Combination Chemotherapy and Bevacizumab With or Without Bevacizumab Maintenance Therapy in Treating Patients With Metastatic Colorectal Cancer
- Conditions
- Colorectal Cancer
- Interventions
- Biological: bevacizumabDrug: FOLFIRI regimenDrug: fluorouracilDrug: irinotecan hydrochlorideDrug: leucovorin calcium
- Registration Number
- NCT00952029
- Lead Sponsor
- Federation Francophone de Cancerologie Digestive
- Brief Summary
RATIONALE: Drugs used in chemotherapy, such as irinotecan hydrochloride, leucovorin calcium, and fluorouracil, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Bevacizumab may stop the growth of colorectal cancer by blocking blood flow to the tumor. It is not yet known whether giving more than one drug (combination chemotherapy) is more effective when given with or without bevacizumab in treating patients with metastatic colorectal cancer.
PURPOSE: This randomized phase III trial is studying giving combination chemotherapy with or without bevacizumab to see how well it works in treating patients with metastatic colorectal cancer.
- Detailed Description
OBJECTIVES:
Primary
* Compare disease-control duration in patients with metastatic colorectal cancer receiving FOLFIRI chemotherapy in combination with bevacizumab with or without bevacizumab maintenance therapy.
Secondary
* Determine objective response rate.
* Determine non-hematologic grade 3-4 (except alopecia) toxicity rate.
* Determine overall toxicity rate.
* Determine duration of chemotherapy-free interval.
* Determine progression-free survival.
* Determine overall survival.
* Determine time-to-treatment failure.
* Determine quality of life (EORTC QLQ-C30).
* Complete geriatric evaluation.
OUTLINE: This is a multicenter study. Patients are stratified according to cancer center, primary tumor (resected vs unresected), and Köhne criteria (low vs intermediate vs high). Patients are randomized to 1 of 2 treatment arms.
* Arm A: Patients receive FOLFIRI chemotherapy comprising irinotecan hydrochloride IV over 90 minutes and leucovorin calcium IV over 2 hours on day 1 and fluorouracil IV over 46 hours on days 1-2. Chemotherapy treatment repeats every 2 weeks for 12 courses. Patients also receive bevacizumab IV over 30-90 minutes once every 2 weeks during chemotherapy. Patients then receive bevacizumab maintenance therapy once every 2 weeks during the chemotherapy-free interval.
* Arm B: Patients receive FOLFIRI chemotherapy and bevacizumab as in arm A. Patients receive no treatment during the chemotherapy-free interval.
In all arms, the chemotherapy treatment and the chemotherapy-free interval treatment repeats in the absence of disease progression during the chemotherapy portion or unacceptable toxicity. Patients who progress during the chemotherapy-free interval will receive 12 more courses of chemotherapy.
All patients complete quality of life questionnaires (QLQ-30) and patients ≥ 75 also complete the geriatric questionnaire at baseline and every 8 weeks during study treatment.
After completion of study treatment, patients are followed up every 8 weeks.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 492
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description No maintenance with bevacizumab leucovorin calcium FOLFIRI + Avastin and during the chemotherapy-free interval NO maintenance Maintenance with bevacizumab bevacizumab FOLFIRI + Avastin and during the chemotherapy-free interval maintenance with bevacizumab Maintenance with bevacizumab leucovorin calcium FOLFIRI + Avastin and during the chemotherapy-free interval maintenance with bevacizumab Maintenance with bevacizumab FOLFIRI regimen FOLFIRI + Avastin and during the chemotherapy-free interval maintenance with bevacizumab No maintenance with bevacizumab bevacizumab FOLFIRI + Avastin and during the chemotherapy-free interval NO maintenance No maintenance with bevacizumab FOLFIRI regimen FOLFIRI + Avastin and during the chemotherapy-free interval NO maintenance Maintenance with bevacizumab fluorouracil FOLFIRI + Avastin and during the chemotherapy-free interval maintenance with bevacizumab Maintenance with bevacizumab irinotecan hydrochloride FOLFIRI + Avastin and during the chemotherapy-free interval maintenance with bevacizumab No maintenance with bevacizumab fluorouracil FOLFIRI + Avastin and during the chemotherapy-free interval NO maintenance No maintenance with bevacizumab irinotecan hydrochloride FOLFIRI + Avastin and during the chemotherapy-free interval NO maintenance
- Primary Outcome Measures
Name Time Method Disease-control duration one year after last patient included
- Secondary Outcome Measures
Name Time Method Progression-free survival one year after last patient is included Rate of non-hematologic grade 3-4 toxicities (except alopecia) one year after last patient is included Overall toxicity rate one year after last patient is included Time-to-treatment failure one year after last patient is included Overall survival one and 2 year after last patient is included Geriatric evaluation one year after last patient is included Objective response rate one year after last patient is included Duration of chemotherapy-free interval one year after last patient is included Quality of life as assessed by EORTC QLQ-C30 one year after last patient is included
Trial Locations
- Locations (58)
Centre Bourgogne
🇫🇷Lille, France
Croix Rousse
🇫🇷Lyon, France
CHU La Timone
🇫🇷Marseille, France
Hôpital A. Paré
🇫🇷Marseille, France
CH Le Raincy
🇫🇷Montfermeil, France
Centre Cancérologique
🇫🇷Montpellier, France
Centre Azuréen
🇫🇷Mougins, France
L'Archet II
🇫🇷Nice, France
CH Bretagne Atlantique
🇫🇷Vannes, France
Clinique Tivoli
🇫🇷Bordeaux, France
CHIC
🇫🇷Castres, France
Hôpital Privé Sainte Marie
🇫🇷Chalon sur Saone, France
Parc
🇫🇷Dijon, France
CHU
🇫🇷Rouen, France
Centre Pierre Curie
🇫🇷Beuvry, France
Clinique des Cèdres
🇫🇷Cornebarrieu, France
Centre Leclerc
🇫🇷Dijon, France
CHBS
🇫🇷Lorient, France
CHR (Oncologie Médicale)
🇫🇷Orléans, France
Centre Léon Bérard
🇫🇷Lyon, France
Centre Paul Papin
🇫🇷Angers, France
Polyclinique Sainte Marguerite
🇫🇷Auxerre, France
Centre Léonard de Vinci
🇫🇷Dechy, France
CHG
🇫🇷Mont de Marsan, France
Clinique Valdegour, Centre ONCOGARD - Institut de Cancérologie du Gard
🇫🇷Nimes, France
Clinique
🇫🇷Vienne, France
Bichat
🇫🇷Paris, France
Pringny
🇫🇷Annecy, France
Hôpital Nord
🇫🇷Marseille, France
Hôpital Saint Herblain
🇫🇷Nantes, France
Polyclinique
🇫🇷Narbonne, France
CH
🇫🇷Villejuif, France
Hôpital Avicenne
🇫🇷Bobigny, France
Hôpital Saint Louis
🇫🇷Paris, France
CHU Saint Etienne
🇫🇷Saint Priest en Jarez, France
CHU - Kremlin Bicêtre
🇫🇷Paris, France
CHU Trousseau
🇫🇷Tours, France
Pitié Salpetière
🇫🇷Paris, France
Ch
🇫🇷Blois, France
Clinique F. Chenieux
🇫🇷Limoges, France
Clinique de la Sauvegarde
🇫🇷Lyon, France
Centre Radiothérapie et Oncologie de Moyenne Garonne
🇫🇷Agen, France
Institut Bergonié
🇫🇷Bordeaux, France
CHU Edouard Herriot
🇫🇷Lyon, France
HEGP
🇫🇷Paris, France
Hôpital Chicas
🇫🇷Gap, France
Clinique Mutualiste
🇫🇷Saint Nazaire, France
Hôpital Saint Joseph
🇫🇷Marseille, France
Centre Antoine Lacassagne
🇫🇷Nice, France
Clinique Les Murlins
🇫🇷Orléans, France
HIA Begin
🇫🇷Saint Mande, France
Clinique Armoricaine
🇫🇷Saint-Brieuc, France
Centre Joliot Curie
🇫🇷Saint-Martin-Boulogne, France
Centre Paul Strauss
🇫🇷Strasbourg, France
Clinique Générale
🇫🇷Valence, France
CAC
🇫🇷Vandoeuvre Les Nancy, France
Hôpital Intercommunal
🇫🇷Villeneuve Saint Georges, France
CHR
🇫🇷Orléans, France