Liver Surgery and Chemotherapy in Treating Patients With Colorectal Cancer With Liver Metastases That Can Be Removed by Surgery and Lung Metastases That Cannot Be Removed by Surgery

NCT ID: NCT02738606

Last Updated: 2025-12-17

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

TERMINATED

Clinical Phase

PHASE2

Total Enrollment

28 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-05-25

Study Completion Date

2025-12-05

Brief Summary

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This randomized phase II trial studies how well liver surgery and chemotherapy compared to chemotherapy alone work in treating patients with colorectal cancer that has spread to the liver (liver metastases) that can be removed by surgery and that has spread to the lungs (lung metastases) that cannot be removed by surgery. Liver surgery removes a portion of the liver affected by the tumor. Chemotherapy drugs work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Liver surgery and chemotherapy may work better than chemotherapy alone in treating patients with colorectal cancer which has spread to the liver and lungs.

Detailed Description

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PRIMARY OBJECTIVE:

I. To determine a survival benefit of liver resection in patients with resectable liver and unresectable low-volume pulmonary metastases from colorectal cancer.

SECONDARY OBJECTIVES:

I. To identify biomarkers in blood and resected liver specimens that correlate with survival, and development of extrahepatic and extrapulmonary metastases.

II. To assess patients' quality-of-life in each treatment arm with serial questionnaires.

OUTLINE: Patients are randomized to 1 of 2 groups.

GROUP I: Patients undergo hepatectomy and receive chemotherapy at the discretion of treating oncologist. Patients whose lung tumors become able to be removed by surgery with chemotherapy may undergo lung metastasectomy.

GROUP II: Patients receive chemotherapy at the discretion of the treating oncologist. Patients whose lung tumors become able to be removed by surgery with chemotherapy may undergo lung metastasectomy.

Patients are followed up every 3-6 months up to 3 years.

Conditions

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Metastatic Colorectal Carcinoma Metastatic Malignant Neoplasm in the Liver Metastatic Malignant Neoplasm in the Lung Recurrent Colorectal Carcinoma Resectable Colorectal Carcinoma Stage IV Colorectal Cancer AJCC v7 Stage IVA Colorectal Cancer AJCC v7 Stage IVB Colorectal Cancer AJCC v7

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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Group II (chemotherapy)

Patients receive chemotherapy at the discretion of the treating oncologist. Patients whose lung tumors become able to be removed by surgery with chemotherapy may undergo lung metastasectomy.

Group Type ACTIVE_COMPARATOR

Chemotherapy

Intervention Type DRUG

Laboratory Biomarker Analysis

Intervention Type OTHER

Correlative studies

Metastasectomy

Intervention Type PROCEDURE

Undergo lung metastasectomy

Quality-of-Life Assessment

Intervention Type OTHER

Ancillary studies

Group I (surgery, chemotherapy)

Patients undergo hepatectomy and receive chemotherapy at the discretion of treating oncologist. Patients whose lung tumors become able to be removed by surgery with chemotherapy may undergo lung metastasectomy.

Group Type EXPERIMENTAL

Therapeutic Conventional Surgery

Intervention Type PROCEDURE

Undergo hepatectomy

Chemotherapy

Intervention Type DRUG

Laboratory Biomarker Analysis

Intervention Type OTHER

Correlative studies

Metastasectomy

Intervention Type PROCEDURE

Undergo lung metastasectomy

Quality-of-Life Assessment

Intervention Type OTHER

Ancillary studies

Interventions

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Therapeutic Conventional Surgery

Undergo hepatectomy

Intervention Type PROCEDURE

Chemotherapy

Intervention Type DRUG

Laboratory Biomarker Analysis

Correlative studies

Intervention Type OTHER

Metastasectomy

Undergo lung metastasectomy

Intervention Type PROCEDURE

Quality-of-Life Assessment

Ancillary studies

Intervention Type OTHER

Other Intervention Names

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Chemo Chemotherapy (NOS) Chemotherapy, Cancer, General Quality of Life Assessment

Eligibility Criteria

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Inclusion Criteria

* Patients with synchronous or metachronous diagnosis of resectable liver metastases by computed tomography (CT) or magnetic resonance imaging (MRI) of the abdomen

* Patients requiring percutaneous or intraoperative ablation of liver metastases \< 2 cm in size are eligible
* Patients who underwent prior liver resection or ablation for colorectal liver metastases are eligible
* Patients previously treated with systemic chemotherapy and/or biologic agents for colorectal cancer are eligible
* The primary tumor in the colon or rectum may be intact or resected
* Low-volume lung metastases are defined as solid pulmonary nodules \< 2 cm with non-spiculated contours, no benign-appearing calcifications, and =\< 14 in number, diagnosed by computed tomography of the chest or positron emission tomography (PET)
* Lung metastases will be unresectable due to anatomic location, distribution, or patients' comorbidities, as determined by review of imaging by a faculty member in the Department of Thoracic \& Cardiovascular Surgery
* Patients must sign a study-specific consent form
* Patients will undergo CT imaging of the chest, abdomen, and pelvis to evaluate lung and liver metastases within 60 days of registration; for patients who cannot tolerate CT contrast or have hepatic steatosis that reduces the sensitivity of CT, MRI of the liver will be performed

Exclusion Criteria

* Radiographic evidence of disease other than liver and lungs, with the exception of mediastinal lymph nodes \< 2 cm and hepatoduodenal ligament lymphadenopathy, diagnosed by computed tomography, magnetic resonance imaging, or positron emission tomography
* Serum bilirubin \>= 2 mg/dL
* Platelet count \< 50,000/uL
* Eastern Cooperative Oncology Group (ECOG) performance status of 3-4
* Patient refusal to participate in randomization
* Pregnant women are excluded from this study
* Planned stereotactic body radiation therapy (SBRT) for the pulmonary metastases
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Cancer Institute (NCI)

NIH

Sponsor Role collaborator

M.D. Anderson Cancer Center

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Yun S Chun

Role: PRINCIPAL_INVESTIGATOR

M.D. Anderson Cancer Center

Locations

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M D Anderson Cancer Center

Houston, Texas, United States

Site Status

Countries

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United States

Provided Documents

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Document Type: Informed Consent Form

View Document

Related Links

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http://www.mdanderson.org

MD Anderson Cancer Center

Other Identifiers

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NCI-2016-00740

Identifier Type: REGISTRY

Identifier Source: secondary_id

2015-1133

Identifier Type: OTHER

Identifier Source: secondary_id

2015-1133

Identifier Type: -

Identifier Source: org_study_id