Maintenance Treatment Versus Observation After Induction in Advanced Colorectal Carcinoma

NCT00442637 | Unknown Phase 3 DMC

• 1 other identifier: CAIRO3
• Study Type: interventional
• Target: 635
• Locations: 1 country
• Sites: 1

Brief Summary

The optimal duration of systemic treatment in patients with advanced colorectal cancer is unknown. In this study the effects of bevacizumab and low-dose continuous chemotherapy with capecitabine is investigated in patients who have responded to 6 courses of oxaliplatin, capecitabine and bevacizumab ("induction treatment", at standard doses). This treatment is continued until progression or severe toxicity. This regimen is compared to the effects a observation without treatment after the induction treatment. In case of disease progression, induction treatment will be reintroduced.

Conditions

Colorectal Cancer Metastatic

Keywords

CAIRO3; DCCG; colorectal cancer; induction; metronomic chemotherapy; observation; capecitabine; bevacizumab; oxaliplatin

Outcome Measures

Primary Outcomes (1)

• Progression-free survival after re-introduction of MTD chemotherapy and bevacizumab (PFS2)

  study duration

Secondary Outcomes (6)

• Progression-free survival between observation versus maintenance therapy (PFS1)

  study duration

• Response rate during re-introduction of MTD chemotherapy and bevacizumab

  study duration

• Toxicity

  study duration

• Quality of life

  study duration

• Overall survival

  study duration

Study Arms (2)

1

EXPERIMENTAL

observation

Other: observation

2

ACTIVE COMPARATOR

capecitabine plus bevacizumab

Drug: capecitabine + bevacizumab

Interventions

capecitabine + bevacizumab DRUG

Ca 1250 mg/m2 daily orally continuously, B 7.5 mg/kg i.v. q 3 w

2

observation OTHER

observation after induction treatment

1

Eligibility Criteria

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

You may qualify if:

• Histological proof of colorectal cancer (in case of a single metastasis, histological or cytological proof of this lesion should be obtained);
• Distant metastases (patients with only local recurrence are not eligible);
• Unidimensionally measurable disease (\> 1 cm on spiral CT scan or \> 2 cm on chest X-ray; liver ultrasound is not allowed). Serum CEA may not be used as a parameter for disease evaluation;
• In case of previous radiotherapy, at least one measurable lesion should be located outside the irradiated field.
• Ongoing or planned first line treatment with 6 cycles of Xeloda, Eloxatin, and Avastin.

You may not qualify if:

• Prior adjuvant treatment for stage II/III colorectal cancer ending within 6 months before the start of induction treatment
• Any prior adjuvant treatment after resection of distant metastases
• Previous systemic treatment for advanced disease
• At randomisation:
• WHO performance status 0-1 (Karnofsky PS \> 70%);
• Disease evaluation with proven SD, PR or CR according to RECIST after 6 cycles of MTD chemotherapy performed in week 3-4 of the 6th cycle induction therapy, and randomisation performed in week 3-5 of the 6th cycle (see time table);
• Laboratory values obtained ≤ 2 weeks prior to randomisation: adequate bone marrow function (Hb \> 6.0 mmol/L, absolute neutrophil count \> 1.5 x 109/L, platelets \> 100 x 109/L), renal function (serum creatinine ≤ 1.5x ULN and creatinine clearance, Cockroft formula, \> 30 ml/min), liver function (serum bilirubin ≤ 2 x ULN, serum transaminases ≤ 3 x ULN without presence of liver metastases or ≤ 5x ULN with presence of liver metastases);
• Life expectancy \> 12 weeks;
• Age \>= 18 yrs;
• Negative pregnancy test in women with childbearing potential;
• Expected adequacy of follow-up;
• Institutional Review Board approval;
• History or clinical signs/symptoms of CNS metastases;
• History of a second malignancy ≤ 5 years with the exception of adequately treated carcinoma of cervix or basal/squamous cell carcinoma of skin;
• Previous intolerance of XelodaR, EloxatinR, and/or AvastinR for which any of these drugs have been permanently discontinued; patients with previous dose reductions or delays are eligible; patients with grade 2 neurotoxicity after the 6th cycle are eligible, and retreatment with EloxatinR after PFS1 should depend on the grade of neurotoxicity at that moment;

Sponsors & Collaborators

• Dutch Colorectal Cancer Group: lead
• Koningin Wilhelmina Fonds: collaborator
• Sanofi: collaborator
• Hoffmann-La Roche: collaborator

Study Sites (1)

University Medical Center Nijmegen

Nijmegen, Gelderland, Netherlands

Location

Related Publications (3)

• Kurk S, Peeters P, Stellato R, Dorresteijn B, de Jong P, Jourdan M, Creemers GJ, Erdkamp F, de Jongh F, Kint P, Simkens L, Tanis B, Tjin-A-Ton M, Van Der Velden A, Punt C, Koopman M, May A. Skeletal muscle mass loss and dose-limiting toxicities in metastatic colorectal cancer patients. J Cachexia Sarcopenia Muscle. 2019 Aug;10(4):803-813. doi: 10.1002/jcsm.12436. Epub 2019 May 15.

  PMID: 31094083 DERIVED

• Goey KKH, Elias SG, van Tinteren H, Lacle MM, Willems SM, Offerhaus GJA, de Leng WWJ, Strengman E, Ten Tije AJ, Creemers GM, van der Velden A, de Jongh FE, Erdkamp FLG, Tanis BC, Punt CJA, Koopman M. Maintenance treatment with capecitabine and bevacizumab versus observation in metastatic colorectal cancer: updated results and molecular subgroup analyses of the phase 3 CAIRO3 study. Ann Oncol. 2017 Sep 1;28(9):2128-2134. doi: 10.1093/annonc/mdx322.

  PMID: 28911067 DERIVED

• Simkens LH, van Tinteren H, May A, ten Tije AJ, Creemers GJ, Loosveld OJ, de Jongh FE, Erdkamp FL, Erjavec Z, van der Torren AM, Tol J, Braun HJ, Nieboer P, van der Hoeven JJ, Haasjes JG, Jansen RL, Wals J, Cats A, Derleyn VA, Honkoop AH, Mol L, Punt CJ, Koopman M. Maintenance treatment with capecitabine and bevacizumab in metastatic colorectal cancer (CAIRO3): a phase 3 randomised controlled trial of the Dutch Colorectal Cancer Group. Lancet. 2015 May 9;385(9980):1843-52. doi: 10.1016/S0140-6736(14)62004-3. Epub 2015 Apr 7.

  PMID: 25862517 DERIVED

Related Links

• Dutch Colorectal Cancer Group

MeSH Terms

Conditions

Colorectal Neoplasms

Interventions

Capecitabine; Bevacizumab; Observation

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)

Deoxycytidine; Cytidine; Pyrimidine Nucleosides; Pyrimidines; Heterocyclic Compounds, 1-Ring; Heterocyclic Compounds; Fluorouracil; Uracil; Pyrimidinones; Deoxyribonucleosides; Nucleosides; Nucleic Acids, Nucleotides, and Nucleosides; Antibodies, Monoclonal, Humanized; Antibodies, Monoclonal; Antibodies; Immunoglobulins; Immunoproteins; Blood Proteins; Proteins; Amino Acids, Peptides, and Proteins; Serum Globulins; Globulins; Methods; Investigative Techniques

Study Officials

• C. JA Punt, MD PhD

  Amsterdam Medical Centre, Amsterdam Netherlands

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 3
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: February 28, 2007
• First Posted: March 2, 2007
• Study Start: January 1, 2007
• Primary Completion: September 1, 2013
• Study Completion: December 1, 2013
• Last Updated: December 12, 2013

Record last verified: 2013-12

Locations

NL (1)