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A Phase II Study of Oxaliplatin Capecitabine and Pre-operative Radiotherapy for Patients With Locally Advanced and Inoperable Rectal Cancer

Phase 2
Completed
Conditions
Rectal Cancer
Registration Number
NCT00220051
Lead Sponsor
Royal Marsden NHS Foundation Trust
Brief Summary

To assess the efficacy and safety of pre-operative capecitabine and oxaliplatin followed by capecitabine with concurrent radiotherapy followed by post-operative capecitabine in the treatment of patients with locally advanced or inoperable rectal cancer.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
109
Inclusion Criteria
  • Age over 18.

  • Histological diagnosis of adenocarcinoma of rectum.

  • Locally advanced/ poor prognosis primary rectal cancer defined by MRI criteria of any of the categories below;

    • Tumour within 2 mm of mesorectal fascia ie circumferential resection margin threatened
    • Any T3 tumour at/below levatores
    • T3c tumour at any other level ie tumour extends >5 mm into peri-rectal fat
    • T4 tumour
    • Any T stage with 4 or more involved lymph nodes
  • WHO performance status 0, 1 or 2.

  • No evidence of metastatic disease as determined by CT scan of chest, abdomen, pelvis or other investigations such as PET scan or biopsy if required.

  • Adequate bone marrow function with platelets > 100 X 109/l; WBC > 3 X 109/l; neutrophils > 1.5 X 109/l

  • Normal renal function, with serum creatinine within the normal range or calculated creatinine clearance >50 ml/min.

  • Adequate hepatic function with serum total bilirubin < 1.5 X upper limit of normal range.

  • No concurrent uncontrolled medical conditions

  • No previous malignant disease other than non-melanotic skin cancer or carcinoma in situ of the uterine cervix

  • Adequate contraceptive precautions if relevant

  • Informed written consent

Exclusion Criteria
  • Medical or psychiatric conditions that compromise the patient's ability to give informed consent
  • Presence of metastatic disease or recurrent rectal tumour
  • Renal impairment (creatinine clearance<30 ml/min)
  • Pregnancy or breast feeding
  • Patients with a lack of physical integrity of the upper gastrointestinal tract, or known malabsorption syndromes
  • Participation in any investigational drug study within the previous 4 weeks.
  • Clinically significant (i.e. active) cardiac disease (e.g. congestive heart failure, symptomatic coronary artery disease and cardiac arrhythmia even if controlled with medication) or myocardial infarction within the last 12 months)
  • Patients with any symptoms or history of peripheral neuropathy.
  • Prior pelvic radiotherapy

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Primary Outcome Measures
NameTimeMethod
Pathological complete response rate.
Acute toxicity has been evaluated in previous phase I studies and should occur to a similar extent.
Secondary Outcome Measures
NameTimeMethod
Progression-free survival
Treatment related toxicity
Overall survival
Radiological response rate
Proportion of patients achieving pathological down staging compared with the pre-treatment MRI scan
Surgical complications
Bowel function and quality of life
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