Colon Cancer
Conditions
Brief summary
The main cause of recurrence after surgical treatment of colon cancer is distant metastasis. Neoadjuvant chemotherapy has potential benefits of improving the effectiveness of chemotherapy. Preoperative chemotherapy may eradicate microscopic metastatic cancer cells earlier than adjuvant chemotherapy, reduce cancer cell spillage during surgery, and lessen the invasiveness of surgical resection. This randomized multicenter phase III trial is assessing whether preoperative chemotherapy improves oncologic outcomes of patients with locally advanced colon cancer.
Interventions
DRUGNeoadjuvant FOLFOX
4 cycles of FOLFOX neoadjuvant chemotherapy and 8 cycles of postoperative chemotherapy
DRUGConventional adjuvant FOLFOX
12 cycles of postoperative FOLFOX chemotherapy
Sponsors
Kyungpook National University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* Pathologically confirmed colon adenocarcinoma (\> 15 cm from the anal verge) * Radiologic T3/T4 and high risk features by CT scan * No metastasis on CT or PET(positron emission computed tomography) * Age ≥ 18 and ≤ 70 years * ECOG (Eastern Cooperative Oncology Group) performance status 0-1 * No history of colorectal cancer within 5 years * No history of chemotherapy * Patients with childbearing potential should use effective contraception during the study and the following 6 months * Adequate bone marrow function : white blood cell count of 2 x 109/L or more with neutrophils of1.5 x 109/L or more, platelet count of 100 x 109/L or more, hemoglobin of 9 g/dL (5,6 mmol/l) or more * Adequate hepatobiliary function : total bilirubin of 0.4 mg/dl or less, ASAT (aspartate aminotransferase) and ALAT (alanine aminotransferase) of 2.5 x ULN (upper limits of normal) or less, Alkaline phosphatase of 1.5 x ULN or less * Adequate renal function : GFR (Glomerular Filtration Rate) \> 50ml/min by Wright or Cockcroft formula * Signed written informed consent obtained prior to any study specific screening procedures
Exclusion criteria
* Age \> 70 years and \< 18 years * Rectal cancer : 15 cm or less from the anal verge * Complicated colon cancer (complete obstruction, perforation, bleeding) * Metastatic colon cancer * Known hypersensitivity reaction to any of the components of study treatments * Inflammatory bowel disease * Hereditary nonpolyposis colorectal cancerHNPCC, familial Adenomatous Polyposis * Clinically relevant coronary artery disease or history of myocardial infarction in the last 6 months, high risk of uncontrolled arrhythmia * Galactose intolerance, Lapp lactase deficiency, glucose-galactose malabsorption * Pregnancy or breast-feeding period * Serious non-healing wound or bone fracture * Medical, geographical, sociological, psychological or legal conditions that would not permit the patient to complete the study or sign informed consent * Any significant disease which, in the investigator's opinion, would exclude the patient from the study
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Relapse free survival after randomization | 3 years after randomization |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Overall survival | 3 year after randomization | — |
| Radiological assessment of response to neoadjuvant treatment | 6 months after surgery | — |
| Pathological assessment of response to neoadjuvant treatment | 1 months after surgery | Replacement of the tumor by fibrous or fibro-inflammatory granulation tissue |
| Surgical complication | 60 days after surgery | — |
| Length of hospital stay | 60 days after surgery | — |
| Quality of life (EORTC QLQ-C30) | before treatment, before surgery, 3 months after surgery, 6 months after surgery, 1 year after surgery | QLQ (quality of life questionnaire) |
| Quality of life (EORTC QLQ-C38) | before treatment, before surgery, 3 months after surgery, 6 months after surgery, 1 year after surgery | — |
| Toxicity of chemotherapy | 1 year | Toxicity : incidence of chemotherapy-related adverse events according to CTCAE (Common Terminology Criteria for Adverse Events) v4.0 |
| Incidence of completion of chemotherapy | 1 year | — |
| Accuracy of CT staging | 1 year | — |
| Total cycles of perioperative chemotherapy | 1 year | — |
| Pathological tumor stage | 1 month after surgery | Colon cancer stage by AJCC 8th edition |
Countries
South Korea
Contacts
STUDY_DIRECTORSoo Yeun Park, MD
Kyungpook National University Chilgok Hospital
PRINCIPAL_INVESTIGATORGyu-Seog Choi, MD, PhD
Kyungpook National University Chilgok Hospital
Outcome results
None listed