- ICH GCP
- 미국 임상 시험 레지스트리
- 임상시험 NCT05863195
절제 불가능한 결장직장 간 전이가 있는 환자를 위한 치료 표준 화학 요법과 단독 치료 화학 요법에 펌프 화학 요법을 테스트: PUMP 시험
절제 불가능한 결장직장 간 전이에 대한 간동맥 주입 유무에 따른 전신 요법의 무작위 3상 연구: PUMP 시험
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.
연구 개요
상태
개입 / 치료
- 생물학적: Bevacizumab
- 의약품: Fluorouracil
- 절차: Magnetic Resonance Imaging
- 의약품: Capecitabine
- 생물학적: Panitumumab
- 의약품: Oxaliplatin
- 의약품: Leucovorin
- 생물학적: Cetuximab
- 의약품: Irinotecan
- 의약품: Floxuridine
- 절차: Computed Tomography
- 절차: Implantation
- 절차: Intrahepatic Infusion Procedure
- 절차: Single Photon Emission Computed Tomography
상세 설명
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.
연구 유형
등록 (추정된)
단계
- 3단계
연락처 및 위치
연구 장소
-
-
Alabama
-
Birmingham, Alabama, 미국, 35233
- 빼는
- University of Alabama at Birmingham Cancer Center
-
-
Arizona
-
Gilbert, Arizona, 미국, 85234
- 모병
- Banner MD Anderson Cancer Center
-
연락하다:
- Site Public Contact
- 전화번호: 602-747-9738
-
수석 연구원:
- Rajesh Ramanathan
-
Phoenix, Arizona, 미국, 85006
- 모병
- Banner-University Medical Center Phoenix
-
연락하다:
- Site Public Contact
- 이메일: BannerResearch@bannerhealth.com
-
수석 연구원:
- Rajesh Ramanathan
-
Sun City, Arizona, 미국, 85351
- 모병
- Banner Boswell Medical Center
-
연락하다:
- Site Public Contact
- 전화번호: 480-440-7458
- 이메일: BMDACCResearch@bannerhealth.com
-
수석 연구원:
- Rajesh Ramanathan
-
-
Colorado
-
Aurora, Colorado, 미국, 80045
- 모병
- UCHealth University of Colorado Hospital
-
연락하다:
- Site Public Contact
- 전화번호: 720-848-0650
-
수석 연구원:
- Alexis D. Leal
-
-
Florida
-
Aventura, Florida, 미국, 33180
- 모병
- UM Sylvester Comprehensive Cancer Center at Aventura
-
수석 연구원:
- Jashodeep Datta
-
연락하다:
- Site Public Contact
- 전화번호: 954-461-2180
-
Coral Gables, Florida, 미국, 33146
- 모병
- UM Sylvester Comprehensive Cancer Center at Coral Gables
-
수석 연구원:
- Jashodeep Datta
-
연락하다:
- Site Public Contact
- 전화번호: 305-243-2647
-
Deerfield Beach, Florida, 미국, 33442
- 모병
- UM Sylvester Comprehensive Cancer Center at Deerfield Beach
-
수석 연구원:
- Jashodeep Datta
-
연락하다:
- Site Public Contact
- 전화번호: 305-243-2647
-
Hollywood, Florida, 미국, 33021
- 모병
- UM Sylvester Comprehensive Cancer Center at Hollywood
-
수석 연구원:
- Jashodeep Datta
-
연락하다:
- Site Public Contact
- 전화번호: 305-243-2647
-
Miami, Florida, 미국, 33136
- 모병
- University of Miami Miller School of Medicine-Sylvester Cancer Center
-
수석 연구원:
- Jashodeep Datta
-
연락하다:
- Site Public Contact
- 전화번호: 305-243-2647
-
Miami, Florida, 미국, 33176
- 모병
- UM Sylvester Comprehensive Cancer Center at Kendall
-
수석 연구원:
- Jashodeep Datta
-
연락하다:
- Site Public Contact
- 전화번호: 305-243-2647
-
Plantation, Florida, 미국, 33324
- 모병
- UM Sylvester Comprehensive Cancer Center at Plantation
-
수석 연구원:
- Jashodeep Datta
-
연락하다:
- Site Public Contact
- 전화번호: 305-243-2647
-
-
Georgia
-
Atlanta, Georgia, 미국, 30322
- 모병
- Emory University Hospital/Winship Cancer Institute
-
연락하다:
- Site Public Contact
- 전화번호: 404-778-1868
-
수석 연구원:
- Olumide B. Gbolahan
-
Atlanta, Georgia, 미국, 30342
- 모병
- Emory Saint Joseph's Hospital
-
수석 연구원:
- Olumide B. Gbolahan
-
연락하다:
- Site Public Contact
- 전화번호: 404-851-7115
-
-
Illinois
-
Chicago, Illinois, 미국, 60637
- 모병
- University of Chicago Comprehensive Cancer Center
-
연락하다:
- Site Public Contact
- 전화번호: 773-702-8222
- 이메일: cancerclinicaltrials@bsd.uchicago.edu
-
수석 연구원:
- Ryan Merkow
-
Chicago, Illinois, 미국, 60611
- 모병
- Northwestern University
-
연락하다:
- Site Public Contact
- 전화번호: 312-695-1301
- 이메일: cancer@northwestern.edu
-
수석 연구원:
- Shishir K. Maithel
-
Chicago, Illinois, 미국, 60641
- 모병
- Northwestern Medicine Cancer Center Old Irving Park
-
수석 연구원:
- Shishir K. Maithel
-
연락하다:
- Site Public Contact
- 이메일: nctnprogram_rhlccc@northwestern.edu
-
Shiloh, Illinois, 미국, 62269
- 빼는
- Memorial Hospital East
-
-
Indiana
-
Carmel, Indiana, 미국, 46032
- 모병
- IU Health North Hospital
-
연락하다:
- Site Public Contact
- 전화번호: 317-278-5632
- 이메일: iutrials@iu.edu
-
수석 연구원:
- Anita Turk
-
Indianapolis, Indiana, 미국, 46202
- 모병
- Indiana University/Melvin and Bren Simon Cancer Center
-
연락하다:
- Site Public Contact
- 전화번호: 317-278-5632
- 이메일: iutrials@iu.edu
-
수석 연구원:
- Anita Turk
-
-
Kentucky
-
Lexington, Kentucky, 미국, 40536
- 모병
- University of Kentucky/Markey Cancer Center
-
수석 연구원:
- Michael J. Cavnar
-
연락하다:
- Site Public Contact
- 전화번호: 859-257-3379
-
-
Michigan
-
Ann Arbor, Michigan, 미국, 48109
- 모병
- University of Michigan Rogel Cancer Center
-
수석 연구원:
- Benjamin D. Ferguson
-
연락하다:
- Site Public Contact
- 전화번호: 800-865-1125
- 이메일: CancerAnswerLine@med.umich.edu
-
Grand Rapids, Michigan, 미국, 49503
- 모병
- Corewell Health Grand Rapids Hospitals - Butterworth Hospital
-
연락하다:
- Site Public Contact
- 전화번호: 616-391-1230
- 이메일: crcwm-regulatory@crcwm.org
-
수석 연구원:
- Kathleen Y. Butler
-
-
Minnesota
-
Minneapolis, Minnesota, 미국, 55455
- 모병
- University of Minnesota/Masonic Cancer Center
-
연락하다:
- Site Public Contact
- 전화번호: 612-624-2620
-
수석 연구원:
- Ajay Prakash
-
Rochester, Minnesota, 미국, 55905
- 모병
- Mayo Clinic in Rochester
-
연락하다:
- Site Public Contact
- 전화번호: 855-776-0015
-
수석 연구원:
- Cornelius A. Thiels
-
-
Missouri
-
City of Saint Peters, Missouri, 미국, 63376
- 빼는
- Siteman Cancer Center at Saint Peters Hospital
-
Creve Coeur, Missouri, 미국, 63141
- 빼는
- Siteman Cancer Center at West County Hospital
-
St Louis, Missouri, 미국, 63110
- 빼는
- Washington University School of Medicine
-
St Louis, Missouri, 미국, 63129
- 빼는
- Siteman Cancer Center-South County
-
St Louis, Missouri, 미국, 63136
- 빼는
- Siteman Cancer Center at Christian Hospital
-
-
New Jersey
-
Basking Ridge, New Jersey, 미국, 07920
- 모병
- Memorial Sloan Kettering Basking Ridge
-
연락하다:
- Site Public Contact
- 전화번호: 212-639-7592
-
수석 연구원:
- Andrea Cercek
-
Middletown, New Jersey, 미국, 07748
- 모병
- Memorial Sloan Kettering Monmouth
-
연락하다:
- Site Public Contact
- 전화번호: 212-639-7592
-
수석 연구원:
- Andrea Cercek
-
Montvale, New Jersey, 미국, 07645
- 모병
- Memorial Sloan Kettering Bergen
-
연락하다:
- Site Public Contact
- 전화번호: 212-639-7592
-
수석 연구원:
- Andrea Cercek
-
-
New York
-
Buffalo, New York, 미국, 14263
- 모병
- Roswell Park Cancer Institute
-
수석 연구원:
- Anuradha Krishnamurthy
-
연락하다:
- Site Public Contact
- 전화번호: 800-767-9355
- 이메일: askroswell@roswellpark.org
-
Commack, New York, 미국, 11725
- 모병
- Memorial Sloan Kettering Commack
-
연락하다:
- Site Public Contact
- 전화번호: 212-639-7592
-
수석 연구원:
- Andrea Cercek
-
East White Plains, New York, 미국, 10604
- 모병
- Memorial Sloan Kettering Westchester
-
연락하다:
- Site Public Contact
- 전화번호: 212-639-7592
-
수석 연구원:
- Andrea Cercek
-
New York, New York, 미국, 10065
- 모병
- Memorial Sloan Kettering Cancer Center
-
연락하다:
- Site Public Contact
- 전화번호: 212-639-7592
-
수석 연구원:
- Andrea Cercek
-
New York, New York, 미국, 10029
- 모병
- Mount Sinai Hospital
-
연락하다:
- Site Public Contact
- 전화번호: 212-824-7309
- 이메일: CCTO@mssm.edu
-
수석 연구원:
- James O. Park
-
Uniondale, New York, 미국, 11553
- 모병
- Memorial Sloan Kettering Nassau
-
연락하다:
- Site Public Contact
- 전화번호: 212-639-7592
-
수석 연구원:
- Andrea Cercek
-
-
North Carolina
-
Durham, North Carolina, 미국, 27710
- 모병
- Duke University Medical Center
-
연락하다:
- Site Public Contact
- 전화번호: 888-275-3853
-
수석 연구원:
- Hope E. Uronis
-
Raleigh, North Carolina, 미국, 27609
- 모병
- Duke Cancer Center Raleigh
-
수석 연구원:
- Hope E. Uronis
-
연락하다:
- Site Public Contact
- 이메일: NCTNStudyTeam@dm.duke.edu
-
Winston-Salem, North Carolina, 미국, 27157
- 모병
- Wake Forest University Health Sciences
-
수석 연구원:
- Perry Shen
-
연락하다:
- Site Public Contact
- 전화번호: 336-713-6771
-
-
Ohio
-
Cleveland, Ohio, 미국, 44106
- 모집하지 않고 적극적으로
- Case Western Reserve University
-
Columbus, Ohio, 미국, 43210
- 모병
- Ohio State University Comprehensive Cancer Center
-
연락하다:
- Site Public Contact
- 전화번호: 800-293-5066
- 이메일: Jamesline@osumc.edu
-
수석 연구원:
- Alex B. Blair
-
Youngstown, Ohio, 미국, 44501
- 모병
- Saint Elizabeth Youngstown Hospital
-
연락하다:
- Site Public Contact
- 전화번호: 937-528-2900
- 이메일: clinical.trials@daytonncorp.org
-
수석 연구원:
- Howard M. Gross
-
-
Oregon
-
Portland, Oregon, 미국, 97239
- 모병
- Oregon Health and Science University
-
연락하다:
- Site Public Contact
- 전화번호: 503-494-1080
- 이메일: trials@ohsu.edu
-
수석 연구원:
- Skye C. Mayo
-
-
Pennsylvania
-
Allentown, Pennsylvania, 미국, 18103
- 모병
- Lehigh Valley Hospital-Cedar Crest
-
연락하다:
- Site Public Contact
- 전화번호: 610-402-9543
- 이메일: Morgan_M.Horton@lvhn.org
-
수석 연구원:
- Tareq Al baghdadi
-
Erie, Pennsylvania, 미국, 16544
- 모병
- Saint Vincent Hospital
-
연락하다:
- Site Public Contact
- 전화번호: 814-452-5000
-
수석 연구원:
- Patrick L. Wagner
-
Jefferson Hills, Pennsylvania, 미국, 15025
- 모병
- Jefferson Hospital
-
연락하다:
- Site Public Contact
- 전화번호: 412-359-3043
- 이메일: ddefazio@wpahs.org
-
수석 연구원:
- Patrick L. Wagner
-
Monroeville, Pennsylvania, 미국, 15146
- 모병
- Forbes Hospital
-
연락하다:
- Site Public Contact
- 전화번호: 412-858-7746
-
수석 연구원:
- Patrick L. Wagner
-
Philadelphia, Pennsylvania, 미국, 19111
- 모병
- Fox Chase Cancer Center
-
연락하다:
- Site Public Contact
- 전화번호: 215-728-4790
-
수석 연구원:
- Vanessa Wookey
-
Pittsburgh, Pennsylvania, 미국, 15224
- 모병
- West Penn Hospital
-
연락하다:
- Site Public Contact
- 전화번호: 412-578-5000
-
수석 연구원:
- Patrick L. Wagner
-
Pittsburgh, Pennsylvania, 미국, 15212
- 모병
- Allegheny General Hospital
-
연락하다:
- Site Public Contact
- 전화번호: 877-284-2000
-
수석 연구원:
- Patrick L. Wagner
-
Wexford, Pennsylvania, 미국, 15090
- 모병
- Wexford Health and Wellness Pavilion
-
연락하다:
- Site Public Contact
- 이메일: Dawnmarie.DeFazio@ahn.org
-
수석 연구원:
- Patrick L. Wagner
-
-
Tennessee
-
Nashville, Tennessee, 미국, 37232
- 모병
- Vanderbilt University/Ingram Cancer Center
-
연락하다:
- Site Public Contact
- 전화번호: 800-811-8480
-
수석 연구원:
- Chandrasekhar Padmanabhan
-
-
Texas
-
Dallas, Texas, 미국, 75390
- 모병
- UT Southwestern/Simmons Cancer Center-Dallas
-
연락하다:
- Site Public Contact
- 전화번호: 214-648-7097
- 이메일: canceranswerline@UTSouthwestern.edu
-
수석 연구원:
- Adam C. Yopp
-
Dallas, Texas, 미국, 75235
- 모병
- Parkland Memorial Hospital
-
연락하다:
- Site Public Contact
- 전화번호: 214-590-5582
- 이메일: canceranswerline@UTSouthwestern.edu
-
수석 연구원:
- Adam C. Yopp
-
Dallas, Texas, 미국, 75237
- 모병
- UT Southwestern Simmons Cancer Center - RedBird
-
수석 연구원:
- Adam C. Yopp
-
연락하다:
- Site Public Contact
- 전화번호: 214-648-7097
- 이메일: canceranswerline@utsouthwestern.edu
-
Fort Worth, Texas, 미국, 76104
- 모병
- UT Southwestern/Simmons Cancer Center-Fort Worth
-
연락하다:
- Site Public Contact
- 전화번호: 214-648-7097
- 이메일: canceranswerline@UTSouthwestern.edu
-
수석 연구원:
- Adam C. Yopp
-
Richardson, Texas, 미국, 75080
- 모병
- UT Southwestern Clinical Center at Richardson/Plano
-
연락하다:
- Site Public Contact
- 전화번호: 972-669-7044
- 이메일: Suzanne.cole@utsouthwestern.edu
-
수석 연구원:
- Adam C. Yopp
-
-
Wisconsin
-
Madison, Wisconsin, 미국, 53792
- 모병
- University of Wisconsin Carbone Cancer Center - University Hospital
-
연락하다:
- Site Public Contact
- 전화번호: 800-622-8922
- 이메일: clinicaltrials@cancer.wisc.edu
-
수석 연구원:
- Patrick Varley
-
Madison, Wisconsin, 미국, 53718
- 모병
- University of Wisconsin Carbone Cancer Center - Eastpark Medical Center
-
연락하다:
- Site Public Contact
- 전화번호: 800-622-8922
- 이메일: clinicaltrials@cancer.wisc.edu
-
수석 연구원:
- Patrick Varley
-
-
참여기준
자격 기준
공부할 수 있는 나이
건강한 자원 봉사자를 받아들입니다
연구 대상 성별
설명
Inclusion Criteria:
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Patient must be >= 18 years of age
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Patient must have confirmed unresectable liver confined metastatic colorectal cancer (CRC).
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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.
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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.
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Patient's primary tumor may be in place
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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
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Patient must have measurable disease
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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
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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.
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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.
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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.
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Patient must not have a liver tumor burden exceeding 70% of total liver volume.
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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).
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Patient must not have had prior trans-arterial bland embolization, chemoembolization (TACE) or radioembolization (TARE).
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Patient must not have had prior treatment with HAI/floxuridine (FUDR)
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Patient must not have microsatellite instability-high (MSI-H) colorectal cancer.
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Patient must not have CRLM that could be resected with 2-stage hepatectomy, including associating liver partition and portal vein ligation (ALPPS).
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Patient must not have an active infection, serious or non-healing active wound, ulcer, or bone fracture.
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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.
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Patient must not have cirrhosis and/or clinical or radiographic evidence of portal hypertension
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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)
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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.
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Leukocytes >= 3,000/mcL (obtained =< 28 days prior to protocol randomization)
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Absolute neutrophil count (ANC) >= 1,500/mcL (obtained =< 28 days prior to protocol randomization)
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Platelets >= 100,000/mcL (obtained =< 28 days prior to protocol randomization)
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Total Bilirubin =< 1.5 mg/dL (obtained =< 28 days prior to protocol randomization)
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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)
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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)
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Calcium >= institutional lower limit of normal (LLN)
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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.
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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
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 치료
- 할당: 무작위
- 중재 모델: 병렬 할당
- 마스킹: 없음(오픈 라벨)
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
|---|---|
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실험적: 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. |
Given IV
다른 이름들:
Undergo MRI
다른 이름들:
Given IV
다른 이름들:
Given IV
다른 이름들:
Given IV
다른 이름들:
Given IV
다른 이름들:
Given IV Given via HAI pump
다른 이름들:
Undergo SPECT/CT and/or CT
다른 이름들:
Undergo surgery to place the HAI pump Undergo HAI
다른 이름들:
Undergo SPECT/CT
다른 이름들:
|
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활성 비교기: 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. |
Given IV
다른 이름들:
Given IV
다른 이름들:
Undergo MRI
다른 이름들:
Given PO
다른 이름들:
Given IV
다른 이름들:
Given IV
다른 이름들:
Given IV
다른 이름들:
Given IV
다른 이름들:
Given IV Undergo SPECT/CT and/or CT
다른 이름들:
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연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
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Overall survival (OS)
기간: From randomization to death from any cause, assessed up to 5 years
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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
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2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
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Progression free survival (PFS)
기간: From randomization to first observed disease progression at any site, or death from any cause, assessed up to 5 years
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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
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Hepatic PFS
기간: From randomization to first observed disease progression in the liver, or death from any cause, assessed up to 5 years
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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
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Extrahepatic-PFS
기간: From randomization to first observed disease progression outside of the liver, or death from any cause, assessed up to 5 years
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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
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Objective response rate
기간: Up to 5 years
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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
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Rate of conversion to resectable disease
기간: Up to 5 years
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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
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Intra-operative ineligibility rate
기간: Up to 5 years
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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
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Incidence of adverse events
기간: Up to 5 years
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Defined according to the Common Terminology Criteria for Adverse Events. |
Up to 5 years
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공동 작업자 및 조사자
수사관
- 수석 연구원: Michael Lidsky, ECOG-ACRIN Cancer Research Group
연구 기록 날짜
연구 주요 날짜
연구 시작 (실제)
기본 완료 (추정된)
연구 완료 (추정된)
연구 등록 날짜
최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (실제)
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
- 부위별 신생물
- 신생물
- 장 질환
- 위장관 신생물
- 소화계 신생물
- 소화기계 질환
- 위장병
- 장 신생물
- 직장 질환
- 결장 질환
- 대장 신생물
- 아미노산, 펩티드 및 단백질
- 단백질
- 황 화합물
- 유기 화학 물질
- 이종 사이 클릭 화합물, 1- 링
- 이종 사이 클릭 화합물
- 이종 사이 클릭 화합물, 2- 링
- 이종 사이 클릭 화합물, 융합 링
- 제약 준비
- 조사 기술
- 복용량 형태
- 핵산, 뉴클레오티드 및 뉴 클레오 시드
- 물리적 현상
- Camptothecin
- 알칼로이드
- 효소 및 코엔자임
- 항체, 모노클로 날, 인간화
- 항체, 모노클로 날
- 항체
- 면역 글로불린
- 면역 단백질
- 혈액 단백질
- 혈청 글로불린
- 글로불린
- 무기 화학 물질
- 조정 복합체
- 데 옥시 시티 딘
- 시티 딘
- 피리 미딘 뉴 클레오 시드
- 피리 미딘
- 화학 기술, 분석
- 스펙트럼 분석
- 뉴 클레오 시드
- Formyltetrahydrofolates
- 테트라 하이드로 폴 레이트
- 엽산
- Pterins
- Teridines
- 우라실
- 피리 미디 논
- 코엔자임
- 면역 글로불린 이소 타입
- 황화물
- 음이온
- 이온
- 전해질
- 황화수소
- 전자기 현상
- 자기 현상
- 데 옥시 리보 뉴 클레오 시드
- 전자기 방사선
- 방사
- 방사선, 이온화
- 기본 입자
- 빛
- 광학 현상
- 방사선, 비 이온화
- 데 옥시 우리 딘
- 우리 딘
- 지연 조치 준비
- 카페시타빈
- 옥살리플라틴
- 베바시주맙
- 이리노테칸
- 파니투무맙
- 세툭시맙
- 플루오로우라실
- 류코보린
- 면역글로불린 G
- 플록수리딘
- 자기 공명 분광법
- 이황화
- 엑스선
- 광자
- Dehydroftorafur
- (225) AC-DOTA-C (RGDYK)
- 5- 플루오로 -2'- 데 옥시 루리 딘
- 약물 임플란트
기타 연구 ID 번호
- EA2222
- U10CA180820 (미국 NIH 보조금/계약)
- EA2222 (기타 식별자: CTEP)
- NCI-2023-02357 (레지스트리 식별자: CTRP (Clinical Trial Reporting Program))
- EA2222 (기타 식별자: ECOG-ACRIN Cancer Research Group)
약물 및 장치 정보, 연구 문서
미국 FDA 규제 의약품 연구
미국 FDA 규제 기기 제품 연구
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