NCT03813641

Brief Summary

Raltitrexed is an inhibitor of thymidylate synthase.As a folate antimetabolite drug, raltitrexed has been used in treatment of colorectal cancer(CRC) since 1998, and also used in malignant mesothelioma.Several phase III studies performed in patients with advanced CRC showed that it is as effective as 5-fluorouracil(5-FU) /leucovorin(LV) with regard to response rates and survival. The combination of raltitrexed with oxaliplatin shows response rates of 41%-54% and median survivals of 14.6-14.8 months, which are comparable to those achieved with 5-FU/LV combination with oxaliplatin. This study discussed the efficacy and safety of raltitrexed-oxaliplatin(RALOX) combined with bevacizumab or capecitabine-oxaliplatin(CAPOX) combined with bevacizumab in first-line treatment of patients with advanced colorectal cancer who could not undergo radical surgery. The main endpoint will be progression free survival (PFS). The secondary endpoints will be overall survival, objective response rate and disease control rate (OS,ORR and DCR).It is expected that raltitrexed may be one of options for the treatment of advanced CRC in the first-line setting.

Trial Health

43
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
100

participants targeted

Target at P50-P75 for phase_2 colorectal-cancer

Timeline
Completed

Started Jan 2019

Geographic Reach
1 country

1 active site

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

January 20, 2019

Completed
3 days until next milestone

First Posted

Study publicly available on registry

January 23, 2019

Completed
5 days until next milestone

Study Start

First participant enrolled

January 28, 2019

Completed
2.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

February 28, 2021

Completed
10 months until next milestone

Study Completion

Last participant's last visit for all outcomes

December 31, 2021

Completed
Last Updated

September 9, 2019

Status Verified

September 1, 2019

Enrollment Period

2.1 years

First QC Date

January 20, 2019

Last Update Submit

September 5, 2019

Conditions

Keywords

RaltitrexedFirst-line therapyBevacizumabColorectal Cancer

Outcome Measures

Primary Outcomes (1)

  • Progression-free Survival (PFS) Time

    PFS is defined as the time from the date of randomization until the date of objectively determined progressive disease (PD) \[according to Response Evaluation Criteria in Solid Tumors (RECIST) version (v). 1.1\] or death due to any cause, whichever will be first. PD is at least a 20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study). In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 millimeters (mm). Participants who died without a reported prior progression will be considered to have progressed on the day of their death. Participants who do not progress or be lost to follow-up will be censored at the day of their last radiographic tumor assessment.

    The follow-up period ranges from the first patient recruited to the last patient within 6 months after admission, up to 2 years.

Secondary Outcomes (3)

  • Overall Survival (OS)

    The follow-up period ranges from the first patient recruited to the last patient within 6 months after admission,up to 2 years.

  • Percentage of Participants Achieving an Objective Response (Objective Response Rate)

    The follow-up period ranges from the first patient recruited to the last patient within 3 months after admission.

  • Percentage of Participants Achieving a Stable Disease (SD) or a confirmed CR or PR (Disease Control Rate)

    The follow-up period ranges from the first patient recruited to the last patient within 3 months after admission.

Study Arms (2)

RALOX + bevacizumab

EXPERIMENTAL

Oxaliplatin 130mg/m2, i.v.gtt 2h, d1 Raltitrexed 3mg/m2, i.v.gtt 15min ,d1 Bevacizumab 7.5mg/kg, i.v.gtt, d1 The above schemes are repeated every three weeks. After 8 cycles, such as CR, PR or SD, the regimen is changed to raltitrexed (3mg/m2, intravenous drip for 15 minutes, d1)+bevacizumab (7.5mg/kg, intravenous drip, d1). The regimen is repeated every 3 weeks until the disease progresses.

Drug: Raltitrexed

CAPOX + bevacizumab

ACTIVE COMPARATOR

Oxaliplatin 130mg/m2, i.v.gtt 2h, d1 Capecitabine 1000mg/m2, po. ,d1 Bevacizumab 7.5mg/kg, i.v.gtt, d1 The above schemes are repeated every three weeks. After 8 cycles, such as CR, PR or SD, the regimen is changed to Capecitabine (1000mg/m2 po. d1-14)+bevacizumab (7.5mg/kg, intravenous drip, d1). The regimen is repeated every 3 weeks until the disease progresses.

Drug: Capecitabine

Interventions

Experimental: Oxaliplatin + Raltitrexed + Bevacizumab The above schemes are repeated every three weeks. After 8 cycles, such as CR, PR or SD, the regimen is changed to Raltitrexed (3mg/m2, intravenous drip for 15 minutes, d1)+bevacizumab (7.5mg/kg, intravenous drip, d1). The regimen is repeated every 3 weeks until the disease progresses.

Also known as: Tomudex
RALOX + bevacizumab

Other: Oxaliplatin + Capecitabine + Bevacizumab The above schemes are repeated every three weeks. After 8 cycles, such as CR, PR or SD, the regimen is changed to Capecitabine (1000mg/m2 po. d1-14)+bevacizumab (7.5mg/kg, intravenous drip, d1). The regimen is repeated every 3 weeks until the disease progresses.

Also known as: Xeloda
CAPOX + bevacizumab

Eligibility Criteria

Age18 Years - 75 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Age 18\~75 years;
  • Patients are diagnosed by histopathological and/or cytological examination as local advanced or metastatic colorectal cancer who are unable to undergo radical surgery with no symptom of the primary lesions;
  • There are one or more measurable lesions, the longest diameter of which is at least 10 mm by spiral CT scanning (RECIST standard, version 1.1)
  • ECOG performance status (ECOG PS) 0\~1;
  • Life expectancy not less than 3 month
  • Blood routine, liver and kidney function reached the following criteria within 14 days before screening:
  • Absolute neutrophil count (\> 1.5x109/L); hemoglobin (\> 9.0 g/dl); platelet count (\> 100 x109/L); total bilirubin (\< 1.5 times the normal upper limit (ULN); alanine aminotransferase and glutamic oxaloacetate aminotransferase (\< 2.5 x ULN) in patients with liver metastasis (\< 5 x ULN); alkaline phosphatase (\< 3 x ULN( in patients with liver metastasis \< 5 x ULN)); serum creatinine (\< 1.5 x ULN);
  • Adequate blood coagulation function \[International Normalized Ratio (INR) ≤1.5 and Partial Thromboplastin Time (PTT) or activated PTT (aPTT) ≤1.5 x upper limit of normal (ULN)). Participants on full-dose anticoagulation must be in a stable phase of anticoagulant therapy and if taking oral anticoagulation, participants must have an INR ≤3 without clinically significant active bleeding or a high risk of bleeding.
  • Agree to provide histological specimens from previous operations for biomarker assessment and specimens remain。
  • Signed informed consent to be provided

You may not qualify if:

  • Previous treatment with Raltitrexed;
  • With a large amount of pleural effusions or ascites requiring puncture drainage;
  • Active clinical severe infections include hepatitis;
  • One of the following complications: 1) Gastrointestinal obstruction (including paralytic ileus) or gastrointestinal bleeding 2) Symptomatic cardiac disease (including unstable angina, myocardial infarction, and heart failure) 3) Pulmonary fibrosis or interstitial pneumonia 4) Uncontrolled diabetes mellitus 5) Uncontrolled diarrhea (that affects daily activities although adequate therapy )
  • Symptomatic brain or meningeal metastasis (unless the patient has been treated for \> 6 months, the imaging results are negative in the 4 weeks before entering the study, and the clinical symptoms associated with the tumor are stable at the time of entering the study);
  • Undergoing kidney dialysis;
  • History of other malignant tumors within 5 years, except for cured cervical carcinoma in situ or basal cell carcinoma of the skin;
  • Drug abuse and medical, psychological or social conditions may interfere with patients' participation in the study or have an impact on the evaluation of the study results;
  • Pregnant or lactating females, and males and females reluctant to use contraception
  • History of concurrent gastrointestinal perforation or gastrointestinal perforation within 1 year prior to enrollment
  • Pulmonary hemorrhage/hemoptysis ≥ Grade 2 (identified as bright red blood of not less 2.5mL) within 1 month before enrollment.
  • History of thoracotomy,laparotomy, or intestinal resection within 28 days prior to enrollment;
  • Unhealed wound (other than suture wounds due to implantation of a central venous port), traumatic fracture, or gastrointestinal ulcer
  • Current cerebrovascular disease or thromboembolism or either within 1 year before enrollment
  • Current anticoagulation therapy or requiring anticoagulation agents (\> 325 mg/day of aspirin)
  • +4 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Shenzhen People's Hospital

Shenzhen, Guangdong, China

RECRUITING

Related Publications (34)

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MeSH Terms

Conditions

Colorectal Neoplasms

Interventions

raltitrexedCapecitabine

Condition Hierarchy (Ancestors)

Intestinal NeoplasmsGastrointestinal NeoplasmsDigestive System NeoplasmsNeoplasms by SiteNeoplasmsDigestive System DiseasesGastrointestinal DiseasesColonic DiseasesIntestinal DiseasesRectal Diseases

Intervention Hierarchy (Ancestors)

DeoxycytidineCytidinePyrimidine NucleosidesPyrimidinesHeterocyclic Compounds, 1-RingHeterocyclic CompoundsFluorouracilUracilPyrimidinonesDeoxyribonucleosidesNucleosidesNucleic Acids, Nucleotides, and Nucleosides

Study Officials

  • Ruilian Xu, MD

    Shen Zhen People's Hospital

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Study Design

Study Type
interventional
Phase
phase 2
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: Randomized controlled trial
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Phase Ⅱ Clinical Study of RALOX or CAPOX Combined With Bevacizumab in the First-line Treatment of Advanced Colorectal Cancer

Study Record Dates

First Submitted

January 20, 2019

First Posted

January 23, 2019

Study Start

January 28, 2019

Primary Completion

February 28, 2021

Study Completion

December 31, 2021

Last Updated

September 9, 2019

Record last verified: 2019-09

Data Sharing

IPD Sharing
Will not share

Locations