A Randomized Phase III Study Comparing Maintenance Treatment With Fluoropyrimidine + Bevacizumab Versus Fluoropyrimidine After Induction Chemotherapy for a Metastatic Colorectal Cancer

NCT04188145 | Unknown Phase 3

• 1 other identifier: PRODIGE 71
• Study Type: interventional
• Target: 400
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of BEVAMAINT is to improve benefic effect of maintenance therapy after a first line of induction chemotherapy for patients with colorectal cancer

Conditions

Metastatic Colorectal Cancer

Outcome Measures

Primary Outcomes (1)

• The Time-to-Treatment Failure (TTF)

  Will be calculated from date of randomization (after the end of induction chemotherapy) to first radiological progression (according to RECIST 1.1) or death or start of a new chemotherapy (induction regimen or second line) or end of maintenance treatment without further chemotherapy, even if there is no radiological progression. Patients alive with no radiological progression and under maintenance treatment will be censored at the date of last news.

  8 months

Secondary Outcomes (5)

• Progression-free survival (PFS1)

  16 months

• Progression-free survival (PFS2)

  16 months

• Overall Survival (OS)

  3 years

• Safety

  3 years

• Quality of Life (QoL)

  3 years

Study Arms (2)

Fluoropyrimidine

ACTIVE COMPARATOR

Drug: Fluoropyrimidine

Fluoropyrimidine + Bevacizumab

ACTIVE COMPARATOR

Drug: Fluoropyrimidine; Drug: Bevacizumab

Interventions

Fluoropyrimidine DRUG

Option 1: Capecitabine 1250 mg/m2 twice daily (i.e. 2500 mg/m²/d) (D1 to D14, D1 = D22) For frail patients according to investigator evaluation capecitabine dose may be reduced to 1000 mg/m2 twice daily (2000 mg/m²/d). Or Option 2: Capecitabine 625 mg/m2 twice daily (i.e. 1250 mg/m²/d) (D1 to D21, D1 = D22) Or Option 3: LV5FU2 simplified (folinic acid 200 mg/m² (or Elvorin 400 mg/m²) IV during 2h followed by 5-FU bolus IV of 400 mg/m² during 10 min and IV continuous 5-FU at 2400 mg/m² during 46h). (D1=D15).

Fluoropyrimidine; Fluoropyrimidine + Bevacizumab

Bevacizumab DRUG

Option 1 and Option 2 : D1 bevacizumab 7.5 mg/kg IV (D1=D21). See smPCs for infusion time of bevacizumab. Or Option 3: D1 bevacizumab 5 mg/kg IV (D1=D15). See smPCs for infusion time of bevacizumab

Fluoropyrimidine + Bevacizumab

Eligibility Criteria

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

You may qualify if:

• Histologically confirmed metastatic colorectal adenocarcinoma before induction treatment
• Measurable or non-measurable lesion before the induction treatment according to the Response Evaluation Criteria in Solid Tumors (RECIST 1.1)
• Metastatic, unresectable disease according local practice after induction treatment
• ECOG performance status ≤ 2
• Disease control (complete response, partial response or stable disease) after 4-6 months of frontline induction chemotherapy with doublet (fluoropyrimidine + irinotecan or oxaliplatin) or triplet (fluoropyrimidine + irinotecan + oxaliplatin) +/- (cetuximab, panitumumab, bevacizumab) or IAH chemotherapy
• Life expectancy \> 3 months
• Age ≥ 18 years
• Patient is at least 4 weeks from any major surgery
• Total bilirubin \< 25 µmol/L, ASAT \< 3 x ULN, ALAT \< 3 x ULN (ASAT , ALAT \< 5 x ULN in case of hepatic metastasis) , PT \>60% , PAL\<2.5 x ULN ( \< 5 x ULN in case of hepatic metastasis) - Neutrophils \> 1500/mm3, platelets \> 100 000/mm3, haemoglobin ≥ 9 g/dL
• Creatinin clearance \> 30 ml/min (MDRD) - if creatinin clearance comprised between 30 and 50 ml/min, see smPCs for dose adjustments
• Proteinuria ≤ 2+ (dipstick urinalysis) (if more than 2+, so proteinuria at or ≤1g/24hour must be ≤1g)
• Patient is able to understand, sign, and date the written informed consent
• Evidence of post-menopausal status or negative urinary or serum pregnancy test for premenopausal female patients
• Male and female patients of childbearing potential agree to use a highly effective contraceptive measure
• Patient affiliated to a social security system

You may not qualify if:

• Myocardial infarction, severe coronaropathy or severe cardiac dysfunction less than 6 months prior randomization
• Follow-up impossible
• Patients with all metastases resected (R0/R1) after induction chemotherapy
• Patient with a hand-foot syndrome \> 1 before maintenance treatment
• Known brain or leptomeningeal metastases
• Other concomitant or previous malignancy, except: adequately treated in situ carcinoma in complete remission for \> 5 years
• Uncontrolled hypertension (defined as systolic blood pressure \>140 mmHg and/or diastolic blood pressure \>90 mmHg), or history of hypertensive crisis, or hypertensive encephalopathy
• Pregnancy or breast feeding
• Treatment with sorivudine or analogs (brivudine)
• Treatment with phenytoin or analogs
• Partial or complete DPD deficiency (Uracilemia ≥ 16 ng/ml)
• Peptic ulcer not healed after treatment
• Any contraindication to bevacizumab or fluoropyrimidine treatments according to the updated SmPC
• Intestinal perforation or intestinal fistula
• Previous or active gastrointestinal bleeding

Sponsors & Collaborators

• Centre Hospitalier Universitaire Dijon: lead

Study Sites (1)

Chu Dijon Bourgogne

Dijon, France

RECRUITING

MeSH Terms

Conditions

Colorectal Neoplasms

Interventions

Bevacizumab

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

Central Study Contacts

Thomas Aparicio

CONTACT

(0)1 42 49 95 97; thomas.aparicio@aphp.fr

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: December 3, 2019
• First Posted: December 5, 2019
• Study Start: January 27, 2020
• Primary Completion: September 1, 2023
• Study Completion: December 1, 2025
• Last Updated: October 28, 2021

Record last verified: 2021-10

Locations

FR (1)