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Hepatic Arterial Infusion With Floxuridine and Systemic Irinotecan After Surgery in Treating Patients With Hepatic (Liver) Metastases From Colorectal Cancer

A Phase II Trial Of Toxicity Assessment In Two Cohorts Of Patients (Resection Alone Or Ablation With Or Without Resection Of Hepatic Metastases From Colorectal Cancer) Treated With Adjuvant Hepatic Arterial Infusion (HAI) FUDR Plus Systemic CPT-11

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00063960
Enrollment
94
Registered
2003-07-09
Start date
2003-08-31
Completion date
2004-12-31
Last updated
2016-07-06

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Colorectal Cancer, Metastatic Cancer

Keywords

stage IV colon cancer, adenocarcinoma of the colon, adenocarcinoma of the rectum, stage IV rectal cancer, liver metastases

Brief summary

RATIONALE: Drugs used in chemotherapy such as floxuridine and irinotecan use different ways to stop tumor cells from dividing so they stop growing or die. Hepatic arterial infusion uses a catheter to deliver chemotherapy directly to the liver. Combining more than one drug and giving them in different ways may kill any tumor cells remaining after surgery. PURPOSE: Phase II trial to study the effectiveness of systemic irinotecan and hepatic arterial infusion with floxuridine after surgery in treating patients who have hepatic (liver) metastases from colorectal cancer.

Detailed description

OBJECTIVES: * Determine the toxicity of hepatic arterial infusion with floxuridine and systemic irinotecan adjuvant to liver metastases resection or ablation with or without resection in patients with hepatic metastases secondary to colorectal cancer. * Determine the overall survival of patients treated with this regimen. * Determine the time to any hepatic recurrence or progression in patients treated with this regimen. OUTLINE: This is a multicenter study. Patients are stratified according to prior therapy (liver metastases resection only vs ablation with or without resection). Within 4-8 weeks after prior resection or ablation, patients receive hepatic arterial infusion of floxuridine continuously on days 1-14 and irinotecan IV over 30 minutes on days 1 and 15. Treatment repeats every 28 days for 6 courses in the absence of unacceptable toxicity. Patients are followed every 3 months for 2 years.

Interventions

DRUGfloxuridine
DRUGirinotecan hydrochloride

Sponsors

National Cancer Institute (NCI)
CollaboratorNIH
Alliance for Clinical Trials in Oncology
Lead SponsorOTHER

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

DISEASE CHARACTERISTICS: * Histologically confirmed metastatic colorectal adenocarcinoma * Primary colorectal adenocarcinoma that has been completely resected (R0 disease) * No evidence of residual, viable tumor by abdominal/pelvic helical CT scan or MRI with IV contrast * Metastatic disease * No more than 9 liver metastases * All lesions completely resected or completely treated by ablation (with or without resection) * All lesions treated by ablation must have been less than 5 cm in size and at least 5 mm away from main/left/right portal vein, common bile duct, and inferior vena cava * All resected lesions must have a negative surgical margin (R0) * Disease progression after prior systemic irinotecan for metastatic disease allowed * No extrahepatic metastases confirmed by chest CT scan except colorectal mesenteric lymph node metastases resected at the time of primary tumor resection * No other prior resection of extrahepatic metastases * Must have the entire liver remnant perfused with a single catheter * Must have a nuclear medicine macro-aggregated albumin flow scan to confirm the area of pump perfusion before study registration PATIENT CHARACTERISTICS: Age * 18 and over Performance status * ECOG 0-2 OR * Zubrod 0-2 Life expectancy * Not specified Hematopoietic * WBC at least 3,000/mm\^3 * Absolute granulocyte count at least 1,500/mm\^3 * Absolute neutrophil count at least 1,500/mm\^3 * Platelet count at least 100,000/mm\^3 Hepatic * Bilirubin no greater than 2 mg/dL * Alkaline phosphatase no greater than 2.0 times upper limit of normal (ULN) * AST and ALT no greater than 2.0 times ULN * No active hepatitis B or C infection * No histological evidence of cirrhosis Renal * Creatinine no greater than 1.5 times ULN * Calcium less than 1.3 times ULN Other * Not pregnant or nursing * Negative pregnancy test * Fertile patients must use effective contraception * Postmenopausal women must be amenorrheic for at least 12 consecutive months to be deemed not fertile * Medically fit to begin chemotherapy between 4 and 8 weeks after surgery * Prior cancer allowed if all of the following criteria are met: * Undergone potentially curative therapy for all prior malignancies * No other malignancy within the past 5 years except the following: * Effectively treated basal cell or squamous cell skin cancer * Carcinoma in situ of the cervix that has been effectively treated by surgery alone * Lobular carcinoma in situ of the ipsilateral or contralateral breast treated by surgery alone * No evidence of recurrence of any prior malignancy * No prior hepatic arterial infusion pump malfunction, malperfusion, or infection PRIOR CONCURRENT THERAPY: Biologic therapy * No concurrent immunologic or biologic therapy Chemotherapy * No prior chemotherapy within 4 weeks before hepatic resection or hepatic ablation (with or without resection) * No prior hepatic arterial infusion with fluorouracil or floxuridine Radiotherapy * No concurrent adjuvant radiotherapy to the pelvis * No other concurrent radiotherapy Other * No other concurrent systemic therapy

Design outcomes

Primary

MeasureTime frame
overall survivalUp to 2 years

Secondary

MeasureTime frame
time to hepatic recurrence or progressionUp to 2 years

Countries

United States

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026