A Randomized Phase III Trial of Three Different Regimens of CPT-11 Plus 5-Fluorouracil and Leucovorin Compared to 5-Fluorouracil and Leucovorin in Patients With Advanced Adenocarcinoma of the Colon and Rectum
Trial Snapshot
- Phase
- Phase 3
- Status
- Completed
- Enrollment
- 1,691
- Locations
- 462
- Primary Endpoint
- time to progression
Study Overview
Brief Summary
RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Combining more than one drug may kill more tumor cells. It is not yet known which regimen of combination chemotherapy is most effective in treating advanced colorectal cancer.
PURPOSE: Randomized phase III trial to compare the effectiveness of various combination chemotherapy regimens in treating patients who have advanced, recurrent, or metastatic colorectal cancer that cannot be treated with surgery or radiation therapy.
Detailed Description
OBJECTIVES:
- Compare the time to progression in patients with locally advanced, locally recurrent, or metastatic colorectal adenocarcinoma treated with combinations of oxaliplatin, fluorouracil, leucovorin calcium, and irinotecan.
- Compare the quality of life, response rate, time to treatment failure, and overall survival in patients treated with these regimens.
- Compare the toxicity of these regimens in these patients.
OUTLINE: This is a randomized, multicenter study. Patients are stratified according to ECOG performance status (0-1 vs 2), prior adjuvant chemotherapy (yes vs no), prior immunotherapy (yes vs no), and age (under 65 vs 65 and over). Patients are randomized to one of three treatment arms.
Only arm II remains open to accrual.
- Arm I (Saltz regimen): Patients receive irinotecan IV over 90 minutes followed by leucovorin calcium IV over 15 minutes and fluorouracil IV once a week for 4 weeks followed by 2 weeks of rest. Courses repeat every 6 weeks. (Arm I closed to accrual as of March 15, 2002.)
- Arm II (FOLFOX4 regimen): Patients receive oxaliplatin IV over 2 hours on day 1 and leucovorin calcium IV over 2 hours plus fluorouracil IV over 22 hours on days 1 and 2. Courses repeat every 2 weeks.
- Arm III (oxaliplatin plus irinotecan): Patients receive oxaliplatin IV over 2 hours and irinotecan IV over 30 minutes on day 1. Courses repeat every 3 weeks. (Arm III closed to accrual as of March 15, 2002.) Treatment continues in the absence of disease progression or unacceptable toxicity.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- Not provided
Exclusion Criteria
- Not provided
Arms & Interventions
irinotecan + leucovorin + fluorouracil
Patients receive irinotecan IV over 90 minutes followed by leucovorin calcium IV over 15 minutes and fluorouracil IV once a week for 4 weeks followed by 2 weeks of rest. Courses repeat every 6 weeks.
Treatment continues in the absence of disease progression or unacceptable toxicity.
Quality of life is assessed before treatment, during treatment (arm specific), and after completion of treatment.
Patients are followed every 3 months for 1 year, every 6 months for 2 years, and then annually thereafter.
Intervention: irinotecan (Drug)
irinotecan + leucovorin + fluorouracil
Patients receive irinotecan IV over 90 minutes followed by leucovorin calcium IV over 15 minutes and fluorouracil IV once a week for 4 weeks followed by 2 weeks of rest. Courses repeat every 6 weeks.
Treatment continues in the absence of disease progression or unacceptable toxicity.
Quality of life is assessed before treatment, during treatment (arm specific), and after completion of treatment.
Patients are followed every 3 months for 1 year, every 6 months for 2 years, and then annually thereafter.
Intervention: fluorouracil (Drug)
irinotecan + leucovorin + fluorouracil
Patients receive irinotecan IV over 90 minutes followed by leucovorin calcium IV over 15 minutes and fluorouracil IV once a week for 4 weeks followed by 2 weeks of rest. Courses repeat every 6 weeks.
Treatment continues in the absence of disease progression or unacceptable toxicity.
Quality of life is assessed before treatment, during treatment (arm specific), and after completion of treatment.
Patients are followed every 3 months for 1 year, every 6 months for 2 years, and then annually thereafter.
Intervention: leucovorin calcium (Drug)
oxaliplatin + leucovorin + fluorouracil
Patients receive oxaliplatin IV over 2 hours on day 1 and leucovorin calcium IV over 2 hours plus fluorouracil IV over 22 hours on days 1 and 2. Courses repeat every 2 weeks.
Treatment continues in the absence of disease progression or unacceptable toxicity.
Quality of life is assessed before treatment, during treatment (arm specific), and after completion of treatment.
Patients are followed every 3 months for 1 year, every 6 months for 2 years, and then annually thereafter.
Intervention: fluorouracil (Drug)
oxaliplatin + leucovorin + fluorouracil
Patients receive oxaliplatin IV over 2 hours on day 1 and leucovorin calcium IV over 2 hours plus fluorouracil IV over 22 hours on days 1 and 2. Courses repeat every 2 weeks.
Treatment continues in the absence of disease progression or unacceptable toxicity.
Quality of life is assessed before treatment, during treatment (arm specific), and after completion of treatment.
Patients are followed every 3 months for 1 year, every 6 months for 2 years, and then annually thereafter.
Intervention: leucovorin calcium (Drug)
oxaliplatin + leucovorin + fluorouracil
Patients receive oxaliplatin IV over 2 hours on day 1 and leucovorin calcium IV over 2 hours plus fluorouracil IV over 22 hours on days 1 and 2. Courses repeat every 2 weeks.
Treatment continues in the absence of disease progression or unacceptable toxicity.
Quality of life is assessed before treatment, during treatment (arm specific), and after completion of treatment.
Patients are followed every 3 months for 1 year, every 6 months for 2 years, and then annually thereafter.
Intervention: oxaliplatin (Drug)
oxaliplatin + irinotecan
Patients receive oxaliplatin IV over 2 hours and irinotecan IV over 30 minutes on day 1. Courses repeat every 3 weeks.
Treatment continues in the absence of disease progression or unacceptable toxicity.
Quality of life is assessed before treatment, during treatment (arm specific), and after completion of treatment.
Patients are followed every 3 months for 1 year, every 6 months for 2 years, and then annually thereafter.
Intervention: irinotecan (Drug)
oxaliplatin + irinotecan
Patients receive oxaliplatin IV over 2 hours and irinotecan IV over 30 minutes on day 1. Courses repeat every 3 weeks.
Treatment continues in the absence of disease progression or unacceptable toxicity.
Quality of life is assessed before treatment, during treatment (arm specific), and after completion of treatment.
Patients are followed every 3 months for 1 year, every 6 months for 2 years, and then annually thereafter.
Intervention: oxaliplatin (Drug)
Outcomes
Primary Outcomes
time to progression
Time Frame: Up to 5 years
Secondary Outcomes
- overall survival(Up to 5 years)
- time to treatment failure(Up to 5 years)
- response rate(Up to 5 years)
- quality of life(Up to 5 years)