Treatment for liver metastases in colorectal cancer
Systemic Oxaliplatin or Intra-arterial Chemotherapy Combined With LV5FU2 +/- Irinotecan and an Target Therapy in First Line Treatment of Metastatic Colorectal Cancer Restricted to the Liver
This study is testing a new combination of chemotherapy treatments for patients with colorectal cancer that has spread to the liver, to see if it can help them live longer and feel better when surgery isn't an option.
Quick facts
| Phase | Phase 3 |
|---|---|
| Study type | Interventional |
| Enrollment | 348 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Federation Francophone de Cancerologie Digestive Academic / other |
| Drugs / interventions | chemotherapy, panitumumab, bevacizumab |
| Locations | 49 sites (Brussels and 48 other locations) |
| Trial ID | NCT02885753 on ClinicalTrials.gov |
What this trial studies
This clinical trial investigates the effectiveness of systemic oxaliplatin and intra-arterial chemotherapy combined with LV5FU2, with or without irinotecan and targeted therapy, for patients with metastatic colorectal cancer confined to the liver. The study aims to improve treatment outcomes by enhancing the response rates and overall survival in patients who are not candidates for surgical resection. Participants will receive a combination of intravenous and intra-arterial chemotherapy, focusing on those with specific genetic markers and measurable liver metastases.
Who should consider this trial
Good fit: Ideal candidates include adults aged 18 and older with histologically confirmed colorectal adenocarcinoma and measurable liver metastases.
Not a fit: Patients with extensive metastases beyond the liver or those who have received chemotherapy within the last 12 months may not benefit from this study.
Why it matters
Potential benefit: If successful, this treatment could significantly improve survival rates and quality of life for patients with liver metastases from colorectal cancer.
How similar studies have performed: Previous studies have shown promising results with similar intra-arterial chemotherapy approaches, indicating potential for success in this trial.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Histologically proven colorectal adenocarcinoma with hepatic metastasis(es) * At least one measurable hepatic metastasis according to the criteria RECIST v1.1 * No other metastatic sites except lung nodules if number ≤ 3 and \< 10 mm * RAS mutation status known (determination of KRAS mutation (exons 2,3 and 4) and determination of the NRAS mutation (exons 2,3 and 4)) * Age ≥ 18 * WHO ≤ 2 (Appendix 4) * No prior treatment by chemotherapy except perioperative or adjuvant chemotherapy discontinued for more than 12 months * Life expectancy \> 3 months * PNN \> 1500/mm3, platelets \> 100 000/mm3, Hb \> 9 g/dLq * Bilirubin \< 25 mmol/L, AST \< 5x ULN, ALT \< 5 x ULN, ALP \< 5 x ULN, TP \> 60%, proteinuria from 24H \< 1 g * Creatinine clearance \> 50 mL/min according to MDRD formula (Appendix 4) * Patient affiliated to a social security scheme * Patient information and signature of the informed consent Exclusion Criteria: * Contraindications specific to the installation of a KTHIA: thrombosis of the hepatic artery, arterial vascular anatomy may compromise a secondary hepatic resection. * Patient immediately eligible for a curative therapy (surgical and/or percutaneous) after discussion in CPR * Following alterations in the 6 months prior to inclusion: myocardial infarction, angina, severe/unstable angina, coronary artery bypass surgery, congestive heart failure NYHA class II, III or IV, stroke or transient ischemic attack * Hypertension not controlled by medical treatment (SBP \> 140 mmHg and/or DBP\> 90 mmHg with blood pressure taken according to the diagram of the HAS) * A history of abdominal fistula, gastrointestinal perforation, intra-abdominal abscess or active gastrointestinal bleeding in the 6 months preceding the start of treatment * Progressive gastroduodenal ulcer, wound or fractured bone * Abdominal or major extra-abdominal surgery (except diagnostic biopsy) or irradiation in the 4 weeks before starting the treatment * Transplant patients, HIV positive or other immune deficiency syndromes * Any progressive pathology not balanced over the past 6 months: hepatic failure, renal failure, respiratory failure * Peripheral neuropathy \> 1 * Patient with interstitial pneumonitis or pulmonary fibrosis * History of chronic diarrhea or inflammatory disease of the colon or rectum, or unresolved occlusion or sub-occlusion in symptomatic treatment * History of malignant pathologies during the past 5 years except basocellular skin carcinoma considered in complete remission or in situ cervical carcinoma, properly treated * Patient already included in another clinical trial with an experimental molecule * Any known specific contraindication or allergy or hypersensitivity to the drugs used in the study (cf RCP Appendix 7) * Known deficit in DPD * QT/QTc range \> 450 msec for men and \> 470 msec for women * K+ \< LNL, Mg2+ \< LNL, Ca2+ \< LNL * Lack of effective contraception in patients (men and/or women) of childbearing age, pregnant or breastfeeding women, women of childbearing age not having had a pregnancy test * Persons deprived of liberty or under supervision * Impossibility of undergoing medical monitoring during the trial for geographic, social or psychological reasons
Where this trial is running
Brussels and 48 other locations
- Hôpital Erasme — Brussels, Belgium (Recruiting)
- Chu Hotel Dieu — Angers, France (Recruiting)
- Institut de Cancérologie de l'Ouest — Angers, France (Recruiting)
- Hôpital Privé d'Antony — Antony, France (Recruiting)
- CH Henri Duffaut — Avignon, France (Not_yet_recruiting)
- Institut du cancer Avignon Provence — Avignon, France (Recruiting)
- Ch Cote Basque — Bayonne, France (Recruiting)
- Clinique Belharra — Bayonne, France (Recruiting)
- Centre Hospitalier — Beauvais, France (Not_yet_recruiting)
- Institut Bergonié — Bordeaux, France (Recruiting)
- Polyclinique Bordeaux Nord — Bordeaux, France (Recruiting)
- Infirmerie Protestante de Lyon — Caluire-et-Cuire, France (Recruiting)
- CH Loire Vendée Océan — Challans, France (Not_yet_recruiting)
- Centre Hospitalier Sud Francilien — Corbeil-Essonnes, France (Recruiting)
- Chu Le Bocage — Dijon, France (Not_yet_recruiting)
- Chd Vendee — La Roche-sur-Yon, France (Recruiting)
- Groupe Hospitalier de la Rochelle Re-Aunis — La Rochelle, France (Recruiting)
- Ch de Bicetre — Le Kremlin-Bicêtre, France (Not_yet_recruiting)
- GH Nord Essone — Longjumeau, France (Not_yet_recruiting)
- Hôpital du Scorff — Lorient, France (Recruiting)
- Centre Léon Bérard — Lyon, France (Recruiting)
- Hôpital de la Croix Rousse — Lyon, France (Recruiting)
- Hôpital Européen — Marseille, France (Recruiting)
- Hôpital Saint-Joseph — Marseille, France (Recruiting)
- Institut Paoli Calmettes — Marseille, France (Not_yet_recruiting)
- Chu Hotel Dieu — Nantes, France (Recruiting)
- CHR La Source — Orléans, France (Not_yet_recruiting)
- Hôpital Cochin — Paris, France (Not_yet_recruiting)
- Hôpital Saint Joseph — Paris, France (Recruiting)
- Hôpital Saint Louis — Paris, France (Recruiting)
- Paris Hôpital Européen Georges Pompidou — Paris, France (Recruiting)
- Centre Hospitalier — Pau, France (Recruiting)
- Centre Hospitalier Saint Jean — Perpignan, France (Recruiting)
- CHU Haut Lévêque — Pessac, France (Recruiting)
- CHU La Milétrie — Poitiers, France (Recruiting)
- Centre Eugène Marquis — Rennes, France (Recruiting)
- Clinique Pasteur — Ris-Orangis, France (Not_yet_recruiting)
- Crome — Ris-Orangis, France (Not_yet_recruiting)
- CHU Charles Nicolle — Rouen, France (Recruiting)
- Chp — Saint-Grégoire, France (Recruiting)
- Institut de cancérologie de l'Ouest — Saint-Herblain, France (Recruiting)
- CHU Saint-Etienne — Saint-Priest-en-Jarez, France (Recruiting)
- Hôpital FOCH — Suresnes, France (Recruiting)
- Maison de Santé Protestante de Bordeaux Bagatelle — Talence, France (Not_yet_recruiting)
- Hia Sainte Anne — Toulon, France (Recruiting)
- Chu Toulouse Rangueil — Toulouse, France (Recruiting)
- Clinique Pasteur — Toulouse, France (Not_yet_recruiting)
- Hôpital Paul Brousse — Villejuif, France (Not_yet_recruiting)
- Institut Gustave Roussy — Villejuif, France (Recruiting)
Study contacts
- Principal investigator: Julien TAIEB, MD-PhD — HEGP, Paris
- Study coordinator: Sofia JOURDAN
- Email: sofia.jourdan@u-bourgogne.fr
- Phone: +33 (0)380393404
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.