Short-course Radiotherapy With Induction and Consolidation Chemotherapy in Patients With Locally Advanced Rectal Cancer

NCT ID: NCT04674696

Last Updated: 2020-12-19

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

UNKNOWN

Clinical Phase

PHASE2

Total Enrollment

54 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-11-10

Study Completion Date

2022-06-30

Brief Summary

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Short-course radiotherapy followed by consolidation chemotherapy has shown a better response rate when compared to chemoradiotherapy treatment.

In addition, recent studies have shown better tolerance with total neoadjuvant treatment, with induction or consolidation chemotherapy. Induction chemotherapy could reduce the size of the tumor, treat micrometastases early and allow treatment to start immediately (avoiding potential delays in waiting for radiotherapy). While consolidation chemotherapy allows longer waiting times for surgery, with higher response rates.

Detailed Description

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Methods: This trial aim to evaluate induction treatment with CAPOX, followed by short-course radiotherapy consolidation chemotherapy with CAPOX. After 5-7 weeks, patients will be evaluate by MRI. Patients with incomplete clinical response will be referred to immediate surgery and patients with complete clinical response will be managed with "watch and wait" approach. Patients with progression disease during the treatment phase will be withdrawn from the study and will receive their treatment according to the investigator's judgment.

The sample size was calculated according to Simon's optimal two-stage design. Accordingly, 21 patients must be included in each group during the first stage and 24 during the second stage. Treatment regimen will be considered effective if 9 or more patients show good response (final analysis), reaching 80% power with an alpha of 0.10 level of significance.

Conditions

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Rectal Cancer Total Neoadjuvant Treatment

Keywords

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rectal cancer

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Experimental

Patients will receive 2 CAPOX cycles, followed by short-course radiotherapy and 4 CAPOX cycles.

Group Type EXPERIMENTAL

Approach

Intervention Type OTHER

Patients will receive 2 CAPOX cycles, followed by short-course radiotherapy and 4 CAPOX cycles.

Interventions

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Approach

Patients will receive 2 CAPOX cycles, followed by short-course radiotherapy and 4 CAPOX cycles.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Histologically confirmed adenocarcinoma of mid or low rectum
* Locally advanced rectal cancer with one of the high-risk factors confirmed by high-resolution thin-slice Magnetic resonance image (3 mm) tumors extending to within 1 mm of, or beyond the mesorectal fascia; tumor extending 5 mm or more into perirectal fat; resectable cT4 tumors; lower third; nodal involvement; extramural vascular invasion
* ECOG performance status of 0-2
* An informed consent has been signed by the patient

Exclusion Criteria

* Upper rectal cancer
* Metastatic disease
* The patient received any previous therapy for colorectal cancer or another malignancy
* Other malignant tumours within the last 5 years except cervical carcinoma in situ and basal cell carcinoma of the skin
* Previous thromboembolic or haemorrhagic events within 6 months prior to registration
* Patients with malabsorption syndrome or difficulties in swallowing
* The patient has severe underlying diseases or poor condition to receive chemotherapy or radiotherapy
* Pregnant of breastfeeding women
* The patient who participate in another clinical trial, or receives any drug for the trial
* Uncontrolled peripheral neuropathy (more than grade 2)
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Instituto Nacional de Cancer, Brazil

OTHER_GOV

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Juliana Souza

Role: PRINCIPAL_INVESTIGATOR

Instituto Nacional de Cancer, Brazil

Locations

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INCA- Instituto Nacional de Câncer

Rio de Janeiro, , Brazil

Site Status RECRUITING

Countries

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Brazil

Central Contacts

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Juliana Souza

Role: CONTACT

Phone: 5521988734435

Email: [email protected]

Isabele Small

Role: CONTACT

Phone: 00552132076666

Email: [email protected]

Facility Contacts

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Luana Cerva

Role: primary

Other Identifiers

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SHORT-ICAR

Identifier Type: -

Identifier Source: org_study_id