Colorectal Cancer
Conditions
Brief summary
This study will assess the efficacy and safety of treatment with the combination Avastin (bevacizumab) 5mg/kg iv every 2 weeks, Xeloda (capecitabine) 1000 mg po b.i.d. on Days 1-14 of every 28-day cycle and oxaliplatin 40mg/m2 iv weekly in patients with inoperable locally advanced or metastatic colorectal cancer. The anticipated time on study treatment is until disease progression.
Interventions
5 mg/kg intravenously every 14 days
1000 mg/m2 orally b.i.d. , Days 1 - 14 of every 28-day cycle
40 mg/m2 iv weekly
Sponsors
Study design
Eligibility
Inclusion criteria
* Adult patients \>=18 years of age * Locally advanced or metastatic colorectal cancer * No previous treatment with chemotherapy for metastatic disease * Measurable and/or evaluable lesions
Exclusion criteria
* Radiotherapy within 4 weeks before study * Untreated brain metastases or primary brain tumors * Chronic, daily treatment with high-dose aspirin (\>325mg/day) * Co-existing malignancies, or malignancies diagnosed within the last 5 years, with the exception of basal and squamous cell cancer, or cervical cancer in situ
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With Objective Response (OR) | Baseline, every 3 months to progression of disease or end of study (up to 24 months) | Percentage of participants with OR was defined as the percentage of participants who achieved complete response (CR) or partial response (PR) according to Response Evaluation Criteria in Solid Tumors (RECIST). CR was defined as disappearance of all target lesions, non-target lesions, and normalization of tumor marker level. PR was defined as greater than or equal to (≥)30 percent (%) decrease under baseline of the sum of the longest diameter (LD) diameters of all target lesions. No unequivocal progression of non-target disease. No new lesions. Complete and partial responses must have been confirmed no less than 4 weeks after the criteria for response were first met. |
| Percentage of Participants by Best Overall Response | Baseline, every 3 months to progression of disease or end of study (up to 24 months) | Best response recorded from the start of treatment until disease progression. Based on assessment of CR, PR, stable disease (SD), or progressive disease (PD), according to RECIST. CR: disappearance of all target lesions, non-target lesions, and normalization of tumor marker level. PR: ≥30% decrease under baseline of the sum of the LD diameters of all target lesions. CR and PR persist on repeat imaging study at least 4 weeks after initial documentation. SD: neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD. Reference is the smallest sum LD. PD: at least a 20% increase in the sum of the LD of target lesions, taking as reference the smallest sum longest diameter recorded or the appearance of one or more new lesions. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Duration of Stable Disease - Percentage of Participants With an Event by 24 Months | Baseline, every 3 months to progression of disease or end of study (up to 24 months) | Duration of stable response (CR, PR, or stable disease \[SD\]) was calculated only for participants of the ITT population whose best overall response was CR, PR, or SD based on RECIST criteria. Duration of overall response was defined as the time from the date of the first assessment of CR, PR, or SD status until the date of progression or death. Data for participants who were alive without any objectively documented disease progression at the end of the study were censored as of the date of last contact. |
| Duration of Stable Disease | Baseline, every 3 months to progression of disease or end of study (up to 24 months) | Duration of stable response (CR, PR, or SD) was calculated only for participants of the ITT population whose best overall response was CR, PR, or SD based on RECIST criteria. Duration of overall response was defined as the time from the date of the first assessment of CR, PR, or SD status until the date of progression or death. Data for participants who were alive without any objectively documented disease progression at the end of the study were censored as of the date of last contact. Mean time to event was estimated using the Kaplan-Meier method. |
| Time to Treatment Failure (TTF) - Percentage of Participants With an Event by 24 Months | Baseline, every month to end of treatment (up to 24 months) | TTF was defined as the time in months from Day 1 until discontinuation of treatment for any reasons. These reasons included: death due to any cause, treatment toxicity (adverse event), insufficient therapeutic response (progression of disease), failure to return (lost to follow-up), refusing treatment (participant non-compliance), being unwilling to cooperate and withdrawing consent (participant withdrew consent). |
| Time to Treatment Failure | Baseline, monthly to end of study (up to 24 months) | TTF was defined as the time in months from Day 1 until discontinuation of treatment for any reasons. These reasons included: death due to any cause, treatment toxicity (adverse event), insufficient therapeutic response (progression of disease), failure to return (lost to follow-up), refusing treatment (participant non-compliance), being unwilling to cooperate and withdrawing consent (participant withdrew consent). Mean TTF was estimated using the Kaplan-Meier method. |
| Duration of Response - Percentage of Participants With an Event by 24 Months | Baseline, every 3 months to progression of disease or end of study (up to 24 months) | Duration of overall response (CR or PR) was calculated only for participants of the ITT population whose best overall response was CR or PR based on RECIST criteria. Duration of overall response was defined as the time from the date of the first assessment of CR or PR status until the date of progression or death. Data for participants who were alive without any objectively documented disease progression at the end of the study were censored as of the date of last contact. |
| Time to Progression | Baseline, monthly to end of study (up to 24 months) | TTP was defined as the time in months from Day 1 until the date of first documented progressive disease, or death due to any cause. Data for participants who were alive without disease progression at the end of study, or who were non-responder participants (without tumor assessment after baseline) were censored at Day 1. Mean TTP was estimated using the Kaplan-Meier method. |
| Overall Survival (OS) - Percentage of Participants With an Event by 24 Months | Baseline, monthly to end of study (up to 24 months) | OS was defined as the time in months from Day 1 until the date of death due to any cause. Data for participants who were alive at the end of the study were censored at the date of the last available follow-up visit. |
| Overall Survival | Baseline, monthly to end of study (up to 24 months) | OS was defined as the time in months from Day 1 until the date of death due to any cause. Data for participants who were alive at the end of the study were censored at the date of the last available follow-up visit. Mean OS was estimated using the Kaplan-Meier method. |
| Time to Progression (TTP) - Percentage of Participants With an Event by 24 Months | Baseline, monthly to end of study (up to 24 months) | TTP was defined as the time time in months from Day 1 until the date of first documented progressive disease, or death due to any cause. Data for participants who were alive without disease progression at the end of study, or who were non-responder participants (without tumor assessment after baseline) were censored at Day 1. |
| Duration of Response | Baseline, every 3 months to progression of disease or end of study (up to 24 months) | Duration of overall response (CR or PR) was calculated for participants of the ITT population whose best overall response was CR or PR based on RECIST criteria. Duration of overall response was defined as the time from the date of the first assessment of CR or PR status until the date of progression or death. Data for participants who were alive without any objectively documented disease progression at the end of the study were censored as of the date of last contact. Mean time to event was estimated using the Kaplan-Meier method. |
Countries
Italy
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Bevacizumab + Oxaliplatin + Capecitabine Participants received bevacizumab 5 mg/kg IV on Days 1 and 15; oxaliplatin 40 mg/m\^2 IV on Days 1, 8, 15, and 22; and capecitabine 1000 mg/m\^2 PO BID on Days 1 through 14 followed by 2 weeks without treatment. This cycle was repeated until disease progression, unacceptable toxicity, or participant withdrawal. | 49 |
| Total | 49 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Adverse Event | 11 |
| Overall Study | Death | 1 |
| Overall Study | Medical Decision | 4 |
| Overall Study | Need for Surgery | 5 |
| Overall Study | Progression of Disease | 28 |
| Overall Study | Protocol Violation | 1 |
Baseline characteristics
| Characteristic | Bevacizumab + Oxaliplatin + Capecitabine |
|---|---|
| Age, Continuous | 59.08 years STANDARD_DEVIATION 9.62 |
| Sex: Female, Male Female | 25 Participants |
| Sex: Female, Male Male | 24 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | — / — |
| other Total, other adverse events | 48 / 49 |
| serious Total, serious adverse events | 18 / 49 |
Outcome results
Percentage of Participants by Best Overall Response
Best response recorded from the start of treatment until disease progression. Based on assessment of CR, PR, stable disease (SD), or progressive disease (PD), according to RECIST. CR: disappearance of all target lesions, non-target lesions, and normalization of tumor marker level. PR: ≥30% decrease under baseline of the sum of the LD diameters of all target lesions. CR and PR persist on repeat imaging study at least 4 weeks after initial documentation. SD: neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD. Reference is the smallest sum LD. PD: at least a 20% increase in the sum of the LD of target lesions, taking as reference the smallest sum longest diameter recorded or the appearance of one or more new lesions.
Time frame: Baseline, every 3 months to progression of disease or end of study (up to 24 months)
Population: ITT Population. 5 participants were not assessed as they did not reach the 3 month time-point.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Bevacizumab + Oxaliplatin + Capecitabine | Percentage of Participants by Best Overall Response | CR | 4.08 percentage of participants |
| Bevacizumab + Oxaliplatin + Capecitabine | Percentage of Participants by Best Overall Response | PR | 38.78 percentage of participants |
| Bevacizumab + Oxaliplatin + Capecitabine | Percentage of Participants by Best Overall Response | SD | 38.78 percentage of participants |
| Bevacizumab + Oxaliplatin + Capecitabine | Percentage of Participants by Best Overall Response | PD | 8.16 percentage of participants |
Percentage of Participants With Objective Response (OR)
Percentage of participants with OR was defined as the percentage of participants who achieved complete response (CR) or partial response (PR) according to Response Evaluation Criteria in Solid Tumors (RECIST). CR was defined as disappearance of all target lesions, non-target lesions, and normalization of tumor marker level. PR was defined as greater than or equal to (≥)30 percent (%) decrease under baseline of the sum of the longest diameter (LD) diameters of all target lesions. No unequivocal progression of non-target disease. No new lesions. Complete and partial responses must have been confirmed no less than 4 weeks after the criteria for response were first met.
Time frame: Baseline, every 3 months to progression of disease or end of study (up to 24 months)
Population: Intent to Treat (ITT) Population: all participants who signed the informed consent, were assigned a study patient number, and who were administered at least 1 dose of 1 study medication.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Bevacizumab + Oxaliplatin + Capecitabine | Percentage of Participants With Objective Response (OR) | 42.86 percentage of participants |
Duration of Response
Duration of overall response (CR or PR) was calculated for participants of the ITT population whose best overall response was CR or PR based on RECIST criteria. Duration of overall response was defined as the time from the date of the first assessment of CR or PR status until the date of progression or death. Data for participants who were alive without any objectively documented disease progression at the end of the study were censored as of the date of last contact. Mean time to event was estimated using the Kaplan-Meier method.
Time frame: Baseline, every 3 months to progression of disease or end of study (up to 24 months)
Population: ITT Population; only participants with a best overall response of CR or PR were included in the analysis.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Bevacizumab + Oxaliplatin + Capecitabine | Duration of Response | 8.31 months | Standard Deviation 1.97 |
Duration of Response - Percentage of Participants With an Event by 24 Months
Duration of overall response (CR or PR) was calculated only for participants of the ITT population whose best overall response was CR or PR based on RECIST criteria. Duration of overall response was defined as the time from the date of the first assessment of CR or PR status until the date of progression or death. Data for participants who were alive without any objectively documented disease progression at the end of the study were censored as of the date of last contact.
Time frame: Baseline, every 3 months to progression of disease or end of study (up to 24 months)
Population: ITT population; only participants with a best overall response of CR or PR were included in the analysis.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Bevacizumab + Oxaliplatin + Capecitabine | Duration of Response - Percentage of Participants With an Event by 24 Months | 57.14 percentage of participants |
Duration of Stable Disease
Duration of stable response (CR, PR, or SD) was calculated only for participants of the ITT population whose best overall response was CR, PR, or SD based on RECIST criteria. Duration of overall response was defined as the time from the date of the first assessment of CR, PR, or SD status until the date of progression or death. Data for participants who were alive without any objectively documented disease progression at the end of the study were censored as of the date of last contact. Mean time to event was estimated using the Kaplan-Meier method.
Time frame: Baseline, every 3 months to progression of disease or end of study (up to 24 months)
Population: ITT Population: only participants with a best overall response of CR, PR, or SD were included in the analysis.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Bevacizumab + Oxaliplatin + Capecitabine | Duration of Stable Disease | 10.09 months | Standard Deviation 1.3 |
Duration of Stable Disease - Percentage of Participants With an Event by 24 Months
Duration of stable response (CR, PR, or stable disease \[SD\]) was calculated only for participants of the ITT population whose best overall response was CR, PR, or SD based on RECIST criteria. Duration of overall response was defined as the time from the date of the first assessment of CR, PR, or SD status until the date of progression or death. Data for participants who were alive without any objectively documented disease progression at the end of the study were censored as of the date of last contact.
Time frame: Baseline, every 3 months to progression of disease or end of study (up to 24 months)
Population: ITT Population; only participants with a best overall response of CR, PR, or SD were included in the analysis.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Bevacizumab + Oxaliplatin + Capecitabine | Duration of Stable Disease - Percentage of Participants With an Event by 24 Months | 52.50 percentage of participants |
Overall Survival
OS was defined as the time in months from Day 1 until the date of death due to any cause. Data for participants who were alive at the end of the study were censored at the date of the last available follow-up visit. Mean OS was estimated using the Kaplan-Meier method.
Time frame: Baseline, monthly to end of study (up to 24 months)
Population: ITT Population
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Bevacizumab + Oxaliplatin + Capecitabine | Overall Survival | 20.23 months | Standard Deviation 1.68 |
Overall Survival (OS) - Percentage of Participants With an Event by 24 Months
OS was defined as the time in months from Day 1 until the date of death due to any cause. Data for participants who were alive at the end of the study were censored at the date of the last available follow-up visit.
Time frame: Baseline, monthly to end of study (up to 24 months)
Population: ITT Population
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Bevacizumab + Oxaliplatin + Capecitabine | Overall Survival (OS) - Percentage of Participants With an Event by 24 Months | 89.90 percentage of participants |
Time to Progression
TTP was defined as the time in months from Day 1 until the date of first documented progressive disease, or death due to any cause. Data for participants who were alive without disease progression at the end of study, or who were non-responder participants (without tumor assessment after baseline) were censored at Day 1. Mean TTP was estimated using the Kaplan-Meier method.
Time frame: Baseline, monthly to end of study (up to 24 months)
Population: ITT Population
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Bevacizumab + Oxaliplatin + Capecitabine | Time to Progression | 9.61 months | Standard Deviation 0.9 |
Time to Progression (TTP) - Percentage of Participants With an Event by 24 Months
TTP was defined as the time time in months from Day 1 until the date of first documented progressive disease, or death due to any cause. Data for participants who were alive without disease progression at the end of study, or who were non-responder participants (without tumor assessment after baseline) were censored at Day 1.
Time frame: Baseline, monthly to end of study (up to 24 months)
Population: ITT Population
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Bevacizumab + Oxaliplatin + Capecitabine | Time to Progression (TTP) - Percentage of Participants With an Event by 24 Months | 91.84 percentage of participants |
Time to Treatment Failure
TTF was defined as the time in months from Day 1 until discontinuation of treatment for any reasons. These reasons included: death due to any cause, treatment toxicity (adverse event), insufficient therapeutic response (progression of disease), failure to return (lost to follow-up), refusing treatment (participant non-compliance), being unwilling to cooperate and withdrawing consent (participant withdrew consent). Mean TTF was estimated using the Kaplan-Meier method.
Time frame: Baseline, monthly to end of study (up to 24 months)
Population: ITT Population
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Bevacizumab + Oxaliplatin + Capecitabine | Time to Treatment Failure | 7.44 months | Standard Deviation 0.84 |
Time to Treatment Failure (TTF) - Percentage of Participants With an Event by 24 Months
TTF was defined as the time in months from Day 1 until discontinuation of treatment for any reasons. These reasons included: death due to any cause, treatment toxicity (adverse event), insufficient therapeutic response (progression of disease), failure to return (lost to follow-up), refusing treatment (participant non-compliance), being unwilling to cooperate and withdrawing consent (participant withdrew consent).
Time frame: Baseline, every month to end of treatment (up to 24 months)
Population: ITT Population
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Bevacizumab + Oxaliplatin + Capecitabine | Time to Treatment Failure (TTF) - Percentage of Participants With an Event by 24 Months | 81.63 percentage of participants |