Trial Outcomes & Findings for Capecitabine + Irinotecan Followed by Combined Modality Capecitabine and Radiation in Locally Advanced Rectal Cancer (NCT NCT00216086)

NCT ID: NCT00216086

Last Updated: 2016-06-06

Results Overview

· To determine the pathological response rate of preoperative chemotherapy with capecitabine and irinotecan followed by combined modality chemoradiation with capecitabine in patients with locally advanced rectal cancer. Pathological response was defined in the protocol as the proportion of complete (pCR) and non-complete pathological response (pNCR) among all evaluable patients.

Recruitment status

TERMINATED

Study phase

PHASE2

Target enrollment

22 participants

Primary outcome timeframe

36 months

Results posted on

2016-06-06

Participant Flow

Participant milestones

Participant milestones
Measure
Single Group Assignment
Irinotecan 200 mg/m2 IV, day 1 Capecitabine 1000\* mg/m2 po bid day 1-14; repeat every three weeks for two cycles \*For calculated creatinine clearance of 30-50 mL/min or patients \> 70 years old, capecitabine starting dose is 825 mg/m2 po bid Capecitabine: Capecitabine 1000\* mg/m2 po bid day 1-14; repeat every three weeks for two cycles \*For calculated creatinine clearance of 30-50 mL/min or patients \> 70 years old, capecitabine starting dose is 825 mg/m2 po bid Irinotecan: Irinotecan 200 mg/m2 IV, day 1 EUS: biopsy per EUS Neoadjuvant Chemotherapy: Irinotecan 200 mg/m2 IV, day 1 Capecitabine 1000 mg/m2 po bid day 1-14; repeat every three weeks for two cycles Preoperative Radiation: Pelvic XRT 45 Gy/1.8 GY/fx/qd+5/4 Gy/1.8 Gy/fx/qd for T3+9 Gy/1.8/Gy/fx/qd for T4 Surgery: Surgery within 8 weeks following chemoradiotherapy Adjuvant Chemotherapy: Adjuvant chemotherapy at investigator's discretion
Overall Study
STARTED
22
Overall Study
COMPLETED
18
Overall Study
NOT COMPLETED
4

Reasons for withdrawal

Reasons for withdrawal
Measure
Single Group Assignment
Irinotecan 200 mg/m2 IV, day 1 Capecitabine 1000\* mg/m2 po bid day 1-14; repeat every three weeks for two cycles \*For calculated creatinine clearance of 30-50 mL/min or patients \> 70 years old, capecitabine starting dose is 825 mg/m2 po bid Capecitabine: Capecitabine 1000\* mg/m2 po bid day 1-14; repeat every three weeks for two cycles \*For calculated creatinine clearance of 30-50 mL/min or patients \> 70 years old, capecitabine starting dose is 825 mg/m2 po bid Irinotecan: Irinotecan 200 mg/m2 IV, day 1 EUS: biopsy per EUS Neoadjuvant Chemotherapy: Irinotecan 200 mg/m2 IV, day 1 Capecitabine 1000 mg/m2 po bid day 1-14; repeat every three weeks for two cycles Preoperative Radiation: Pelvic XRT 45 Gy/1.8 GY/fx/qd+5/4 Gy/1.8 Gy/fx/qd for T3+9 Gy/1.8/Gy/fx/qd for T4 Surgery: Surgery within 8 weeks following chemoradiotherapy Adjuvant Chemotherapy: Adjuvant chemotherapy at investigator's discretion
Overall Study
Protocol Violation
1
Overall Study
Diagnosis of Metastatic Disease
1
Overall Study
Social Reasons
2

Baseline Characteristics

Capecitabine + Irinotecan Followed by Combined Modality Capecitabine and Radiation in Locally Advanced Rectal Cancer

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Single Group Assignment
n=22 Participants
Irinotecan 200 mg/m2 IV, day 1 Capecitabine 1000\* mg/m2 po bid day 1-14; repeat every three weeks for two cycles \*For calculated creatinine clearance of 30-50 mL/min or patients \> 70 years old, capecitabine starting dose is 825 mg/m2 po bid Capecitabine: Capecitabine 1000\* mg/m2 po bid day 1-14; repeat every three weeks for two cycles \*For calculated creatinine clearance of 30-50 mL/min or patients \> 70 years old, capecitabine starting dose is 825 mg/m2 po bid Irinotecan: Irinotecan 200 mg/m2 IV, day 1 EUS: biopsy per EUS Neoadjuvant Chemotherapy: Irinotecan 200 mg/m2 IV, day 1 Capecitabine 1000 mg/m2 po bid day 1-14; repeat every three weeks for two cycles Preoperative Radiation: Pelvic XRT 45 Gy/1.8 GY/fx/qd+5/4 Gy/1.8 Gy/fx/qd for T3+9 Gy/1.8/Gy/fx/qd for T4 Surgery: Surgery within 8 weeks following chemoradiotherapy Adjuvant Chemotherapy: Adjuvant chemotherapy at investigator's discretion
Age, Continuous
54 years
n=5 Participants
Sex: Female, Male
Female
11 Participants
n=5 Participants
Sex: Female, Male
Male
11 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
5 Participants
n=5 Participants
Race (NIH/OMB)
White
17 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
Region of Enrollment
United States
22 participants
n=5 Participants
Eastern Cooperative Oncology Group (ECOG) performance status
0
7 participants
n=5 Participants
Eastern Cooperative Oncology Group (ECOG) performance status
1
15 participants
n=5 Participants
Tumor Node Metastatis (TNM) Stage
T2
1 participants
n=5 Participants
Tumor Node Metastatis (TNM) Stage
T3
19 participants
n=5 Participants
Tumor Node Metastatis (TNM) Stage
T4
2 participants
n=5 Participants

PRIMARY outcome

Timeframe: 36 months

· To determine the pathological response rate of preoperative chemotherapy with capecitabine and irinotecan followed by combined modality chemoradiation with capecitabine in patients with locally advanced rectal cancer. Pathological response was defined in the protocol as the proportion of complete (pCR) and non-complete pathological response (pNCR) among all evaluable patients.

Outcome measures

Outcome measures
Measure
Single Group Assignment
n=18 Participants
Irinotecan 200 mg/m2 IV, day 1 Capecitabine 1000\* mg/m2 po bid day 1-14; repeat every three weeks for two cycles \*For calculated creatinine clearance of 30-50 mL/min or patients \> 70 years old, capecitabine starting dose is 825 mg/m2 po bid Capecitabine: Capecitabine 1000\* mg/m2 po bid day 1-14; repeat every three weeks for two cycles \*For calculated creatinine clearance of 30-50 mL/min or patients \> 70 years old, capecitabine starting dose is 825 mg/m2 po bid Irinotecan: Irinotecan 200 mg/m2 IV, day 1 EUS: biopsy per EUS Neoadjuvant Chemotherapy: Irinotecan 200 mg/m2 IV, day 1 Capecitabine 1000 mg/m2 po bid day 1-14; repeat every three weeks for two cycles Preoperative Radiation: Pelvic XRT 45 Gy/1.8 GY/fx/qd+5/4 Gy/1.8 Gy/fx/qd for T3+9 Gy/1.8/Gy/fx/qd for T4 Surgery: Surgery within 8 weeks following chemoradiotherapy Adjuvant Chemotherapy: Adjuvant chemotherapy at investigator's discretion
Pathological Complete Response (pCR) Rate
pCR
33 percentage of patients
Interval 13.0 to 59.0
Pathological Complete Response (pCR) Rate
pNCR
56 percentage of patients
Interval 31.0 to 78.0

SECONDARY outcome

Timeframe: 36 months

To determine the rates of local and distant disease recurrence after treatment.

Outcome measures

Outcome measures
Measure
Single Group Assignment
n=18 Participants
Irinotecan 200 mg/m2 IV, day 1 Capecitabine 1000\* mg/m2 po bid day 1-14; repeat every three weeks for two cycles \*For calculated creatinine clearance of 30-50 mL/min or patients \> 70 years old, capecitabine starting dose is 825 mg/m2 po bid Capecitabine: Capecitabine 1000\* mg/m2 po bid day 1-14; repeat every three weeks for two cycles \*For calculated creatinine clearance of 30-50 mL/min or patients \> 70 years old, capecitabine starting dose is 825 mg/m2 po bid Irinotecan: Irinotecan 200 mg/m2 IV, day 1 EUS: biopsy per EUS Neoadjuvant Chemotherapy: Irinotecan 200 mg/m2 IV, day 1 Capecitabine 1000 mg/m2 po bid day 1-14; repeat every three weeks for two cycles Preoperative Radiation: Pelvic XRT 45 Gy/1.8 GY/fx/qd+5/4 Gy/1.8 Gy/fx/qd for T3+9 Gy/1.8/Gy/fx/qd for T4 Surgery: Surgery within 8 weeks following chemoradiotherapy Adjuvant Chemotherapy: Adjuvant chemotherapy at investigator's discretion
Local and Distant Disease Recurrence Rates
metastatic disease recurrence
22 percentage of particpants
Local and Distant Disease Recurrence Rates
locally recurrence
0 percentage of particpants

SECONDARY outcome

Timeframe: 36 months

Population: Data for this secondary objective was not captured or analyzed due to the withdrawal of funding and subsequent termination of the study.

To determine the rate of clinical response following induction chemotherapy with capecitabine and irinotecan, and also the overall clinical response after the completion of chemoradiation with capecitabine.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 36 months

The three year rate of Disease-Free Survival

Outcome measures

Outcome measures
Measure
Single Group Assignment
n=18 Participants
Irinotecan 200 mg/m2 IV, day 1 Capecitabine 1000\* mg/m2 po bid day 1-14; repeat every three weeks for two cycles \*For calculated creatinine clearance of 30-50 mL/min or patients \> 70 years old, capecitabine starting dose is 825 mg/m2 po bid Capecitabine: Capecitabine 1000\* mg/m2 po bid day 1-14; repeat every three weeks for two cycles \*For calculated creatinine clearance of 30-50 mL/min or patients \> 70 years old, capecitabine starting dose is 825 mg/m2 po bid Irinotecan: Irinotecan 200 mg/m2 IV, day 1 EUS: biopsy per EUS Neoadjuvant Chemotherapy: Irinotecan 200 mg/m2 IV, day 1 Capecitabine 1000 mg/m2 po bid day 1-14; repeat every three weeks for two cycles Preoperative Radiation: Pelvic XRT 45 Gy/1.8 GY/fx/qd+5/4 Gy/1.8 Gy/fx/qd for T3+9 Gy/1.8/Gy/fx/qd for T4 Surgery: Surgery within 8 weeks following chemoradiotherapy Adjuvant Chemotherapy: Adjuvant chemotherapy at investigator's discretion
Disease-Free Survival
75.5 percentage
Interval 39.7 to 91.8

Adverse Events

Single Group Assignment

Serious events: 6 serious events
Other events: 21 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Single Group Assignment
n=22 participants at risk
Irinotecan 200 mg/m2 IV, day 1 Capecitabine 1000\* mg/m2 po bid day 1-14; repeat every three weeks for two cycles \*For calculated creatinine clearance of 30-50 mL/min or patients \> 70 years old, capecitabine starting dose is 825 mg/m2 po bid Capecitabine: Capecitabine 1000\* mg/m2 po bid day 1-14; repeat every three weeks for two cycles \*For calculated creatinine clearance of 30-50 mL/min or patients \> 70 years old, capecitabine starting dose is 825 mg/m2 po bid Irinotecan: Irinotecan 200 mg/m2 IV, day 1 EUS: biopsy per EUS Neoadjuvant Chemotherapy: Irinotecan 200 mg/m2 IV, day 1 Capecitabine 1000 mg/m2 po bid day 1-14; repeat every three weeks for two cycles Preoperative Radiation: Pelvic XRT 45 Gy/1.8 GY/fx/qd+5/4 Gy/1.8 Gy/fx/qd for T3+9 Gy/1.8/Gy/fx/qd for T4 Surgery: Surgery within 8 weeks following chemoradiotherapy Adjuvant Chemotherapy: Adjuvant chemotherapy at investigator's discretion
Cardiac disorders
CARDIAC GENERAL - OTHER (SPECIFY, __)
4.5%
1/22 • Number of events 1
Gastrointestinal disorders
DIARRHEA
4.5%
1/22 • Number of events 1
Nervous system disorders
DIZZINESS
4.5%
1/22 • Number of events 1
Respiratory, thoracic and mediastinal disorders
DYSPNEA (SHORTNESS OF BREATH)
4.5%
1/22 • Number of events 1
Blood and lymphatic system disorders
EDEMA: HEAD AND NECK
4.5%
1/22 • Number of events 1
Infections and infestations
FEBRILE NEUTROPENIA (ANC <1.0 X 10E9/L, FEVER >=38.5 DEGREES C)
4.5%
1/22 • Number of events 1
Cardiac disorders
HYPOTENSION
4.5%
1/22 • Number of events 1
Infections and infestations
INFECTION - OTHER (SPECIFY, __)
4.5%
1/22 • Number of events 1
Blood and lymphatic system disorders
NEUTROPHILS/GRANULOCYTES (ANC/AGC)
4.5%
1/22 • Number of events 1
Nervous system disorders
SYNCOPE (FAINTING)
4.5%
1/22 • Number of events 1
Vascular disorders
THROMBOSIS/THROMBUS/EMBOLISM
4.5%
1/22 • Number of events 1

Other adverse events

Other adverse events
Measure
Single Group Assignment
n=22 participants at risk
Irinotecan 200 mg/m2 IV, day 1 Capecitabine 1000\* mg/m2 po bid day 1-14; repeat every three weeks for two cycles \*For calculated creatinine clearance of 30-50 mL/min or patients \> 70 years old, capecitabine starting dose is 825 mg/m2 po bid Capecitabine: Capecitabine 1000\* mg/m2 po bid day 1-14; repeat every three weeks for two cycles \*For calculated creatinine clearance of 30-50 mL/min or patients \> 70 years old, capecitabine starting dose is 825 mg/m2 po bid Irinotecan: Irinotecan 200 mg/m2 IV, day 1 EUS: biopsy per EUS Neoadjuvant Chemotherapy: Irinotecan 200 mg/m2 IV, day 1 Capecitabine 1000 mg/m2 po bid day 1-14; repeat every three weeks for two cycles Preoperative Radiation: Pelvic XRT 45 Gy/1.8 GY/fx/qd+5/4 Gy/1.8 Gy/fx/qd for T3+9 Gy/1.8/Gy/fx/qd for T4 Surgery: Surgery within 8 weeks following chemoradiotherapy Adjuvant Chemotherapy: Adjuvant chemotherapy at investigator's discretion
Investigations
ALT, SGPT (SERUM GLUTAMIC PYRUVIC TRANSAMINASE)
4.5%
1/22 • Number of events 1
Gastrointestinal disorders
ANOREXIA
40.9%
9/22 • Number of events 13
Psychiatric disorders
APNEA
4.5%
1/22 • Number of events 1
Investigations
AST, SGOT(SERUM GLUTAMIC OXALOACETIC TRANSAMINASE)
4.5%
1/22 • Number of events 1
Ear and labyrinth disorders
AUDITORY/EAR - OTHER (SPECIFY, __)
4.5%
1/22 • Number of events 1
Investigations
CALCIUM, SERUM-LOW (HYPOCALCEMIA)
4.5%
1/22 • Number of events 1
Investigations
CHOLESTEROL, SERUM-HIGH (HYPERCHOLESTREMIA)
4.5%
1/22 • Number of events 1
Gastrointestinal disorders
CONSTIPATION
31.8%
7/22 • Number of events 7
General disorders
CONSTITUTIONAL SYMPTOMS - OTHER (SPECIFY, __)
4.5%
1/22 • Number of events 1
Respiratory, thoracic and mediastinal disorders
COUGH
18.2%
4/22 • Number of events 4
Gastrointestinal disorders
DEHYDRATION
9.1%
2/22 • Number of events 2
Gastrointestinal disorders
DIARRHEA
81.8%
18/22 • Number of events 32
Nervous system disorders
DIZZINESS
9.1%
2/22 • Number of events 2
Gastrointestinal disorders
DRY MOUTH/SALIVARY GLAND (XEROSTOMIA)
4.5%
1/22 • Number of events 1
Respiratory, thoracic and mediastinal disorders
DYSPNEA (SHORTNESS OF BREATH)
18.2%
4/22 • Number of events 7
Blood and lymphatic system disorders
EDEMA: LIMB
4.5%
1/22 • Number of events 1
General disorders
FATIGUE (ASTHENIA, LETHARGY, MALAISE)
77.3%
17/22 • Number of events 25
General disorders
FEVER (IN THE ABSENCE OF NEUTROPENIA, WHERE NEUTROPENIA IS DEFINED AS ANC <1.0 X 10E9/L)
9.1%
2/22 • Number of events 2
Gastrointestinal disorders
FLATULENCE
13.6%
3/22 • Number of events 3
Skin and subcutaneous tissue disorders
FLUSHING
4.5%
1/22 • Number of events 1
Gastrointestinal disorders
GASTROINTESTINAL - OTHER (SPECIFY, __)
13.6%
3/22 • Number of events 4
Skin and subcutaneous tissue disorders
HAIR LOSS/ALOPECIA (SCALP OR BODY)
59.1%
13/22 • Number of events 14
Gastrointestinal disorders
HEARTBURN/DYSPEPSIA
27.3%
6/22 • Number of events 6
Blood and lymphatic system disorders
HEMOGLOBIN
13.6%
3/22 • Number of events 3
Gastrointestinal disorders
HEMORRHOIDS
18.2%
4/22 • Number of events 4
Cardiac disorders
HYPOTENSION
4.5%
1/22 • Number of events 1
Infections and infestations
INFECTION - OTHER (SPECIFY, __)
13.6%
3/22 • Number of events 3
Infections and infestations
INFECTION WITH NORMAL ANC OR GRADE 1 OR 2 NEUTROPHILS / PENIS
4.5%
1/22 • Number of events 1
Infections and infestations
INFECTION WITH NORMAL ANC OR GRADE 1 OR 2 NEUTROPHILS / URINARY TRACT NOS
4.5%
1/22 • Number of events 1
Infections and infestations
INFECTION WITH NORMAL ANC OR GRADE 1 OR 2 NEUTROPHILS / VAGINA
4.5%
1/22 • Number of events 1
General disorders
INSOMNIA
40.9%
9/22 • Number of events 10
Psychiatric disorders
MOOD ALTERATION / ANXIETY
18.2%
4/22 • Number of events 4
Psychiatric disorders
MOOD ALTERATION / DEPRESSION
27.3%
6/22 • Number of events 6
Surgical and medical procedures
MUCOSITIS/STOMATITIS (CLINICAL EXAM) / ANUS
4.5%
1/22 • Number of events 1
Gastrointestinal disorders
MUCOSITIS/STOMATITIS (FUNCTIONAL/SYMPTOMATIC) / ORAL CAVITY
9.1%
2/22 • Number of events 2
General disorders
MUCOSITIS/STOMATITIS (FUNCTIONAL/SYMPTOMATIC) / PHARYNX
4.5%
1/22 • Number of events 1
Gastrointestinal disorders
MUCOSITIS/STOMATITIS (FUNCTIONAL/SYMPTOMATIC) / RECTUM
4.5%
1/22 • Number of events 1
Gastrointestinal disorders
NAUSEA
72.7%
16/22 • Number of events 22
Nervous system disorders
NEUROLOGY - OTHER (SPECIFY, __)
4.5%
1/22 • Number of events 1
Nervous system disorders
NEUROPATHY: SENSORY
18.2%
4/22 • Number of events 4
Blood and lymphatic system disorders
NEUTROPHILS/GRANULOCYTES (ANC/AGC)
18.2%
4/22 • Number of events 5
Gastrointestinal disorders
PAIN / ABDOMEN NOS
18.2%
4/22 • Number of events 4
Gastrointestinal disorders
PAIN / ANUS
4.5%
1/22 • Number of events 1
General disorders
PAIN / BACK
4.5%
1/22 • Number of events 1
General disorders
PAIN / BUTTOCK
4.5%
1/22 • Number of events 1
Musculoskeletal and connective tissue disorders
PAIN / EXTREMITY-LIMB
9.1%
2/22 • Number of events 2
General disorders
PAIN / HEAD/HEADACHE
4.5%
1/22 • Number of events 1
Musculoskeletal and connective tissue disorders
PAIN / JOINT
4.5%
1/22 • Number of events 1
Gastrointestinal disorders
PAIN / RECTUM
31.8%
7/22 • Number of events 8
Gastrointestinal disorders
PAIN / STOMACH
4.5%
1/22 • Number of events 1
Reproductive system and breast disorders
PAIN / VAGINA
4.5%
1/22 • Number of events 1
General disorders
PAIN - OTHER (SPECIFY, __)
22.7%
5/22 • Number of events 5
Blood and lymphatic system disorders
PLATELETS
9.1%
2/22 • Number of events 2
Investigations
POTASSIUM, SERUM-LOW (HYPOKALEMIA)
18.2%
4/22 • Number of events 4
Gastrointestinal disorders
PROCTITIS
4.5%
1/22 • Number of events 1
Skin and subcutaneous tissue disorders
PRURITUS/ITCHING
4.5%
1/22 • Number of events 1
Cardiac disorders
PULMONARY HYPERTENSION
4.5%
1/22 • Number of events 1
Respiratory, thoracic and mediastinal disorders
PULMONARY/UPPER RESPIRATORY - OTHER (SPECIFY, __)
4.5%
1/22 • Number of events 1
Skin and subcutaneous tissue disorders
RASH/DESQUAMATION
4.5%
1/22 • Number of events 1
Skin and subcutaneous tissue disorders
RASH: ACNE/ACNEIFORM
4.5%
1/22 • Number of events 1
Skin and subcutaneous tissue disorders
RASH: DERMATITIS ASSOCIATED WITH RADIATION / CHEMORADIATION
18.2%
4/22 • Number of events 5
Skin and subcutaneous tissue disorders
RASH: DERMATITIS ASSOCIATED WITH RADIATION / RADIATION
4.5%
1/22 • Number of events 1
Skin and subcutaneous tissue disorders
RASH: HAND-FOOT SKIN REACTION
13.6%
3/22 • Number of events 3
Renal and urinary disorders
RENAL/GENITOURINARY - OTHER (SPECIFY, __)
4.5%
1/22 • Number of events 2
Investigations
SODIUM, SERUM-LOW (HYPONATREMIA)
4.5%
1/22 • Number of events 1
Psychiatric disorders
SOMNOLENCE/DEPRESSED LEVEL OF CONSCIOUSNESS
9.1%
2/22 • Number of events 2
General disorders
SWEATING (DIAPHORESIS)
9.1%
2/22 • Number of events 2
General disorders
SYNDROMES - OTHER (SPECIFY, __)
4.5%
1/22 • Number of events 1
Gastrointestinal disorders
TASTE ALTERATION (DYSGEUSIA)
18.2%
4/22 • Number of events 4
Renal and urinary disorders
URINARY FREQUENCY/URGENCY
4.5%
1/22 • Number of events 1
Gastrointestinal disorders
VOMITING
31.8%
7/22 • Number of events 9
General disorders
WEIGHT LOSS
13.6%
3/22 • Number of events 3

Additional Information

Principal Investigator

Hoosier Cancer Research Network, Inc.

Phone: 317-921-2050

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place