Neoadjuvant Cetuximab, Fluorouracil, and Pelvic Irradiation in Treating Patients With Locally Advanced or Locally Recurrent Rectal Cancer

NCT00084773 | Completed

• 2 other identifiers: 04-006MSKCC-04006
• Study Type: interventional
• Target: 28
• Locations: 1 country
• Sites: 1

Brief Summary

RATIONALE: Monoclonal antibodies such as cetuximab can locate tumor cells and either kill them or deliver tumor-killing substances to them without harming normal cells. Drugs used in chemotherapy such as fluorouracil work in different ways to stop tumor cells from dividing so they stop growing or die. Radiation therapy uses high-energy x-rays to damage tumor cells. Giving cetuximab with fluorouracil and radiation therapy may kill more tumor cells.

Conditions

Colorectal Cancer

Keywords

recurrent rectal cancer; stage II rectal cancer; stage III rectal cancer; adenocarcinoma of the rectum

Outcome Measures

Primary Outcomes (1)

• Safety profile

  2 years

Secondary Outcomes (1)

• Activity in terms of pathological complete response rate

  2 years

Study Arms (1)

Cetuximab, Fluorouracil, and Pelvic Irradiation

EXPERIMENTAL

Patients receive cetuximab IV over 1-2 hours on days 1, 8, 15, 22, 29, 36, 43, 50, 57, and 64 and fluorouracil IV continuously on days 1-42. Patients undergo whole-pelvic radiotherapy once daily on days 1-5, 8-12, 15-19, 22-26, 29-33, and 36-40. Treatment continues in the absence of disease progression or unacceptable toxicity. Approximately 1-3 weeks after completion of study treatment, patients undergo surgical resection followed by adjuvant chemotherapy off-study. Patients are followed for up to 5 years.

Biological: cetuximab; Drug: fluorouracil; Procedure: neoadjuvant therapy; Radiation: radiation therapy

Interventions

cetuximab BIOLOGICAL

Cetuximab, Fluorouracil, and Pelvic Irradiation

fluorouracil DRUG

Cetuximab, Fluorouracil, and Pelvic Irradiation

neoadjuvant therapy PROCEDURE

Cetuximab, Fluorouracil, and Pelvic Irradiation

radiation therapy RADIATION

Cetuximab, Fluorouracil, and Pelvic Irradiation

Eligibility Criteria

• Age: 18 Years - 120 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

DISEASE CHARACTERISTICS: * Histologically confirmed rectal adenocarcinoma meeting 1 of the following staging criteria: * Locally advanced disease * Resectable (uT3) disease * Primary gross transmural tumor that is not adherent to adjacent pelvic structures by endorectal ultrasound * Primary tethered or unresectable (cT4 or uT4) disease * Primary tumor is contiguous with or adherent or fixed to adjacent pelvic structures by clinical exam and CT scan * Primary surgery would likely leave residual tumor * Small volume extrapelvic metastases allowed * Recurrent disease after definitive resection * Disease limited to the pelvis * Requires combined modality treatment * Epidermal growth factor receptor status-positive, -negative, or -unknown * If previously treated with adjuvant fluorouracil-based chemotherapy, no disease recurrence during or within 12 months after completion of adjuvant therapy PATIENT CHARACTERISTICS: Age * 18 and over Performance status * ECOG 0 -1 Life expectancy * Not specified Hematopoietic * Absolute neutrophil count ≥ 1,500/mm\^3 * Hemoglobin \> 8.0 g/dL * Platelet count \> 150,000/mm\^3 Hepatic * Not specified Renal * Creatinine ≤ 1.5 times upper limit of normal Cardiovascular * No myocardial infarction within the past 6 months * No evidence of uncontrolled congestive heart failure requiring therapy Other * No other malignancy within the past 5 years except adequately treated basal cell or squamous cell skin cancer or carcinoma in situ of the cervix * No known severe hypersensitivity to cetuximab or any of its excipients * No uncontrolled infection * No high-grade bowel obstruction (bowel lumen ≤ 1 cm) unless patient has undergone protective surgical diversion or endoscopic stenting procedure * No other concurrent medical or psychiatric condition or disease that would preclude study participation * HIV negative * Not pregnant or nursing * Negative pregnancy test * Fertile patients must use effective contraception during and for at least 3 months after study treatment PRIOR CONCURRENT THERAPY: Biologic therapy * No prior cetuximab * No prior murine or chimeric monoclonal antibody therapy * No prior biological response modifiers for metastatic colorectal cancer * No concurrent anti-vascular endothelial growth factor/Flk-1 monoclonal antibody therapy * No other concurrent antibody therapy or immunotherapy * No concurrent gene therapy * No concurrent vaccine therapy * No concurrent angiogenesis inhibitors, including thalidomide Chemotherapy * See Disease Characteristics * No prior chemotherapy for metastatic colorectal cancer * No other concurrent chemotherapy Endocrine therapy * No concurrent hormonal therapy Radiotherapy * No prior radiotherapy for metastatic colorectal cancer * No prior pelvic radiotherapy * No other concurrent radiotherapy Surgery * See Disease Characteristics * Fully recovered from prior oncologic or other major surgery Other * No other prior therapy that targets the epidermal growth factor receptor pathway * No other concurrent experimental therapy or drugs * No concurrent matrix metalloprotease inhibitors * No concurrent participation in another clinical study

Contact the study team to discuss eligibility requirements. They can help determine if this study is right for you.

Sponsors & Collaborators

• Memorial Sloan Kettering Cancer Center: lead
• National Cancer Institute (NCI): collaborator

Study Sites (1)

Memorial Sloan-Kettering Cancer Center

New York, New York, 10021, United States

Location

MeSH Terms

Conditions

Colorectal Neoplasms; Rectal Neoplasms

Interventions

Cetuximab; Fluorouracil; Neoadjuvant Therapy; Radiotherapy

Condition Hierarchy (Ancestors)

Intestinal Neoplasms; Gastrointestinal Neoplasms; Digestive System Neoplasms; Neoplasms by Site; Neoplasms; Digestive System Diseases; Gastrointestinal Diseases; Colonic Diseases; Intestinal Diseases; Rectal Diseases

Intervention Hierarchy (Ancestors)

Antibodies, Monoclonal, Humanized; Antibodies, Monoclonal; Antibodies; Immunoglobulins; Immunoproteins; Blood Proteins; Proteins; Amino Acids, Peptides, and Proteins; Serum Globulins; Globulins; Uracil; Pyrimidinones; Pyrimidines; Heterocyclic Compounds, 1-Ring; Heterocyclic Compounds; Combined Modality Therapy; Therapeutics

Study Officials

• Leonard B. Saltz, MD

  Memorial Sloan Kettering Cancer Center

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: June 10, 2004
• First Posted: June 11, 2004
• Study Start: March 1, 2004
• Primary Completion: January 1, 2007
• Study Completion: March 1, 2010
• Last Updated: December 22, 2015

Record last verified: 2015-12

Locations

US (1)