Description:
The trial is a phase III, multicenter, open-labeled randomized trial comparing the
association 5-fluorouracil (5-FU), folinic acid, irinotecan and oxaliplatin (mFOLFIRINOX)
versus oxaliplatin, folinic acid, 5-FU (mFOLFOX 6) chemotherapy protocols in patients with
high-risk stage III colon cancer in the adjuvant setting.
Title
- Brief Title: IRinotecan and Oxaliplatin for Colon Cancer in Adjuvant Setting
- Official Title: A Phase III, Randomised, International Trial Comparing mFOLFIRINOX Triplet Chemotherapy to mFOLFOX for High-risk Stage III Colon Cancer in Adjuvant Setting
Clinical Trial IDs
- ORG STUDY ID:
UC-0110/1609_PRODIGE52/UCGI29
- SECONDARY ID:
2016-001491-29
- NCT ID:
NCT02967289
Conditions
- Colon Cancer (High-risk Stage III: pT4N1 or pT1 to 4 N2)
Interventions
Drug | Synonyms | Arms |
---|
Irinotecan | Campto | Arm A |
Folfox Protocol | acid folinic + oxaliplatine + 5-FU | Arm A |
Purpose
The trial is a phase III, multicenter, open-labeled randomized trial comparing the
association 5-fluorouracil (5-FU), folinic acid, irinotecan and oxaliplatin (mFOLFIRINOX)
versus oxaliplatin, folinic acid, 5-FU (mFOLFOX 6) chemotherapy protocols in patients with
high-risk stage III colon cancer in the adjuvant setting.
Detailed Description
After inclusion and non-inclusion criteria have been fulfilled and the patient consent has
been obtained, the patient will be included and randomized in the trial. The maximum delay
allowed between the signature of the consent form by the patient and the randomization in the
study is 28 days.
The randomization procedure using minimization method will allocate the treatments
mFOLFIRINOX or mFOLFOX 6 with a 1:1 ratio, and will be stratified by the following criteria:
- Perforation or urgent surgery versus no perforation and no urgent surgery.
- T1-T3N2 vs T4aN1 versus T4bN1 versus T4N2.
- Right colon (right of splenic flexure) vs left colon.
- Country (France vs Canada vs Italy). Patient eligible and who have signed the informed
consent will be randomized in one of the two treatments arms and will receive every 14
days their treatment for a duration of 12 cycles.
Arm A: mFOLFIRINOX Arm B: mFOLFOX 6
Trial Arms
Name | Type | Description | Interventions |
---|
Arm A | Experimental | mFOLFIRINOX Folfox Protocol + Irinotecan | - Irinotecan
- Folfox Protocol
|
Arm B | Active Comparator | mFOLFOX 6 Folfox Protocol | |
Eligibility Criteria
DIAGNOSIS AND INCLUSION CRITERIA:
1. Patient ≥18 years and < 75 years
2. Patient ≥18 years and <71 years must have an ECOG ≤1 - Patients ≥71 years and < 75
years must have an ECOG = 0
3. Pathologically confirmed high-risk stage III colon adenocarcinoma, restricted to pT4N1
or pT1-4N2 tumor.
4. Curative R0 surgical resection.
5. Patients who have undergone surgery for colon cancer, defined as a tumor location >12
cm from the anal verge by endoscopy and/or above the peritoneal reflection at surgery
(high rectum), without gross or microscopic evidence of residual disease after surgery
with curative intent
6. Start of study drug treatment has to be performed less than 56 days after surgery.
7. No prior chemotherapy.
8. No prior abdominal or pelvic irradiation.
9. Patient with adequate organ function:
- Absolute neutrophil count (ANC) ≥ 2 x 109/L
- Haemoglobin ≥9 g/dL
- Platelets (PTL) ≥100 x 109/L
- AST/ALT ≤2.5 x ULN
- Alkaline phosphatase ≤2.5 x ULN
- Total Bilirubin ≤1.5 x ULN (Upper Limit of Normal)
- Creatinine clearance ≥50 mL/min (Cockcroft and Gault formula)
- Kalemia, magnesemia, calcemia ≥ 1 LLN (Lower Limit of Normal)
- Carcinoembryogenic antigen (CEA) ≤10ng/mL after surgery (during screening period)
10. Adequate contraception if applicable.
11. Patient able and willing to comply with study procedures as per protocol
12. Patient able to understand and willing to sign and date the written voluntary informed
consent form at screening visit prior to any protocol-specific procedures
13. Public or private health insurance coverage
14. Life expectancy of > or = at 5 years
15. Uracilemia < 16 ng/ml (only for french centers)
Exclusion Criteria:
1. Major surgical procedure, open biopsy or significant traumatic injury within 28 days
prior to study treatment start. Incompletely healed wounds or anticipation of the need
for major surgical procedure during the course of the study
2. Metastatic disease
3. Presence of inflammatory bowel disease and/or ileus
4. Known hypersensitivity reaction to any of the components of study treatments.
5. Pregnancy (absence to be confirmed by β-hCG test) or breast-feeding period
6. Clinically relevant coronary artery disease or history of myocardial infarction in the
last 12 months, or high risk of uncontrolled arrhythmia (for men: QTc ≥450 msec, for
women: QTc ≥470 msec)
7. Previous malignancy in the last 5 years except curative treated basal cell carcinoma
of the skin and/or in situ carcinoma of the cervix
8. Medical, geographical, sociological, psychological or legal conditions that would not
permit the patient to complete the study or sign informed consent
9. History or current evidence on physical examination of central nervous system disease
or peripheral neuropathy ≥ grade 1 Common Toxicity Criteria for Adverse Events (CTCAE)
v4.03.
10. Any significant disease which, in the investigator's opinion, would exclude the
patient from the study.
11. Patient with a DPD deficiency or UGT1A1 homozygous 7/7; the test should be done for
all patients before 5-FU administration, according to ANSM communication regarding
recommendation about high risk of no testing DPD in patient before 5-FU
administration; (Appendices 8 to 11).
12. Patients already included in another therapeutic trial involving an experimental drug
Maximum Eligible Age: | 75 Years |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Disease Free Survival (DFS) |
Time Frame: | 3 YEARS after inclusion |
Safety Issue: | |
Description: | DFS :
defined as the time from the date of randomization up to the date of:
first local, regional or distant relapse;
second colorectal cancer;
death from any cause included treatment-related death. |
Secondary Outcome Measures
Measure: | Disease Free Survival |
Time Frame: | 2 YEARS after inclusion |
Safety Issue: | |
Description: | DFS :
defined as the time from the date of randomization up to the date of:
first local, regional or distant relapse;
second colorectal cancer;
death from any cause included treatment-related death. |
Measure: | Overall Survival |
Time Frame: | 5 YEARS after inclusion |
Safety Issue: | |
Description: | Overall Survival (OS) is defined as the time from the date of randomization to the date of documented death from any cause |
Measure: | Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability] |
Time Frame: | 2 YEARS after inclusion |
Safety Issue: | |
Description: | Safety of the study treatment will be assessed on occurrence of Adverse Events (AEs), intake of concomitant treatments, per-treatment arising changes in physical examination, vital signs (blood pressure, pulse rate and body temperature), ECG, and clinical laboratory tests (biochemistry, haematology). Safety parameters will be graded based on NCI CTCAE v4.03 classification.
The following parameters will be particularly followed:
The incidence of haematological toxicities (grade 3-4, in particular neutropenia and febrile neutropenia); The incidence of GI toxicities, in particular diarrhea; The incidence of peripheral neuropathy. |
Details
Phase: | Phase 3 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | UNICANCER |
Trial Keywords
- colon
- cancer
- stage 3
- high-risk
- mFolfirinox
- mFolfox6
- adjuvant
Last Updated
July 22, 2021