- ICH GCP
- 미국 임상 시험 레지스트리
- 임상시험 NCT00321685
Bevacizumab, Radiation Therapy, and Combination Chemotherapy in Treating Patients Who Are Undergoing Surgery for Locally Advanced Nonmetastatic Rectal Cancer
Phase II Study of Preoperative Radiation With Concurrent Capecitabine, Oxaliplatin and Bevacizumab Followed by Surgery and Postoperative 5-FU, Leucovorin, Oxaliplatin (FOLFOX) and Bevacizumab in Patients With Locally Advanced Rectal Cancer
연구 개요
상태
상세 설명
PRIMARY OBJECTIVES:
I. To evaluate the pathological complete response rate in patients with T3 and T4 rectal cancers when treated preoperatively with capecitabine, oxaliplatin, bevacizumab, and concurrent radiotherapy (XRT).
II. To evaluate the resection rate for T3 and T4 rectal cancers and the expected versus actual type of resection (abdominoperinal resection [APR] vs. low anterior resection [LAR] vs. LAR/coloanal anastomosis).
III. To make preliminary observations of patient survival and patterns of recurrence for this treatment combination.
IV. To gain additional experience regarding the toxicity and tolerability of this preoperative and postoperative regimen.
OUTLINE:
PREOPERATIVE CHEMORADIOTHERAPY: Patients undergo radiotherapy (total dose to the tumor bed was 5040 cGy) once daily (QD) 5 days a week and receive capecitabine 825 mg/m^2 orally (PO) twice daily (BID) 5 days a week for 5.5 weeks. Patients also receive oxaliplatin 50 mg/m^2 intravenously (IV) over 2 hours on days 1, 8, 15, 22, and 29 and bevacizumab 5 mg/kg IV over 30-90 minutes on days 1, 15, and 29 during radiotherapy.
SURGERY: Approximately 6-8 weeks after completion of chemoradiotherapy, patients undergo surgical resection. Patients whose tumors are not completely resected or who have metastatic disease discontinue protocol therapy.
POSTOPERATIVE CHEMOTHERAPY: Approximately 4-12 weeks after surgery, patients receive oxaliplatin IV over 2 hours, leucovorin calcium 400 mg/m^2 IV over 2 hours, and bevacizumab 5 mg/kg IV over 30-90 minutes on day 1. Patients also receive fluorouracil 2400 mg/m^2 IV continuously over 46 hours beginning on day 1. Treatment repeats every 2 weeks for 9 courses in the absence of disease progression or unacceptable toxicity. Patients then receive up to 3 additional courses of leucovorin calcium, fluorouracil, and bevacizumab.
After completion of study treatment, patients are followed up periodically for 10 years.
연구 유형
등록 (실제)
단계
- 2 단계
연락처 및 위치
연구 장소
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Alabama
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Birmingham, Alabama, 미국, 35233
- University of Alabama at Birmingham Cancer Center
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Connecticut
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New Britain, Connecticut, 미국, 06050
- The Hospital of Central Connecticut
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Georgia
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Atlanta, Georgia, 미국, 30322
- Emory University Hospital/Winship Cancer Institute
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Decatur, Georgia, 미국, 30033
- Atlanta VA Medical Center
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Macon, Georgia, 미국, 31201
- Medical Center of Central Georgia
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Illinois
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Aurora, Illinois, 미국, 60504
- Rush - Copley Medical Center
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Berwyn, Illinois, 미국, 60402
- MacNeal Hospital and Cancer Center
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Chicago, Illinois, 미국, 60611
- Northwestern University
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Chicago, Illinois, 미국, 60625
- Swedish Covenant Hospital
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Chicago, Illinois, 미국, 60611
- Hematology and Oncology Associates
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Chicago, Illinois, 미국, 60657
- Presence Saint Joseph Hospital-Chicago
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Chicago, Illinois, 미국, 60612
- Jesse Brown Veterans Affairs Medical Center
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Chicago, Illinois, 미국, 60616
- Mercy Hospital and Medical Center
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Effingham, Illinois, 미국, 62401
- Saint Anthony Memorial Hospital
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Highland Park, Illinois, 미국, 60035
- Hematology Oncology Associates of Illinois-Highland Park
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Hinsdale, Illinois, 미국, 60521
- Hinsdale Hematology Oncology Associates Incorporated
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Joliet, Illinois, 미국, 60435
- Joliet Oncology-Hematology Associates Limited
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Joliet, Illinois, 미국, 60432
- Midwest Center for Hematology Oncology
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Libertyville, Illinois, 미국, 60048
- NorthShore Hematology Oncology-Libertyville
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Moline, Illinois, 미국, 61265
- Garneau, Stewart C MD (UIA Investigator)
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Moline, Illinois, 미국, 61265
- Porubcin, Michael MD (UIA Investigator)
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Moline, Illinois, 미국, 61265
- Spector, David MD (UIA Investigator)
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Moline, Illinois, 미국, 61265
- Trinity Medical Center
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Moline, Illinois, 미국, 61265
- Sharis, Christine M MD (UIA Investigator)
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Moline, Illinois, 미국, 61265
- Stoffel, Thomas J MD (UIA Investigator)
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Moline, Illinois, 미국, 61265
- Vigliotti, Antonio, P.G. M.D. (UIA Investigator)
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Naperville, Illinois, 미국, 60563
- DuPage Medical Group-Ogden
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Niles, Illinois, 미국, 60714
- Illinois Cancer Specialists-Niles
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Skokie, Illinois, 미국, 60076
- Hematology Oncology Associates of Illinois - Skokie
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Skokie, Illinois, 미국, 60076
- Edward H Kaplan MD and Associates
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Urbana, Illinois, 미국, 61801
- Carle Cancer Center
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Indiana
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Michigan City, Indiana, 미국, 46360
- Franciscan Saint Anthony Health-Michigan City
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Iowa
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Bettendorf, Iowa, 미국, 52722
- Constantinou, Costas L MD (UIA Investigator)
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Sioux City, Iowa, 미국, 51101
- Siouxland Regional Cancer Center
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Sioux City, Iowa, 미국, 51102
- Mercy Medical Center-Sioux City
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Sioux City, Iowa, 미국, 51104
- Saint Luke's Regional Medical Center
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Michigan
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Kalamazoo, Michigan, 미국, 49007
- West Michigan Cancer Center
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Kalamazoo, Michigan, 미국, 49007
- Bronson Methodist Hospital
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Kalamazoo, Michigan, 미국, 49048
- Borgess Medical Center
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Minnesota
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Burnsville, Minnesota, 미국, 55337
- Fairview Ridges Hospital
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Coon Rapids, Minnesota, 미국, 55433
- Mercy Hospital
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Edina, Minnesota, 미국, 55435
- Fairview-Southdale Hospital
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Fridley, Minnesota, 미국, 55432
- Unity Hospital
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Hutchinson, Minnesota, 미국, 55350
- Hutchinson Area Health Care
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Litchfield, Minnesota, 미국, 55355
- Meeker County Memorial Hospital
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Maplewood, Minnesota, 미국, 55109
- Saint John's Hospital - Healtheast
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Maplewood, Minnesota, 미국, 55109
- Minnesota Oncology Hematology PA-Maplewood
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Minneapolis, Minnesota, 미국, 55415
- Hennepin County Medical Center
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Minneapolis, Minnesota, 미국, 55407
- Abbott-Northwestern Hospital
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Minneapolis, Minnesota, 미국, 55407
- Virginia Piper Cancer Institute
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Robbinsdale, Minnesota, 미국, 55422
- North Memorial Medical Health Center
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Saint Louis Park, Minnesota, 미국, 55416
- Park Nicollet Clinic - Saint Louis Park
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Saint Louis Park, Minnesota, 미국, 55416
- Metro Minnesota Community Oncology Research Consortium
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Saint Paul, Minnesota, 미국, 55101
- Regions Hospital
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Saint Paul, Minnesota, 미국, 55102
- United Hospital
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Saint Paul, Minnesota, 미국, 55102
- Saint Joseph's Hospital - Healtheast
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Shakopee, Minnesota, 미국, 55379
- Saint Francis Regional Medical Center
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Waconia, Minnesota, 미국, 55387
- Ridgeview Medical Center
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Woodbury, Minnesota, 미국, 55125
- Minnesota Oncology Hematology PA-Woodbury
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Woodbury, Minnesota, 미국, 55125
- Woodwinds Health Campus
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Nebraska
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Lincoln, Nebraska, 미국, 68510
- Nebraska Cancer Research Center
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Omaha, Nebraska, 미국, 68124
- Alegent Health Bergan Mercy Medical Center
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Omaha, Nebraska, 미국, 68122
- Alegent Health Immanuel Medical Center
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Omaha, Nebraska, 미국, 68131
- Creighton University Medical Center
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Omaha, Nebraska, 미국, 68106
- Missouri Valley Cancer Consortium
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New Jersey
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Mount Holly, New Jersey, 미국, 08060
- Virtua Memorial
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Sparta, New Jersey, 미국, 07871
- Sparta Cancer Treatment Center
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Voorhees, New Jersey, 미국, 08043
- Virtua Voorhees
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Woodbury, New Jersey, 미국, 08096
- Inspira Medical Center Woodbury
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New York
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Bronx, New York, 미국, 10467
- Montefiore Medical Center - Moses Campus
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Bronx, New York, 미국, 10466
- Montefiore Medical Center-Wakefield Campus
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Ohio
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Akron, Ohio, 미국, 44304
- Summa Akron City Hospital/Cooper Cancer Center
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Barberton, Ohio, 미국, 44203
- Summa Barberton Hospital
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Bellefontaine, Ohio, 미국, 43311
- Mary Rutan Hospital
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Chillicothe, Ohio, 미국, 45601
- Adena Regional Medical Center
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Columbus, Ohio, 미국, 43214
- Riverside Methodist Hospital
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Columbus, Ohio, 미국, 43228
- Doctors Hospital
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Columbus, Ohio, 미국, 43215
- Grant Medical Center
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Columbus, Ohio, 미국, 43222
- Mount Carmel Health Center West
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Delaware, Ohio, 미국, 43015
- Grady Memorial Hospital
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Lancaster, Ohio, 미국, 43130
- Fairfield Medical Center
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Lima, Ohio, 미국, 45801
- Saint Rita's Medical Center
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Marietta, Ohio, 미국, 45750
- Marietta Memorial Hospital
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Newark, Ohio, 미국, 43055
- Licking Memorial Hospital
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Springfield, Ohio, 미국, 45505
- Springfield Regional Medical Center
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Westerville, Ohio, 미국, 43081
- Saint Ann's Hospital
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Zanesville, Ohio, 미국, 43701
- Genesis Healthcare System Cancer Care Center
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Oklahoma
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Tulsa, Oklahoma, 미국, 74136
- Natalie Warren Bryant Cancer Center at Saint Francis
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Pennsylvania
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Allentown, Pennsylvania, 미국, 18103
- Lehigh Valley Hospital-Cedar Crest
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Darby, Pennsylvania, 미국, 19023-1291
- Mercy Fitzgerald Hospital
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East Stroudsburg, Pennsylvania, 미국, 18301
- Pocono Medical Center
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Ephrata, Pennsylvania, 미국, 17522
- Ephrata Cancer Center
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Media, Pennsylvania, 미국, 19063
- Riddle Memorial Hospital
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Philadelphia, Pennsylvania, 미국, 19111
- Fox Chase Cancer Center
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Philadelphia, Pennsylvania, 미국, 19107
- Thomas Jefferson University Hospital
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Philadelphia, Pennsylvania, 미국, 19141
- Einstein Medical Center Philadelphia
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Philadelphia, Pennsylvania, 미국, 19114
- Aria Health-Torresdale Campus
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Scranton, Pennsylvania, 미국, 18508
- Hematology and Oncology Associates of North East Pennsylvania
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Upland, Pennsylvania, 미국, 19013
- Associates In Hematology Oncology PC-Upland
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South Dakota
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Sioux Falls, South Dakota, 미국, 57105
- Avera Cancer Institute
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Sioux Falls, South Dakota, 미국, 57117-5134
- Sanford USD Medical Center - Sioux Falls
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Sioux Falls, South Dakota, 미국, 57104
- Sanford Cancer Center Oncology Clinic
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Sioux Falls, South Dakota, 미국, 57105
- Medical X-Ray Center
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Sioux Falls, South Dakota, 미국, 57105
- Avera McKennan Hospital and University Health Center
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Texas
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Dallas, Texas, 미국, 75390
- UT Southwestern/Simmons Cancer Center-Dallas
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Wisconsin
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La Crosse, Wisconsin, 미국, 54601
- Gundersen Lutheran Medical Center
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Milwaukee, Wisconsin, 미국, 53226
- Froedtert and The Medical College of Wisconsin
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참여기준
자격 기준
공부할 수 있는 나이
건강한 자원 봉사자를 받아들입니다
연구 대상 성별
설명
Inclusion Criteria:
- Patients must have histologically confirmed, locally advanced, non-metastatic primary T3 or T4 adenocarcinoma of the rectum
- Patients must not have evidence of tumor outside of the pelvis including liver metastases, peritoneal seeding, or metastatic inguinal lymphadenopathy
- Patients must not have intra-operative radiotherapy (IORT) or brachytherapy treatment to the pelvis
- The distal border of the tumor must be at or below the peritoneal reflection, defined as within 12 centimeters of the anal verge by proctoscopic examination
- Transmural penetration of tumor through the muscularis propria must be demonstrated by either of the following: computed tomography (CT) scan plus endorectal ultrasound, or a magnetic resonance imaging (MRI); an endorectal coil or pelvic MRI is allowed
- For the patient to be eligible, the surgeon must prospectively define the tumor as either initially resectable or potentially resectable after pre-operative chemoradiation; clinically resectable tumors are defined as completely resectable with negative margins based on routine examination of the non-anesthetized patient; patients whose tumors are not resectable are not eligible; before pre-operative (op) treatment, the surgeon should estimate and record the type of resection anticipated: pelvic exenteration, posterior pelvic exenteration, APR, LAR, or LAR/coloanal anastomosis
Patients with tumors that are clinically fixed, clinical stage T4N0-2, M0 are eligible if it is believed that their tumors are potentially resectable after chemoradiation; based on the following:
- Clinically fixed tumors on rectal examination with tumor adherent to the pelvic sidewall or sacrum
- Sciatica attributed to sacral root invasion with CT scan/MRI evidence of the lack of clear tissue plane will be considered evidence of fixation
- Hydronephrosis on CT scan or intravenous pyelogram (IVP) or ureteric or bladder invasion as documented by cystoscopy and cytology or biopsy, or invasion into prostate
- Vaginal or uterine involvement
- Patients must have Eastern Cooperative Oncology Group (ECOG) performance status 0-1
- A surgical evaluation must confirm patient's ability to tolerate the proposed surgical procedure
- Patients must have a caloric intake > 1500 kilocalories/day (d)
- Within 4 weeks prior to registration, the patient's absolute neutrophil count (ANC) level must be >= 1,500/mm^3
- Within 4 weeks prior to registration, the patients platelet level must be >= 100,000/mm^3
- Within 4 weeks prior to registration, serum creatinine must be < 1.5 X upper limit of normal (ULN); if serum creatinine > 1.5 x ULN, then creatinine clearance must be >= 50 mL/mm
- Within 4 weeks prior to registration, serum bilirubin must be =< 1.5 X ULN
- Within 4 weeks prior to registration, alkaline phosphatase (alk phos) must be < 2 x ULN
- Within 4 weeks prior to registration, serum glutamic oxaloacetic transaminase (SGOT) must be < 2 x ULN
- Carcinoembryonic antigen (CEA) must be determined prior to initiation of therapy
- Within 4 weeks prior to registration, urine protein/creatinine (UPC) ratio must be < 1; patients with a ratio of >= 1 must undergo a 24-hour urine collection which must be an adequate collection and must demonstrate < 1 gram (gm) of protein in order to participate
- Within 4 weeks prior to registration, albumin must be >= 2 gm/dl
- Absence of clinical evidence of high-grade (lumen diameter < 1 cm) large bowel obstruction, unless diverting colostomy has been performed
- Eligible patients of reproductive potential (both sexes) must agree to use an accepted and effective method of contraceptive during study therapy and for at least 6 months after the completion of bevacizumab
- Women must not be pregnant or breast-feeding; all females of childbearing potential must have a serum pregnancy test to rule out pregnancy within 2 weeks of registration
- Patients must have had no prior chemotherapy for rectal cancer or pelvic irradiation therapy
- Patients with prior malignancies, including pelvic cancer, are eligible if they have been disease free for > 5 years; patients with prior in situ carcinomas are eligible provided there was complete removal
- Patients must have no active inflammatory bowel disease or other serious medical illness or disease that might limit the patient's ability to receive protocol therapy
- Patients with a history of cerebrovascular accident (CVA)/transient ischemic attack (TIA) at any time, or myocardial infarction/unstable angina within 12 months of study entry are not eligible
- Patients with > grade 1 peripheral neuropathy are not eligible
- Patients must have urine protein/creatinine (UPC) ratio of < 1.0; patients with a UPC ratio >= 1.0 must undergo a 24-hour urine collection, which must be an adequate collection and must demonstrate < 1 gm of protein in order to participate
- Patients with a history of hypertension must measure < 150/90 mmHg and be on a stable regimen of anti-hypertensive therapy
- Patients with clinically significant peripheral vascular disease are not eligible
Patients must not have any of the following:
- Unstable angina (within 12 months of study entry)
- New York Heart Association (NYHA) grade II or higher congestive heart failure
- Evidence of bleeding diathesis/coagulopathy
- Serious non-healing wound or bone fracture
Patients with a history of the following within 28 days prior to registration are not eligible:
- Abdominal fistula
- Gastrointestinal perforation
- Intrabdominal abscess
Patients with a history of the following within 28 days prior to day 0 (first treatment day) are not eligible:
- Major surgical procedure
- Open biopsy
- Significant traumatic injury
- Patients must not have core biopsy within 7 days prior to day 0 (first treatment day)
Patients with prothrombin time (PT) (international normalized ratio [INR]) > 1.5 are not eligible, unless the patient is on full-dose anticoagulants; if so, the following criteria must be met for enrollment:
- The subject must have an in-range INR (usually between 2 and 3), be on a stable dose of warfarin or on a stable dose of low molecular weight heparin
- The subject must not have active bleeding or a pathological condition that is associated with a high risk of bleeding
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 치료
- 할당: 해당 없음
- 중재 모델: 단일 그룹 할당
- 마스킹: 없음(오픈 라벨)
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
|---|---|
|
실험적: Treatment (bevacizumab and chemoradiotherapy)
See Detailed Description
|
주어진 IV
다른 이름들:
주어진 IV
다른 이름들:
주어진 IV
다른 이름들:
주어진 PO
다른 이름들:
주어진 IV
다른 이름들:
수술적 절제술을 받다
방사선 치료를 받다
다른 이름들:
|
연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
|
Pathologic Complete Response Rate
기간: Assessed at surgery time
|
Pathologic complete response to preoperative therapy was determined at the time of surgical resection.
Pathologic complete response (pCR) is defined as no evidence of invasive cells on pathologic examination of the primary rectal cancer (or tissue from the area where the tumor had been if there is a complete clinical response).
Pathologic complete response rate is calculated as number of patients achieving pathologic complete response divided by all eligible and treated patients
|
Assessed at surgery time
|
2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
|
Resection Rate for T3 Rectal Cancers
기간: Assessed at surgery time
|
Resection rate is defined as number of patients with T3 rectal cancer who underwent curative surgical resection among all eligible and treated patients with T3 rectal cancers
|
Assessed at surgery time
|
|
Resection Rate for T4 Rectal Cancers
기간: Assessed at surgery time
|
Resection rate is defined as number of patients with T4 rectal cancer who underwent curative surgical resection among all eligible and treated patients with T4 rectal cancers
|
Assessed at surgery time
|
|
5-year Overall Survival Rate
기간: survival follow-up began after post-operative chemotherapy, assessed every 3 months for patients 3-5 years from registration, every 6 months for patients 5-10 years from registration and every 12 months for patients 10 years from registration
|
Overall survival is defined as time from registration to death from any cause.
5-year overall survival rate is estimated using Kaplan-Meier method.
|
survival follow-up began after post-operative chemotherapy, assessed every 3 months for patients 3-5 years from registration, every 6 months for patients 5-10 years from registration and every 12 months for patients 10 years from registration
|
|
5-year Recurrence-free Survival Rate
기간: recurrence follow-up began after post-operative chemotherapy, assessed every 3 months for patients 3-5 years from registration, every 6 months for patients 5-10 years from registration and every 12 months for patients 10 years from registration
|
Recurrence free survival is defined as time from surgery to disease recurrence or death without recurrence (whichever occurred first) among resected patients.
5-year recurrence-free survival rate is estimated using Kaplan-Meier method, with 90% confidence interval calculated using Greenwood's formula.
|
recurrence follow-up began after post-operative chemotherapy, assessed every 3 months for patients 3-5 years from registration, every 6 months for patients 5-10 years from registration and every 12 months for patients 10 years from registration
|
공동 작업자 및 조사자
수사관
- 수석 연구원: Jerome C Landry, ECOG-ACRIN Cancer Research Group
간행물 및 유용한 링크
연구 기록 날짜
연구 주요 날짜
연구 시작 (실제)
기본 완료 (실제)
연구 완료 (실제)
연구 등록 날짜
최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (추정)
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
추가 정보
이 연구와 관련된 용어
추가 관련 MeSH 약관
- 소화기계 질환
- 신생물
- 부위별 신생물
- 위장관 신생물
- 소화계 신생물
- 위장병
- 장 질환
- 장 신생물
- 직장 질환
- 대장 신생물
- 직장 신생물
- 약물의 생리적 효과
- 약리작용의 분자기전
- 항대사물질, 항종양
- 항대사물질
- 항종양제
- 면역억제제
- 면역학적 요인
- 보호제
- 혈관신생 억제제
- 혈관신생 조절제
- 성장 물질
- 성장 억제제
- 미량 영양소
- 비타민
- 골밀도 보존제
- 칼슘 조절 호르몬 및 작용제
- 해독제
- 비타민 B 복합체
- 혈액학
- 항체
- 플루오로우라실
- 카페시타빈
- 옥살리플라틴
- 면역글로불린
- 베바시주맙
- 류코보린
- 칼슘
- 레볼류코보린
- 항체, 단클론
- 항종양제, 면역학적
- 엽산
- 칼슘, 식이
- 면역글로불린 G
- 내피 성장 인자
기타 연구 ID 번호
- NCI-2009-01081 (레지스트리 식별자: CTRP (Clinical Trial Reporting Program))
- U10CA180820 (미국 NIH 보조금/계약)
- U10CA021115 (미국 NIH 보조금/계약)
- CDR0000471148
- ECOG-E3204
- E3204 (기타 식별자: CTEP)
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