First Line Treatment by FOLFIRINOX for Patients With a Rectum Cancer With Synchronous Non Resectable Metastasis
- Conditions
- Adenocarcinoma of Rectum
- Interventions
- Drug: FOLFORINOX
- Registration Number
- NCT01674309
- Lead Sponsor
- Federation Francophone de Cancerologie Digestive
- Brief Summary
The FOLFIRINOX protocol seems a promising protocol as attack treatment of a rectum cancer, with an objective response rate of about 70 %. This phase II is to investigate if this systematic attack chemotherapy could control at the same time the rectal tumor and the synchronous metastasis without compromising secondarily the tumor or the metastasis resection or a radiochemotherapy administration.
1. The main objective of the trial is to investigate the tumoral control rate at 4 months, according to the RECIST criteria (version 1.1).
2. The secondary objectives are:
* safety of the treament,
* rate of local failure and local complication (occlusion, important bleedings, resistant pains with morphinic treatment, perforation),
* survival without local failure (radiological or clinical progression of the rectal cancer or local complication),
* rectal tumor response rate (CT scan, MRI and endocopy),
* metastasis response rate,
* disease free survival after complete resection (of primitive tumor and metastases),
* progression free survival (local or distal),
* overall survival, quality of life (QLQ-C30 + CR 29).
- Detailed Description
The FOLFIRINOX protocol seems a promising protocol as attack treatment of a rectum cancer, with an objective response rate of about 70 %. This phase II is to investigate if this systematic attack chemotherapy could control at the same time the rectal tumor and the synchronous metastasis without compromising secondarily the tumor or the metastasis resection or a radiochemotherapy administration.
1. The main objective of the trial is to investigate the tumoral control rate at 4 months, according to the RECIST criteria (version 1.1).
2. The secondary objectives are:
* safety of the treament,
* rate of local failure and local complication (occlusion, important bleedings, resistant pains with morphinic treatment, perforation),
* survival without local failure (radiological or clinical progression of the rectal cancer or local complication),
* rectal tumor response rate (CT scan, MRI and endocopy),
* metastasis response rate,
* disease free survival after complete resection (of primitive tumor and metastases),
* progression free survival (local or distal),
* overall survival, quality of life (QLQ-C30 + CR 29).
3. Inclusion and non inclusion criteria
4. Treatment
5. Follow up
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 65
- Histologically proven adenocarcinoma of the rectum, the lower pole less than 15 cm from the anal verge
- Patient should not have receive any treatment for cancer
- Synchronous metastases with unresectable hepatic and/or lung localization or uncertain resectability (potentially resectable)
- Measurable lesions by RECIST 1.1 (metastasis and primary cancer of the rectum)
- Age ≥ 18 years
- WHO ≤ 2
- ANC ≥ 1.5 x 10 9/L, platelets ≥ 100 x 10 9/L, creatinine clearance ≥ 60 mL/min
- Hemoglobin ≥ 10 g /dL
- Signed informed consent
- Rectal Cancer in occlusion requiring surgery or a prosthesis in emergency
- Rectal bleeding severe and active
- Prior pelvic irradiation
- History of cancer, except non-melanoma skin cancer, carcinoma in situ of the cervix treated curatively and other cancers treated curatively if they do not relapse over 3 years,
- Hepatic impairment (total bilirubin> 1.5 x upper limit of normal (ULN) and serum albumin <25g / L); known Gilbert's disease
- Uncontrolled severe infection,
- Severe pain (VAS> 5/10) uncontrollable by opioid therapy
- Symptomatic sensorimotor peripheral neuropathy
- Pregnant or lactating patients or patient of both sexes with childbearing potential and not using adequate contraception method
- Patient receiving or having received an experimental therapy within 4 weeks prior to enter into the study or participating in another clinical study of other experimental drugs
- Known hypersensitivity to any component of the treatment
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description single arm study/ non randomized trial FOLFORINOX FOLFORINOX
- Primary Outcome Measures
Name Time Method Tumor control rate of the primary tumor and metastasis 4 months The tumor control rate of the primary site and metastasis is defined as Complete response or Partial response or stability according to RECIST 1.1 criteria
- Secondary Outcome Measures
Name Time Method metastasis response rate 4 months The metastasis tumor response rate is the Complete response or the Partial response of metastasis using RECIST 1.1 criteria
Toxicity of the treatment Up to 4 months after Last Patient First Visit Number of patients presenting the main toxicities during the study
survival without local failure (radiological or clinical progression of the rectal cancer or local complication) Up to 4 months after Last Patient First Visit The survival time is defined as the time between the patient's inclusion and the time of the local failure or patient's death
rectal tumor response rate (CT scan, MRI and endocopy) 4 months The rectal tumor response rate is the Complete response or the Partial response of the rectal tumor using RECIST 1.1 criteria
rate of local failure and local complication (occlusion, important bleedings, resistant pains with morphinic treatment, perforation) 4 months The rate is defined as the clinical progression or a radiological progression of the rectum cancer or a local complication due to the treatment or due to the progression
Trial Locations
- Locations (29)
Institut Bergonie
🇫🇷Bordeaux, France
CHU - Ht Lévêque
🇫🇷Bordeaux, France
CH Georges Menon
🇫🇷Niort, France
CHR - Gasto
🇫🇷Orléans, France
Polyclinique Côte Basque Sud
🇫🇷Saint Jean De Luz, France
CHD Vendée
🇫🇷La Roche Sur Yon, France
Centre Cahterine de Sienne
🇫🇷Nantes, France
CHU d'Estaing
🇫🇷Clermont Ferrand, France
Centre G.F. Leclerc
🇫🇷Dijon, France
Polyclinique de l'Ormeau
🇫🇷Tarbes, France
Avicennes
🇫🇷Bobigny, France
Colmar Ch
🇫🇷Colmar, France
Polyclinique
🇫🇷Francheville, France
Clinique Victor Hugo
🇫🇷Le Mans, France
CHRU - Hôpital Huriez
🇫🇷Lille, France
CH Le Foll
🇫🇷Saint Brieuc, France
Clinique Armoricaine
🇫🇷Saint Brieuc, France
CHRU Trousseau
🇫🇷Tours, France
CH Robert Morlevat
🇫🇷Semur en Auxois, France
CH
🇫🇷Perpignan, France
CHU La Timone
🇫🇷Marseille, France
Ipc - Cac
🇫🇷Marseille, France
CH Layne
🇫🇷Mont de Marsan, France
Polyclinique le Languedoc
🇫🇷Narbonne, France
AP - HP - Pitié Salpêtrière
🇫🇷Paris, France
CAC
🇫🇷Strasbourg, France
Hôpitaux du Leman
🇫🇷Thonon Les Bains, France
CHU
🇫🇷Rouen, France
Clinique Saint Jean du Languedoc
🇫🇷Toulouse, France