Efficacy of Hyperthermic Intraperitoneal Chemotherapy

NCT ID: NCT04861558

Last Updated: 2025-05-30

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

RECRUITING

Clinical Phase

PHASE3

Total Enrollment

213 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-05-01

Study Completion Date

2029-12-31

Brief Summary

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A dose titration study and a combined superiority registry-based open-label randomized control trial is planned to answer the trial objectives. The study will be registry-based to allow simpler and more comprehensive follow-up. Patients with colorectal cancer will be treated with cytoreductive surgery (CRS) together with either standard oxaliplatin HIPEC (the control for the efficacy study) or oxaliplatin/irinotecan HIPEC in combination with 5-FU 24-hour EPIC. The 5-FU will be administered postoperatively when the abdomen is completely sutured. The drug is divided equally into 2 injections of 200 ml each and injected through two abdominal drains that are clamped for 16 hours.

For dose escalation, the titration groups (á 3 or 6 patients) are followed for 30 days postoperatively after which the Data Monitoring Committee (DMC) will determine whether or not to increase the 5-FU dose for the following group of patients.

To study efficacy, randomization is performed intraoperatively. The patient is followed up postoperatively for a total of 3 years for the secondary endpoints which may be extended by the study committee to 5 years. Since the trial is registry based, the long-term follow-up does not require separate eCRF evaluations. These evaluations can be automatically retrieved from the registry - both recurrence data, quality of life, and morbidity data. Some specific eCRF evaluations will be integrated as a separate study part of the HIPEC registry, such as inclusion/exclusion criteria and adverse event reporting (including SUSAR reporting).

Detailed Description

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Not detailed description entered.

Conditions

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Colorectal Cancer Peritoneal Metastases

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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Standard HIPEC

Injection of oxaliplatin 460 mg/m2 and an intraoperational IV of 5-fluorouracil 400 mg/m2, and calcium folinate 60 mg/m2.

Group Type ACTIVE_COMPARATOR

Oxaliplatin

Intervention Type DRUG

Injection of 460 mg/m2

Intensified HIPEC+EPIC

Injection of irinotecan 360 mg/m2 and 5-fluorouracil 24-hr EPIC 250-850 mg/m2 in combination with Oxaliplatin 360 mg/m2 and an intraoperational IV of 5-fluorouracil bolus 400 mg/m2 with calcium folinate 60mg/m2.

The EPIC treatment is given after the abdomen is completely sutured in the operating theater. The dose will be divided equally into 2 injections á 200ml each through two abdominal drains.

Group Type EXPERIMENTAL

5Fluorouracil

Intervention Type DRUG

Injection of 250-850 mg/m2.

Irinotecan

Intervention Type DRUG

Injection of 360 mg/m2

Oxaliplatin

Intervention Type DRUG

Injection of 460 mg/m2

Interventions

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5Fluorouracil

Injection of 250-850 mg/m2.

Intervention Type DRUG

Irinotecan

Injection of 360 mg/m2

Intervention Type DRUG

Oxaliplatin

Injection of 460 mg/m2

Intervention Type DRUG

Other Intervention Names

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Fluorouracil Accord Fluorouracil Tevo Irinotecan Accord Irinotecan Actavis Irinotecan Fresenius Kabi Oxaliplatin Accord Oxaliplatin Teva Oxaliplatin Fresenius Kabi

Eligibility Criteria

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Inclusion Criteria

1. Provision of written informed consent prior to any study specific procedures.
2. ECOG Performance Status Score 0,1 or 2 alternatively Karnofsky 60-100
3. Adequate kidney, liver, bone marrow function according to laboratory tests
4. For females of childbearing potential, a negative pregnancy test must be documented
5. ≥ 18 years old and ≤78 years old
6. Colorectal cancer with peritoneal metastases +/- liver metastases (maximum 3)
7. Concomitant resectable pulmonary metastases are allowed
8. All patients deemed eligible for CRS and HIPEC according to clinical routine management during a HIPEC multidisciplinary board at each respective hospital can be included.

Exclusion Criteria

1. Previous severe toxicity/allergic reactions to systemic chemotherapy agents oxaliplatin or irinotecan or 5-fluorouracil
2. Unable to tolerate intensified HIPEC treatment due to comorbidity
3. Metastasis other than peritoneum or liver or lung
4. Complex liver-perenchymal sparing surgery or hemihepatectomy procedures are to be excluded.
5. Previous CRS or HIPEC
6. Pregnant or lactating (nursing) women
7. Active infections requiring antibiotics
8. Active liver disease with positive serology for active hepatitis B, C, or known HIV
9. Concurrent administration of any cancer therapy other than planned study treatment within 4 weeks prior to and up to 4 weeks after study treatment
10. Incomplete cytoreduction defined as completeness of cytoreduction score 2-3
11. Histopathology of other origin than colorectal cancer
Minimum Eligible Age

18 Years

Maximum Eligible Age

79 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Uppsala University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Peter Cashin, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Uppsala University Hospital

Locations

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INDEPSO

Ahmedabad, , India

Site Status RECRUITING

Sahlgrenska östra sjukhuset

Gothenburg, , Sweden

Site Status RECRUITING

Skånes universitetssjukhus

Malmo, , Sweden

Site Status RECRUITING

Karolinska sjukhuset

Stockholm, , Sweden

Site Status RECRUITING

Akademiska sjukhuset

Uppsala, , Sweden

Site Status RECRUITING

Countries

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India Sweden

Central Contacts

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Peter Cashin, MD, PhD

Role: CONTACT

+46 (0)18 6174304

Lana Ghanipour, MD, PhD

Role: CONTACT

+46 (0)18 6110000

Facility Contacts

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Aditi Bhatt, MD

Role: primary

Elinor Bexe-Lindskog, MD,PhD

Role: primary

Ingvar Syk, MD, PhD

Role: primary

Gabriella Jansson Palmer

Role: primary

Lana Ghanipour

Role: primary

Other Identifiers

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EFFIPECv5

Identifier Type: -

Identifier Source: org_study_id

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