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A Phase I/II Study to Determine the Safety and Efficacy of Second-Line Treatment With XELOX Plus Gemcitabine in Irinotecan Pre-Treated Advanced Colorectal Cancer Patients


Phase 1/Phase 2
18 Years
N/A
Open (Enrolling)
Both
Colorectal Cancer

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Trial Information

A Phase I/II Study to Determine the Safety and Efficacy of Second-Line Treatment With XELOX Plus Gemcitabine in Irinotecan Pre-Treated Advanced Colorectal Cancer Patients


OBJECTIVES:

Primary

- Define the dose-limiting toxicity and maximum tolerated dose of gemcitabine
hydrochloride when administered with capecitabine and oxaliplatin as second-line
therapy in patients with advanced colorectal cancer previously treated with irinotecan
hydrochloride. (Phase I)

- Determine the recommended phase II dose of gemcitabine hydrochloride in these patients.
(Phase I)

- Assess overall response rate in patients treated with this regimen. (Phase II)

Secondary

- Assess the progression-free survival of patients treated with this regimen. (Phase II)

- Assess the time to treatment failure, duration of response, and time to response in
patients treated with this regimen. (Phase II)

- Assess the overall survival of patients treated with this regimen. (Phase II)

- Assess the safety of this regimen in these patients. (Phase II)

OUTLINE: This is a multicenter, phase I, dose-escalation study of gemcitabine hydrochloride,
followed by a phase II, open-label study.

- Phase I: Patients receive gemcitabine hydrochloride IV over 30 minutes on days 1 and 8,
oral capecitabine twice daily on days 1-14, and oxaliplatin IV over 2 hours on day 1.
Courses repeat every 21 days.

Cohorts of 3-6 patients receive escalating doses of gemcitabine hydrochloride until the
maximum tolerated dose (MTD) is determined.

- Phase II: Patients receive gemcitabine hydrochloride at the MTD determined in phase I
and capecitabine and oxaliplatin as in phase I.

Inclusion Criteria


DISEASE CHARACTERISTICS:

- Histologically confirmed advanced colorectal adenocarcinoma

- Measurable disease, defined as ≥ 1 unidimensionally measurable lesion ≥ 20 mm by
conventional techniques or ≥ 10 mm by spiral CT scan

- Must have received prior irinotecan hydrochloride with a progression-free interval of
< 3 months

- No symptomatic brain metastases

PATIENT CHARACTERISTICS:

- ECOG performance status 0-2

- Life expectancy ≥ 3 months

- ANC ≥ 1,500/mm³

- Platelet count ≥ 100,000/mm³

- Hemoglobin ≥ 9 g/dL

- Total bilirubin ≤ 2 times upper limit of normal (ULN)

- AST and ALT ≤ 3 times ULN (5 times ULN if liver metastases are present)

- Creatinine ≤ 1.5 times ULN

- No significant cardiac abnormalities by ECG

- No known hypersensitivity to the study drugs or any of their components

- No myocardial infarction within the past 12 months

- No uncontrolled congestive heart failure

- No cardiovascular disorder ≥ grade 3 despite treatment

- No other malignancies or invasive carcinomas diagnosed within the past 5 years,
except for adequately treated basal cell carcinoma of the skin or in situ carcinoma
of the cervix

- No significant disease, that in the opinion of the investigator, would preclude study
treatment (e.g., active infections, interstitial lung disease, or peripheral
neuropathy)

- No history of significant neurological or psychiatric disorder (e.g., dementia,
seizures, or bipolar disorder)

- No legal incapacity or limited legal capacity that would preclude study participation

PRIOR CONCURRENT THERAPY:

- See Disease Characteristics

- Recovered from all prior therapy

- More than 30 days since prior participation in another clinical trial

- No concurrent warfarin, phenprocoumon, phenytoin, or sorivudine

Type of Study:

Interventional

Study Design:

Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Overall response rate as assessed by RECIST criteria

Safety Issue:

No

Principal Investigator

Joong B. Ahn, MD

Investigator Role:

Principal Investigator

Investigator Affiliation:

Yonsei University

Authority:

Unspecified

Study ID:

CDR0000549901

NCT ID:

NCT00496704

Start Date:

January 2007

Completion Date:

Related Keywords:

  • Colorectal Cancer
  • adenocarcinoma of the colon
  • recurrent colon cancer
  • stage III colon cancer
  • stage IV colon cancer
  • adenocarcinoma of the rectum
  • recurrent rectal cancer
  • stage III rectal cancer
  • stage IV rectal cancer
  • Colorectal Neoplasms

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