Surgery With or Without Combination Chemotherapy in Treating Patients With Liver Metastases From Colorectal Cancer

NCT ID: NCT00006479

Last Updated: 2011-04-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

UNKNOWN

Clinical Phase

PHASE3

Study Classification

INTERVENTIONAL

Study Start Date

2000-09-30

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Combining more than one drug and combining chemotherapy with surgery may kill more tumor cells. It is not yet known if surgery is more effective with or without chemotherapy for liver metastases.

PURPOSE: Randomized phase III trial to compare the effectiveness of surgery with or without combination chemotherapy in treating patients who have liver metastases from colorectal cancer.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

OBJECTIVES:

* Compare the progression-free and overall survival of patients with resectable colorectal liver metastases treated with surgery with or without neoadjuvant and adjuvant oxaliplatin, fluorouracil, and leucovorin calcium.
* Compare the percentage of patients with total resection with these two treatments.

OUTLINE: This is a multicenter study. Patients are stratified according to participating center, prior adjuvant chemotherapy (yes vs no), plasma CEA level in ng/mL at diagnosis of liver metastases (5 or less vs 6 to 30 vs 31 or greater), serosa extension of primary cancer (absent T1 or T2 vs present T3 or T4), lymphatic spread of primary cancer (absent vs present N+), time interval between diagnosis of primary tumor to metastases (2 years or more vs fewer than 2 years), and number of metastases (1 to 3 vs 4). Patients are randomized to one of two treatment arms.

* Arm I: Patients receive oxaliplatin IV over 2 hours on day 1 and leucovorin calcium (LV) IV over 2 hours followed by fluorouracil (5-FU) IV over 22 hours on days 1 and 2. Treatment repeats every 15 days for 6 courses in the absence of disease progression or unacceptable toxicity.

At 2 to 5 weeks after chemotherapy, patients undergo liver resection. Patients with progressive disease after 3 courses of chemotherapy undergo liver resection at least 2 weeks after completion of course 3 and do not receive postoperative chemotherapy.

At 2 to 5 weeks after surgery, patients receive oxaliplatin, LV, and 5-FU as in preoperative chemotherapy.

* Arm II: Patients undergo liver resection. Patients are followed every 3 months for 2 years and then every 6 months thereafter.

Peer Reviewed and Funded or Endorsed by Cancer Research UK

PROJECTED ACCRUAL: A total of 330 patients (165 per arm) will be accrued for this study within 3 years.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Colorectal Cancer Metastatic Cancer

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Primary Study Purpose

TREATMENT

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

FOLFOX regimen

Intervention Type DRUG

fluorouracil

Intervention Type DRUG

leucovorin calcium

Intervention Type DRUG

oxaliplatin

Intervention Type DRUG

adjuvant therapy

Intervention Type PROCEDURE

conventional surgery

Intervention Type PROCEDURE

neoadjuvant therapy

Intervention Type PROCEDURE

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

DISEASE CHARACTERISTICS:

* Diagnosis of potentially resectable colorectal liver metastases that meets one of the following criteria:

* Metachronous metastases after complete resection of primary tumor without gross or microscopic evidence of residual disease
* Synchronous metastases after complete resection of primary tumor more than 1 month before study
* Synchronous metastases with sufficient evidence (i.e., CAT scan or diagnostic laparoscopy) that both the primary tumor and liver metastases can be completely resected during the same procedure and resection of primary may be delayed 3-4 months

PATIENT CHARACTERISTICS:

Age:

* 18 to 80

Performance status:

* WHO 0-2
* Karnofsky 60-100%

Life expectancy:

* Not specified

Hematopoietic:

* Absolute neutrophil count greater than 1,500/mm\^3
* Platelet count greater than 100,000/mm\^3

Hepatic:

* No hepatic insufficiency

Renal:

* Creatinine less than 2 times upper limit of normal

Cardiovascular:

* No uncontrolled congestive heart failure or angina pectoris
* No hypertension or arrhythmia

Other:

* No other malignancy within the past 10 years except adequately treated carcinoma in situ of the cervix or nonmelanoma skin cancer
* No peripheral neuropathy greater than grade 1
* No prior significant neurologic or psychiatric disorders
* No active infection
* Not pregnant or nursing
* Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

Biologic therapy:

* No concurrent biologic therapy

Chemotherapy:

* No prior chemotherapy for advanced disease
* Prior adjuvant chemotherapy for primary cancer allowed unless included oxaliplatin
* No other concurrent chemotherapy

Endocrine therapy:

* No concurrent anticancer endocrine therapy

Radiotherapy:

* No concurrent radiotherapy

Surgery:

* See Disease Characteristics

Other:

* At least 30 days since prior investigational drugs
* No concurrent investigational drugs
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Australasian Gastro-Intestinal Trials Group

NETWORK

Sponsor Role collaborator

Arbeitsgruppe Lebermetastasen und Tumoren

OTHER

Sponsor Role collaborator

Cancer Research UK

OTHER

Sponsor Role collaborator

Fondation Francaise de Cancerologie Digestive

OTHER

Sponsor Role collaborator

European Organisation for Research and Treatment of Cancer - EORTC

NETWORK

Sponsor Role lead

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Bernard Nordlinger, MD

Role:

Hopital Ambroise Pare

Euan T. Walpole, MD

Role: STUDY_CHAIR

Princess Alexandra Hospital

Wolf O. Bechstein, MD

Role: STUDY_CHAIR

Arbeitsgruppe Lebermetastasen und Tumoren

John N. Primrose, MD

Role: STUDY_CHAIR

University Hospital Southampton NHS Foundation Trust

Philippe Rougier, MD

Role: STUDY_CHAIR

Hopital Ambroise Pare

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Bankstown - Lidcombe Hospital

Bankstown, New South Wales, Australia

Site Status

Institute of Oncology at Prince of Wales Hospital

Randwick, New South Wales, Australia

Site Status

Royal North Shore Hospital

St Leonards, New South Wales, Australia

Site Status

Newcastle Mater Misericordiae Hospital

Waratah, New South Wales, Australia

Site Status

Royal Brisbane and Women's Hospital

Brisbane, Queensland, Australia

Site Status

Princess Alexandra Hospital

Brisbane, Queensland, Australia

Site Status

Ashford Cancer Centre

Ashford, South Australia, Australia

Site Status

Flinder Medical Centres

Bedford Park, South Australia, Australia

Site Status

Queen Elizabeth Hospital

Woodville, South Australia, Australia

Site Status

Launceston General Hospital

Launceston, Tasmania, Australia

Site Status

Frankston Hospital

Frankston, Victoria, Australia

Site Status

Austin and Repatriation Medical Centre

Heidelberg West, Victoria, Australia

Site Status

Mount Hospital

Perth, Western Australia, Australia

Site Status

Royal Perth Hospital

Perth, Western Australia, Australia

Site Status

Sir Charles Gairdner Hospital - Perth

Perth, Western Australia, Australia

Site Status

Allgemeines Krankenhaus der Stadt Wien

Vienna, , Austria

Site Status

Kaiser Franz Josef Hospital

Vienna, , Austria

Site Status

Institut Jules Bordet

Brussels, , Belgium

Site Status

Hopital Universitaire Erasme

Brussels, , Belgium

Site Status

Academisch Ziekenhuis der Vrije Universiteit Brussel

Brussels, , Belgium

Site Status

Universitair Ziekenhuis Gent

Ghent, , Belgium

Site Status

Hopital de Jolimont

Haine-Saint-Paul, , Belgium

Site Status

Cazk Groeninghe - Campus St-Niklaas

Kortrijk, , Belgium

Site Status

U.Z. Gasthuisberg

Leuven, , Belgium

Site Status

Centre Hospitalier - Abbeville

Abbeville, , France

Site Status

Centre Hospitalier Regional et Universitaire d'Angers

Angers, , France

Site Status

C.H.G. Beauvais

Beauvais, , France

Site Status

CHR de Besancon - Hopital Jean Minjoz

Besançon, , France

Site Status

Institut Bergonie

Bordeaux, , France

Site Status

CHU Ambroise Pare

Boulogne-Billancourt, , France

Site Status

C.H. Bourg En Bresse

Bourg-en-Bresse, , France

Site Status

CMC Bligny

Briis-sous-Forges, , France

Site Status

CHU de Caen

Caen, , France

Site Status

Hopital Louis Pasteur

Colmar, , France

Site Status

Centre Hospitalier Universitaire Henri Mondor

Créteil, , France

Site Status

Hopital Du Bocage

Dijon, , France

Site Status

CHU de Grenoble - Hopital de la Tronche

Grenoble, , France

Site Status

Centre Hospitalier Departemental

La Roche-sur-Yon, , France

Site Status

Clinique Du Pre

Le Mans, , France

Site Status

Hopital Robert Boulin

Libourne, , France

Site Status

Centre Hospital Regional Universitaire de Limoges

Limoges, , France

Site Status

CHU de la Timone

Marseille, , France

Site Status

Centre Regional de Lutte Contre le Cancer - Centre Val d'Aurelle

Montpellier, , France

Site Status

Hopital Lariboisiere

Paris, , France

Site Status

Hopital Europeen Georges Pompidou

Paris, , France

Site Status

Hopital Cochin

Paris, , France

Site Status

C.H.G. De Pau

Pau, , France

Site Status

Hopital Haut Leveque

Pessac, , France

Site Status

Centre Eugene Marquis

Rennes, , France

Site Status

Hopital Charles Nicolle

Rouen, , France

Site Status

Hopital Universitaire Hautepierre

Strasbourg, , France

Site Status

Centre Hospitalier Regional de Purpan

Toulouse, , France

Site Status

CHU de Tours

Tours, , France

Site Status

Centre Alexis Vautrin

Vandœuvre-lès-Nancy, , France

Site Status

Hopital Paul Brousse

Villejuif, , France

Site Status

Helios Klinikum Berlin

Berlin, , Germany

Site Status

Robert Roessle Klinik at Charite - Campus Berlin Buch im Helios Klinikum Berlin

Berlin, , Germany

Site Status

Staedtisches Klinikum Dessau

Dessau, , Germany

Site Status

Medizinische Klinik I

Dresden, , Germany

Site Status

Department of Medicine III

Erlangen, , Germany

Site Status

Kliniken Essen - Mitte

Essen, , Germany

Site Status

Klinikum der J.W. Goethe Universitaet

Frankfurt, , Germany

Site Status

Universitaetsklinikum Freiburg

Freiburg im Breisgau, , Germany

Site Status

Klinik der Justus - Leibig - Universitaet Giessen

Giessen, , Germany

Site Status

Klinikum der Friedrich-Schiller Universitaet Jena

Jena, , Germany

Site Status

Knappschaft Krankenhaus

Langendreer, , Germany

Site Status

Universitaet Leipzig

Leipzig, , Germany

Site Status

Staedtisches Klinikum Leipzig

Leipzig, , Germany

Site Status

Universitaetsklinkum Magdeburg der Otto-von-Guericke-Universitaet Magdeburg

Magdeburg, , Germany

Site Status

Johannes Gutenberg University

Mainz, , Germany

Site Status

Klinikum Rechts Der Isar - Technische Universitaet Muenchen

Munich, , Germany

Site Status

Klinikum der Universitaet Regensburg

Regensburg, , Germany

Site Status

Caritasklinik St. Theresia

Saarbrücken, , Germany

Site Status

Eberhard Karls Universitaet

Tübingen, , Germany

Site Status

Dr. Horst-Schmidt-Kliniken

Wiesbaden, , Germany

Site Status

Universitaets-Hautklinik Wuerzburg

Würzburg, , Germany

Site Status

Prince of Wales Hospital

Shatin, N.T., , Hong Kong

Site Status

Ospedale San Martino/Cliniche Universitarie Convenzionate

Genoa (Genova), , Italy

Site Status

Universita di Padova

Padua, , Italy

Site Status

Leiden University Medical Center

Leiden, , Netherlands

Site Status

Academisch Ziekenhuis Maastricht

Maastricht, , Netherlands

Site Status

Christchurch Hospital

Christchurch, , New Zealand

Site Status

Haukeland Hospital - University of Bergen

Bergen, , Norway

Site Status

Instituto Portugues de Oncologia Centro do Porto, SA

Porto, , Portugal

Site Status

Sahlgrenska University Hospital

Gothenburg (Goteborg), , Sweden

Site Status

Karolinska University Hospital/Huddinge

Stockholm, , Sweden

Site Status

Uppsala University Hospital

Uppsala, , Sweden

Site Status

North Hampshire Hospital

Basingstoke, England, United Kingdom

Site Status

Queen Elizabeth Hospital at University of Birmingham

Birmingham, England, United Kingdom

Site Status

Bristol Haematology and Oncology Centre

Bristol, England, United Kingdom

Site Status

Bristol Royal Infirmary

Bristol, England, United Kingdom

Site Status

Addenbrooke's NHS Trust

Cambridge, England, United Kingdom

Site Status

St. Luke's Cancer Center

Guildford, England, United Kingdom

Site Status

Cookridge Hospital at Leeds Teaching Hospital NHS Trust

Leeds, England, United Kingdom

Site Status

St. James's University Hospital

Leeds, England, United Kingdom

Site Status

Leicester Royal Infirmary

Leicester, England, United Kingdom

Site Status

Royal Liverpool and Broadgreen Hospitals

Liverpool, England, United Kingdom

Site Status

Royal London Hospital

London, England, United Kingdom

Site Status

Royal Free Hospital

London, England, United Kingdom

Site Status

St. George's Hospital

London, England, United Kingdom

Site Status

Clatterbridge Centre for Oncology NHS Trust

Merseyside, England, United Kingdom

Site Status

Freeman Hospital

Newcastle upon Tyne, England, United Kingdom

Site Status

Mount Vernon Hospital

Northwood, England, United Kingdom

Site Status

Queen's Medical Centre

Nottingham, England, United Kingdom

Site Status

Royal Preston Hospital

Preston, England, United Kingdom

Site Status

Weston Park Hospital

Sheffield, England, United Kingdom

Site Status

Royal South Hants Hospital

Southampton, England, United Kingdom

Site Status

Southampton General Hospital

Southampton, England, United Kingdom

Site Status

Royal Infirmary of Edinburgh at Little France

Edinburgh, Scotland, United Kingdom

Site Status

Ysbyty Gwynedd

Bangor, Wales, United Kingdom

Site Status

North Manchester Healthcare NHS Trust

Manchester, , United Kingdom

Site Status

Countries

Review the countries where the study has at least one active or historical site.

Australia Austria Belgium France Germany Hong Kong Italy Netherlands New Zealand Norway Portugal Sweden United Kingdom

References

Explore related publications, articles, or registry entries linked to this study.

Sorbye H, Mauer M, Gruenberger T, et al.: Predictive factors for the effect of perioperative FOLFOX for resectable liver metastasis in colorectal cancer patients (EORTC phase III study 40983). [Abstract] J Clin Oncol 28 (Suppl 15): A-3544, 2010.

Reference Type RESULT

Sorbye H, Mauer M, Gruenberger T, et al.: Evaluation of carcinoembryonic antigen (CEA) as a predictive baseline factor for the benefit of perioperative FOLFOX in resectable liver metastasis from colorectal cancer (EORTC study 40983). [Abstract] American Society of Clinical Oncology 2010 Gastrointestinal Cancers Symposium, 22-24 January 2010, Orlando, Florida. A-407, 2010.

Reference Type RESULT

Benoist S, Nordlinger B. The role of preoperative chemotherapy in patients with resectable colorectal liver metastases. Ann Surg Oncol. 2009 Sep;16(9):2385-90. doi: 10.1245/s10434-009-0492-7. Epub 2009 Jun 25.

Reference Type RESULT
PMID: 19554377 (View on PubMed)

Nordlinger B, Sorbye H, Glimelius B, Poston GJ, Schlag PM, Rougier P, Bechstein WO, Primrose JN, Walpole ET, Finch-Jones M, Jaeck D, Mirza D, Parks RW, Collette L, Praet M, Bethe U, Van Cutsem E, Scheithauer W, Gruenberger T; EORTC Gastro-Intestinal Tract Cancer Group; Cancer Research UK; Arbeitsgruppe Lebermetastasen und-tumoren in der Chirurgischen Arbeitsgemeinschaft Onkologie (ALM-CAO); Australasian Gastro-Intestinal Trials Group (AGITG); Federation Francophone de Cancerologie Digestive (FFCD). Perioperative chemotherapy with FOLFOX4 and surgery versus surgery alone for resectable liver metastases from colorectal cancer (EORTC Intergroup trial 40983): a randomised controlled trial. Lancet. 2008 Mar 22;371(9617):1007-16. doi: 10.1016/S0140-6736(08)60455-9.

Reference Type RESULT
PMID: 18358928 (View on PubMed)

Julie C, Lutz MP, Aust D, et al.: Pathological analysis of hepatic injury after oxaliplatin-based neoadjuvant chemotherapy of colorectal cancer liver metastases: results of the EORTC Intergroup phase III study 40983. [Abstract] American Society of Clinical Oncology 2007 Gastrointestinal Cancers Symposium, 19 -21 January 2007, Orlando, Florida A-241, 2007.

Reference Type RESULT

Nordlinger B, Sorbye H, Collette L, et al.: Final results of the EORTC Intergroup randomized phase III study 40983 [EPOC] evaluating the benefit of peri-operative FOLFOX4 chemotherapy for patients with potentially resectable colorectal cancer liver metastases. [Abstract] J Clin Oncol 25 (Suppl 18): A-LBA5, 2007.

Reference Type RESULT

Gruenberger T, Sorbye H, Debois M, et al.: Tumor response to pre-operative chemotherapy (CT) with FOLFOX-4 for resectable colorectal cancer liver metastases (LM). Interim results of EORTC Intergroup randomized phase III study 40983. [Abstract] J Clin Oncol 24 (Suppl 18): A-3500, 2006.

Reference Type RESULT

Nordlinger B, Sorbye H, Debois M, et al.: Feasibility and risks of pre-operative chemotherapy (CT) with Folfox 4 and surgery for resectable colorectal cancer liver metastases (LM). Interim results of the EORTC Intergroup randomized phase III study 40983. [Abstract] J Clin Oncol 23 (Suppl 16): A-3528, 253s, 2005.

Reference Type RESULT

Tanis E, Julie C, Emile JF, Mauer M, Nordlinger B, Aust D, Roth A, Lutz MP, Gruenberger T, Wrba F, Sorbye H, Bechstein W, Schlag P, Fisseler A, Ruers T. Prognostic impact of immune response in resectable colorectal liver metastases treated by surgery alone or surgery with perioperative FOLFOX in the randomised EORTC study 40983. Eur J Cancer. 2015 Nov;51(17):2708-17. doi: 10.1016/j.ejca.2015.08.014. Epub 2015 Sep 2.

Reference Type DERIVED
PMID: 26342674 (View on PubMed)

Nordlinger B, Sorbye H, Glimelius B, Poston GJ, Schlag PM, Rougier P, Bechstein WO, Primrose JN, Walpole ET, Finch-Jones M, Jaeck D, Mirza D, Parks RW, Mauer M, Tanis E, Van Cutsem E, Scheithauer W, Gruenberger T; EORTC Gastro-Intestinal Tract Cancer Group; Cancer Research UK; Arbeitsgruppe Lebermetastasen und-tumoren in der Chirurgischen Arbeitsgemeinschaft Onkologie (ALM-CAO); Australasian Gastro-Intestinal Trials Group (AGITG); Federation Francophone de Cancerologie Digestive (FFCD). Perioperative FOLFOX4 chemotherapy and surgery versus surgery alone for resectable liver metastases from colorectal cancer (EORTC 40983): long-term results of a randomised, controlled, phase 3 trial. Lancet Oncol. 2013 Nov;14(12):1208-15. doi: 10.1016/S1470-2045(13)70447-9. Epub 2013 Oct 11.

Reference Type DERIVED
PMID: 24120480 (View on PubMed)

Sorbye H, Mauer M, Gruenberger T, Glimelius B, Poston GJ, Schlag PM, Rougier P, Bechstein WO, Primrose JN, Walpole ET, Finch-Jones M, Jaeck D, Mirza D, Parks RW, Collette L, Van Cutsem E, Scheithauer W, Lutz MP, Nordlinger B; EORTC Gastro-Intestinal Tract Cancer Group; Cancer Research UK (CRUK); Arbeitsgruppe Lebermetastasen und-tumoren in der Chirurgischen Arbeitsgemeinschaft Onkologie (ALM-CAO); Australasian Gastro-Intestinal Trials Group (AGITG); Federation Francophone de Cancerologie Digestive (FFCD). Predictive factors for the benefit of perioperative FOLFOX for resectable liver metastasis in colorectal cancer patients (EORTC Intergroup Trial 40983). Ann Surg. 2012 Mar;255(3):534-9. doi: 10.1097/SLA.0b013e3182456aa2.

Reference Type DERIVED
PMID: 22314329 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

EORTC-40983

Identifier Type: -

Identifier Source: secondary_id

AGITG-EORTC-40983

Identifier Type: -

Identifier Source: secondary_id

ALM-CAO-EORTC-40983

Identifier Type: -

Identifier Source: secondary_id

CRUK-LON-EORTC-40983

Identifier Type: -

Identifier Source: secondary_id

FFCD-EORTC-40983

Identifier Type: -

Identifier Source: secondary_id

EU-20048

Identifier Type: -

Identifier Source: secondary_id

CRC-EORTC-40983

Identifier Type: -

Identifier Source: secondary_id

CDR0000068309

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.