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Home > "C" Clinical Trials Conditions > Combination Chemotherapy in Treating Patients With Liver Metastases from Colorectal Cancer

Combination Chemotherapy in Treating Patients With Liver Metastases from Colorectal Cancer



Combination Chemotherapy in Treating Patients With Liver Metastases from Colorectal Cancer

For Condition: Colon Cancer,liver metastases,Rectal Cancer
Status: Completed
Sponsor(s): Cancer and Leukemia Group B , National Cancer Institute (NCI),Eastern Cooperative Oncology Group
Synopsis: RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Combining more than one drug may kill more cancer cells. It is not yet known which chemotherapy regimen is more effective for metastatic colorectal cancer. PURPOSE: Randomizedphase III trial to compare the effectiveness of intrahepaticfloxuridine, leucovorin, and dexamethasone with that of systemicfluorouracil and leucovorin in treating patients who have unresectableliver metastases from colorectal cancer.
Details: OBJECTIVES: - Compare the efficacy, toxicity, and cost of hepatic artery infusion of floxuridine, leucovorin calcium (CF), and dexamethasone vs IV fluorouracil and IV CF after resection of primary disease in patients with hepatic metastases secondary to colorectal cancer. - Compare the quality of life of patients treated with these regimens. - Measure the level of thymidylate synthase present in liver metastases, and correlate these levels with objective response and survival in patients treated with these regimens. - Assess the p53 mutations, and correlate findings with objective response and survival in patients treated with these regimens. OUTLINE: This is a randomized, multicenter study. Patients are stratified according to center, percentage of liver involvement on CT scan or MRI (less than 30% vs 30% to under 70%), prior chemotherapy (none vs adjuvant chemotherapy comprising fluorouracil (5-FU) and leucovorin calcium (CF) or 5-FU, CF, and levamisole (LEV) completed at least 1 year before study vs adjuvant chemotherapy comprising 5-FU with or without LEV completed at least 6 months before study), and synchronous disease (yes vs no). Patients are randomized to 1 of 2 treatment arms. - Arm I: Patients undergo laparotomy for placement of a hepatic artery catheter and then subcutaneous placement of a hepatic artery infusion pump. Patients with unresected primary disease also undergo resection at the time of catheter and pump placement. Beginning within 1-2 weeks after surgery, patients receive floxuridine, dexamethasone, and leucovorin calcium (CF) via continuous hepatic artery infusion on days 1-14. - Arm II: Patients receive CF IV and fluorouracil IV on days 1-5. Patients with unresected primary disease undergo resection within 3-4 weeks before initiation of chemotherapy. Treatment for patients on both arms continues every 4 weeks in the absence of disease progression or unacceptable toxicity. Quality of life and medical resource utilization are assessed at baseline, every 3 months for 1 year, and then at 18 months. Patients are followed every 3 months. PROJECTED ACCRUAL: Approximately 340 patients (170 per arm) will be accrued for this study within approximately 4.5 years.
Eligibility:
Study Type:
  Interventional, Treatment
Minimum Age/Maximum Age: 18 Years/
Genders: Both
Protocol Entry Criteria: DISEASE CHARACTERISTICS: - Unresectable liver metastases secondary to colorectal cancer - Less than 70% liver involvement on CT scan or MRI - Liver biopsy required before study unless 1 of the following conditions are met: - Carcinoembryonic antigen greater than 30 - 5 or more liver metastases visible on CT scan or MRI - Greater than 50% to under 70% liver involvement on CT scan or MRI - Histologically proven primary colorectal cancer that is resected or appears resectable on CT scan and physical exam - Documentation of previously resected primaries must be based on pathologic results of the resected tumor - Histological documentation of synchronous disease must be based on 1 of the following: - Biopsy of primary colorectal tumor before study - Suspicious lesion on barium enema, colonoscopy, or sigmoidoscopy, and a liver biopsy positive for adenocarcinoma consistent with the primary colorectal tumor - Measurable disease - Clearly defined liver mass measuring at least 2 cm or at least 3 liver masses on CT scan or MRI - No evidence of extrahepatic disease on CT scan and physical exam - No portal vein occlusion or ascites PATIENT CHARACTERISTICS: Age: - 18 and over Performance status: - Not specified Life expectancy: - Not specified Hematopoietic: - Not specified Hepatic: - See Disease Characteristics - Bilirubin no greater than 2 times normal Renal: - Not specified Other: - No other malignancy within the past 5 years except inactive nonmelanomatous skin cancer, carcinoma in situ of the cervix, or grade 1 bladder cancer - Not pregnant or nursing - Fertile patients must use effective contraception PRIOR CONCURRENT THERAPY: Biologic therapy: - Not specified Chemotherapy: - At least 1 year since prior adjuvant chemotherapy comprising fluorouracil (5-FU) and leucovorin calcium (CF) or 5-FU, CF, and levamisole (LEV) - At least 6 months since prior adjuvant chemotherapy comprising 5-FU with or without LEV - No other prior chemotherapy - No other concurrent chemotherapy Endocrine therapy: - No concurrent hormonal therapy except for nondisease-related conditions, e.g.: - Steroids for adrenal failure - Insulin for diabetes - Intermittent dexamethasone as an antiemetic Radiotherapy: - No prior radiotherapy to the liver Surgery: - See Disease Characteristics
Total Enrollment: 

Location and Contact Information:

Overall Study Official:
NancyKemeny,  Study Chair,  Memorial Sloan-Kettering Cancer Center

CCOP - Cedar Rapids Oncology Project
Cedar Rapids,  Iowa,  52403-1206
United States
 

Westmead Hospital
Westmead,  New South Wales,  2145
Australia
 

Fox Chase Cancer Center
Philadelphia,  Pennsylvania,  19111-2497
United States
 

Mercy Cancer Center at Mercy Medical Center-Des Moines
Des Moines,  Iowa,  50314
United States
 

CCOP - St. Vincent Hospital Cancer Center, Green Bay
Green Bay,  Wisconsin,  54307-3453
United States
 

CCOP - Iowa Oncology Research Association
Des Moines,  Iowa,  50309-1016
United States
 

San Juan City Hospital
San Juan,  ,  00936-7344
Puerto Rico
 

John Stoddard Cancer Center at Iowa Methodist Medical Center
Des Moines,  Iowa,  50309
United States
 

Midlands Cancer Center at Midlands Community Hospital
Papillion,  Nebraska,  68128-4157
United States
 

Instituto de Enfermedades Neoplasicas
Lima,  ,  34
Peru
 

MBCCOP - University of New Mexico HSC
Albuquerque,  New Mexico,  87131
United States
 

MetroHealth Medical Center
Cleveland,  Ohio,  44109
United States
 

Iowa Lutheran Hospital
Des Moines,  Iowa,  50316-2301
United States
 

Penn State Cancer Institute at Milton S. Hershey Medical Center
Hershey,  Pennsylvania,  17033-0850
United States
 


Additional Information:
Study ID Numbers:
  CDR0000064553;  CALGB-9481,ECOG-C9481
Study Start Date: 
Record last reviewed: May 2004
Additional information available at: clinicaltrials.gov
Clinicaltrials.gov Reference link: NCT00002716

Other Colon Cancer Studies:
1. Irinotecan Followed By Fluorouracil and Leucovorin in Treating Patients With Stage III or Stage IV Colorectal Carcinoma (Cancer), Other Refractory Carcinoma, or Metastatic Adenoma (Cancer) of Unknown Primary Origin

2. Celecoxib With or Without Eflornithine in Preventing Colorectal Cancer in Patients With Familial Adenomatous Polyposis.

3. Erlotinib and Combination Chemotherapy in Treating Patients With Metastatic or Locally Advanced Colorectal Cancer

4. Eflornithine Plus Sulindac in Preventing Colorectal Cancer in Patients Who Have Had Surgery to Remove Benign Colorectal Polyps

5. Combination Chemotherapy and Oblimersen in Treating Patients With Advanced Colorectal Cancer

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Combination Chemotherapy in Treating Patients With Liver Metastases from Colorectal Cancer

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