Investigate the Efficacy of Chemotherapy in Patients With Positive ctDNA After Surgery and Adjuvant Chemotherapy for a Stage III Colorectal Cancer

NCT ID: NCT06197425

Last Updated: 2024-01-09

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

NOT_YET_RECRUITING

Clinical Phase

PHASE3

Total Enrollment

1660 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-01-31

Study Completion Date

2030-01-31

Brief Summary

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Phase III multicentric, open-label, randomized study

The main objective is to assess the efficacy on time to disease recurrence (TTR) of treating minimal residual disease diagnosed by the presence of ctDNA after full treatment (surgery + chemotherapy) in stage III or high-risk stage II colon or upper rectum adenocarcinoma

Detailed Description

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Conditions

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Colon or Upper Rectum Adenocarcinoma

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 by FOLFIRI

Group Type EXPERIMENTAL

"FOLFIRI" cures

Intervention Type DRUG

(Irinotecan 180 mg/m2, leucovorine 400mg/m2, 5FU bolus 400 mg/m2, 5FU continuous infusion 2400 mg/m2) every 14 days for 6 months or until disease progression on imaging

BIOLOGICAL ASSESSMENT

Intervention Type BIOLOGICAL

blood sample ACE markers

Questionnaires

Intervention Type OTHER

Quality of life questionnaires (QLQ-C30 ; EQ-5D-5L ; GPAQ)

Thoracic-abdomino-pelvic scan or MRI

Intervention Type OTHER

Thoracic-abdomino-pelvic scan or MRI

Chemotherapy by Trifluridine tipiracil

Group Type EXPERIMENTAL

Trifluridine cures

Intervention Type DRUG

Trifluridine tipiracil 35 mg/m2 bid during 5 days/w on week 1 and 2 every 4 weeks, for 6 months or until disease progression on imaging

BIOLOGICAL ASSESSMENT

Intervention Type BIOLOGICAL

blood sample ACE markers

Questionnaires

Intervention Type OTHER

Quality of life questionnaires (QLQ-C30 ; EQ-5D-5L ; GPAQ)

Thoracic-abdomino-pelvic scan or MRI

Intervention Type OTHER

Thoracic-abdomino-pelvic scan or MRI

Surveillance inside the trial/control arm

Group Type ACTIVE_COMPARATOR

BIOLOGICAL ASSESSMENT

Intervention Type BIOLOGICAL

blood sample ACE markers

Questionnaires

Intervention Type OTHER

Quality of life questionnaires (QLQ-C30 ; EQ-5D-5L ; GPAQ)

Thoracic-abdomino-pelvic scan or MRI

Intervention Type OTHER

Thoracic-abdomino-pelvic scan or MRI

Surveillance outside the trial

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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"FOLFIRI" cures

(Irinotecan 180 mg/m2, leucovorine 400mg/m2, 5FU bolus 400 mg/m2, 5FU continuous infusion 2400 mg/m2) every 14 days for 6 months or until disease progression on imaging

Intervention Type DRUG

Trifluridine cures

Trifluridine tipiracil 35 mg/m2 bid during 5 days/w on week 1 and 2 every 4 weeks, for 6 months or until disease progression on imaging

Intervention Type DRUG

BIOLOGICAL ASSESSMENT

blood sample ACE markers

Intervention Type BIOLOGICAL

Questionnaires

Quality of life questionnaires (QLQ-C30 ; EQ-5D-5L ; GPAQ)

Intervention Type OTHER

Thoracic-abdomino-pelvic scan or MRI

Thoracic-abdomino-pelvic scan or MRI

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Fully resected stage III or high-risk stage II colon or upper rectum adenocarcinoma previously treated by standard adjuvant chemotherapy or peri-operative chemotherapy (FOLFOX or CAPOX) for either 3 or 6 months based on local multidisciplinary meeting, and on TNCD recommendations
* Positive ctDNA screening (methylation) and confirmation (NGS) on samples collected at the 3- or 6 months follow-up visit post-adjuvant chemotherapy
* Patients ≥ 18 years and ≤ 80 years (provided the score of the G8 geriatric questionnaire is \>14 for patients 70 years or older)
* Subjects with WHO performance status \< 2
* No documented disease using TAP CT-scanner and liver MRI in the case of contra-indication to dye contrast (or TEP-scanner may be also used in addition depending on physicians' choice and local availabilities).
* Adequate haematological function: with neutrophils ≥ 1,500 /mm3, platelet count ≥ 100,000/mm3, hemoglobin ≥ 9 g/dL (5,6 mmol/l)

Total bilirubin ≤ 1.5 x ULN (upper limit of normal) ASAT and ALAT ≤ 2.5 x ULN Alkaline phosphatase ≤ 2.5 x ULN Creatinine clearance ≥50 ml/min according MDRD (Modification of Diet in Renal Disease)

* Available tumor sample for NGS analysis
* Signed written informed consent obtained prior to any study specific procedures
* Patient affiliated to a social security scheme

Exclusion Criteria

* Patients already treated with trifluridine tipiracil or irinotecan in the past 5 years
* Uncontrolled intercurrent illness
* Previous malignancies other than adequately treated in situ carcinoma of the uterine cervix or basal or squamous cell carcinoma of the skin, unless there has been a disease-free interval of at least 3 years
* Pregnant or breastfeeding women, women of childbearing age not having had a negative pregnancy test
* Any known specific contraindication or allergy to the treatments used in the study†
* Total or partial dihydropyrimidine dehydrogenase (DPD) deficiency (uracilemia \> 16ng/ml)
* Known Gilbert's disease (UGT1A1\*28 genotype)
* In case of concomitant use with St John's Wort related to irinotecan
* In case of bowel obstruction according related to irinotecan
* In case of recent concomitant treatment with brivudine, related to fluorouracil.
* Participation to another interventional study for postoperative therapy
* Persons deprived of liberty or under guardianship or incapable of giving consent
* Any psychological, familial, sociological, or geographical condition potentially hampering compliance with the study protocol or follow-up schedule.
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Centre Hospitalier Universitaire Dijon

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Chu Dijon Bourgogne

Dijon, , France

Site Status

Countries

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France

Central Contacts

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Julien TAIEB

Role: CONTACT

01 56 09 50 42

Facility Contacts

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Côme LEPAGE

Role: primary

03 80 29 37 50

Other Identifiers

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LEPAGE PHRCK 2022

Identifier Type: -

Identifier Source: org_study_id

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