Folfox-B Study for Patients With Colorectal Liver Metastases

NCT00508872 | Terminated Phase 2 Results

• 1 other identifier: 2004-0816
• Study Type: interventional
• Target: 2
• Locations: 1 country
• Sites: 1

Brief Summary

Objective:

• To evaluate the efficacy of the use of the combination of oxaliplatin, 5-fluorouracil, leucovorin and bevacizumab (FOLFOX-B) in patients with unresectable colorectal liver metastases, with the objective to downstage hepatic disease and enable complete resection of residual disease. Primary Objective:
• To evaluate the resection rate in patients with initially unresectable hepatic colorectal metastases downstaged with FOLFOX-B. Complete resection of all liver lesions is the goal. Secondary Objectives:
• To evaluate the probability of complete response, partial response or stable disease.
• To evaluate the proportion of patients who are resected, and the proportion of patients achieving an R0 resection (among those receiving surgery).
• To correlate survival with downstaging and resection based on metastatic colorectal prognostic score.
• To evaluate the disease-free survival and overall survival.
• To evaluate the positron emission tomography response rate.
• To explore correlations of clinical response with telomerase and hTERT expression.

Conditions

Colorectal Liver Metastases

Keywords

Colorectal Liver Metastases; Oxaliplatin; Eloxatin; Fluorouracil; Leucovorin; Bevacizumab; Anti-VEGF monoclonal antibody; rhuMAb-VEGF; Folfox-B; 5-FU; Avastin

Outcome Measures

Primary Outcomes (1)

• Complete Gross Resection Rate

  Complete gross resection rate for patients with initially unresectable hepatic colorectal metastasis who are treated with a combination of oxaliplatin/ 5-fluorouracil/ leucovorin/ bevacizumab (Number of Resectable versus Not Resectable Patients).

  Over 4 year study period

Study Arms (1)

FOLFOX-B

EXPERIMENTAL

FOLFOX-B: 5-Fluorouracil 400 mg/m\^2 IV + Bevacizumab 5 mg/kg IV + Leucovorin 400 mg/m\^2 IV + Oxaliplatin 85 mg/m\^2 IV

Drug: 5-Fluorouracil; Drug: Bevacizumab; Drug: Leucovorin; Drug: Oxaliplatin

Interventions

5-Fluorouracil DRUG

400 mg/m\^2 IV over 15 minutes, followed by 2400 mg/m\^2 IV Over 46 Hours

Also known as: 5-FU, Adrucil, Efudex

FOLFOX-B

Bevacizumab DRUG

5 mg/kg IV Over 30-90 Minutes On Day 1 Every 14 Days

Also known as: Avastin, Anti-VEGF monoclonal antibody, rhuMAb-VEGF

FOLFOX-B

Leucovorin DRUG

400 mg/m\^2 IV Over 2 Hours On Day 1 Every 14 Days

Also known as: Citrovorum, Wellcovorin

FOLFOX-B

Oxaliplatin DRUG

85 mg/m\^2 IV Over 2 Hours On Day 1 Every 14 Days

Also known as: Eloxatin

FOLFOX-B

Eligibility Criteria

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

You may qualify if:

• Patients must have hepatic colorectal metastasis confirmed by percutaneous or intraoperative hepatic tumor biopsy.
• Patients must have radiological evidence of measurable liver metastasis with helical CT scan (1 cm or greater in greatest transverse dimension).
• Patients with synchronous disease and resectable intact primary tumors are eligible.
• Colorectal liver metastases will be determined to be unresectable by a surgeon with expertise in hepatic surgery (equal to or greater than 10 resections performed in a year). A patient is defined as unresectable when distribution and extent of disease preclude margin negative resection (tumor contact with or involvement of all three major hepatic veins or portal confluence or a combination of involvement of main branches of portal veins and hepatic veins), but two adjacent hepatic segments with adequate vascular inflow and outflow are relatively spared (contain 4 or fewer lesions).
• Performance status: Zubrod 0 or 1.
• Patients with a prior history of non-colorectal cancer may be included if there is no evidence of malignancy for at least 5 years from last treatment and no evidence of recurrence. In addition, patients with completely resected non-melanoma skin cancer or cervical carcinoma in-situ may be included.
• Radiological baseline studies shall be completed within 21 days of protocol registration.
• Laboratory data as follows (within 21 days of protocol registration): Adequate bone marrow as evidenced by; Hemoglobin greater than or equal to 9.0 g %; White blood cell count greater than or equal to 3,000 cells/mm; Platelet count greater than or equal to 100,000 cells/mm(3); Absolute neutrophil count greater than or equal to 1500/mm(3).
• Women must not be pregnant or lactating. Women of childbearing potential must have a negative Beta-HCG serum pregnancy test and to refrain from breast-feeding, as specified in the informed consent given the unknown risk of teratogenicity of agents in the study. Patients of childbearing potential agree to use an effective form of contraception during the study and for 90 days following the last dose of study medication.
• Age greater than or equal to 18 years.
• Coumadin, 1 mg, for patency of central venous catheter or therapeutic doses of coumadin (INR less than or equal to 3) permitted.
• Patients or their legally authorized representative must agree to participate, be able to read, understand and provide informed consent to participate in the trial.
• Patients must be recovered from both acute and late effects of any prior surgery, radiotherapy or other antineoplastic therapy.

You may not qualify if:

• Patients with surgically resectable colorectal liver metastases.
• Patients with evidence of unresectable extrahepatic disease.
• Patients with CNS metastases.
• Patients with diffusely distributed bilateral hepatic metastases without sparing of two adjacent hepatic segments.
• Patients who have previously undergone chemotherapy treatment for metastatic disease.
• Patients who developed metastatic disease less than or equal to 6 months from adjuvant chemotherapy for stage II or stage III colorectal cancer.
• Patients who have ever received bevacizumab.
• Previous or concurrent treatment of hepatic metastatic disease with resection, radiotherapy, radiofrequency ablation, cryotherapy/other ablative techniques, or hepatic artery infusion chemotherapy.
• Patients who underwent a major invasive surgical procedure or open biopsy within 28 days prior to registration.
• Patients who underwent colonoscopy, core biopsy, or fine needle aspiration within 7 days prior to registration.
• Patients who had an arterial thromboembolic event, including transient ischemic attack (TIA), cerebrovascular accident (CVA), unstable angina, or myocardial infarction (MI) within 12 months of registration. Patients must not have greater than or equal to Grade 2 peripheral vascular disease.
• Patients with uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, cardiac disease NYHA class III or IV, unstable angina pectoris, unstable cardiac arrhythmia or tachycardia (heart rate greater than or equal to 100 beats per minute), poorly controlled hypertension (systolic blood pressure greater than or equal to 200 mmHg or diastolic blood pressure greater than or equal to 100 mmHg) or psychiatric illness/social situations that would limit compliance with study requirements are excluded.
• Patients with preexisting chronic hepatic disease (chronic active hepatitis B or C, cirrhosis), which would preclude surgical resection of metastases.
• Patients with known hypersensitivity to any of the components of oxaliplatin, 5-fluorouracil, leucovorin or bevacizumab (AVASTIN™).
• Patients who have received chemotherapy within 30 days of the first scheduled day of protocol treatment.

Sponsors & Collaborators

• M.D. Anderson Cancer Center: lead
• Sanofi: collaborator

Study Sites (1)

U.T.M.D. Anderson Cancer Center

Houston, Texas, 77030, United States

Location

Related Links

• The University of Texas M.D.Anderson Cancer Center

MeSH Terms

Interventions

Fluorouracil; Bevacizumab; Leucovorin; Oxaliplatin

Intervention Hierarchy (Ancestors)

Uracil; Pyrimidinones; Pyrimidines; Heterocyclic Compounds, 1-Ring; Heterocyclic Compounds; Antibodies, Monoclonal, Humanized; Antibodies, Monoclonal; Antibodies; Immunoglobulins; Immunoproteins; Blood Proteins; Proteins; Amino Acids, Peptides, and Proteins; Serum Globulins; Globulins; Formyltetrahydrofolates; Tetrahydrofolates; Folic Acid; Pterins; Pteridines; Heterocyclic Compounds, 2-Ring; Heterocyclic Compounds, Fused-Ring; Coenzymes; Enzymes and Coenzymes; Coordination Complexes; Organic Chemicals

Results Point of Contact

• Title: Eddie Abdalla, MD/Assistant Professor
• Organization: UT MD Anderson Cancer Center

713-792-6940

Study Officials

• Eddie Abdalla, MD

  M.D. Anderson Cancer Center

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: Yes
• Restrictive Agreement: No

Study Design

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

Study Record Dates

• First Submitted: July 27, 2007
• First Posted: July 30, 2007
• Study Start: November 1, 2005
• Primary Completion: June 1, 2009
• Study Completion: June 1, 2009
• Last Updated: August 1, 2012
• Results First Posted: November 4, 2010

Record last verified: 2012-07

Locations

US (1)