Essai De Phase III De Chimiotherapie Par FOLFOX 4 Ou Par Une Succession FOLFOX 7 - FOLFIRI Chez Des Patients Ayant Des Metastases Resecables D'Origine Colorectale - MIROX
- Compare the 2-year disease-free survival rate in patients treated with these regimens.
- Compare the overall survival of patients treated with these regimens.
- Compare the tolerability of these regimens in these patients.
- Compare the quality of life of patients treated with these regimens.
- Compare the objective response rate, postoperative complication rate, and transfusing
rate in patients having metastasis surgery,
- Determine the pharmacogenetics of these regimens in these patients.
OUTLINE: This is a randomized, open-label, multicenter phase III study. Patients are
stratified according to prior chemotherapy (perioperative vs postoperative), prior treatment
(surgery only vs radiotherapy with or without surgery), and Blumgart score (0-1 vs 2-3 vs
4-5). Patients are randomized to 1 of 2 treatment arms.
- Arm I (FOLFOX 4): Patients receive FOLFOX 4 combination chemotherapy comprising
oxaliplatin 85mg/m² IV over 2 hours, leucovorin calcium IV over 2 hours, fluorouracil
IV bolus /15min and fluorouracil continuously over 22 hours on day 1. Treatment repeats
every 2 weeks for 12 courses in the absence of disease progression or unacceptable
- Arm II (FOLFOX 7 and FOLFIRI): Patients receive FOLFOX 7 combination chemotherapy
comprising high-dose oxaliplatin 130mg/m² IV over 2 hours and leucovorin calcium IV
over 2 hours on day 1 and fluorouracil IV over 46 hours on days 1 and 2. Treatment
repeats every 2 weeks for 6 courses in the absence of disease progression or
unacceptable toxicity. Patients then receive FOLFIRI combination chemotherapy
comprising irinotecan hydrochloride 180mg/m² IV over 30-90 minutes and leucovorin
calcium and fluorouracil IV bolus /15min on day 1, and fluorouracil IV continuously
over 46 hours on days 1 and 2. Treatment repeats every 2 weeks for 6 courses in the
absence of disease progression or unacceptable toxicity.
Patients in both arms who have undergone prior resection of metastatic lesions may undergo
surgery after 6 courses of chemotherapy or after chemotherapy is completed.
Quality of life is assessed at baseline and after courses 4, 8, and 12.
After completion of study treatment, patients are followed periodically for 5 years.
PROJECTED ACCRUAL: A total of 284 patients will be accrued for this study.
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
Mohamed Hebbar, MD
Centre Hospital Universitaire Hop Huriez
France: Agence française de sécurité sanitaire des produits de santé (AFSSAPS)