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Oxaliplatin, Irinotecan, and Capecitabine in Treating Patients With Advanced or Metastatic Colorectal Cancer That Cannot Be Removed By Surgery

Oxaliplatin, Irinotecan, and Capecitabine as a Combination Regimen for First-Line Treatment of Advanced or Metastatic Colorectal Cancer

Status
Completed
Phases
Phase 1Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00217711
Enrollment
23
Registered
2005-09-22
Start date
2005-05-31
Completion date
2011-10-31
Last updated
2012-06-05

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

Conditions

Colorectal Cancer

Keywords

stage III colon cancer, stage IV colon cancer, stage III rectal cancer, stage IV rectal cancer

Brief summary

RATIONALE: Drugs used in chemotherapy, such as oxaliplatin, irinotecan, and capecitabine, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more tumor cells. PURPOSE: This phase I/II trial is studying the side effects and best dose of capecitabine when given together with oxaliplatin and irinotecan and to see how well they work in treating patients with advanced or metastatic colorectal cancer that cannot be removed by surgery.

Detailed description

OBJECTIVES: Primary * Determine the maximum tolerated dose and recommended phase II dose of capecitabine administered in combination with oxaliplatin and irinotecan in patients with unresectable advanced or metastatic colorectal cancer. (Phase I) * Determine the efficacy of this regimen in these patients. (Phase II) Secondary * Determine the tolerability of this regimen in these patients. (Phase II) OUTLINE: This is a multicenter, phase I dose-escalation study of capecitabine followed by a phase II study. * Phase I: Patients receive oxaliplatin IV over 2 hours on days 1 and 15, irinotecan IV over 1 hour on days 8 and 22, and oral capecitabine twice daily on days 1-29. Treatment repeats every 5 weeks for up to 6 courses in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of capecitabine until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. * Phase II: Patients receive capecitabine at the MTD and irinotecan and oxaliplatin as in phase I. After completion of study treatment, patients are followed every 2 months for 1 year and then every 4 months thereafter. PROJECTED ACCRUAL: A total of 23-32 patients (3-12 for the phase I portion and 20 for the phase II portion) will be accrued for this study within 2.75 years

Interventions

DRUGCapecitabine

capecitabine

DRUGirinotecan hydrochloride

irinotecan hydrochloride

DRUGoxaliplatin

oxaliplatin

Sponsors

Swiss Cancer Institute
Lead SponsorOTHER

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No

Inclusion criteria

DISEASE CHARACTERISTICS: * Histologically or cytologically confirmed unresectable advanced or metastatic colorectal cancer * Measurable disease (phase II only) * At least 1 unidimensionally measurable lesion ≥ 20 mm by conventional techniques OR ≥ 10 mm by spiral CT scan or MRI * No presence or history of CNS metastases PATIENT CHARACTERISTICS: Age * 18 to 70 Performance status * WHO 0-1 Life expectancy * Not specified Hematopoietic * Absolute neutrophil count ≥ 1,500/mm\^3 * Platelet count ≥ 100,000/mm\^3 Hepatic * Bilirubin ≤ 1.25 times upper limit of normal (ULN) (1.5 times ULN if liver metastases are present) * AST and ALT ≤ 3 times ULN (5 times ULN if liver metastases are present) Renal * Creatinine clearance \> 60 mL/min Cardiovascular * No New York Heart Association class III-IV congestive heart failure * No symptomatic coronary artery disease * No uncontrolled cardiac arrhythmia * No myocardial infarction within the past year * No other clinically significant cardiac disease Immunologic * No active autoimmune disease * No uncontrolled infection * No prior severe reaction to fluoropyrimidine therapy or known hypersensitivity to fluorouracil * No known hypersensitivity to any component of study drugs Other * Not pregnant or nursing * Negative pregnancy test * Patients must use effective contraception during and for 1 year after study participation * No other malignancy within the past 5 years except adequately treated carcinoma in situ of the cervix or localized nonmelanoma skin cancer * No peripheral neuropathy \> grade 1 of any origin (e.g., alcohol or diabetes) * No nausea, vomiting, or malabsorption syndrome that would preclude ingestion or absorption of oral medication * No psychiatric disability that would preclude study compliance * No uncontrolled diabetes * No other serious underlying medical condition that would preclude study participation * No known dihydropyrimidine dehydrogenase deficiency PRIOR CONCURRENT THERAPY: Biologic therapy * No concurrent prophylactic hematopoietic growth factors Chemotherapy * More than 6 months since prior adjuvant fluoropyrimidine chemotherapy * No other prior chemotherapy Endocrine therapy * Not specified Radiotherapy * No concurrent radiotherapy * Concurrent radiotherapy of a single painful lesion allowed Surgery * Not specified Other * More than 30 days since prior clinical trial participation * No other concurrent experimental drugs * No other concurrent anticancer therapy * No concurrent sorivudine or its chemically-related analogues (e.g., lamivudine)

Design outcomes

Primary

MeasureTime frameDescription
capecitabine + oxaliplatin + irinotecan dose finding30 daysDetermine the maximum tolerated dose and recommended phase II dose of capecitabine administered in combination with oxaliplatin and irinotecan in patients with unresectable advanced or metastatic colorectal cancer. (Phase I)
Efficacy of Oxaliplatin, Irinotecan, and Capecitabine2 monthsDetermine the efficacy of this regimen in these patients (Phase II)

Secondary

MeasureTime frame
Time to progressionlife-long
Objective response (CR or PR) as measured after completion of study treatment2 months
Overall survivallife-long
Time to treatment failure as measured after completion of study treatmentlife-long
Adverse events as measured after completion of study treatment2 months

Countries

Switzerland

Outcome results

None listed

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