Siteman Cancer Center at Saint Peters Hospital
      • Creve Coeur, Missouri, Stati Uniti, 63141
        • Ritirato
        • Siteman Cancer Center at West County Hospital
      • St Louis, Missouri, Stati Uniti, 63110
        • Ritirato
        • Washington University School of Medicine
      • St Louis, Missouri, Stati Uniti, 63129
        • Ritirato
        • Siteman Cancer Center-South County
      • St Louis, Missouri, Stati Uniti, 63136
        • Ritirato
        • Siteman Cancer Center at Christian Hospital
    • New Jersey
      • Basking Ridge, New Jersey, Stati Uniti, 07920
        • Reclutamento
        • Memorial Sloan Kettering Basking Ridge
        • Contatto:
          • Site Public Contact
          • Numero di telefono: 212-639-7592
        • Investigatore principale:
          • Andrea Cercek
      • Middletown, New Jersey, Stati Uniti, 07748
        • Reclutamento
        • Memorial Sloan Kettering Monmouth
        • Contatto:
          • Site Public Contact
          • Numero di telefono: 212-639-7592
        • Investigatore principale:
          • Andrea Cercek
      • Montvale, New Jersey, Stati Uniti, 07645
        • Reclutamento
        • Memorial Sloan Kettering Bergen
        • Contatto:
          • Site Public Contact
          • Numero di telefono: 212-639-7592
        • Investigatore principale:
          • Andrea Cercek
    • New York
      • Buffalo, New York, Stati Uniti, 14263
        • Reclutamento
        • Roswell Park Cancer Institute
        • Investigatore principale:
          • Anuradha Krishnamurthy
        • Contatto:
      • Commack, New York, Stati Uniti, 11725
        • Reclutamento
        • Memorial Sloan Kettering Commack
        • Contatto:
          • Site Public Contact
          • Numero di telefono: 212-639-7592
        • Investigatore principale:
          • Andrea Cercek
      • East White Plains, New York, Stati Uniti, 10604
        • Reclutamento
        • Memorial Sloan Kettering Westchester
        • Contatto:
          • Site Public Contact
          • Numero di telefono: 212-639-7592
        • Investigatore principale:
          • Andrea Cercek
      • New York, New York, Stati Uniti, 10065
        • Reclutamento
        • Memorial Sloan Kettering Cancer Center
        • Contatto:
          • Site Public Contact
          • Numero di telefono: 212-639-7592
        • Investigatore principale:
          • Andrea Cercek
      • New York, New York, Stati Uniti, 10029
        • Reclutamento
        • Mount Sinai Hospital
        • Contatto:
          • Site Public Contact
          • Numero di telefono: 212-824-7309
          • Email: CCTO@mssm.edu
        • Investigatore principale:
          • James O. Park
      • Uniondale, New York, Stati Uniti, 11553
        • Reclutamento
        • Memorial Sloan Kettering Nassau
        • Contatto:
          • Site Public Contact
          • Numero di telefono: 212-639-7592
        • Investigatore principale:
          • Andrea Cercek
    • North Carolina
      • Durham, North Carolina, Stati Uniti, 27710
        • Reclutamento
        • Duke University Medical Center
        • Contatto:
          • Site Public Contact
          • Numero di telefono: 888-275-3853
        • Investigatore principale:
          • Hope E. Uronis
      • Raleigh, North Carolina, Stati Uniti, 27609
        • Reclutamento
        • Duke Cancer Center Raleigh
        • Investigatore principale:
          • Hope E. Uronis
        • Contatto:
      • Winston-Salem, North Carolina, Stati Uniti, 27157
        • Reclutamento
        • Wake Forest University Health Sciences
        • Investigatore principale:
          • Perry Shen
        • Contatto:
          • Site Public Contact
          • Numero di telefono: 336-713-6771
    • Ohio
      • Cleveland, Ohio, Stati Uniti, 44106
        • Attivo, non reclutante
        • Case Western Reserve University
      • Columbus, Ohio, Stati Uniti, 43210
        • Reclutamento
        • Ohio State University Comprehensive Cancer Center
        • Contatto:
        • Investigatore principale:
          • Alex B. Blair
      • Youngstown, Ohio, Stati Uniti, 44501
        • Reclutamento
        • Saint Elizabeth Youngstown Hospital
        • Contatto:
        • Investigatore principale:
          • Howard M. Gross
    • Oregon
      • Portland, Oregon, Stati Uniti, 97239
        • Reclutamento
        • Oregon Health and Science University
        • Contatto:
          • Site Public Contact
          • Numero di telefono: 503-494-1080
          • Email: trials@ohsu.edu
        • Investigatore principale:
          • Skye C. Mayo
    • Pennsylvania
      • Allentown, Pennsylvania, Stati Uniti, 18103
        • Reclutamento
        • Lehigh Valley Hospital-Cedar Crest
        • Contatto:
        • Investigatore principale:
          • Tareq Al baghdadi
      • Erie, Pennsylvania, Stati Uniti, 16544
        • Reclutamento
        • Saint Vincent Hospital
        • Contatto:
          • Site Public Contact
          • Numero di telefono: 814-452-5000
        • Investigatore principale:
          • Patrick L. Wagner
      • Jefferson Hills, Pennsylvania, Stati Uniti, 15025
        • Reclutamento
        • Jefferson Hospital
        • Contatto:
        • Investigatore principale:
          • Patrick L. Wagner
      • Monroeville, Pennsylvania, Stati Uniti, 15146
        • Reclutamento
        • Forbes Hospital
        • Contatto:
          • Site Public Contact
          • Numero di telefono: 412-858-7746
        • Investigatore principale:
          • Patrick L. Wagner
      • Philadelphia, Pennsylvania, Stati Uniti, 19111
        • Reclutamento
        • Fox Chase Cancer Center
        • Contatto:
          • Site Public Contact
          • Numero di telefono: 215-728-4790
        • Investigatore principale:
          • Vanessa Wookey
      • Pittsburgh, Pennsylvania, Stati Uniti, 15224
        • Reclutamento
        • West Penn Hospital
        • Contatto:
          • Site Public Contact
          • Numero di telefono: 412-578-5000
        • Investigatore principale:
          • Patrick L. Wagner
      • Pittsburgh, Pennsylvania, Stati Uniti, 15212
        • Reclutamento
        • Allegheny General Hospital
        • Contatto:
          • Site Public Contact
          • Numero di telefono: 877-284-2000
        • Investigatore principale:
          • Patrick L. Wagner
      • Wexford, Pennsylvania, Stati Uniti, 15090
        • Reclutamento
        • Wexford Health and Wellness Pavilion
        • Contatto:
        • Investigatore principale:
          • Patrick L. Wagner
    • Tennessee
      • Nashville, Tennessee, Stati Uniti, 37232
        • Reclutamento
        • Vanderbilt University/Ingram Cancer Center
        • Contatto:
          • Site Public Contact
          • Numero di telefono: 800-811-8480
        • Investigatore principale:
          • Chandrasekhar Padmanabhan
    • Texas
      • Dallas, Texas, Stati Uniti, 75390
        • Reclutamento
        • UT Southwestern/Simmons Cancer Center-Dallas
        • Contatto:
        • Investigatore principale:
          • Adam C. Yopp
      • Dallas, Texas, Stati Uniti, 75235
        • Reclutamento
        • Parkland Memorial Hospital
        • Contatto:
        • Investigatore principale:
          • Adam C. Yopp
      • Dallas, Texas, Stati Uniti, 75237
        • Reclutamento
        • UT Southwestern Simmons Cancer Center - RedBird
        • Investigatore principale:
          • Adam C. Yopp
        • Contatto:
      • Fort Worth, Texas, Stati Uniti, 76104
        • Reclutamento
        • UT Southwestern/Simmons Cancer Center-Fort Worth
        • Contatto:
        • Investigatore principale:
          • Adam C. Yopp
      • Richardson, Texas, Stati Uniti, 75080
        • Reclutamento
        • UT Southwestern Clinical Center at Richardson/Plano
        • Contatto:
        • Investigatore principale:
          • Adam C. Yopp
    • Wisconsin
      • Madison, Wisconsin, Stati Uniti, 53792
        • Reclutamento
        • University of Wisconsin Carbone Cancer Center - University Hospital
        • Contatto:
        • Investigatore principale:
          • Patrick Varley
      • Madison, Wisconsin, Stati Uniti, 53718
        • Reclutamento
        • University of Wisconsin Carbone Cancer Center - Eastpark Medical Center
        • Contatto:
        • Investigatore principale:
          • Patrick Varley

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

18 anni e precedenti (Adulto, Adulto più anziano)

Accetta volontari sani

No

Sessi ammissibili allo studio

Tutto

Descrizione

Inclusion Criteria:

  • Patient must be >= 18 years of age

  • Patient must have confirmed unresectable liver confined metastatic colorectal cancer (CRC).

    • Patient must not have radiographically or clinically evident extrahepatic disease (including but not limited to radiographically positive periportal lymph nodes).

      • NOTE: Patients found to have positive periportal nodes at the time of HAI placement can remain on study.

    • Patient may have calcified pulmonary nodules, and/or =< 5 indeterminate and stable (for a minimum of 3 months on chemotherapy) pulmonary nodules each measuring =< 6 mm in maximal axial dimension.

    • Patient's primary tumor may be in place

  • Patient must have received previous first-line chemotherapy that meets one of the following three criteria: a) have received at least 6 but no more than 12 cycles of first-line cytotoxic chemotherapy (where 1 cycle = 14 days) OR b) have received at least 4 but no more than 8 cycles of first-line cytotoxic chemotherapy (where 1 cycle = 21 days) OR c) have developed new colorectal liver metastases (CRLM) within 12 months of completing adjuvant systemic therapy for stage II-III colorectal cancer.

    • NOTE: First-line chemotherapy may have included any of the following regimens as listed in the National Comprehensive Cancer Network (NCCN) Guidelines: leucovorin calcium (folinic acid), fluorouracil, and oxaliplatin (FOLFOX) (or equivalent), leucovorin calcium (calcium folinate), 5-fluorouracil, and irinotecan (FOLFIRI) (or equivalent), leucovorin calcium (calcium folinate), 5-fluorouracil, oxaliplatin, and irinotecan (FOLFOXIRI), each with or without any of the following: bevacizumab, cetuximab, or panitumumab

  • Patient must have measurable disease

  • Patients who have disease progression, in the judgement of the treating multidisciplinary team, are not eligible.

    • This requirement does not apply to patients who developed new colorectal liver metastases within 12 months of completing adjuvant systemic therapy for stage II-III colorectal cancer

  • Patient must meet the following criteria for technical unresectability:

    • A margin-negative resection requires resection of three hepatic veins, both portal veins, or the retrohepatic vena cava OR a resection that leaves less than two adequately perfused and drained segments.
    • NOTE: Institutional multidisciplinary review is required to confirm unresectability and rule out radiographically positive extrahepatic disease.
    • NOTE: Patients who are deemed technically resectable but simultaneous biologically unresectable are not eligible.

  • Patient must undergo multiphase imaging of the chest, abdomen, and pelvis inclusive of CT and/or MRI angiography to confirm acceptable hepatic arterial anatomy for HAI and to rule out extrahepatic disease within 28 days prior to randomization.

    • NOTE: If the patient had remote liver-arterial phase imaging greater than 4 weeks from randomization, then only a single phase (portal venous) intravenous contrasted staging CT and/or MRI of the chest/abdomen/pelvis is required.

  • Patient must have an Eastern Cooperative Oncology Group (ECOG) Performance Status 0-1 and be clinically fit to undergo surgery as determined by the pre-operative evaluation.

  • Patient must not have a liver tumor burden exceeding 70% of total liver volume.

  • Patient must not have had prior radiation to the liver (prior radiation therapy to the pelvis is acceptable if completed at least 2 weeks prior to randomization).

  • Patient must not have had prior trans-arterial bland embolization, chemoembolization (TACE) or radioembolization (TARE).

  • Patient must not have had prior treatment with HAI/floxuridine (FUDR)

  • Patient must not have microsatellite instability-high (MSI-H) colorectal cancer.

  • Patient must not have CRLM that could be resected with 2-stage hepatectomy, including associating liver partition and portal vein ligation (ALPPS).

  • Patient must not have an active infection, serious or non-healing active wound, ulcer, or bone fracture.

  • Patient must not have any serious medical problems which would preclude receiving the protocol treatment or would interfere with the cooperation with the requirements of this trial.

  • Patient must not have cirrhosis and/or clinical or radiographic evidence of portal hypertension

  • Patient must not be pregnant or breast-feeding due to the potential harm to an unborn fetus and possible risk for adverse events in nursing infants with the treatment regimens being used.

    • All patients of childbearing potential must have a blood test or urine study within 14 days prior to randomization to rule out pregnancy.
    • A patient of childbearing potential is defined as anyone, regardless of whether they have undergone tubal ligation, who meets the following criteria: 1) has achieved menarche at some point, 2) has not undergone a hysterectomy or bilateral oophorectomy; or 3) has not been naturally postmenopausal (amenorrhea following cancer therapy does not rule out childbearing potential) for at least 24 consecutive months (i.e., has had menses at any time in the preceding 24 consecutive months)

  • Patient must not expect to conceive or father children by using accepted and effective method(s) of contraception or by abstaining from sexual intercourse for the duration of their participation in the study.

  • Leukocytes >= 3,000/mcL (obtained =< 28 days prior to protocol randomization)

  • Absolute neutrophil count (ANC) >= 1,500/mcL (obtained =< 28 days prior to protocol randomization)

  • Platelets >= 100,000/mcL (obtained =< 28 days prior to protocol randomization)

  • Total Bilirubin =< 1.5 mg/dL (obtained =< 28 days prior to protocol randomization)

  • Aspartate aminotransferase (AST)(serum glutamic oxaloacetic transaminase [SGOT]) and alanine aminotransferase (ALT)(serum glutamic pyruvic transaminase [SGPT]) =< 3.0 x institutional upper limit of normal (ULN) (obtained =< 28 days prior to protocol randomization)

  • Creatinine =< 1.5 x institutional ULN OR creatinine clearance >= 50 mL/min calculated by the Cockcroft-Gault method (obtained =< 28 days prior to protocol randomization)

  • Calcium >= institutional lower limit of normal (LLN)

  • Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial.

  • Human immunodeficiency virus (HIV)-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months of randomization are eligible for this trial. Testing for HIV is not required for entry onto the study

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: Randomizzato
  • Modello interventistico: Assegnazione parallela
  • Mascheramento: Nessuno (etichetta aperta)

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Sperimentale: Arm A (HAI, floxuridine, standard chemotherapy)

Patients undergo surgery to place the HAI pump within 6 weeks of randomization, followed by single SPECT/CT on study. Patients then receive floxuridine via the HAI pump within 12 weeks of randomization on study. Patients also receive one of the following standard chemotherapy regimens per the treating physician within 16 weeks of randomization: FOLFOX IV, FOLFIRI IV, or OX/IRI IV with or without cetuximab IV and/or panitumumab IV on days 1 and 15 of each cycle. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients may have leucovorin omitted from their regimen per institutional standards. Patients also undergo CT and/or MRI scans throughout the trial.
Droga: Fluorouracil

Given IV

Altri nomi:
  • 5-Fluracile
  • Fluracil
  • 5 Fluorouracile
  • 5FU
  • 5-Fluoro-2,4(1H, 3H)-pirimidinedione
  • 5-Fluorouracile
  • 5-Fu
  • Accu Site
  • Carac
  • Fluorouracile
  • Fluuracile
  • Flurablastina
  • Fluracedil
  • Fluril
  • Fluroblastina
  • Ribofluor
  • Ro 2-9757
  • Ro-2-9757
Procedura: Magnetic Resonance Imaging

Undergo MRI

Altri nomi:
  • Risonanza magnetica
  • Scansione di immagini a risonanza magnetica
  • Imaging medico, risonanza magnetica/risonanza magnetica nucleare
  • SIG
  • Imaging RM
  • Scansione MRI
  • Imaging NMR
  • RMN
  • Risonanza Magnetica Nucleare
  • Imaging a risonanza magnetica (MRI)
  • sMRI
  • Imaging a risonanza magnetica (procedura)
  • RM strutturale
Biologico: Panitumumab

Given IV

Altri nomi:
  • ABX-EGF
  • Anticorpo monoclonale ABX-EGF
  • ABX-EGF, clone E7.6.3
  • MoAb ABX-EGF
  • Vectibix
  • E7.6.3
  • Anticorpo monoclonale umano IgG2K
  • MoAb E7.6.3
  • Anticorpo monoclonale E7.6.3
Droga: Oxaliplatin

Given IV

Altri nomi:
  • 1-OHP
  • Dacotin
  • Dacplat
  • Eloxatina
  • Ai Heng
  • Aiheng
  • Diamminocicloesano ossalatoplatino
  • JM-83
  • Oxalatoplatino
  • RP 54780
  • RP-54780
  • SR-96669
  • SR96669
  • Elplat
  • GM 83
  • JM83
  • RP54780
Droga: Leucovorin

Given IV

Altri nomi:
  • Acido folinico
Biologico: Cetuximab

Given IV

Altri nomi:
  • C225
  • Erbitux
  • IMC-C225
  • Cetuximab biosimilare CDP-1
  • Cetuximab biosimilare CMAB009
  • Cetuximab Biosimilare KL 140
  • Anticorpo monoclonale chimerico anti-EGFR
  • Chimerico MoAb C225
  • Anticorpo monoclonale chimerico C225
  • C-225
  • Cetuximab-cetu
  • Cetuxa
  • ENZ 124
  • ENZ-124
  • ENZ124
Droga: Irinotecan

Given IV

Droga: Floxuridine

Given via HAI pump

Altri nomi:
  • 5-Fluorodesossiuridina
  • 5-Fluorouracile desossiriboside
  • 5-FUdR
  • FDUR
  • Floxuridina
  • Fluorodesossiuridina
  • Fluorouridina desossiribosio
  • Fluoruridina desossiribosio
  • FUdR
  • WR-138720
  • 2'-deossi-5-fluorouridina
  • 5-Fluoro-2'-deossiuridina
  • WR 138720
  • WR138720
Procedura: Computed Tomography

Undergo SPECT/CT and/or CT

Altri nomi:
  • CT
  • GATTO
  • TAC
  • Tomografia assiale computerizzata
  • Tomografia computerizzata
  • tomografia
  • Tomografia assiale computerizzata (procedura)
  • Scansione tomografia computerizzata (CT).
  • Scansione CAT diagnostica
  • Tipo di servizio di scansione CAT diagnostica
Procedura: Implantation

Undergo surgery to place the HAI pump

Procedura: Intrahepatic Infusion Procedure

Undergo HAI

Altri nomi:
  • Infusione dell'arteria epatica
  • HAI
  • Infusione arteriosa epatica
  • IHI
  • Infusione intraepatica
Procedura: Single Photon Emission Computed Tomography

Undergo SPECT/CT

Altri nomi:
  • ST
  • Imaging medico, tomografia computerizzata a emissione di fotone singolo
  • Tomografia a emissione di fotone singolo
  • tomografia computerizzata ad emissione di singolo fotone
  • SPETTACOLO
  • Imaging SPECT
  • SCANSIONE SPECT
  • SPET
  • tomografia, emissione calcolata, singolo fotone
  • Tomografia, calcolo delle emissioni, fotone singolo
  • Emissione di fotone singolo calcolata
Comparatore attivo: Arm B (standard chemotherapy)

Patients receive one of the following standard chemotherapy regimens per the treating physician within 6 weeks of randomization: FOLFOXIRI IV, FOLFOX IV, FOLFIRI IV, or OX/IRI IV with or without cetuximab IV, panitumumab IV, and/or bevacizumab IV on days 1 and 15 of each cycle. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients may receive capecitabine PO in substitution for fluorouracil at the discretion of the investigator and may have leucovorin omitted from their regimen per institutional standards. Patients also undergo CT and/or MRI scans throughout the trial.
Biologico: Bevacizumab

Given IV

Altri nomi:
  • Avastin
  • SOA 215
  • Anti-VEGF
  • Anticorpo monoclonale umanizzato anti-VEGF
  • Anticorpo monoclonale anti-VEGF SIBP04
  • Anti-VEGF rhuMAb
  • Bevacizumab awwb
  • Bevacizumab biosimilare ABP 215
  • Bevacizumab biosimilare BEVZ92
  • Bevacizumab biosimilare BI 695502
  • Bevacizumab biosimilare CBT 124
  • Bevacizumab biosimilare CT-P16
  • Bevacizumab biosimilare FKB238
  • Bevacizumab biosimilare GB-222
  • Bevacizumab biosimilare HD204
  • Bevacizumab biosimilare HLX04
  • Bevacizumab biosimilare IBI305
  • Bevacizumab biosimilare LY01008
  • Bevacizumab biosimilare MIL60
  • Bevacizumab biosimilare Mvasi
  • Bevacizumab biosimilare MYL-1402O
  • Bevacizumab biosimilare QL 1101
  • Bevacizumab biosimilare RPH-001
  • Bevacizumab biosimilare SCT501
  • Bevacizumab Biosimilare Zirabev
  • Bevacizumab-awwb
  • Bevacizumab-bvzr
  • BP102
  • BP102 Biosimilare
  • HD204
  • Immunoglobulina G1 (fattore di crescita endoteliale vascolare monoclonale umano-topo rhuMab-VEGF anti-catena gamma), disolfuro con catena leggera monoclonale umano-topo rhuMab-VEGF, dimero
  • Mvasi
  • MYL-1402O
  • Anticorpo monoclonale anti-VEGF umanizzato ricombinante
  • rhuMab-VEGF
  • SCT501
  • SIBP 04
  • SIBP-04
  • SIBP04
  • Zirabev
  • Avegra
  • QL1101
  • IBI305
  • Byvasda
  • Bevacizumab biosimilare QL1101
  • BAT1706
  • BAT 1706
  • BAT-1706
  • BAT1706 Biosimilare
  • Bevacizumab biosimilare BAT1706
  • Bevacizumab-adcd
  • CT-P16
  • Vegzelma
  • Alymsys
  • ABP-215
  • ABP215
  • Aybintio
  • Bevacizumab-aybi
  • Bevacizumab-equi
  • Bevacizumab-mal
  • Bevacizumab-onbe
  • CT P16
  • CTP16
  • Equidacente
  • Onbevzi
  • Avzivi
  • Bevacizumab biosimilare MB02
  • Bevacizumab-tnjn
  • FKB238
  • FKB-238
  • MB02
  • MB-02
  • Oyavas
  • PF06439535
  • PF-06439535
  • Bevacizumab-aveg
  • Bevacizumab-byva
  • Bevacizumab-nwgd
  • Jobevne
  • IBI 305
  • IBI-305
Droga: Fluorouracil

Given IV

Altri nomi:
  • 5-Fluracile
  • Fluracil
  • 5 Fluorouracile
  • 5FU
  • 5-Fluoro-2,4(1H, 3H)-pirimidinedione
  • 5-Fluorouracile
  • 5-Fu
  • Accu Site
  • Carac
  • Fluorouracile
  • Fluuracile
  • Flurablastina
  • Fluracedil
  • Fluril
  • Fluroblastina
  • Ribofluor
  • Ro 2-9757
  • Ro-2-9757
Procedura: Magnetic Resonance Imaging

Undergo MRI

Altri nomi:
  • Risonanza magnetica
  • Scansione di immagini a risonanza magnetica
  • Imaging medico, risonanza magnetica/risonanza magnetica nucleare
  • SIG
  • Imaging RM
  • Scansione MRI
  • Imaging NMR
  • RMN
  • Risonanza Magnetica Nucleare
  • Imaging a risonanza magnetica (MRI)
  • sMRI
  • Imaging a risonanza magnetica (procedura)
  • RM strutturale
Droga: Capecitabine

Given PO

Altri nomi:
  • Xeloda
  • Ro 09-1978/000
Biologico: Panitumumab

Given IV

Altri nomi:
  • ABX-EGF
  • Anticorpo monoclonale ABX-EGF
  • ABX-EGF, clone E7.6.3
  • MoAb ABX-EGF
  • Vectibix
  • E7.6.3
  • Anticorpo monoclonale umano IgG2K
  • MoAb E7.6.3
  • Anticorpo monoclonale E7.6.3
Droga: Oxaliplatin

Given IV

Altri nomi:
  • 1-OHP
  • Dacotin
  • Dacplat
  • Eloxatina
  • Ai Heng
  • Aiheng
  • Diamminocicloesano ossalatoplatino
  • JM-83
  • Oxalatoplatino
  • RP 54780
  • RP-54780
  • SR-96669
  • SR96669
  • Elplat
  • GM 83
  • JM83
  • RP54780
Droga: Leucovorin

Given IV

Altri nomi:
  • Acido folinico
Biologico: Cetuximab

Given IV

Altri nomi:
  • C225
  • Erbitux
  • IMC-C225
  • Cetuximab biosimilare CDP-1
  • Cetuximab biosimilare CMAB009
  • Cetuximab Biosimilare KL 140
  • Anticorpo monoclonale chimerico anti-EGFR
  • Chimerico MoAb C225
  • Anticorpo monoclonale chimerico C225
  • C-225
  • Cetuximab-cetu
  • Cetuxa
  • ENZ 124
  • ENZ-124
  • ENZ124
Droga: Irinotecan

Given IV

Procedura: Computed Tomography

Undergo SPECT/CT and/or CT

Altri nomi:
  • CT
  • GATTO
  • TAC
  • Tomografia assiale computerizzata
  • Tomografia computerizzata
  • tomografia
  • Tomografia assiale computerizzata (procedura)
  • Scansione tomografia computerizzata (CT).
  • Scansione CAT diagnostica
  • Tipo di servizio di scansione CAT diagnostica

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Overall survival (OS)
Lasso di tempo: From randomization to death from any cause, assessed up to 5 years

Patients still living will be censored at the date last known alive. OS will be evaluated using the Kaplan-Meier method, and arms will be compared via a stratified log rank test.
From randomization to death from any cause, assessed up to 5 years

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Progression free survival (PFS)
Lasso di tempo: From randomization to first observed disease progression at any site, or death from any cause, assessed up to 5 years

Patients still living without disease progression will be censored at the date of last disease assessment. Disease progression will be based on findings from surveillance cross-sectional imaging of the chest/abdomen/pelvis every 3 months after randomization, defined by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1. Will be analyzed similarly to OS, but with and without stratification for sensitivity.
From randomization to first observed disease progression at any site, or death from any cause, assessed up to 5 years
Hepatic PFS
Lasso di tempo: From randomization to first observed disease progression in the liver, or death from any cause, assessed up to 5 years

Patients still living without hepatic disease progression will be censored at the date of last disease assessment. Hepatic disease progression will be based on findings from surveillance cross-sectional imaging of the chest/abdomen/pelvis every 3 months after randomization, defined by RECIST 1.1.
From randomization to first observed disease progression in the liver, or death from any cause, assessed up to 5 years
Extrahepatic-PFS
Lasso di tempo: From randomization to first observed disease progression outside of the liver, or death from any cause, assessed up to 5 years

Patients still living without extrahepatic disease progression will be censored at the date of last disease assessment. Extrahepatic disease progression will be based on findings from surveillance cross-sectional imaging of the chest/abdomen/pelvis every 3 months after randomization, defined by RECIST 1.1.
From randomization to first observed disease progression outside of the liver, or death from any cause, assessed up to 5 years
Objective response rate
Lasso di tempo: Up to 5 years

Will assess hepatic disease burden specifically. Defined as the proportion of patients achieving complete or partial response by RECIST 1.1. Response will be based on surveillance cross-sectional imaging of the chest/abdomen/pelvis every 3 months (+/- 2 weeks) from randomization. Arms will be compared via a Pearson chi-square test. All rates will be reported with exact binomial 95% confidence intervals.
Up to 5 years
Rate of conversion to resectable disease
Lasso di tempo: Up to 5 years

Defined as the proportion of patients who successfully convert from unresectable to resectable status and undergo R0/R1 resection/ablation. All rates will be reported with exact binomial 95% confidence intervals.
Up to 5 years
Intra-operative ineligibility rate
Lasso di tempo: Up to 5 years

Defined as the proportion of patients intended to receive hepatic arterial infusion that do not undergo pump implantation due to intraoperative detection of occult extrahepatic disease or unsuitable hepatic arterial anatomy. All rates will be reported with exact binomial 95% confidence intervals.
Up to 5 years
Incidence of adverse events
Lasso di tempo: Up to 5 years

Defined according to the Common Terminology Criteria for Adverse Events.
Up to 5 years

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

ECOG-ACRIN Cancer Research Group

Investigatori

  • Investigatore principale: Michael Lidsky, ECOG-ACRIN Cancer Research Group

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Effettivo)

10 aprile 2024

Completamento primario (Stimato)

30 giugno 2029

Completamento dello studio (Stimato)

30 giugno 2029

Date di iscrizione allo studio

Primo inviato

9 maggio 2023

Primo inviato che soddisfa i criteri di controllo qualità

9 maggio 2023

Primo Inserito (Effettivo)

17 maggio 2023

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

24 settembre 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

21 settembre 2026

Ultimo verificato

1 settembre 2026

Maggiori informazioni

Termini relativi a questo studio

Termini MeSH pertinenti aggiuntivi

Altri numeri di identificazione dello studio

  • EA2222
  • U10CA180820 (Sovvenzione/contratto NIH degli Stati Uniti)
  • EA2222 (Altro identificatore: CTEP)
  • NCI-2023-02357 (Identificatore di registro: CTRP (Clinical Trial Reporting Program))
  • EA2222 (Altro identificatore: ECOG-ACRIN Cancer Research Group)

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

Sì

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .

Sottoscrivi