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Testando a quimioterapia com bomba além da quimioterapia padrão versus a quimioterapia padrão isolada para pacientes com metástases hepáticas colorretais irressecáveis: o estudo PUMP

21 de setembro de 2026 atualizado por: ECOG-ACRIN Cancer Research Group

Um estudo randomizado de fase III de terapia sistêmica com ou sem infusão arterial hepática para metástases hepáticas colorretais irressecáveis: o estudo PUMP

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

Visão geral do estudo

Status

Recrutamento

Condições

Intervenção / Tratamento

Descrição detalhada

PRIMARY OBJECTIVE:

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

SECONDARY OBJECTIVES:

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

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

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

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

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

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

OUTLINE: Patients are randomized to 1 of 2 arms.

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

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

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

Tipo de estudo

Intervencional

Inscrição (Estimado)

408

Estágio

  • Fase 3

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Locais de estudo

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

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

18 anos e mais velhos (Adulto, Adulto mais velho)

Aceita Voluntários Saudáveis

Não

Gêneros Elegíveis para o Estudo

Tudo

Descrição

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

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Tratamento
  • Alocação: Randomizado
  • Modelo Intervencional: Atribuição Paralela
  • Mascaramento: Nenhum (rótulo aberto)

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Experimental: 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.
Medicamento: Fluorouracil

Given IV

Outros nomes:
  • 5-Fluracil
  • Fluracil
  • 5 Fluorouracil
  • 5 Fluorouracilo
  • 5FU
  • 5-Fluoro-2,4(1H, 3H)-pirimidinadiona
  • 5-Fluorouracil
  • 5-Fu
  • AccuSite
  • Carac
  • Fluoro Uracil
  • Fluuracila
  • Flurablastina
  • Fluracedil
  • Fluril
  • Fluroblastina
  • Ribofluor
  • Ro 2-9757
  • Ro-2-9757
Procedimento: Magnetic Resonance Imaging

Undergo MRI

Outros nomes:
  • Ressonância magnética
  • Varredura de imagem por ressonância magnética
  • Imagem Médica, Ressonância Magnética / Ressonância Magnética Nuclear
  • SENHOR
  • Exame de ressonância magnética
  • Imagem NMR
  • Ressonância Magnética Nuclear
  • Ressonância Magnética (MRI)
  • ressonância magnética
  • Ressonância magnética (procedimento)
  • Ressonâncias magnéticas
  • RM estrutural
Biológico: Panitumumab

Given IV

Outros nomes:
  • ABX-EGF
  • Anticorpo Monoclonal ABX-EGF
  • ABX-EGF, Clone E7.6.3
  • MoAb ABX-EGF
  • Vectibix
  • E7.6.3
  • Anticorpo Monoclonal IgG2K Humano
  • MoAb E7.6.3
  • Anticorpo Monoclonal E7.6.3
Medicamento: Oxaliplatin

Given IV

Outros nomes:
  • 1-OHP
  • Dacotin
  • Dacplat
  • Eloxatina
  • Ai Heng
  • Aiheng
  • Diaminociclohexano Oxalatoplatina
  • JM-83
  • Oxalatoplatina
  • RP 54780
  • RP-54780
  • SR-96669
  • SR96669
  • Elplat
  • Marcos 83
  • JM83
  • RP54780
  • RS 96669
Medicamento: Leucovorin

Given IV

Outros nomes:
  • Ácido folínico
Biológico: Cetuximab

Given IV

Outros nomes:
  • C225
  • Erbitux
  • IMC-C225
  • Cetuximabe Biossimilar CDP-1
  • Cetuximabe Biossimilar CMAB009
  • Cetuximabe Biossimilar KL 140
  • Anticorpo Monoclonal Quimérico Anti-EGFR
  • Quimérico MoAb C225
  • Anticorpo Monoclonal Quimérico C225
  • C-225
  • C 225
  • Cetuximab-cetu
  • Cetuxa
  • ENZ 124
  • ENZ-124
  • ENZ124
Medicamento: Irinotecan

Given IV

Medicamento: Floxuridine

Given via HAI pump

Outros nomes:
  • 5-Fluorodesoxiuridina
  • 5-Fluorouracil desoxirribosídeo
  • 5-FUdR
  • FDUR
  • Floxuridina
  • Fluorodesoxiuridina
  • Fluorouridina Desoxirribose
  • Fluoruridina Desoxirribose
  • FUdR
  • WR-138720
  • 2'-Desoxi-5-fluorouridina
  • 5-Fluoro-2'-desoxiuridina
  • WR 138720
  • WR138720
Procedimento: Computed Tomography

Undergo SPECT/CT and/or CT

Outros nomes:
  • TC
  • GATO
  • Tomografia
  • Tomografia Axial Computadorizada
  • Tomografia computadorizada
  • tomografia
  • Tomografia axial computadorizada (procedimento)
  • Tomografia computadorizada (TC)
  • Diagnóstico Cat Scan
  • Tipo de serviço de varredura de gato diagnóstico
Procedimento: Implantation

Undergo surgery to place the HAI pump

Procedimento: Intrahepatic Infusion Procedure

Undergo HAI

Outros nomes:
  • Infusão da Artéria Hepática
  • HAI
  • Infusão Arterial Hepática
  • EU OI
  • Infusão intra-hepática
Procedimento: Single Photon Emission Computed Tomography

Undergo SPECT/CT

Outros nomes:
  • ST
  • Imagem Médica, Tomografia Computadorizada por Emissão de Fóton Único
  • Tomografia por emissão de fóton único
  • tomografia computadorizada por emissão de fóton único
  • SPECT
  • Imagem SPECT
  • VARREDURA DE ESPECIFICAÇÃO
  • SPET
  • tomografia computadorizada por emissão, fóton único
  • Tomografia computadorizada por emissão, fóton único
  • Emissão de fóton único computada
Comparador Ativo: 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.
Biológico: Bevacizumab

Given IV

Outros nomes:
  • AvastinName
  • ABP 215
  • Anti-VEGF
  • Anticorpo Monoclonal Humanizado Anti-VEGF
  • Anticorpo Monoclonal Anti-VEGF SIBP04
  • Anti-VEGF rhuMAb
  • Bevacizumabe awwb
  • Bevacizumabe Biossimilar ABP 215
  • Bevacizumabe Biossimilar BEVZ92
  • Bevacizumabe Biossimilar BI 695502
  • Bevacizumabe Biossimilar CBT 124
  • Bevacizumabe Biossimilar CT-P16
  • Bevacizumabe Biossimilar FKB238
  • Bevacizumabe Biossimilar GB-222
  • Bevacizumabe Biossimilar HD204
  • Bevacizumabe Biossimilar HLX04
  • Bevacizumabe Biossimilar IBI305
  • Bevacizumabe Biossimilar LY01008
  • Bevacizumabe Biossimilar MIL60
  • Bevacizumabe Biossimilar Mvasi
  • Bevacizumabe Biossimilar MYL-1402O
  • Bevacizumabe Biossimilar QL 1101
  • Bevacizumabe Biossimilar RPH-001
  • Bevacizumabe Biossimilar SCT501
  • Bevacizumabe Biossimilar Zirabev
  • Bevacizumabe-awwb
  • Bevacizumabe-bvzr
  • BP102
  • BP102 Biossimilar
  • HD204
  • Imunoglobulina G1 (fator de crescimento endotelial vascular anti-humano monoclonal de cadeia gama rhuMab-VEGF humano-camundongo), dissulfeto com cadeia leve rhuMab-VEGF monoclonal humano-camundongo, dímero
  • Mvasi
  • MYL-1402O
  • Anticorpo Monoclonal Anti-VEGF Humanizado Recombinante
  • rhuMab-VEGF
  • SCT501
  • SIBP 04
  • SIBP-04
  • SIBP04
  • Zirabev
  • Avegra
  • QL1101
  • IBI305
  • Byvasda
  • Bevacizumabe Biossimilar QL1101
  • BAT1706
  • BAT 1706
  • BAT-1706
  • Biossimilar BAT1706
  • Bevacizumabe Biossimilar BAT1706
  • Bevacizumabe-adcd
  • CT-P16
  • Vegzelma
  • Alymsys
  • ABP-215
  • ABP215
  • Aybintio
  • Bevacizumabe-aybi
  • Bevacizumabe-equi
  • Bevacizumabe-maly
  • Bevacizumabe-onbe
  • CT P16
  • CTP16
  • Equidacente
  • Onbevzi
  • Avzivi
  • Bevacizumabe Biossimilar MB02
  • Bevacizumabe-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
Medicamento: Fluorouracil

Given IV

Outros nomes:
  • 5-Fluracil
  • Fluracil
  • 5 Fluorouracil
  • 5 Fluorouracilo
  • 5FU
  • 5-Fluoro-2,4(1H, 3H)-pirimidinadiona
  • 5-Fluorouracil
  • 5-Fu
  • AccuSite
  • Carac
  • Fluoro Uracil
  • Fluuracila
  • Flurablastina
  • Fluracedil
  • Fluril
  • Fluroblastina
  • Ribofluor
  • Ro 2-9757
  • Ro-2-9757
Procedimento: Magnetic Resonance Imaging

Undergo MRI

Outros nomes:
  • Ressonância magnética
  • Varredura de imagem por ressonância magnética
  • Imagem Médica, Ressonância Magnética / Ressonância Magnética Nuclear
  • SENHOR
  • Exame de ressonância magnética
  • Imagem NMR
  • Ressonância Magnética Nuclear
  • Ressonância Magnética (MRI)
  • ressonância magnética
  • Ressonância magnética (procedimento)
  • Ressonâncias magnéticas
  • RM estrutural
Medicamento: Capecitabine

Given PO

Outros nomes:
  • Xeloda
  • Ro 09-1978/000
Biológico: Panitumumab

Given IV

Outros nomes:
  • ABX-EGF
  • Anticorpo Monoclonal ABX-EGF
  • ABX-EGF, Clone E7.6.3
  • MoAb ABX-EGF
  • Vectibix
  • E7.6.3
  • Anticorpo Monoclonal IgG2K Humano
  • MoAb E7.6.3
  • Anticorpo Monoclonal E7.6.3
Medicamento: Oxaliplatin

Given IV

Outros nomes:
  • 1-OHP
  • Dacotin
  • Dacplat
  • Eloxatina
  • Ai Heng
  • Aiheng
  • Diaminociclohexano Oxalatoplatina
  • JM-83
  • Oxalatoplatina
  • RP 54780
  • RP-54780
  • SR-96669
  • SR96669
  • Elplat
  • Marcos 83
  • JM83
  • RP54780
  • RS 96669
Medicamento: Leucovorin

Given IV

Outros nomes:
  • Ácido folínico
Biológico: Cetuximab

Given IV

Outros nomes:
  • C225
  • Erbitux
  • IMC-C225
  • Cetuximabe Biossimilar CDP-1
  • Cetuximabe Biossimilar CMAB009
  • Cetuximabe Biossimilar KL 140
  • Anticorpo Monoclonal Quimérico Anti-EGFR
  • Quimérico MoAb C225
  • Anticorpo Monoclonal Quimérico C225
  • C-225
  • C 225
  • Cetuximab-cetu
  • Cetuxa
  • ENZ 124
  • ENZ-124
  • ENZ124
Medicamento: Irinotecan

Given IV

Procedimento: Computed Tomography

Undergo SPECT/CT and/or CT

Outros nomes:
  • TC
  • GATO
  • Tomografia
  • Tomografia Axial Computadorizada
  • Tomografia computadorizada
  • tomografia
  • Tomografia axial computadorizada (procedimento)
  • Tomografia computadorizada (TC)
  • Diagnóstico Cat Scan
  • Tipo de serviço de varredura de gato diagnóstico

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
Overall survival (OS)
Prazo: 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

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
Progression free survival (PFS)
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: Up to 5 years

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

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Patrocinador

ECOG-ACRIN Cancer Research Group

Investigadores

  • Investigador principal: Michael Lidsky, ECOG-ACRIN Cancer Research Group

Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo (Real)

10 de abril de 2024

Conclusão Primária (Estimado)

30 de junho de 2029

Conclusão do estudo (Estimado)

30 de junho de 2029

Datas de inscrição no estudo

Enviado pela primeira vez

9 de maio de 2023

Enviado pela primeira vez que atendeu aos critérios de CQ

9 de maio de 2023

Primeira postagem (Real)

17 de maio de 2023

Atualizações de registro de estudo

Última Atualização Postada (Real)

24 de setembro de 2026

Última atualização enviada que atendeu aos critérios de controle de qualidade

21 de setembro de 2026

Última verificação

1 de setembro de 2026

Mais Informações

Termos relacionados a este estudo

Termos MeSH relevantes adicionais

Outros números de identificação do estudo

  • EA2222
  • U10CA180820 (Concessão/Contrato do NIH dos EUA)
  • EA2222 (Outro identificador: CTEP)
  • NCI-2023-02357 (Identificador de registro: CTRP (Clinical Trial Reporting Program))
  • EA2222 (Outro identificador: ECOG-ACRIN Cancer Research Group)

Informações sobre medicamentos e dispositivos, documentos de estudo

Estuda um medicamento regulamentado pela FDA dos EUA

Sim

Estuda um produto de dispositivo regulamentado pela FDA dos EUA

Não

Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .

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