Hepatic Arterial Infusion With Floxuridine and Dexamethasone Combination With Chemotherapy With/Without Bevacizumab for Hepatic Metastases From Colorectal Cancer

NCT00200200 | Completed Phase 2

• 1 other identifier: 04-086
• Study Type: interventional
• Target: 73
• Locations: 1 country
• Sites: 5

Brief Summary

The purpose of this study is to determine whether the addition of bevacizumab, to hepatic arterial therapy with floxuridine (FUDR) and dexamethasone (Dex) (regional chemotherapy), and either oxaliplatin or CPT-11, plus 5-fluorouracil and leucovorin (systemic chemotherapy) will increase disease free survival in patients who have undergone liver resection. The patient will be randomized (a computer generated decision as in the flip of a coin) to receive, or not to receive bevacizumab in addition to regional and systemic chemotherapy.

Conditions

Hepatic Metastases; Colon Cancer; Rectal Cancer

Keywords

BEVACIZUMAB (AVASTIN); DEXAMETHASONE; FLOXURIDINE; FLUOROURACIL; IRINOTECAN (CPT-11) CAMPTOSAR; LEUCOVORIN; OXALIPLATIN; Colon; Rectal; 04-086; Adjuvant postoperative chemo for CLM

Outcome Measures

Primary Outcomes (1)

• To determine whether the addition of concurrent intravenous bevacizumab to HAI plus systemic chemotherapy increases the time to progression in patients with completely resected hepatic metastases from colorectal cancer

  7.5 months

Secondary Outcomes (4)

• To assess toxicity

  7.5 months

• To determine survival

  2 years

• To assess the expression pattern of VEGFR1, VEGFR2 (angiogenesis), and VEGFR3 (lymphangiogenesis) and their cognate ligands (VEGF-A, VEGF-C, VEGF-D), and correlate with patient progression and survival following

  2 years

• To compare plasma levels of VEGF-A, VEGF-C, VEGF-D, and CD133+ VEGFR2+ circulating endothelial progenitors

  2 years

Study Arms (2)

1

ACTIVE COMPARATOR

Bevacizumab in addition to HAI plus systemic chemotherapy

Drug: Bevacizumab HAI plus systemic chemotherapy

2

EXPERIMENTAL

HAI plus systemic chemotherapy alone

Drug: HAI plus systemic chemotherapy

Interventions

Bevacizumab HAI plus systemic chemotherapy DRUG

Oxaliplatin (mg/m2) IV, over 2 hours, 5 FU (mg/m2) continuous infusion, over two days, leucovorin (mg/m2) IV, over 2 hours

1

HAI plus systemic chemotherapy DRUG

Irinotecan (mg/m2) IV, over 30 minutes, 5 FU (mg/m2) continuous infusion over two days, leucovorin (mg/m2) IV, over 30 minutes

2

Eligibility Criteria

• Age: 19 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• History of histologically confirmed colorectal adenocarcinoma metastatic to the liver with no clinical or radiographic evidence of extrahepatic disease. Confirmation of diagnosis must be performed at MSKCC.
• Potentially completely resectable hepatic metastases without current evidence of other metastatic disease.
• Abdominal and pelvic CT scans and chest CT or x-ray within 6 weeks prior to registration. (MRI of abdomen may be substituted for CT of abdomen.)
• Lab values within 14 days prior to registration:
• WBC ≥ 3.0 K/uL
• ANC \> 1.5 K/uL
• Platelets ≥ 75 K/uL
• Total bilirubin \< 1.5 mg/dL
• INR \< 1.5
• Creatinine \< 2.0 mg/dL
• HGB ≥ 9 gm/dL
• Prior chemotherapy is acceptable if last dose given ≥ 3 weeks prior to registration to this study. \[Note: no chemotherapy to be given after resection of liver lesions prior to treatment on this study.\]
• KPS ≥ 70%
• Signed informed consent
• Patient age must be \>18

You may not qualify if:

• Prior radiation to the liver. (Prior radiation therapy to the pelvis is acceptable if completed at least 4 weeks prior to registration.)
• Active infection, ascites, hepatic encephalopathy.
• Prior treatment with HAI FUDR.
• Female patients who are pregnant or lactating.
• Subjects discovered to have ≥1+ proteinuria at baseline will undergo a 24-hour urine collection, which must be an adequate collection and must demonstrate \<1 g of protein/24 hours to allow participation in this study.
• Patients may not be receiving any other investigational agents
• Patients with known brain metastases that would confound the evaluation of neurologic and other adverse events will be excluded. Patients with history of primary CNS tumors, seizures not well-controlled with standard medical therapy, or history of stroke will also be excluded.
• History of allergic reactions attributed to compounds of similar chemical or biologic composition to bevacizumab.
• Serious or non-healing active wound, ulcer, or bone fracture
• Major surgical procedure, open biopsy or significant traumatic injury within 28 days prior to Day 1 of protocol treatment. (Surgery performed to resect metastatic lesions and place pump will not exclude patient from protocol; Day 1 of protocol treatment will take place no sooner than 28 days after surgery.)
• Current or recent use of a thrombolytic agent.
• Chronic daily treatment with aspirin (\> 325 mg/d) or nonsteroidal anti-inflammatory medications known to inhibit the platelet function.
• Presence of bleeding diathesis or coagulopathy.
• History of serious systemic disease, including myocardial infarction within the last 12 months, uncontrolled hypertension (blood pressure of \> 160/110 mmHg on medication), unstable angina within the last 12 months, New York Heart Association (NYHA) Grade II or greater congestive heart failure (see Appendix C), unstable symptomatic arrhythmia requiring medication (subjects with chronic atrial arrhythmia, i. e. atrial fibrillation or paroxysmal supraventricular tachycardia are eligible), or peripheral vascular disease (Grade II or greater).
• Patients with a history of stroke or transient ischemic attack.

Sponsors & Collaborators

• Memorial Sloan Kettering Cancer Center: lead

Study Sites (5)

Memorial Sloan Kettering Basking Ridge (Follow Up Only)

Basking Ridge, New Jersey, United States

Location

Memorial Sloan Kettering Cancer Commack (Follow Up Only)

Commack, New York, 11725, United States

Location

Memorial Sloan Kettering Westchester (Follow Up Only)

Harrison, New York, 10604, United States

Location

Memorial Sloan Kettering Cancer Center

New York, New York, 10065, United States

Location

Memorial Sloan Kettering Nassau (Follow Up Only)

Uniondale, New York, 11553, United States

Location

Related Links

• Memorial Sloan-Kettering Cancer Center

MeSH Terms

Conditions

Colonic Neoplasms; Rectal Neoplasms

Condition Hierarchy (Ancestors)

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

Study Officials

• Nancy Kemeny, M.D

  Memorial Sloan Kettering Cancer Center

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 2
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: September 12, 2005
• First Posted: September 20, 2005
• Study Start: November 19, 2004
• Primary Completion: March 13, 2025
• Study Completion: March 13, 2025
• Last Updated: March 19, 2025

Record last verified: 2025-03

Locations

US (5)