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Cediranib (AZD2171, RECENTIN™) in Addition to Chemotherapy in Patients With Untreated Metastatic Colorectal Cancer

A Randomised, Double-blind, Phase III Study to Compare the Efficacy and Safety of Cediranib (AZD2171, RECENTIN™) When Added to 5 Fluorouracil, Leucovorin and Oxaliplatin (FOLFOX) or Capecitabine and Oxaliplatin (XELOX) With the Efficacy and Safety of Placebo When Added to FOLFOX or XELOX in Patients With Previously Untreated Metastatic Colorectal Cancer.

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00399035
Acronym
HORIZON II
Enrollment
1254
Registered
2006-11-14
Start date
2006-11-30
Completion date
2016-08-31
Last updated
2016-12-28

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

Conditions

Metastatic Colorectal Cancer

Keywords

Colorectal Cancer, Cediranib, RECENTIN

Brief summary

The purpose of this study is to determine if Cediranib when added to chemotherapy is more effective than chemotherapy alone in prolonging life expectancy and slowing disease progression in patients with previously untreated metastatic colorectal cancer.

Interventions

DRUGCediranib

oral tablet

intravenous oxaliplatin 130 mg/ m\^2(day 1) followed by oral capecitabine 1,000 mg/ m\^2twice daily (day 1 to day 15)

oral tablet

Sponsors

AstraZeneca
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Eligibility

Sex/Gender
ALL
Age
18 Years to 130 Years
Healthy volunteers
No

Inclusion criteria

* Written Informed Consent * Carcinoma of the colon or rectum * One or more measurable lesions

Exclusion criteria

* Adjuvant/neoadjuvant therapy within 6-12 months of study entry * Untreated unstable brain or meningeal metastases * Specific laboratory ranges * Specific cardiovascular problems * Participation in other trials within 30 days

Design outcomes

Primary

MeasureTime frameDescription
Progression-free SurvivalRECIST assessed at baseline every 6 weeks through to week 24 and 12 week thereafter through to progression or data cut off date of 21/03/10 whichever was earliest.RECIST criteria defined as follows: Target lesions Complete Response (CR) Disappearance of all target lesions Partial Response (PR) At least a 30% decrease in the sum of LD of target lesions taking as reference the baseline sum LD.Progressive Disease (PD) At least a 20% increase in the sum of LD of target lesions taking as references the smallest sum LD recorded (either at baseline or at previous assessment since treatment began).Stable Disease (SD) Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD. Non-target lesions Complete Response (CR) Disappearance of all non-target lesions Non-Complete Response (non-CR/Non- Progression \[non-PD\]) Persistence of one or more non-target lesion or/and maintenance of tumour marker level above the normal limits. Progression (PD) Unequivocal progression of existing nontarget lesions.
Overall SurvivalBaseline through to date of death upto and including data cut off date of 21/03/10Number of months from randomisation to the date of death from any cause

Secondary

MeasureTime frameDescription
Duration of ResponseTreatment period from initial response up until data cut-off date of 21/03/10Based on RECIST measurements taken throughout the study and best objective tumour response at the defined analysis cut-off point. Measured from the time the criteria for CR/PR are first met (whichever is recorded first) until the patient progresses or dies.
Overall Response RateBaseline through to date of death upto and including data cut off date of 21/03/10Objective tumour response(defined as a confirmed response of CR or PR).The definition for a confirmed response was met when an initial RECIST response of PR/CR was confirmed at the next scheduled visit as a PR/CR according to an evaluable assessment.Intervening assessments of non-evaluable or stable disease were allowable as long as the initial RECIST response was confirmed.RECIST criteria defined as follows: Target lesions Complete Response(CR)Disappearance of all target lesions Partial Response (PR).At least a 30% decrease in the sum of LD of target lesions taking as reference the baseline sum LD. Progressive Disease (PD) At least a 20% increase in the sum of LD of target lesions taking as references the smallest sum LD recorded (either at baseline or at previous assessment since treatment began).Stable Disease (SD) Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD.Non-target lesions Complete Response (CR) Disappearance of all non-target lesi
Time to Wound Healing ComplicationsPost-randomisation until end of studyNumber of days from post-randomisation surgery until wound healing complications
Rate of Resection of Liver MetastasesPost-randomisation until end of studyNumber of patients undergoing liver resection, based on patients with liver disease at baseline
Best Percentage Change in Tumour SizeBaseline through to date of death upto and including data cut off date of 21/03/10Maximum percentage reduction or minimum percentage increase in tumour size where size is the sum of the longest diameters of the target lesions

Countries

Argentina, Australia, Brazil, Bulgaria, China, Czechia, Germany, Hungary, India, Philippines, Poland, South Korea, Switzerland, Taiwan, United Kingdom

Participant flow

Recruitment details

Randomised=full analysis set: Cediranib 20mg=502, Placebo=358; Safety set: Cediranib 20mg=500, Cediranib 30mg=214, Placebo=358

Pre-assignment details

Cediranib 30 mg discontinued following Phase II, Cediranib 20 mg chosen dose for comparing with Placebo. 1254 patients enrolled to the study, 1076 recieved study treatment; 2 patients lost for Cediranib 20 mg/day, and 2 patients lost for Cediranib 30 mg/day.The 4 patients that didn't receive drug are intentionally included.

Participants by arm

ArmCount
Cediranib 20 mg
Cediranib 20 mg + FOLFOX/XELOX
502
Placebo
Placebo + FOLFOX/XELOX
358
Cediranib 30 mg
Cediranib 30 mg/day + FOLFOX/XELOX
216
Total1,076

Withdrawals & dropouts

PeriodReasonFG000FG001FG002
Overall StudyDeath289141234
Overall StudyIncorrect enrolment/eligib not fulfilled101
Overall StudyLost to Follow-up215
Overall StudySevere non-compliance with protocol210
Overall StudyWithdrawal by Subject191512

Baseline characteristics

CharacteristicCediranib 20 mgPlaceboCediranib 30 mgTotal
Age, Continuous57.8 years
STANDARD_DEVIATION 11.14
57.2 years
STANDARD_DEVIATION 11.63
59.4 years
STANDARD_DEVIATION 10.69
57.6 years
STANDARD_DEVIATION 11.34
Gender
Female
203 Participants146 Participants93 Participants442 Participants
Gender
Male
299 Participants212 Participants123 Participants634 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
deaths
Total, all-cause mortality
— / —— / —— / —
other
Total, other adverse events
209 / 214485 / 500341 / 358
serious
Total, serious adverse events
94 / 214204 / 500105 / 358

Outcome results

Primary

Overall Survival

Number of months from randomisation to the date of death from any cause

Time frame: Baseline through to date of death upto and including data cut off date of 21/03/10

Population: Two cediranib doses (20 mg and 30 mg) were initially included in this study; however, it was intended that one dose would be selected for continuation. The decision was taken to continue with cediranib 20 mg. All efficacy analyses compared cediranib 20mg to placebo. No statistical analyses were performed on the 30mg group.

ArmMeasureValue (MEDIAN)
Cediranib 20 mgOverall Survival19.7 Months
PlaceboOverall Survival18.9 Months
Primary

Progression-free Survival

RECIST criteria defined as follows: Target lesions Complete Response (CR) Disappearance of all target lesions Partial Response (PR) At least a 30% decrease in the sum of LD of target lesions taking as reference the baseline sum LD.Progressive Disease (PD) At least a 20% increase in the sum of LD of target lesions taking as references the smallest sum LD recorded (either at baseline or at previous assessment since treatment began).Stable Disease (SD) Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD. Non-target lesions Complete Response (CR) Disappearance of all non-target lesions Non-Complete Response (non-CR/Non- Progression \[non-PD\]) Persistence of one or more non-target lesion or/and maintenance of tumour marker level above the normal limits. Progression (PD) Unequivocal progression of existing nontarget lesions.

Time frame: RECIST assessed at baseline every 6 weeks through to week 24 and 12 week thereafter through to progression or data cut off date of 21/03/10 whichever was earliest.

Population: Two cediranib doses (20 mg and 30 mg) were initially included in this study; however, it was intended that one dose would be selected for continuation.The decision was taken to continue with cediranib 20 mg. All efficacy analyses compared cediranib 20mg to placebo. No statistical analyses were performed on the 30mg group.

ArmMeasureValue (MEDIAN)
Cediranib 20 mgProgression-free Survival8.6 Months
PlaceboProgression-free Survival8.2 Months
Secondary

Best Percentage Change in Tumour Size

Maximum percentage reduction or minimum percentage increase in tumour size where size is the sum of the longest diameters of the target lesions

Time frame: Baseline through to date of death upto and including data cut off date of 21/03/10

Population: Two cediranib doses (20 mg and 30 mg) were initially included in this study; however, it was intended that one dose would be selected for continuation. The decision was taken to continue with cediranib 20 mg. All efficacy analyses compared cediranib 20mg to placebo. No statistical analyses were performed on the 30mg group.

ArmMeasureValue (MEAN)Dispersion
Cediranib 20 mgBest Percentage Change in Tumour Size-42.49 Percentage [change in tumour size (mm) ]Standard Deviation 28.139
PlaceboBest Percentage Change in Tumour Size-40.61 Percentage [change in tumour size (mm) ]Standard Deviation 31.992
Secondary

Duration of Response

Based on RECIST measurements taken throughout the study and best objective tumour response at the defined analysis cut-off point. Measured from the time the criteria for CR/PR are first met (whichever is recorded first) until the patient progresses or dies.

Time frame: Treatment period from initial response up until data cut-off date of 21/03/10

Population: Two cediranib doses (20 mg and 30 mg) were initially included in this study; however, it was intended that one dose would be selected for continuation. The decision was taken to continue with cediranib 20 mg. All efficacy analyses compared cediranib 20mg to placebo. No statistical analyses were performed on the 30mg group.

ArmMeasureValue (MEDIAN)
Cediranib 20 mgDuration of Response8.5 Months
PlaceboDuration of Response6.9 Months
Secondary

Overall Response Rate

Objective tumour response(defined as a confirmed response of CR or PR).The definition for a confirmed response was met when an initial RECIST response of PR/CR was confirmed at the next scheduled visit as a PR/CR according to an evaluable assessment.Intervening assessments of non-evaluable or stable disease were allowable as long as the initial RECIST response was confirmed.RECIST criteria defined as follows: Target lesions Complete Response(CR)Disappearance of all target lesions Partial Response (PR).At least a 30% decrease in the sum of LD of target lesions taking as reference the baseline sum LD. Progressive Disease (PD) At least a 20% increase in the sum of LD of target lesions taking as references the smallest sum LD recorded (either at baseline or at previous assessment since treatment began).Stable Disease (SD) Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD.Non-target lesions Complete Response (CR) Disappearance of all non-target lesi

Time frame: Baseline through to date of death upto and including data cut off date of 21/03/10

Population: Two cediranib doses (20 mg and 30 mg) were initially included in this study; however, it was intended that one dose would be selected for continuation. The decision was taken to continue with cediranib 20 mg. All efficacy analyses compared cediranib 20mg to placebo. No statistical analyses were performed on the 30mg group.

ArmMeasureValue (NUMBER)
Cediranib 20 mgOverall Response Rate254 Participants
PlaceboOverall Response Rate178 Participants
Secondary

Rate of Resection of Liver Metastases

Number of patients undergoing liver resection, based on patients with liver disease at baseline

Time frame: Post-randomisation until end of study

Population: Two cediranib doses (20 mg and 30 mg) were initially included in this study; however, it was intended that one dose would be selected for continuation. The decision was taken to continue with cediranib 20 mg. All efficacy analyses compared cediranib 20mg to placebo. No statistical analyses were performed on the 30mg group.

ArmMeasureValue (NUMBER)
Cediranib 20 mgRate of Resection of Liver Metastases21 Participants
PlaceboRate of Resection of Liver Metastases17 Participants
Secondary

Time to Wound Healing Complications

Number of days from post-randomisation surgery until wound healing complications

Time frame: Post-randomisation until end of study

Population: Two cediranib doses (20 mg and 30 mg) were initially included in this study; however, it was intended that one dose would be selected for continuation. The decision was taken to continue with cediranib 20 mg. All efficacy analyses compared cediranib 20mg to placebo. No statistical analyses were performed on the 30mg group.

ArmMeasureValue (MEDIAN)
Cediranib 20 mgTime to Wound Healing Complications18 Days
PlaceboTime to Wound Healing Complications18 Days

Source: ClinicalTrials.gov · Data processed: Mar 24, 2026