Neoadjuvant Celecoxib and Capecitabine Combined With Pelvic Irradiation in Treating Patients With Stage II or Stage III Adenocarcinoma (Cancer) of the Rectum
A Phase II Trial Of Celecoxib (Celebrex) And Capecitabine (Xeloda) Combined With Pelvic Irradiation As Neoadjuvant Treatment Of Stage II or III Adenocarcinoma Of The Rectum
RATIONALE: Celecoxib may stop the growth of tumor cells by blocking the enzymes necessary for their growth. Drugs used in chemotherapy, such as capecitabine, work in different ways to stop tumor cells from dividing so they stop growing or die. Radiation therapy uses high-energy x-rays to damage tumor cells. Celecoxib may also make tumor cells more sensitive to chemotherapy and radiation therapy. Giving celecoxib with capecitabine and radiation therapy before surgery may shrink the tumor so that it can be removed.
PURPOSE: This phase II trial is studying how well giving neoadjuvant celecoxib together with capecitabine and pelvic irradiation works in treating patients with stage II or stage III adenocarcinoma (cancer) of the rectum.
研究概览
详细说明
OBJECTIVES:
Primary
- Determine the pathological complete response rate in patients with stage II or III adenocarcinoma of the rectum treated with neoadjuvant celecoxib and capecitabine in combination with pelvic irradiation.
Secondary
- Determine the safety and tolerability of this regimen in these patients.
- Determine the rectal function of patients treated with this regimen.
- Determine the time to recurrence or progression and survival time of patients treated with this regimen.
- Correlate cellular and molecular markers in pretreatment tumor samples with response in patients treated with this regimen.
OUTLINE: This is a multicenter study.
- Neoadjuvant chemoradiotherapy: Patients receive oral celecoxib twice daily on days 1-7 and oral capecitabine twice daily on days 1-5. Patients undergo pelvic radiotherapy once daily on days 1-5. Courses repeat weekly for 5.5 weeks.
- Surgery: Patients undergo surgery 4-6 weeks after completion of neoadjuvant chemoradiotherapy.
- Adjuvant chemotherapy: Patients with a curative resection receive oral capecitabine twice daily on days 1-14. Treatment repeats every 21 days for up to 4 courses.
Treatment continues in the absence of disease progression or unacceptable toxicity.
Patients are followed every 3 months for 1 year and then every 6 months for 4 years.
研究类型
注册 (实际的)
阶段
- 阶段2
参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
DISEASE CHARACTERISTICS:
Histologically confirmed rectal adenocarcinoma
- Clinical stage T3, N0, M0 OR any T, N1-3, M0 disease
Treatment with neoadjuvant chemotherapy and pelvic radiotherapy is indicated
- All disease must be encompassable within standard pelvic radiotherapy fields
- Distal border of the tumor must be at or below* the peritoneal reflection, defined as within 12 cm of the anal verge by endoscopy NOTE: *If a portion of the tumor is below the peritoneal reflection at the time of surgery, patients are eligible regardless of the distance of the tumor determined at endoscopy
Tumor must be determined to be clinically resectable
- Tumor may not be clinically fixed
- Negative margins by routine examination of an unanesthetized patient
- Transmural penetration of tumor through the muscularis propria by CT scan, endorectal ultrasound, or MRI
No distant metastatic disease
No evidence of tumor outside the pelvis, including any of the following:
- Metastatic inguinal lymphadenopathy
- Peritoneal seeding
- Liver metastases
PATIENT CHARACTERISTICS:
Age
- 18 and over
Performance status
- ECOG 0-1
Life expectancy
- At least 6 months
Hematopoietic
- Absolute neutrophil count ≥ 1,500/mm^3
- Platelet count ≥ 100,000/mm^3
Hepatic
- Bilirubin ≤ upper limit of normal (ULN)
- AST ≤ 3 times ULN
- Alkaline phosphatase ≤ 4 times ULN if AST < ULN
Renal
- Creatinine clearance ≥ 30 mL/min
- No renal impairment
Cardiovascular
- No congestive heart failure
- No symptomatic coronary artery disease
- No uncontrolled cardiac arrhythmias
- No myocardial infarction
- No history of transient ischemic attacks or stroke
- No other clinically significant cardiac disease
Gastrointestinal
- No bleeding peptic ulcer disease within the past 12 months
- No lack of physical integrity of the upper gastrointestinal tract
- No malabsorption syndrome
- No active inflammatory bowel disease
- Must be able to swallow study drugs
Other
- No dihydropyrimidine dehydrogenase deficiency
- No history of uncontrolled seizures
- No CNS disorders
- No clinically significant psychiatric illness that would preclude study compliance or giving informed consent
- No other malignancy within the past 5 years except basal cell or squamous cell skin cancer or carcinoma in situ of the cervix
- No known sensitivity to NSAIDs, sulfonamides, or aspirin
- No other serious medical illness that would preclude study treatment
- No other conditions that would preclude study participation
- Must be able to tolerate major surgery that may include abdominal-perineal resection
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception during and for 30 days after study treatment
PRIOR CONCURRENT THERAPY:
Biologic therapy
- Not specified
Chemotherapy
- See Disease Characteristics
- No prior systemic anticancer chemotherapy
Endocrine therapy
- Not specified
Radiotherapy
- See Disease Characteristics
- No prior radiotherapy to the pelvis
Surgery
- See Disease Characteristics
- More than 3 weeks since prior major surgery and recovered
Other
- At least 7 days since prior nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin
- No other concurrent investigational drugs
- No other concurrent anticancer treatment
- No concurrent NSAIDs
- No concurrent primary prophylactic therapy for hand-foot syndrome
- No concurrent loperamide prophylaxis for diarrhea
- No concurrent sorivudine or brivudine
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:不适用
- 介入模型:单组作业
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
---|---|
实验性的:celecoxib + capecitabine + radiation + surgery
Neoadjuvant chemoradiotherapy: Patients receive oral celecoxib twice daily on days 1-7 and oral capecitabine twice daily on days 1-5. Patients undergo pelvic radiotherapy once daily on days 1-5. Courses repeat weekly for 5.5 weeks. Surgery: Patients undergo surgery 4-6 weeks after completion of neoadjuvant chemoradiotherapy. Adjuvant chemotherapy: Patients with a curative resection receive oral capecitabine twice daily on days 1-14. Treatment repeats every 21 days for up to 4 courses. Treatment continues in the absence of disease progression or unacceptable toxicity. Patients are followed every 3 months for 1 year and then every 6 months for 4 years. |
研究衡量的是什么?
主要结果指标
结果测量 |
大体时间 |
---|---|
Proportion of successes
大体时间:Up to 5 years
|
Up to 5 years
|
次要结果测量
结果测量 |
大体时间 |
---|---|
生存时间
大体时间:长达 5 年
|
长达 5 年
|
生存
大体时间:长达 5 年
|
长达 5 年
|
Time-to event analyses
大体时间:Up to 5 years
|
Up to 5 years
|
Time to disease progression/recurrence
大体时间:Up to 5 years
|
Up to 5 years
|
Time to recurrence
大体时间:Up to 5 years
|
Up to 5 years
|
Time to first progression
大体时间:Up to 5 years
|
Up to 5 years
|
Bowel function as measured by the Patient Bowel Function (Uniscale) Questionnaire, the FACT Diarrhea Subscale and the Mayo Bowel Function Questionnaire
大体时间:Up to 5 years
|
Up to 5 years
|
合作者和调查者
调查人员
- 学习椅:Frank Sinicrope, MD、Mayo Clinic
研究记录日期
研究主要日期
学习开始
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (估计)
上次提交的符合 QC 标准的更新
最后验证
更多信息
与本研究相关的术语
其他相关的 MeSH 术语
其他研究编号
- NCCTG-N0346
- NCI-2012-02582 (注册表标识符:CTRP (Clinical Trials Reporting System))
- CDR0000360666 (注册表标识符:PDQ (Physician Data Query))
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外科手术的临床试验
-
St. Joseph's Healthcare HamiltonHamilton Academic Health Sciences Organization完全的
-
Seoul National University HospitalJohnson & Johnson Medical Companies完全的