Clinical trial NCT01322178: Study of Cetuximab in Combination With mFOLFOX-6 (Oxaliplatin, Leucovorin, 5-FU) to Treat Colorectal Liver Metastatic Cancer Patients
Official title: Open-label, Uncontrolled, Multi-center, Phase II Study of Cetuximab in Combination With mFOLFOX-6 as First-line Treatment in Patients With KRAS Wild-type, Unresectable LIver Metastases of colorEctal Cancer
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: PHASE2
Conditions: Colorectal Cancer
Liver Metastases
Keywords: cetuximab
colorectal carcinoma
Lead sponsor: Fudan University
Sponsor class: OTHER
First posted: 2011-03-24
Enrollment: 90
Sex: ALL
Minimum age (years): 18
Maximum age (years): 75
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: The aim of this study is to explore whether cetuximab in combination with mFOLFOX6 as treatment could improve the resection rate in patients with KRAS wild-type, unresectable liver metastases of mCRC.

Detailed description: During the last decade, chemotherapy in metastatic colorectal cancer (mCRC) has made considerable progress.However, approximately 25% of patients with colorectal cancer present with overt metastatic disease. In selected patients, synchronous or metachronous liver metastases (LM) can be resected in curative intention. Over the last 5 years there has been the recognition that preoperative, neoadjuvant, combination chemotherapy regimens, namely, 5-fluorouracil/folinic acid (5-FU/FA) in combination with either irinotecan or oxaliplatin can facilitate to downsize the initially unresectable LM and make the resection possible. The addition of targeted therapies might render them even more effective.

Due to these results, the investigators hypothesize that cetuximab in combination with mFOLFOX6 as treatment in patients with KRAS wild-type, unresectable liver metastases of mCRC may further improve clinical outcomes.

Eligibility criteria: Inclusion Criteria:

* Male or female 18-75 years of age
* Performance status (ECOG) 0\~1
* Unresectable, histologically confirmed, synchronous or metachronous liver metastasis of colorectal cancer. Unresectable liver metastases is defined as:

  * patients with five and more liver metastases and/or
  * Liver metastases that are technically unresectable immediately, and expected remaining functional liver tissue ≥ 30% after resection. (Patients should be evaluated by a multidisciplinary team of three local surgeons and one local radiologist, including surgical consultation for potentially resectable patients on the basis of remaining liver volume, infiltration of all liver veins, infiltration of both liver arteries, both portal branches or both bile ducts.)
* Tumor tissue (primary or metastasis) genotypologically classified as KRAS wild-type in codon 12 and codon 13 of the KRAS gene exon 2
* No prior chemotherapy (except adjuvant chemotherapy with an interval of ≥ 6 months)
* Presence of at least one index lesion of hepatic metastasis measurable by CT scan or MRI, not in an irradiated area
* Neutrophils ≥ 1.5 x 109/L, platelets ≥ 100 x 109/L, and hemoglobin ≥ 8 g/dL
* Bilirubin level ≤ 1.0 x ULN
* AST and ALT \< 1.5 x ULN
* Serum creatinine ≤ 1.0 x ULN
* Life expectancy of ≥ 3 months
* Male or female of child-bearing period should have effective contraception
* Signed written informed consent

Exclusion Criteria:

* Any investigational agent(s) within 4 weeks prior to entry
* Previous exposure to EGFR-targeting therapy
* Any evidence of extrahepatic metastases and/or primary tumor recurrence
* Total volumes of liver lesions \> 70%
* Clinically relevant peripheral neuropathy
* Acute or sub-acute intestinal obstruction or history of inflammatory bowel disease
* Breast-feeding or pregnant women, no effective contraception if risk of conception exists (for male and female patients up to 4 months after end of chemotherapy)
* Previous malignancy (except colorectal cancer, history of basal cell carcinoma of skin or pre-invasive carcinoma of the cervix with adequate treatment)
* Known drug abuse/ alcohol abuse
* Known dihydropyrimidine dehydrogenase (DPD) deficiency
* Severe organ failures or diseases, including: clinically relevant coronary disease, cardiovascular disorder or myocardial infarction within 12 months before study entry, severe psychiatric illness, severe infection and DIC

Primary outcomes:
measure: Resection rate (R0)
timeFrame: from the first cycle of treatment (day one) to two month after the last cycle
Secondary outcomes:
measure: Response rate,Progression-free Survival,Overall Survival,R1 resection rate
timeFrame: from the first cycle of treatment (day one) to six month after the last cycle
measure: Number of Participants with Adverse Events as a Measure of Safety and Tolerability
timeFrame: from the first cycle of treatment (day one) to six month after the last cycle
Other outcomes:
Locations:
city: Shanghai
country: China
facility: Fudan University Shanghai Cancer Center
state: Shanghai
Study officials:
affiliation: Fudan University
name: Sanjun Cai, PhD
role: PRINCIPAL_INVESTIGATOR
References: