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A Study of Xeloda (Capecitabine) Plus Oxaliplatin in Patients With Colon Cancer

An Open-Label Randomized Phase III Study of Intermittent Oral Capecitabine in Combination With Intravenous Oxaliplatin (Q3W) (XELOX) Versus Fluorouracil/Leucovorin as Adjuvant Therapy for Patients Who Have Undergone Surgery for Colon Carcinoma, AJCC/UICC Stage III (Dukes Stage C)

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00069121
Enrollment
1886
Registered
2003-09-18
Start date
2003-04-18
Completion date
2011-04-21
Last updated
2020-03-06

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

Conditions

Colorectal Cancer

Brief summary

This 2 arm study will compare the efficacy and safety of intermittent oral Xeloda plus Eloxatin (oxaliplatin) with that of fluorouracil/leucovorin in patients who have had surgery for colon cancer and no previous chemotherapy. Patients will be randomized to receive either 1) XELOX (Xeloda 1000mg/m2 po bid on days 1-15 + oxaliplatin) in 3 week cycles or 2)5-fluorouracil + leucovorin in 4 or 8 week cycles. The anticipated time on study treatment is until disease progression and the target sample size is 500+ individuals.

Interventions

DRUGCapecitabine

1000 milligrams per square metre of body surface area (mg/m\^2) orally twice daily on days 1-15 of each 3-week cycle.

DRUGOxaliplatin

130 mg/m\^2 intravenous (IV) infusion over two hours on Day 1 of each 3-week cycle.

Administered by one of two regimens, as specified in the arm description.

DRUG5-Fluorouracil (5-FU)

Administered by one of two regimens, as specified in the arm description.

Sponsors

Hoffmann-La Roche
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

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

Inclusion criteria

* Histologically confirmed colon carcinoma, AJCC/UICC Stage III (Dukes stage C) * Complete tumor resection; Patients operated with curative intent and with no macroscopic or microscopic evidence for remaining tumor who can be randomized to either treatment arm within 8 weeks after surgery. As this is an adjuvant trial patients should never have had any evidence of metastatic disease (including presence of tumor cells in the ascites). * Have a life expectancy of at least 5 years

Exclusion criteria

* Pregnant or lactating women * Sexually active males and females (of childbearing potential) unwilling to practice contraception during the study * Previous cytotoxic chemotherapy, radiotherapy or immunotherapy, for the currently treated colon cancer * Patients who have not completely recovered from surgery

Design outcomes

Primary

MeasureTime frameDescription
Disease-Free Survival (DFS) [Number of Events]Time from randomization date to date of first DFS event/date last known to be event-free. Median observation time for DFS was 74 months (range: 0-95 months).Determination of an event was based on tumor assessments and survival follow-up assessments. A disease-free survival (DFS) event was defined as any recurrence of the original colon cancer or appearance of a new colon or rectal cancer (proven by cytology or histology, when possible) or death due to any cause, whichever was earliest. Participants who had not had any such event at the time of data analysis were censored at the last date they were known to be event-free. Participants with no tumor assessments after baseline were censored at Day 1. An isolated event of increased CEA, or unexplained clinical deterioration were not considered to be evidence of relapse without support of other objective measurements. The date of relapse was defined as the date of the definitive assessment by objective measurements.
Disease-Free Survival (DFS) [Time to Event]Time from randomization date to date of first DFS event/date last known to be event-free. Median observation time for DFS was 74 months (range: 0-95 months).Determination of an event was based on tumor assessments and survival follow-up assessments. A disease-free survival (DFS) event was defined as any recurrence of the original colon cancer or appearance of a new colon or rectal cancer (proven by cytology or histology, when possible) or death due to any cause, whichever was earliest. Participants who had not had any such event at the time of data analysis were censored at the last date they were known to be event-free. Participants with no tumor assessments after baseline were censored at Day 1. An isolated event of increased CEA, or unexplained clinical deterioration were not considered to be evidence of relapse without support of other objective measurements. The date of relapse was defined as the date of the definitive assessment by objective measurements. The median was estimated by the Kaplan-Meier method. The full range values include censored observations.

Secondary

MeasureTime frameDescription
Overall Survival [Number of Events]Time from randomization date to date of death/date last known to be alive. Median observation time was 83 months (range: 0-95 months).Overall survival was measured as the time from randomization to the date of death, irrespective of the cause of death. Participants who were not reported as having died at the time of the analysis were censored using the date they were last known to be alive.
Relapse-Free Survival (RFS) [Number of Events]Time from randomization date to date of first RFS event/date last known to be event-free. Median observation time for RFS was 74 months (range: 0-95 months).A relapse-free survival (RFS) event included recurrence of the original colon cancer, development of a new colon or rectal cancer, and deaths related to any of the following: treatment, recurrence of the original colon cancer, or development of a new colon or rectal cancer. Participants who had not had any such event at the time of data analysis were censored at the last date they were known to be event-free. Participants whose cause of death was unrelated to treatment or disease recurrence were censored at the time of the last tumor assessment.
Number of Participants With at Least One Adverse Event by Most Severe IntensityFrom time of very first drug intake to 28 days after very last drug intake (median [full range] duration of study treatment per arm: 5-FU/LV MAYO CLINIC: 145 [4-208] days; 5-FU/LV ROSWELL PARK: 204 [1-239] days; XELOX: 163 [1-275] days).The intensity of all adverse events (AEs) was categorized according to the National Cancer Institute Common Toxicity Criteria for Adverse Events (NCI CTCAE) (version 3.0) grading system. If an AE had occurred which was not contained in the NCI-CTC, a four-point scale (mild, moderate, severe, life-threatening) was used. The terms severe and serious are not synonymous and are independently assessed for each AE. Only the most severe intensity was counted for multiple occurrences of an AE in one individual. See the AEs results table for details.
Overall Survival [Time to Event]Time from randomization date to date of death/date last known to be alive. Median observation time was 83 months (range: 0-95 months).Overall survival was measured as the time from randomization to the date of death, irrespective of the cause of death. Participants who were not reported as having died at the time of the analysis were censored using the date they were last known to be alive. The median was estimated by the Kaplan-Meier method. The full range values include censored observations.
Relapse-Free Survival (RFS) [Time to Event]Time from randomization date to date of first RFS event/date last known to be event-free. Median observation time for RFS was 74 months (range: 0-95 months).A relapse-free survival (RFS) event included recurrence of the original colon cancer, development of a new colon or rectal cancer, and deaths related to any of the following: treatment, recurrence of the original colon cancer, or development of a new colon or rectal cancer. Participants who had not had any such event at the time of data analysis were censored at the last date they were known to be event-free. Participants whose cause of death was unrelated to treatment or disease recurrence were censored at the time of the last tumor assessment. The median was estimated by the Kaplan-Meier method. The full range values include censored observations.

Countries

Australia, Belgium, Brazil, Canada, China, Finland, France, Germany, Greece, Hong Kong, Hungary, Ireland, Israel, Italy, Mexico, New Zealand, Panama, Poland, Portugal, Russia, Singapore, South Africa, South Korea, Spain, Switzerland, Taiwan, Thailand, United Kingdom, United States

Participant flow

Participants by arm

ArmCount
5-FU/LV
Given by one of two regimens. • Mayo Clinic regimen group: LV 20 mg/m\^2 IV bolus injection + 5-FU 425 mg/m\^2 IV bolus injection daily on Days 1-5 of a four-week cycle, for a total of six cycles (24 weeks), or • Roswell Park regimen group: LV 500 mg/m\^2 by two-hour IV infusion + 5-FU 500 mg/m\^2 IV bolus injection one hour after the start of the LV infusion on Day 1 of Weeks 1 to 6 of each eight-week cycle, for a total of four cycles (32 weeks)
942
XELOX
Capecitabine administered as an oral twice daily outpatient intermittent treatment (3-week cycles consisting of two weeks of treatment followed by one week without treatment) combined with intravenous (IV) oxaliplatin on Day 1 of each cycle. Capecitabine was administered orally at a dose of 1000 mg/m\^2 twice-daily (equivalent to a total daily dose of 2000 mg/m\^2) with the first dose given during the evening of Day 1 and last dose given during the morning of Day 15. Oxaliplatin was administered as a 130 mg/m\^2 IV infusion over two hours on Day 1 of each cycle. The XELOX combination was administered for a total of eight cycles (24 weeks)
944
Total1,886

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyDeath286242
Overall StudyLost to Follow-up6363
Overall StudyWithdrawal by Subject1820

Baseline characteristics

CharacteristicXELOXTotal5-FU/LV
Age, Continuous59.8 years
STANDARD_DEVIATION 10.95
60.2 years
STANDARD_DEVIATION 10.86
60.5 years
STANDARD_DEVIATION 10.76
Sex: Female, Male
Female
431 Participants873 Participants442 Participants
Sex: Female, Male
Male
513 Participants1013 Participants500 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
deaths
Total, all-cause mortality
215 / 66471 / 278242 / 944
other
Total, other adverse events
622 / 657262 / 269926 / 938
serious
Total, serious adverse events
134 / 65788 / 269208 / 938

Outcome results

Primary

Disease-Free Survival (DFS) [Number of Events]

Determination of an event was based on tumor assessments and survival follow-up assessments. A disease-free survival (DFS) event was defined as any recurrence of the original colon cancer or appearance of a new colon or rectal cancer (proven by cytology or histology, when possible) or death due to any cause, whichever was earliest. Participants who had not had any such event at the time of data analysis were censored at the last date they were known to be event-free. Participants with no tumor assessments after baseline were censored at Day 1. An isolated event of increased CEA, or unexplained clinical deterioration were not considered to be evidence of relapse without support of other objective measurements. The date of relapse was defined as the date of the definitive assessment by objective measurements.

Time frame: Time from randomization date to date of first DFS event/date last known to be event-free. Median observation time for DFS was 74 months (range: 0-95 months).

Population: Intent-to-Treat Population

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
5-FU/LVDisease-Free Survival (DFS) [Number of Events]Patients with Event379 Participants
5-FU/LVDisease-Free Survival (DFS) [Number of Events]Patients without Events563 Participants
XELOXDisease-Free Survival (DFS) [Number of Events]Patients with Event320 Participants
XELOXDisease-Free Survival (DFS) [Number of Events]Patients without Events624 Participants
Primary

Disease-Free Survival (DFS) [Time to Event]

Determination of an event was based on tumor assessments and survival follow-up assessments. A disease-free survival (DFS) event was defined as any recurrence of the original colon cancer or appearance of a new colon or rectal cancer (proven by cytology or histology, when possible) or death due to any cause, whichever was earliest. Participants who had not had any such event at the time of data analysis were censored at the last date they were known to be event-free. Participants with no tumor assessments after baseline were censored at Day 1. An isolated event of increased CEA, or unexplained clinical deterioration were not considered to be evidence of relapse without support of other objective measurements. The date of relapse was defined as the date of the definitive assessment by objective measurements. The median was estimated by the Kaplan-Meier method. The full range values include censored observations.

Time frame: Time from randomization date to date of first DFS event/date last known to be event-free. Median observation time for DFS was 74 months (range: 0-95 months).

Population: Intent-to-Treat (ITT) Population: all randomized participants who gave written informed consent. Participants in the ITT population were analyzed according to the treatment arm to which they were randomized.

ArmMeasureValue (MEDIAN)
5-FU/LVDisease-Free Survival (DFS) [Time to Event]NA months
XELOXDisease-Free Survival (DFS) [Time to Event]88.6 months
p-value: 0.003895% CI: [0.69, 0.93]Log Rank
Secondary

Number of Participants With at Least One Adverse Event by Most Severe Intensity

The intensity of all adverse events (AEs) was categorized according to the National Cancer Institute Common Toxicity Criteria for Adverse Events (NCI CTCAE) (version 3.0) grading system. If an AE had occurred which was not contained in the NCI-CTC, a four-point scale (mild, moderate, severe, life-threatening) was used. The terms severe and serious are not synonymous and are independently assessed for each AE. Only the most severe intensity was counted for multiple occurrences of an AE in one individual. See the AEs results table for details.

Time frame: From time of very first drug intake to 28 days after very last drug intake (median [full range] duration of study treatment per arm: 5-FU/LV MAYO CLINIC: 145 [4-208] days; 5-FU/LV ROSWELL PARK: 204 [1-239] days; XELOX: 163 [1-275] days).

Population: Safety Population: all participants who were randomized and did receive at least one dose of capecitabine, 5-FU, or oxaliplatin. Participants in the safety population were analyzed according to the study treatment they received.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
5-FU/LVNumber of Participants With at Least One Adverse Event by Most Severe IntensitySevere AEs299 Participants
5-FU/LVNumber of Participants With at Least One Adverse Event by Most Severe IntensityMild AEs557 Participants
5-FU/LVNumber of Participants With at Least One Adverse Event by Most Severe IntensityModerate AEs493 Participants
5-FU/LVNumber of Participants With at Least One Adverse Event by Most Severe IntensityLife-Threatening83 Participants
XELOXNumber of Participants With at Least One Adverse Event by Most Severe IntensityLife-Threatening21 Participants
XELOXNumber of Participants With at Least One Adverse Event by Most Severe IntensitySevere AEs146 Participants
XELOXNumber of Participants With at Least One Adverse Event by Most Severe IntensityModerate AEs217 Participants
XELOXNumber of Participants With at Least One Adverse Event by Most Severe IntensityMild AEs256 Participants
XELOXNumber of Participants With at Least One Adverse Event by Most Severe IntensityLife-Threatening63 Participants
XELOXNumber of Participants With at Least One Adverse Event by Most Severe IntensityMild AEs855 Participants
XELOXNumber of Participants With at Least One Adverse Event by Most Severe IntensitySevere AEs548 Participants
XELOXNumber of Participants With at Least One Adverse Event by Most Severe IntensityModerate AEs792 Participants
Secondary

Overall Survival [Number of Events]

Overall survival was measured as the time from randomization to the date of death, irrespective of the cause of death. Participants who were not reported as having died at the time of the analysis were censored using the date they were last known to be alive.

Time frame: Time from randomization date to date of death/date last known to be alive. Median observation time was 83 months (range: 0-95 months).

Population: Intent-to-Treat (ITT) Population: all randomized participants who gave written informed consent. Participants in the ITT population were analyzed according to the treatment arm to which they were randomized.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
5-FU/LVOverall Survival [Number of Events]Patients With Event286 Participants
5-FU/LVOverall Survival [Number of Events]Patients Without Events656 Participants
XELOXOverall Survival [Number of Events]Patients With Event242 Participants
XELOXOverall Survival [Number of Events]Patients Without Events702 Participants
Secondary

Overall Survival [Time to Event]

Overall survival was measured as the time from randomization to the date of death, irrespective of the cause of death. Participants who were not reported as having died at the time of the analysis were censored using the date they were last known to be alive. The median was estimated by the Kaplan-Meier method. The full range values include censored observations.

Time frame: Time from randomization date to date of death/date last known to be alive. Median observation time was 83 months (range: 0-95 months).

Population: Intent-to-Treat (ITT) Population: all randomized participants who gave written informed consent. Participants in the ITT population were analyzed according to the treatment arm to which they were randomized.

ArmMeasureValue (MEDIAN)
5-FU/LVOverall Survival [Time to Event]NA months
XELOXOverall Survival [Time to Event]NA months
p-value: 0.036795% CI: [0.7, 0.99]Log Rank
Secondary

Relapse-Free Survival (RFS) [Number of Events]

A relapse-free survival (RFS) event included recurrence of the original colon cancer, development of a new colon or rectal cancer, and deaths related to any of the following: treatment, recurrence of the original colon cancer, or development of a new colon or rectal cancer. Participants who had not had any such event at the time of data analysis were censored at the last date they were known to be event-free. Participants whose cause of death was unrelated to treatment or disease recurrence were censored at the time of the last tumor assessment.

Time frame: Time from randomization date to date of first RFS event/date last known to be event-free. Median observation time for RFS was 74 months (range: 0-95 months).

Population: Intent-to-Treat (ITT) Population: all randomized participants who gave written informed consent. Participants in the ITT population were analyzed according to the treatment arm to which they were randomized.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
5-FU/LVRelapse-Free Survival (RFS) [Number of Events]Patients With Event356 Participants
5-FU/LVRelapse-Free Survival (RFS) [Number of Events]Patients Without Events586 Participants
XELOXRelapse-Free Survival (RFS) [Number of Events]Patients With Event290 Participants
XELOXRelapse-Free Survival (RFS) [Number of Events]Patients Without Events654 Participants
Secondary

Relapse-Free Survival (RFS) [Time to Event]

A relapse-free survival (RFS) event included recurrence of the original colon cancer, development of a new colon or rectal cancer, and deaths related to any of the following: treatment, recurrence of the original colon cancer, or development of a new colon or rectal cancer. Participants who had not had any such event at the time of data analysis were censored at the last date they were known to be event-free. Participants whose cause of death was unrelated to treatment or disease recurrence were censored at the time of the last tumor assessment. The median was estimated by the Kaplan-Meier method. The full range values include censored observations.

Time frame: Time from randomization date to date of first RFS event/date last known to be event-free. Median observation time for RFS was 74 months (range: 0-95 months).

Population: Intent-to-Treat (ITT) Population: all randomized participants who gave written informed consent. Participants in the ITT population were analyzed according to the treatment arm to which they were randomized.

ArmMeasureValue (MEDIAN)
5-FU/LVRelapse-Free Survival (RFS) [Time to Event]NA months
XELOXRelapse-Free Survival (RFS) [Time to Event]88.6 months
p-value: 0.001595% CI: [0.67, 0.91]Log Rank

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