Radiation Therapy and Capecitabine With or Without Oxaliplatin in Treating Patients Who Are Undergoing Surgery for Stage II or Stage III Rectal Cancer

NCT ID: NCT00227747

Last Updated: 2021-02-17

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

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

598 participants

Study Classification

INTERVENTIONAL

Study Start Date

2005-11-08

Study Completion Date

2013-07-15

Brief Summary

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RATIONALE: Radiation therapy uses high-energy x-rays to kill tumor cells. Drugs used in chemotherapy, such as capecitabine and oxaliplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more tumor cells. Giving radiation therapy together with combination chemotherapy before surgery may shrink the tumor so it can be removed. It is not yet known whether giving radiation therapy together with capecitabine is more effective with or without oxaliplatin before surgery in treating rectal cancer.

PURPOSE: This randomized phase III trial is studying radiation therapy, capecitabine, and oxaliplatin to see how well they work compared to radiation therapy and capecitabine in treating patients who are undergoing surgery for stage II or stage III rectal cancer.

Detailed Description

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OBJECTIVES:

Primary

* Compare the efficacy of neoadjuvant chemoradiotherapy comprising radiotherapy and capecitabine with vs without oxaliplatin followed by total mesorectal excision, in terms of the rate of complete surgical resection, in patients with resectable stage II or III rectal cancer.

Secondary

* Compare overall and disease-free survival of patients treated with these regimens.
* Compare clinical tumor response in patients treated with these regimens.
* Compare acute and late toxicity of these regimens in these patients.
* Determine biological parameters that predict tumor response and treatment-related toxicity in patients treated with these regimens.
* Compare sphincter preservation and function in patients treated with these regimens.

OUTLINE: This is a randomized, controlled, multicenter study. Patients are randomized to 1 of 2 treatment arms.

* Arm I: Patients undergo radiotherapy once daily 5 days a week and receive capecitabine once daily 5 days a week in weeks 1-5.
* Arm II: Patient undergo radiotherapy and receive capecitabine as in arm I. Patients also receive oxaliplatin once weekly in weeks 1-5.

All patients undergo total mesorectal excision 6 weeks after completion of chemoradiotherapy.

PROJECTED ACCRUAL: A total of 590 patients will be accrued for this study.

Conditions

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Colorectal Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Radiothérapie + Xelox

Group Type EXPERIMENTAL

capecitabine

Intervention Type DRUG

oxaliplatin

Intervention Type DRUG

conventional surgery

Intervention Type PROCEDURE

neoadjuvant therapy

Intervention Type PROCEDURE

radiation therapy

Intervention Type RADIATION

Radiothérapie + Capécitabine

Group Type ACTIVE_COMPARATOR

capecitabine

Intervention Type DRUG

conventional surgery

Intervention Type PROCEDURE

neoadjuvant therapy

Intervention Type PROCEDURE

radiation therapy

Intervention Type RADIATION

Interventions

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capecitabine

Intervention Type DRUG

oxaliplatin

Intervention Type DRUG

conventional surgery

Intervention Type PROCEDURE

neoadjuvant therapy

Intervention Type PROCEDURE

radiation therapy

Intervention Type RADIATION

Eligibility Criteria

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Inclusion Criteria

DISEASE CHARACTERISTICS:

* Histologically confirmed adenocarcinoma of the rectum

* T3-4, N0-2, M0 disease by endorectal ultrasound

* T2 disease located in the low rectum allowed provided lower pole is ≤ 6 cm from the anal verge
* Tumor must be accessible to digital rectal examination (i.e., tumor located at low- or mid-rectum)
* Resectable disease treatable with chemoradiotherapy

* No unresectable disease (i.e., T4 disease with high risk for incomplete gross resection \[i.e., R2\])

PATIENT CHARACTERISTICS:

Age

* 18 to 80

Performance status

* ECOG 0-2

Life expectancy

* Not specified

Hematopoietic

* WBC ≥ 1,500/mm\^3
* Platelet count ≥ 100,000/mm\^3
* Hemoglobin \> 10 g/dL

Hepatic

* Alkaline phosphatase normal
* Bilirubin normal

Renal

* Creatinine ≤ 130 μmol/L
* No severe renal insufficiency

Cardiovascular

* No cardiac insufficiency
* No symptomatic coronary artery disease

Other

* Not pregnant or nursing
* Negative pregnancy test
* Fertile patients must use effective contraception
* No contraindication to study treatment
* Prior acute intestinal obstruction allowed provided patient underwent surgical diversion with stoma
* No history of other cancer except basal cell skin cancer or carcinoma in situ of the cervix
* No peripheral neuropathy
* No uncontrolled diabetes
* No other uncontrolled severe disease
* No geographical, social, or psychological condition that would preclude study follow-up

PRIOR CONCURRENT THERAPY:

Biologic therapy

* Not specified

Chemotherapy

* No prior chemotherapy for cancer
* No other concurrent chemotherapy

Endocrine therapy

* Not specified

Radiotherapy

* No prior radiotherapy for cancer

Surgery

* Not specified

Other

* No concurrent phenytoin
* No concurrent participation in another clinical trial of an experimental medical treatment
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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UNICANCER

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jean-Pierre Gerard, MD

Role: STUDY_CHAIR

Centre Antoine Lacassagne

Locations

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Centre Hospitalier d'Abbeville

Abbeville, , France

Site Status

Centre Hospitalier

Altkirch, , France

Site Status

Institut Sainte Catherine

Avignon, , France

Site Status

Hopital Duffaut

Avignon, , France

Site Status

Hopital de Beziers

Béziers, , France

Site Status

Centre Hospitalier de Blois

Blois, , France

Site Status

Hopital Saint Andre

Bordeaux, , France

Site Status

Institut Bergonie

Bordeaux, , France

Site Status

Polyclinique Bordeaux Nord Aquitaine

Bordeaux, , France

Site Status

Clinique Tivoli

Bordeaux, , France

Site Status

Centre Hospitalier Docteur Duchenne

Boulogne-sur-Mer, , France

Site Status

Centre Hospitalier Pierre Oudot

Bourgoin, , France

Site Status

CHU de Caen

Caen, , France

Site Status

Centre Regional Francois Baclesse

Caen, , France

Site Status

Clinique Sainte Marie

Chalon-sur-Saône, , France

Site Status

Hopital Louis Pasteur

Chartres, , France

Site Status

Hopital Louis Pasteur

Colmar, , France

Site Status

Centre Hospitalier Universitaire Henri Mondor

Créteil, , France

Site Status

Hopital Drevon

Dijon, , France

Site Status

Hopital Du Bocage

Dijon, , France

Site Status

Centre Hospitalier de Gap

Gap, , France

Site Status

Clinique Sainte-Marguerite

Hyères, , France

Site Status

Centre Hospitalier Departemental

La Roche-sur-Yon, , France

Site Status

Clinique Victor Hugo

Le Mans, , France

Site Status

Hopital Robert Boulin

Libourne, , France

Site Status

Centre Oscar Lambret

Lille, , France

Site Status

Centre Hospital Regional Universitaire de Limoges

Limoges, , France

Site Status

Hopital Jean Bernard

Limoges, , France

Site Status

Centre Hospitalier General

Longjumeau, , France

Site Status

Polyclinique des Quatre Pavillons

Lormont, , France

Site Status

Centre Leon Berard

Lyon, , France

Site Status

Marseille Institute of Cancer - Institut J. Paoli and I. Calmettes

Marseille, , France

Site Status

CHU de la Timone

Marseille, , France

Site Status

Clinique J. B. Menis

Mâcon, , France

Site Status

Hopital Notre-Dame de Bon Secours

Metz, , France

Site Status

Centre Hospitalier General Andre Boulloche

Montbéliard, , France

Site Status

Centre Hospitalier Intercommunal Le Raincy - Montfermeil

Montfermeil, , France

Site Status

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

Montpellier, , France

Site Status

Clinique Clementville

Montpellier, , France

Site Status

Clinique Plein Ciel

Mougins, , France

Site Status

Centre Hospitalier de Mulhouse

Mulhouse, , France

Site Status

Centre Regional Rene Gauducheau

Nantes-Saint Herblain, , France

Site Status

Clinique Hartmann

Neuilly-sur-Seine, , France

Site Status

Polyclinique du Val de Loire

Nevers, , France

Site Status

Centre Antoine Lacassagne

Nice, , France

Site Status

C.H.U. de Nimes - Groupe Hospitals-Universitaire Caremeau

Nîmes, , France

Site Status

CHR D'Orleans - Hopital de la Source

Orléans, , France

Site Status

Hopital Europeen Georges Pompidou

Paris, , France

Site Status

Hopital Bichat - Claude Bernard

Paris, , France

Site Status

Hopital Saint-Louis

Paris, , France

Site Status

CHU Pitie-Salpetriere

Paris, , France

Site Status

Hopital Tenon

Paris, , France

Site Status

Centre Hospitalier - Pau

Pau, , France

Site Status

Clinique Saint - Pierre

Perpignan, , France

Site Status

Centre Hospitalier Lyon Sud

Pierre-Bénite, , France

Site Status

Institut Jean Godinot

Reims, , France

Site Status

CHU - Robert Debre

Reims, , France

Site Status

Polyclinique De Courlancy

Reims, , France

Site Status

Centre Eugene Marquis

Rennes, , France

Site Status

Centre Hospitalier de Rodez

Rodez, , France

Site Status

Clinique Armoricaine De Radiologie

Saint-Brieuc, , France

Site Status

Centre Rene Huguenin

Saint-Cloud, , France

Site Status

Institut de Cancerologie de la Loire

Saint-Priest-en-Jarez, , France

Site Status

Centre Paul Strauss

Strasbourg, , France

Site Status

Institut Claudius Regaud

Toulouse, , France

Site Status

Clinique Pasteur - Toulouse

Toulouse, , France

Site Status

Centre Alexis Vautrin

Vandœuvre-lès-Nancy, , France

Site Status

Centre d'Oncologie Saint-Yves

Vannes, , France

Site Status

Institut Gustave Roussy

Villejuif, , France

Site Status

Countries

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France

References

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Gerard JP, Azria D, Gourgou-Bourgade S, Martel-Laffay I, Hennequin C, Etienne PL, Vendrely V, Francois E, de La Roche G, Bouche O, Mirabel X, Denis B, Mineur L, Berdah JF, Mahe MA, Becouarn Y, Dupuis O, Lledo G, Montoto-Grillot C, Conroy T. Comparison of two neoadjuvant chemoradiotherapy regimens for locally advanced rectal cancer: results of the phase III trial ACCORD 12/0405-Prodige 2. J Clin Oncol. 2010 Apr 1;28(10):1638-44. doi: 10.1200/JCO.2009.25.8376. Epub 2010 Mar 1.

Reference Type RESULT
PMID: 20194850 (View on PubMed)

Azria D, Doyen J, Jarlier M, Martel-Lafay I, Hennequin C, Etienne P, Vendrely V, Francois E, de La Roche G, Bouche O, Mirabel X, Denis B, Mineur L, Berdah J, Mahe M, Becouarn Y, Dupuis O, Lledo G, Seitz J, Bedenne L, Gourgou-Bourgade S, Juzyna B, Conroy T, Gerard J. Late toxicities and clinical outcome at 5 years of the ACCORD 12/0405-PRODIGE 02 trial comparing two neoadjuvant chemoradiotherapy regimens for intermediate-risk rectal cancer. Ann Oncol. 2017 Oct 1;28(10):2436-2442. doi: 10.1093/annonc/mdx351.

Reference Type DERIVED
PMID: 28961836 (View on PubMed)

Other Identifiers

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FRE-FNCLCC-ACCORD-12/0405

Identifier Type: -

Identifier Source: secondary_id

EU-20522

Identifier Type: -

Identifier Source: secondary_id

CDR0000445034

Identifier Type: -

Identifier Source: org_study_id

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