Preoperative Systemic Therapy for Colorectal Cancer Peritoneal Metastases

NCT ID: NCT05353582

Last Updated: 2022-04-29

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

168 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-06-01

Study Completion Date

2025-07-01

Brief Summary

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This is an open-label, parallel-group, phase 2 randomized trial which randomizes patients with isolated resectable colorectal cancer peritoneal metastases to receive preoperative systematic therapy followed by CRS+HIPEC and postoperative chemotherapy or upfront CRS+HIPEC followed by postoperative chemotherapy.

Detailed Description

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Conditions

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Colorectal Neoplasms Colorectal Cancer Colorectal Cancer Metastatic Peritoneal Metastases Peritoneal Cancer Peritoneal Neoplasms Chemotherapy Effect Cytoreductive Surgery Hyperthermic Intraperitoneal Chemotherapy

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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Chemotherapy group

6 cycles of mFOLFOXIRI±Bev is followed by cytoreductive surgery. Postoperative 6 cycles of mFOLFOX is scheduled.

Group Type EXPERIMENTAL

Preoperative systematic therapy

Intervention Type DRUG

6 cycles of mFOLFOXIRI±Bev is administrated before CRS+HIPEC. Irinotecan165mg/m2 IV day 1, oxaliplatin 85mg/m2 IV day 1, leucovorin 400mg/m2 IV day , bevacizumab mg/kg IV day 1, 5-fluorouracil 400mg/m2, continuous infusion over 46-48h. Dose reduction is permitted. Bev will not be administrated in at the last two cycles for minimizing surgery complications.

CRS+HIPEC

Intervention Type PROCEDURE

CRS+HIPEC aims to achieve CC0/CC1 resection. Oxaliplatin or mitomycin C is determined by the treating physician.

Postoperative chemotherapy

Intervention Type DRUG

6 cycles of mFOLFOX+Bev is administrated after CRS+HIPEC. Oxaliplatin 85mg/m2 IV day 1, leucovorin 400mg/m2 IV day , bevacizumab mg/kg IV day 1, 5-fluorouracil 400mg/m2 IV bolus day 1,5-fluorouracil 400mg/m2, continuous infusion over 46-48h. Dose reduction is permitted.

Upfront surgery group

Upfront surgery group is followed by 12 cycles of mFOLFOX+Bev

Group Type ACTIVE_COMPARATOR

CRS+HIPEC

Intervention Type PROCEDURE

CRS+HIPEC aims to achieve CC0/CC1 resection. Oxaliplatin or mitomycin C is determined by the treating physician.

Postoperative chemotherapy

Intervention Type DRUG

12 cycles of mFOLFOX+Bev is administrated after CRS+HIPEC. Oxaliplatin 85mg/m2 IV day 1, leucovorin 400mg/m2 IV day , bevacizumab mg/kg IV day 1, 5-fluorouracil 400mg/m2 IV bolus day 1,5-fluorouracil 400mg/m2, continuous infusion over 46-48h. Dose reduction is permitted.

Interventions

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Preoperative systematic therapy

6 cycles of mFOLFOXIRI±Bev is administrated before CRS+HIPEC. Irinotecan165mg/m2 IV day 1, oxaliplatin 85mg/m2 IV day 1, leucovorin 400mg/m2 IV day , bevacizumab mg/kg IV day 1, 5-fluorouracil 400mg/m2, continuous infusion over 46-48h. Dose reduction is permitted. Bev will not be administrated in at the last two cycles for minimizing surgery complications.

Intervention Type DRUG

CRS+HIPEC

CRS+HIPEC aims to achieve CC0/CC1 resection. Oxaliplatin or mitomycin C is determined by the treating physician.

Intervention Type PROCEDURE

Postoperative chemotherapy

6 cycles of mFOLFOX+Bev is administrated after CRS+HIPEC. Oxaliplatin 85mg/m2 IV day 1, leucovorin 400mg/m2 IV day , bevacizumab mg/kg IV day 1, 5-fluorouracil 400mg/m2 IV bolus day 1,5-fluorouracil 400mg/m2, continuous infusion over 46-48h. Dose reduction is permitted.

Intervention Type DRUG

Postoperative chemotherapy

12 cycles of mFOLFOX+Bev is administrated after CRS+HIPEC. Oxaliplatin 85mg/m2 IV day 1, leucovorin 400mg/m2 IV day , bevacizumab mg/kg IV day 1, 5-fluorouracil 400mg/m2 IV bolus day 1,5-fluorouracil 400mg/m2, continuous infusion over 46-48h. Dose reduction is permitted.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1;
* Historically and radiologically confirmed colorectal cancer peritoneal metastasis except for appendical origin;
* Tolerable to scheduled chemotherapy;
* No evidence of extraperitoneal metastases at enrollment;
* Resectable disease determined by radiological and laparoscopy/laparotomy;
* No systematic therapy within 6 months before enrollment;
* Tolerable to cytoreductive surgery.

Exclusion Criteria

* Without adequate organ function (e.g. :neutrophil countt≤1.5×10\^9/L, or platelets≤75×10\^12/L,or hemoglobin\<90g/L, or aminotransferase、aspartate aminotransferaseAST\<2.5ULN, or total bilirubin\<1.5ULN, or creatinine\<1.5ULN;
* Emergency surgery;
* Recent thromboembolic event or cerebrovascular disease (12 months before enrollment);
* Pregnancy or lactation
* Comorbid with severe physical or mental disease.
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Sun Yat-sen University

OTHER

Sponsor Role lead

Responsible Party

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Yanhong Deng

Director

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Sixth Affiliated Hospital of Sun Yat-sen University

Guangzhou, Guangdong, China

Site Status

Countries

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China

Central Contacts

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Hui Wang, MD

Role: CONTACT

Phone: +86-13926424886

Email: [email protected]

Huaiming Wang

Role: CONTACT

Email: [email protected]

Facility Contacts

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Hui Wang

Role: primary

Other Identifiers

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STUCS

Identifier Type: -

Identifier Source: org_study_id