Capecitabine, Oxaliplatin, and Gefitinib in Treating Patients With Metastatic Colorectal Cancer

NCT ID: NCT00087334

Last Updated: 2013-02-01

Basic Information

• Recruitment Status: TERMINATED
• Clinical Phase: PHASE1/PHASE2
• Total Enrollment: 10 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2004-01-31

Brief Summary

RATIONALE: Drugs used in chemotherapy, such as capecitabine and oxaliplatin, work in different ways to stop tumor cells from dividing so they stop growing or die. Gefitinib may stop the growth of tumor cells by blocking the enzymes necessary for their growth. Combining capecitabine and oxaliplatin with gefitinib may kill more tumor cells.

PURPOSE: This phase I/II trial is studying the side effects and best dose of capecitabine when given together with oxaliplatin and gefitinib and to see how well they work in treating patients with metastatic colorectal cancer.

Detailed Description

OBJECTIVES:

Primary

• Determine the maximum tolerated dose of capecitabine when given in combination with oxaliplatin and gefitinib in patients with metastatic colorectal cancer. (phase I)
• Determine the response rate in patients treated with this regimen. (phase II)

Secondary

• Determine the safety and toxic effects of this regimen in these patients.
• Determine the 1-year survival of patients treated with this regimen. (phase II)
• Determine the progression-free and overall survival of patients treated with this regimen. (phase II)

OUTLINE: This is an open-label, nonrandomized, phase I, dose-escalation study of capecitabine followed by a phase II study.

• Phase I: Patients receive oral capecitabine twice daily on days 1-14 and oxaliplatin IV over 2 hours on day 1. Patients also receive oral gefitinib once daily beginning 5 days before the initiation of capecitabine and oxaliplatin and continuing for the duration of study treatment. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.

Cohorts of 3-6 patients receive escalating doses of capecitabine until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity.

• Phase II: Patients receive oral capecitabine (at the MTD determined in phase I), oxaliplatin IV, and oral gefitinib as in phase I.

Patients are followed for survival.

PROJECTED ACCRUAL: A total of 3-24 patients will be accrued for the phase I portion of this study within 1-12 months; and a total of 26 patients will be accrued for the phase II portion of this study within 8-13 months.

Conditions

Colorectal Cancer

Study Design

• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Interventions

capecitabine

Intervention Type: DRUG

gefitinib

Intervention Type: DRUG

oxaliplatin

Intervention Type: DRUG

Eligibility Criteria

Inclusion Criteria

• No unstable or uncompensated respiratory disease

Other

• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception during and for 3 months after study participation
• No known hypersensitivity to gefitinib or any of its excipients
• No known hypersensitivity to platinum compounds, fluorouracil, or capecitabine
• No severe or uncontrolled systemic disease
• Able to receive oral medication
• No known dihydropyrimidine dehydrogenase (DPD) deficiency
• No known peripheral neuropathy ≥ grade 1

• Absence of deep tendon reflexes as the sole neurological abnormality allowed
• No other significant clinical disorder or laboratory finding that would preclude study participation
• No other malignancy within the past 5 years except basal cell skin cancer or carcinoma in situ of the cervix (phase II only)

PRIOR CONCURRENT THERAPY:

Biologic therapy

• Not specified

Chemotherapy

• At least 4 weeks since prior chemotherapy for metastatic colorectal cancer (phase I)
• No prior chemotherapy for metastatic disease (phase II)

• Prior fluorouracil and leucovorin calcium in the adjuvant setting allowed provided the last treatment was administered more than 6 months before the development of metastatic disease
• No prior irinotecan and oxaliplatin (phase II)

Endocrine therapy

• Not specified

Radiotherapy

• No concurrent radiotherapy for colorectal cancer

Surgery

• See Disease Characteristics
• More than 4 weeks since prior major surgery (e.g., laparotomy)

Other

• Recovered from all prior therapy (no unresolved chronic toxicity > grade 2)
• More than 4 weeks since prior investigational drugs
• No prior epidermal growth factor receptor inhibitor therapy (phase II)
• No concurrent phenytoin, carbamazepine, rifampin, barbiturates, or Hypericum perforatum (St. John's wort)
• No other concurrent investigational drugs
• No other concurrent systemic therapy for colorectal cancer

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 80 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Roswell Park Cancer Institute

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Marwan Fakih, MD

Role: PRINCIPAL_INVESTIGATOR

Roswell Park Cancer Institute

Locations

Roswell Park Cancer Institute

Buffalo, New York, United States

Countries

United States

Other Identifiers

RPCI-I-17403

Identifier Type: -

Identifier Source: secondary_id

ZENECA-IRUSIRES0414

Identifier Type: -

Identifier Source: secondary_id

I 17403

Identifier Type: -

Identifier Source: org_study_id