Colorectal Cancer
Conditions
Brief summary
This 2 arm study will compare the safety and efficacy of oral Xeloda, or 5-fluorouracil in combination with leucovorin, in patients who have undergone surgery for colon cancer. Patients will be randomized to receive either Xeloda 1250mg/m2 po bid on days 1-14 every 21 days, or leucovorin 20mg/m2 iv + 5-fluorouracil 425mg/m2 iv daily from day 1 to day 5 every 28 days. The anticipated time on study treatment is 3-12 months, and the target sample size is 500+ individuals.
Interventions
425mg/m2 iv daily from day 1 to day 5 every 28 days.
20mg/m2 iv daily from day 1 to day 5 every 28 days.
1250mg/m2 po bid on days 1-14 every 21 days.
Sponsors
Study design
Eligibility
Inclusion criteria
* adult patients 18-75 years of age; * histologically confirmed colon cancer with potentially curative resection of the tumor within 8 weeks before study initiation.
Exclusion criteria
* previous chemotherapy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Disease-free Survival | Approximately 3 years | Participants with disease-free survival were reported. Disease-free survival was assessed as the number of days between randomization and the first time at which relapse, a new occurrence of colon cancer, or death was recorded, or the last time at which a participant was known to be disease free (censoring time). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Relapse-Free Survival | Approximately 3 years | Participants with relapse-free survival were reported. Relapse-free survival was assessed as the number of days between randomization and the first time at which relapse, a new occurrence of colon cancer, or death was recorded, or the last time at which a participants was known to be disease free (censoring time), excluding deaths that were not related to treatment or to disease progression. |
| Overall Survival | Approximately 3 years | Participants with overall survival were reported. Overall survival was assessed as the number of days between randomization and death or the last time at which a participant was known to be alive (censoring time). |
| Mean Change From Baseline in Global Health Status at Week 25 | Baseline (Days -7 to 1) and at Week 25 | Global health status was assessed as a sub scale of European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30. It was scored on a scale of 0-100; where higher score indicates better quality of life. Wherever the scores for the participants were not available, the last value carried forward (LVCF) were used. |
| Number of Participants With Abnormalities for Blood Chemistry and Hematological Parameters | Up to Week 25 | Laboratory abnormalities were categorized according to the National Cancer Institute of Canada Common Toxicity Criteria (NCIC - CTC) grading system (May 1991 revised) as Grade 1 (mild), Grade 2 (moderate), Grade 3 (severe) and Grade 4 (life- threatening). Participants with abnormalities in hemoglobin, granulocytes, lymphocytes, neutrophils, neutrophils/granulocytes, platelets, white blood cell, potassium, serum creatinine, sodium, total bilirubin, alanine transaminase, aspartate aminotransferase, alkaline phosphatase, calcium (hyper), and calcium (hypo) with Grades 1-4 were presented. |
| Number of Participants With Any Adverse Events and Serious Adverse Events | Up to Week 29 | An Adverse Event (AE) is defined as any untoward medical occurrence in a participant or clinical investigation participant, temporally associated with the use of a medicinal product, whether or not considered to be related to the medicinal product. An Serious Adverse Events (SAEs) is any untoward medical occurrence that, at any dose, results in death, is life threatening, requires hospitalization or prolongation of existing hospitalization, results in disability/incapacity, or results in a congenital anomaly/birth defect. |
Countries
Argentina, Australia, Austria, Belgium, Brazil, Canada, Germany, Israel, Italy, Portugal, Spain, Switzerland, United Kingdom, United States
Participant flow
Recruitment details
A total of 1987 participants were recruited into the study across 164 centers in 25 countries. This study was conducted from 12 Nov 1998 to 01 Apr 2004.
Participants by arm
| Arm | Count |
|---|---|
| Capecitabine Participants received capecitabine 1250 (mg/m \^ 2) orally, twice a day, for 14 days, followed by a 7-day rest period without treatment, as an intermittent therapy in a 3-week cycle for 8 cycles (24 weeks). | 1,004 |
| 5-Fluorouracil + Leucovorin Participants received leucovorin 20 mg/m \^ 2 followed by 5-fluorouracil at 425 mg/m \^ 2, by rapid intravenous injection, daily, from Days 1 to 5 of the first week in each 4-week cycle for 6 cycles (24 weeks). | 983 |
| Total | 1,987 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Administrative/Other Reasons | 7 | 1 |
| Overall Study | Adverse Event | 112 | 75 |
| Overall Study | Death | 4 | 6 |
| Overall Study | Lack of Efficacy | 17 | 15 |
| Overall Study | Lost to Follow-up | 1 | 1 |
| Overall Study | Other Protocol Violation | 1 | 0 |
| Overall Study | Refused Treatment | 15 | 16 |
| Overall Study | Violation of Selection Criteria at Entry | 13 | 9 |
Baseline characteristics
| Characteristic | Capecitabine | 5-Fluorouracil + Leucovorin | Total |
|---|---|---|---|
| Age, Continuous | 62.0 Years | 63.0 Years | 62.0 Years |
| Sex/Gender, Customized Female | 461 Participants | 451 Participants | 912 Participants |
| Sex/Gender, Customized Male | 542 Participants | 532 Participants | 1074 Participants |
| Sex/Gender, Customized Missing | 1 Participants | 0 Participants | 1 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 838 / 995 | 847 / 974 |
| serious Total, serious adverse events | 181 / 995 | 182 / 974 |
Outcome results
Disease-free Survival
Participants with disease-free survival were reported. Disease-free survival was assessed as the number of days between randomization and the first time at which relapse, a new occurrence of colon cancer, or death was recorded, or the last time at which a participant was known to be disease free (censoring time).
Time frame: Approximately 3 years
Population: All randomized population included all participants who were randomized to one of the two treatment arms, regardless of whether they received any study medication.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Capecitabine | Disease-free Survival | 656 Participants |
| 5-Fluorouracil + Leucovorin | Disease-free Survival | 603 Participants |
Mean Change From Baseline in Global Health Status at Week 25
Global health status was assessed as a sub scale of European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30. It was scored on a scale of 0-100; where higher score indicates better quality of life. Wherever the scores for the participants were not available, the last value carried forward (LVCF) were used.
Time frame: Baseline (Days -7 to 1) and at Week 25
Population: The safety population included all participants who received at least one dose of capecitabine, 5-fluorouracil, or leucovorin and had at least one post baseline safety assessment (adverse events, laboratory test results, or vital signs).
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Capecitabine | Mean Change From Baseline in Global Health Status at Week 25 | 2.1 Score on a scale | Standard Error 0.8 |
| 5-Fluorouracil + Leucovorin | Mean Change From Baseline in Global Health Status at Week 25 | 2.6 Score on a scale | Standard Error 0.78 |
Number of Participants With Abnormalities for Blood Chemistry and Hematological Parameters
Laboratory abnormalities were categorized according to the National Cancer Institute of Canada Common Toxicity Criteria (NCIC - CTC) grading system (May 1991 revised) as Grade 1 (mild), Grade 2 (moderate), Grade 3 (severe) and Grade 4 (life- threatening). Participants with abnormalities in hemoglobin, granulocytes, lymphocytes, neutrophils, neutrophils/granulocytes, platelets, white blood cell, potassium, serum creatinine, sodium, total bilirubin, alanine transaminase, aspartate aminotransferase, alkaline phosphatase, calcium (hyper), and calcium (hypo) with Grades 1-4 were presented.
Time frame: Up to Week 25
Population: The safety population comprises all participants who received at least one dose of capecitabine, 5-fluorouracil, or leucovorin and had at least one post baseline safety assessment.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Capecitabine | Number of Participants With Abnormalities for Blood Chemistry and Hematological Parameters | Neutrophils | 308 Participants |
| Capecitabine | Number of Participants With Abnormalities for Blood Chemistry and Hematological Parameters | Calcium (Hypo) | 150 Participants |
| Capecitabine | Number of Participants With Abnormalities for Blood Chemistry and Hematological Parameters | Neutrophils/Granulocytes | 316 Participants |
| Capecitabine | Number of Participants With Abnormalities for Blood Chemistry and Hematological Parameters | Alkaline Phosphatase | 334 Participants |
| Capecitabine | Number of Participants With Abnormalities for Blood Chemistry and Hematological Parameters | Platelets | 182 Participants |
| Capecitabine | Number of Participants With Abnormalities for Blood Chemistry and Hematological Parameters | Granulocytes | 20 Participants |
| Capecitabine | Number of Participants With Abnormalities for Blood Chemistry and Hematological Parameters | Potassium | 209 Participants |
| Capecitabine | Number of Participants With Abnormalities for Blood Chemistry and Hematological Parameters | Alanine transaminase | 327 Participants |
| Capecitabine | Number of Participants With Abnormalities for Blood Chemistry and Hematological Parameters | Serum Creatinine | 157 Participants |
| Capecitabine | Number of Participants With Abnormalities for Blood Chemistry and Hematological Parameters | Hemoglobin | 691 Participants |
| Capecitabine | Number of Participants With Abnormalities for Blood Chemistry and Hematological Parameters | Sodium | 189 Participants |
| Capecitabine | Number of Participants With Abnormalities for Blood Chemistry and Hematological Parameters | Calcium (Hyper) | 67 Participants |
| Capecitabine | Number of Participants With Abnormalities for Blood Chemistry and Hematological Parameters | Total Bilirubin | 501 Participants |
| Capecitabine | Number of Participants With Abnormalities for Blood Chemistry and Hematological Parameters | Lymphocytes | 778 Participants |
| Capecitabine | Number of Participants With Abnormalities for Blood Chemistry and Hematological Parameters | White blood cell | 220 Participants |
| Capecitabine | Number of Participants With Abnormalities for Blood Chemistry and Hematological Parameters | Aspartate aminotransferase | 300 Participants |
| 5-Fluorouracil + Leucovorin | Number of Participants With Abnormalities for Blood Chemistry and Hematological Parameters | White blood cell | 409 Participants |
| 5-Fluorouracil + Leucovorin | Number of Participants With Abnormalities for Blood Chemistry and Hematological Parameters | Alanine transaminase | 333 Participants |
| 5-Fluorouracil + Leucovorin | Number of Participants With Abnormalities for Blood Chemistry and Hematological Parameters | Alkaline Phosphatase | 289 Participants |
| 5-Fluorouracil + Leucovorin | Number of Participants With Abnormalities for Blood Chemistry and Hematological Parameters | Calcium (Hyper) | 68 Participants |
| 5-Fluorouracil + Leucovorin | Number of Participants With Abnormalities for Blood Chemistry and Hematological Parameters | Calcium (Hypo) | 112 Participants |
| 5-Fluorouracil + Leucovorin | Number of Participants With Abnormalities for Blood Chemistry and Hematological Parameters | Granulocytes | 43 Participants |
| 5-Fluorouracil + Leucovorin | Number of Participants With Abnormalities for Blood Chemistry and Hematological Parameters | Hemoglobin | 650 Participants |
| 5-Fluorouracil + Leucovorin | Number of Participants With Abnormalities for Blood Chemistry and Hematological Parameters | Lymphocytes | 744 Participants |
| 5-Fluorouracil + Leucovorin | Number of Participants With Abnormalities for Blood Chemistry and Hematological Parameters | Neutrophils | 596 Participants |
| 5-Fluorouracil + Leucovorin | Number of Participants With Abnormalities for Blood Chemistry and Hematological Parameters | Neutrophils/Granulocytes | 612 Participants |
| 5-Fluorouracil + Leucovorin | Number of Participants With Abnormalities for Blood Chemistry and Hematological Parameters | Platelets | 160 Participants |
| 5-Fluorouracil + Leucovorin | Number of Participants With Abnormalities for Blood Chemistry and Hematological Parameters | Potassium | 156 Participants |
| 5-Fluorouracil + Leucovorin | Number of Participants With Abnormalities for Blood Chemistry and Hematological Parameters | Serum Creatinine | 138 Participants |
| 5-Fluorouracil + Leucovorin | Number of Participants With Abnormalities for Blood Chemistry and Hematological Parameters | Sodium | 184 Participants |
| 5-Fluorouracil + Leucovorin | Number of Participants With Abnormalities for Blood Chemistry and Hematological Parameters | Total Bilirubin | 185 Participants |
| 5-Fluorouracil + Leucovorin | Number of Participants With Abnormalities for Blood Chemistry and Hematological Parameters | Aspartate aminotransferase | 288 Participants |
Number of Participants With Any Adverse Events and Serious Adverse Events
An Adverse Event (AE) is defined as any untoward medical occurrence in a participant or clinical investigation participant, temporally associated with the use of a medicinal product, whether or not considered to be related to the medicinal product. An Serious Adverse Events (SAEs) is any untoward medical occurrence that, at any dose, results in death, is life threatening, requires hospitalization or prolongation of existing hospitalization, results in disability/incapacity, or results in a congenital anomaly/birth defect.
Time frame: Up to Week 29
Population: The safety population comprises all participants who received at least one dose of capecitabine, 5-fluorouracil, or leucovorin and had at least one post baseline safety assessment
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Capecitabine | Number of Participants With Any Adverse Events and Serious Adverse Events | All adverse events | 910 Participants |
| Capecitabine | Number of Participants With Any Adverse Events and Serious Adverse Events | Serious adverse events | 181 Participants |
| 5-Fluorouracil + Leucovorin | Number of Participants With Any Adverse Events and Serious Adverse Events | All adverse events | 885 Participants |
| 5-Fluorouracil + Leucovorin | Number of Participants With Any Adverse Events and Serious Adverse Events | Serious adverse events | 182 Participants |
Overall Survival
Participants with overall survival were reported. Overall survival was assessed as the number of days between randomization and death or the last time at which a participant was known to be alive (censoring time).
Time frame: Approximately 3 years
Population: All randomized population included all participants who were randomized to one of the two treatment arms, regardless of whether they received any study medication.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Capecitabine | Overall Survival | 804 Participants |
| 5-Fluorouracil + Leucovorin | Overall Survival | 756 Participants |
Relapse-Free Survival
Participants with relapse-free survival were reported. Relapse-free survival was assessed as the number of days between randomization and the first time at which relapse, a new occurrence of colon cancer, or death was recorded, or the last time at which a participants was known to be disease free (censoring time), excluding deaths that were not related to treatment or to disease progression.
Time frame: Approximately 3 years
Population: All randomized population included all participants who were randomized to one of the two treatment arms, regardless of whether they received any study medication.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Capecitabine | Relapse-Free Survival | 677 Participants |
| 5-Fluorouracil + Leucovorin | Relapse-Free Survival | 621 Participants |