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Testing av pumpekjemoterapi i tillegg til standard kjemoterapi versus standard kjemoterapi alene for pasienter med ikke-operable kolorektale levermetastaser: PUMP-forsøket

21. september 2026 oppdatert av: ECOG-ACRIN Cancer Research Group

En randomisert fase III-studie av systemisk terapi med eller uten hepatisk arteriell infusjon for ikke-operable kolorektale levermetastaser: PUMP-forsøket

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.

Studieoversikt

Status

Rekruttering

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

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.

Studietype

Intervensjonell

Registrering (Antatt)

408

Fase

  • Fase 3

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

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

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år og eldre (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

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

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: 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.
Legemiddel: Fluorouracil

Given IV

Andre navn:
  • 5-Fluracil
  • Fluracil
  • 5 Fluorouracil
  • 5 Fluorouracilum
  • 5 FU
  • 5-fluor-2,4(1H,3H)-pyrimidindion
  • 5-Fluorouracil
  • 5-Fu
  • 5FU
  • AccuSite
  • Carac
  • Fluoro Uracil
  • Fluouracil
  • Flurablastin
  • Fluracedyl
  • Fluril
  • Fluroblastin
  • Ribofluor
  • Ro 2-9757
  • Ro-2-9757
Fremgangsmåte: Magnetic Resonance Imaging

Undergo MRI

Andre navn:
  • MR
  • Magnetisk resonans
  • Magnetic Resonance Imaging Scan
  • Medisinsk bildebehandling, magnetisk resonans / kjernemagnetisk resonans
  • MR Imaging
  • MR-skanning
  • NMR-avbildning
  • NMRI
  • Kjernemagnetisk resonansavbildning
  • Magnetisk resonanstomografi (MR)
  • sMRI
  • Magnetisk resonansavbildning (prosedyre)
  • MR-er
  • Strukturell MR
Biologisk: Panitumumab

Given IV

Andre navn:
  • ABX-EGF
  • ABX-EGF monoklonalt antistoff
  • ABX-EGF, klon E7.6.3
  • MoAb ABX-EGF
  • Monoklonalt antistoff ABX-EGF
  • Vectibix
  • E7.6.3
  • Humant IgG2K monoklonalt antistoff
  • MoAb E7.6.3
  • Monoklonalt antistoff E7.6.3
Legemiddel: Oxaliplatin

Given IV

Andre navn:
  • 1-OHP
  • Dakotin
  • Dacplat
  • Eloxatin
  • Ai Heng
  • Aiheng
  • Diaminocykloheksan oksalatoplatina
  • JM-83
  • Oksalatoplatin
  • Oksalatoplatina
  • RP 54780
  • RP-54780
  • SR-96669
  • SR96669
  • Elplat
  • JM 83
  • JM83
  • RP54780
  • SR 96669
Legemiddel: Leucovorin

Given IV

Andre navn:
  • Folinsyre
Biologisk: Cetuximab

Given IV

Andre navn:
  • C225
  • Erbitux
  • IMC-C225
  • Cetuximab Biosimilar CDP-1
  • Cetuximab Biosimilar CMAB009
  • Cetuximab Biosimilar KL 140
  • Kimerisk anti-EGFR monoklonalt antistoff
  • Kimerisk MoAb C225
  • Kimerisk monoklonalt antistoff C225
  • C-225
  • C 225
  • Cetuximab-cetu
  • Cetuxa
  • ENZ 124
  • ENZ-124
  • ENZ124
Legemiddel: Irinotecan

Given IV

Legemiddel: Floxuridine

Given via HAI pump

Andre navn:
  • 5-fluordeoksyuridin
  • 5-Fluorouracil deoksyribosid
  • 5-FUdR
  • FDUR
  • Floxuridin
  • Fluorodeoksyuridin
  • Fluorouridin deoksyribose
  • Fluoruridin deoksyribose
  • FUdR
  • WR-138720
  • 2'-deoksy-5-fluoruridin
  • 5-fluor-2'-deoksyuridin
  • WR 138720
  • WR138720
Fremgangsmåte: Computed Tomography

Undergo SPECT/CT and/or CT

Andre navn:
  • CT
  • KATT
  • CAT-skanning
  • Beregnet aksial tomografi
  • Datastyrt aksialtomografi
  • Datastyrt tomografi
  • CT skann
  • tomografi
  • Datastyrt aksial tomografi (prosedyre)
  • Datastyrt tomografi (CT) skanning
  • Diagnostisk CAT -skanning
  • Diagnostisk CAT -skannertype
Fremgangsmåte: Implantation

Undergo surgery to place the HAI pump

Fremgangsmåte: Intrahepatic Infusion Procedure

Undergo HAI

Andre navn:
  • Leverarterieinfusjon
  • HAI
  • Arteriell leverinfusjon
  • IHI
  • Intrahepatisk infusjon
Fremgangsmåte: Single Photon Emission Computed Tomography

Undergo SPECT/CT

Andre navn:
  • ST
  • Medisinsk bildebehandling, enkeltfoton-emisjons-tomografi
  • Enkeltfotonutslippstomografi
  • enkeltfoton emisjon datatomografi
  • SPECT
  • SPECT-avbildning
  • SPECT SCAN
  • SPET
  • tomografi, emisjonsberegnet, enkelt foton
  • Tomografi, Emission-Computed, Single-Photon
  • Enkeltfotoutslipp beregnet
Aktiv komparator: 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.
Biologisk: Bevacizumab

Given IV

Andre navn:
  • Avastin
  • ABP 215
  • Anti-VEGF
  • Anti-VEGF humanisert monoklonalt antistoff
  • Anti-VEGF monoklonalt antistoff SIBP04
  • Anti-VEGF rhuMAb
  • Bevacizumab awwb
  • Bevacizumab Biosimilar ABP 215
  • Bevacizumab Biosimilar BEVZ92
  • Bevacizumab Biosimilar BI 695502
  • Bevacizumab Biosimilar CBT 124
  • Bevacizumab Biosimilar CT-P16
  • Bevacizumab Biosimilar FKB238
  • Bevacizumab Biosimilar GB-222
  • Bevacizumab Biosimilar HD204
  • Bevacizumab Biosimilar HLX04
  • Bevacizumab Biosimilar IBI305
  • Bevacizumab Biosimilar LY01008
  • Bevacizumab Biosimilar MIL60
  • Bevacizumab Biosimilar Mvasi
  • Bevacizumab Biosimilar MYL-1402O
  • Bevacizumab Biosimilar QL 1101
  • Bevacizumab Biosimilar RPH-001
  • Bevacizumab Biosimilar SCT501
  • Bevacizumab Biosimilar Zirabev
  • Bevacizumab-awwb
  • Bevacizumab-bvzr
  • BP102
  • BP102 Biosimilar
  • HD204
  • Immunoglobulin G1 (Human-mus monoklonal rhuMab-VEGF Gamma-kjede anti-human vaskulær endotelial vekstfaktor), disulfid med human-mus monoklonal rhuMab-VEGF lett kjede, dimer
  • Mvasi
  • MYL-1402O
  • Rekombinant humanisert anti-VEGF monoklonalt antistoff
  • rhuMab-VEGF
  • SCT501
  • SIBP 04
  • SIBP-04
  • SIBP04
  • Zirabev
  • Avegra
  • QL1101
  • IBI305
  • Byvasda
  • Bevacizumab Biosimilar QL1101
  • BAT1706
  • BAT 1706
  • BAT-1706
  • BAT1706 Biosimilar
  • Bevacizumab Biosimilar BAT1706
  • Bevacizumab-adcd
  • CT-P16
  • Vegzelma
  • Alymsys
  • ABP-215
  • ABP215
  • Aybintio
  • Bevacizumab-aybi
  • Bevacizumab-equi
  • Bevacizumab-maly
  • Bevacizumab-onbe
  • CT P16
  • CTP16
  • Likestilt
  • Onbevzi
  • Avzivi
  • Bevacizumab Biosimilar MB02
  • Bevacizumab-tnjn
  • FKB 238
  • FKB-238
  • FKB238
  • MB 02
  • MB-02
  • MB02
  • Oyavas
  • PF 06439535
  • PF-06439535
  • PF06439535
  • Bevacizumab-aveg
  • Bevacizumab-byva
  • Bevacizumab-nwgd
  • Jobevne
  • IBI 305
  • IBI-305
Legemiddel: Fluorouracil

Given IV

Andre navn:
  • 5-Fluracil
  • Fluracil
  • 5 Fluorouracil
  • 5 Fluorouracilum
  • 5 FU
  • 5-fluor-2,4(1H,3H)-pyrimidindion
  • 5-Fluorouracil
  • 5-Fu
  • 5FU
  • AccuSite
  • Carac
  • Fluoro Uracil
  • Fluouracil
  • Flurablastin
  • Fluracedyl
  • Fluril
  • Fluroblastin
  • Ribofluor
  • Ro 2-9757
  • Ro-2-9757
Fremgangsmåte: Magnetic Resonance Imaging

Undergo MRI

Andre navn:
  • MR
  • Magnetisk resonans
  • Magnetic Resonance Imaging Scan
  • Medisinsk bildebehandling, magnetisk resonans / kjernemagnetisk resonans
  • MR Imaging
  • MR-skanning
  • NMR-avbildning
  • NMRI
  • Kjernemagnetisk resonansavbildning
  • Magnetisk resonanstomografi (MR)
  • sMRI
  • Magnetisk resonansavbildning (prosedyre)
  • MR-er
  • Strukturell MR
Legemiddel: Capecitabine

Given PO

Andre navn:
  • Xeloda
  • Ro 09-1978/000
Biologisk: Panitumumab

Given IV

Andre navn:
  • ABX-EGF
  • ABX-EGF monoklonalt antistoff
  • ABX-EGF, klon E7.6.3
  • MoAb ABX-EGF
  • Monoklonalt antistoff ABX-EGF
  • Vectibix
  • E7.6.3
  • Humant IgG2K monoklonalt antistoff
  • MoAb E7.6.3
  • Monoklonalt antistoff E7.6.3
Legemiddel: Oxaliplatin

Given IV

Andre navn:
  • 1-OHP
  • Dakotin
  • Dacplat
  • Eloxatin
  • Ai Heng
  • Aiheng
  • Diaminocykloheksan oksalatoplatina
  • JM-83
  • Oksalatoplatin
  • Oksalatoplatina
  • RP 54780
  • RP-54780
  • SR-96669
  • SR96669
  • Elplat
  • JM 83
  • JM83
  • RP54780
  • SR 96669
Legemiddel: Leucovorin

Given IV

Andre navn:
  • Folinsyre
Biologisk: Cetuximab

Given IV

Andre navn:
  • C225
  • Erbitux
  • IMC-C225
  • Cetuximab Biosimilar CDP-1
  • Cetuximab Biosimilar CMAB009
  • Cetuximab Biosimilar KL 140
  • Kimerisk anti-EGFR monoklonalt antistoff
  • Kimerisk MoAb C225
  • Kimerisk monoklonalt antistoff C225
  • C-225
  • C 225
  • Cetuximab-cetu
  • Cetuxa
  • ENZ 124
  • ENZ-124
  • ENZ124
Legemiddel: Irinotecan

Given IV

Fremgangsmåte: Computed Tomography

Undergo SPECT/CT and/or CT

Andre navn:
  • CT
  • KATT
  • CAT-skanning
  • Beregnet aksial tomografi
  • Datastyrt aksialtomografi
  • Datastyrt tomografi
  • CT skann
  • tomografi
  • Datastyrt aksial tomografi (prosedyre)
  • Datastyrt tomografi (CT) skanning
  • Diagnostisk CAT -skanning
  • Diagnostisk CAT -skannertype

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Overall survival (OS)
Tidsramme: 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

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Progression free survival (PFS)
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: Up to 5 years

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

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

ECOG-ACRIN Cancer Research Group

Etterforskere

  • Hovedetterforsker: Michael Lidsky, ECOG-ACRIN Cancer Research Group

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

10. april 2024

Primær fullføring (Antatt)

30. juni 2029

Studiet fullført (Antatt)

30. juni 2029

Datoer for studieregistrering

Først innsendt

9. mai 2023

Først innsendt som oppfylte QC-kriteriene

9. mai 2023

Først lagt ut (Faktiske)

17. mai 2023

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

24. september 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

21. september 2026

Sist bekreftet

1. september 2026

Mer informasjon

Begreper knyttet til denne studien

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • EA2222
  • U10CA180820 (U.S. NIH-stipend/kontrakt)
  • EA2222 (Annen identifikator: CTEP)
  • NCI-2023-02357 (Registeridentifikator: CTRP (Clinical Trial Reporting Program))
  • EA2222 (Annen identifikator: ECOG-ACRIN Cancer Research Group)

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Ja

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .

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