Combination Chemotherapy With or Without Bevacizumab Compared With Bevacizumab Alone in Treating Patients With Advanced or Metastatic Colorectal Cancer That Has Been Previously Treated

NCT ID: NCT00025337

Last Updated: 2013-01-24

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE3
• Total Enrollment: 880 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2001-09-30

Brief Summary

Randomized phase III trial to compare the effectiveness of combination chemotherapy with or without bevacizumab in treating patients who have advanced or metastatic colorectal cancer that has been previously treated. Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Monoclonal antibodies such as bevacizumab can locate tumor cells and either kill them or deliver tumor-killing substances to them without harming normal cells. Combining monoclonal antibody therapy with combination chemotherapy may kill more tumor cells. It is not yet known if bevacizumab is more effective with or without combination chemotherapy in treating colorectal cancer

Detailed Description

OBJECTIVES:

I. Compare the response, time to progression, and overall survival of patients with previously treated advanced or metastatic colorectal adenocarcinoma treated with oxaliplatin, leucovorin calcium, and fluorouracil with or without bevacizumab versus bevacizumab only. (Arm III closed to accrual as of 03/11/2003).

II. Compare the toxicity of these regimens in these patients.

OUTLINE: This is a randomized study. Patients are stratified according to ECOG performance status (0 vs 1 or 2), and prior radiotherapy (yes vs no). Patients are randomized to 1 of 3 treatment arms.

Arm I: Patients receive bevacizumab IV over 30-90 minutes and oxaliplatin IV over 2 hours on day 1. Patients also receive leucovorin calcium IV over 2 hours and fluorouracil (5-FU) IV over 22 hours on days 1 and 2.

Arm II: Patients receive oxaliplatin, leucovorin calcium, and 5-FU as in arm I.

Arm III: Patients receive bevacizumab as in arm I. (Arm closed to accrual as of 03/11/2003).

Courses in all arms repeat every 2 weeks in the absence of disease progression or unacceptable toxicity. Patients who achieve a complete response may receive 2 additional courses.

Patients are followed every 3 months for 2 years, every 6 months for 3 years, and then annually thereafter.

Conditions

Adenocarcinoma of the Colon; Adenocarcinoma of the Rectum; Recurrent Colon Cancer; Recurrent Rectal Cancer; Stage III Colon Cancer; Stage III Rectal Cancer; Stage IV Colon Cancer; Stage IV Rectal Cancer

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Arm I (bevacizumab, oxaliplatin, leucovorin, fluorouracil)

Patients receive bevacizumab IV over 30-90 minutes and oxaliplatin IV over 2 hours on day 1. Patients also receive leucovorin calcium IV over 2 hours and fluorouracil (5-FU) IV over 22 hours on days 1 and 2.

Group Type: EXPERIMENTAL

bevacizumab

Intervention Type: BIOLOGICAL

Given IV

oxaliplatin

Intervention Type: DRUG

Given IV

leucovorin calcium

Intervention Type: DRUG

Given IV

fluorouracil

Intervention Type: DRUG

Given IV

Arm II (oxaliplatin, leucovorin calcium, fluorouracil)

Patients receive oxaliplatin, leucovorin calcium, and 5-FU as in arm I.

Group Type: EXPERIMENTAL

oxaliplatin

Intervention Type: DRUG

Given IV

leucovorin calcium

Intervention Type: DRUG

Given IV

fluorouracil

Intervention Type: DRUG

Given IV

Arm III (bevacizumab)

Patients receive bevacizumab as in arm I.

Group Type: EXPERIMENTAL

bevacizumab

Intervention Type: BIOLOGICAL

Given IV

Interventions

bevacizumab

Given IV

Intervention Type: BIOLOGICAL

oxaliplatin

Given IV

Intervention Type: DRUG

leucovorin calcium

Given IV

Intervention Type: DRUG

fluorouracil

Given IV

Intervention Type: DRUG

Other Intervention Names

anti-VEGF humanized monoclonal antibody; anti-VEGF monoclonal antibody; Avastin; rhuMAb VEGF; 1-OHP; Dacotin; Dacplat; Eloxatin; L-OHP; CF; CFR; LV; 5-fluorouracil; 5-Fluracil; 5-FU

Eligibility Criteria

Inclusion Criteria

• Histologically confirmed adenocarcinoma of the colon or rectum

• Advanced or metastatic disease
• Must have received a fluoropyrimidine-based regimen and an irinotecan-based regimen, either alone or in combination, for advanced disease
• May have relapsed within 6 months of adjuvant therapy with fluorouracil (5-FU) (or combination 5-FU and irinotecan) and progressed after single-agent irinotecan
• Measurable disease
• No known brain metastases
• Performance status - ECOG 0-2
• Absolute neutrophil count at least 1,500/mm^3
• Platelet count at least 100,000/mm^3
• No history of thrombotic or hemorrhagic disorders
• Bilirubin no greater than 1.5 times upper limit of normal (ULN)
• AST no greater than 5 times ULN
• INR no greater than 1.5
• PTT no greater than ULN
• Creatinine no greater than 1.5 times ULN
• Proteinuria less than 1+ (i.e., 0 or trace)
• Protein less than 500 mg by 24-hour urine collection
• Proteinuria secondary to ureteral stents allowed

• No proteinuria secondary to nephropathy
• Controlled hypertension (less than 150/100 mm Hg) allowed if on a stable antihypertensive regimen
• No prior myocardial infarction
• No uncontrolled congestive heart failure
• No unstable angina within the past 3 months
• No serious nonhealing wound, ulcer, or bone fracture
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception
• No prior bevacizumab
• See Disease Characteristics
• Recovered from prior chemotherapy
• No prior oxaliplatin
• At least 2 weeks since prior radiotherapy and recovered
• At least 28 days since prior major surgical procedure
• At least 10 days since prior aspirin dose of more than 325 mg/day
• No concurrent therapeutic anticoagulation except prophylactic anticoagulation of venous access device
• No concurrent antiplatelet agents (e.g., dipyridamole, ticlopidine, clopidogrel, or cilostazol)
• No concurrent oral cryotherapy on day 1 of oxaliplatin administration

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

National Cancer Institute (NCI)

NIH

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Bruce Giantonio

Role: PRINCIPAL_INVESTIGATOR

Eastern Cooperative Oncology Group

Locations

Eastern Cooperative Oncology Group

Boston, Massachusetts, United States

Countries

United States

Other Identifiers

E3200

Identifier Type: -

Identifier Source: secondary_id

U10CA021115

Identifier Type: NIH

Identifier Source: secondary_id

View Link

CDR0000068951

Identifier Type: REGISTRY

Identifier Source: secondary_id

NCI-2012-02417

Identifier Type: -

Identifier Source: org_study_id