Status:
TERMINATED
Postoperative Chemotherapy With or Without Bevacizumab for Patients With Stage II or III Rectal Cancer
Lead Sponsor:
ECOG-ACRIN Cancer Research Group
Collaborating Sponsors:
National Cancer Institute (NCI)
Conditions:
Adenocarcinoma of the Rectum
Stage II Rectal Cancer
Eligibility:
All Genders
18+ years
Phase:
PHASE3
Brief Summary
Drugs used in chemotherapy, such as oxaliplatin, leucovorin, and fluorouracil, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. ...
Detailed Description
PRIMARY OBJECTIVES: I. Compare the overall survival of patients who have undergone prior surgery and neoadjuvant chemoradiotherapy for clinical stage II or III rectal cancer treated with adjuvant oxa...
Eligibility Criteria
Inclusion
- Histologically confirmed adenocarcinoma of the rectum meeting 1 of the following clinical (e.g., before neoadjuvant therapy) or pathologic staging criteria:
- T3, N+, M0
- T3, N0, M0
- T4, N0, M0
- Any T, N1-2, M0
- T4, N0-2, M0 disease must meet 1 of the following criteria:
- Clinically fixed tumor on rectal examination with tumor adherent to the pelvic sidewall or sacrum
- Hydronephrosis on Computed Tomography (CT) scan or Intravenous Pyelogram (IVP)
- Ureteric or bladder invasion as documented by cystoscopy and cytology or biopsy
- Invasion into prostate
- Vaginal or uterine involvement
- Must have undergone complete tumor resection \>= 28 days ago and able to begin treatment by day 56
- Must have undergone concurrent neoadjuvant chemoradiotherapy\*
- NOTE: \*Neoadjuvant chemoradiotherapy received on protocol NSABP-R-04 allowed provided it met these criteria
- Must have undergone prior radiotherapy at 40-55.8 Gy\*\* AND received 1 of the following chemotherapy regimens:
- Continuous infusion of fluorouracil with or without oxaliplatin; fluorouracil and leucovorin calcium
- Capecitabine with or without oxaliplatin; capecitabine with or without oxaliplatin OR a continuous infusion of fluorouracil with or without oxaliplatin received on protocol NSABP-R-04
- NOTE: \*\*Intensity-modulated radiotherapy allowed
- ECOG performance status 0-1
- Platelet count \>= 100,000/mm\^3
- Absolute granulocyte count \>= 1,500/mm\^3
- Bilirubin normal (unless chronic grade 1 bilirubin elevation due to Gilbert's disease or similar syndrome due to slow conjugation of bilirubin)
- Alkaline phosphatase (AP) \< 2.5 times upper limit of normal (ULN) and aspartate aminotransferase (AST) \< 1.5 times ULN
- Hepatitis B and C negative (for patients with AP \> normal) unless previously vaccinated
- Serum creatinine =\< 1.5 times ULN
- Urine protein:creatinine (UPC) ratio \< 1.0 OR urine protein \< 1 g on 24-hour urine collection
- International Normalized Ratio (INR) =\< 1.5
- INR \> 1.5 allowed provided patient is on full-dose anticoagulants AND meets all of the following criteria:
- In-range INR (i.e., between 2 and 3) on a stable dose of warfarin or low molecular weight heparin
- No active bleeding or pathological condition that is associated with a high risk of bleeding
- Negative pregnancy test
- Fertile patients must use effective contraception during and for at least 3 months after study treatment
- No other previous or concurrent malignancy except nonmelanoma skin cancer, breast cancer in situ, carcinoma in situ of the cervix, or previously treated nonpelvic cancer that has been disease-free for \> 5 years
- Patients with a history of breast cancer (without evidence of disease) who remain on hormonal therapy for \> 5 years are eligible
- Patients with a history of hypertension must have blood pressure \< 150/90 mm Hg AND be on a stable regimen of antihypertensive therapy
- No other prior chemotherapy or pelvic radiotherapy except as neoadjuvant treatment for current diagnosis of rectal cancer
- Concurrent participation on protocol NSABP-R-04 allowed
Exclusion
- Pregnant or nursing
- Evidence of metastatic disease on the surgical/intraoperative examination
- Evidence of metastatic disease confirmed by CT scan, Magnetic resonance imaging (MRI), or ultrasound of the liver or chest CT scan or chest x-ray within the past 6 months
- Evidence of tumor outside of the pelvis, including liver metastases, peritoneal seeding, or metastatic inguinal lymphadenopathy
- Concurrent major surgery
- Active bleeding not related to the primary rectal tumor within the past 6 months
- Active inflammatory bowel disease or other serious medical illness which might limit the ability of the patient to receive protocol therapy
- Active gastroduodenal ulcer determined by endoscopy
- Serious or nonhealing wound, skin ulcer, or bone fracture
- Clinically significant peripheral sensory or motor neuropathy \>= grade 2
- Nonmalignant systemic disease (e.g., cardiovascular, renal, or hepatic) that would preclude study treatment including, but not limited to, any of the following:
- New York Heart Association class III or IV congestive heart failure
- Concurrent symptomatic arrhythmia
- Transient ischemic attack or cerebrovascular accident
- Arterial thromboembolic event, unstable angina, or myocardial infarction within the past 12 months
- Significant peripheral vascular disease
- Psychiatric or addictive disorders or other conditions that, in the opinion of the investigator, would preclude study requirements
- Significant traumatic injury within the past 28 days
- Known allergy to platinum compounds
- Prior invasive procedure, including either of the following:
- Major surgical procedure or open biopsy within the past 28 days
- Core biopsy or other minor procedure, except placement of a vascular access device, within the past 7 days
Key Trial Info
Start Date :
May 11 2006
Trial Type :
INTERVENTIONAL
Allocation :
ACTUAL
End Date :
February 11 2019
Estimated Enrollment :
355 Patients enrolled
Trial Details
Trial ID
NCT00303628
Start Date
May 11 2006
End Date
February 11 2019
Last Update
July 6 2023
Active Locations (617)
Enter a location and click search to find clinical trials sorted by distance.
1
Providence Hospital
Mobile, Alabama, United States, 36608
2
Providence Alaska Medical Center
Anchorage, Alaska, United States, 99508
3
Mayo Clinic in Arizona
Scottsdale, Arizona, United States, 85259
4
Saint Bernards Regional Medical Center
Jonesboro, Arkansas, United States, 72401