This is a randomized phase II study trial that has served as a screening trial to test the increased efficacy of chemotherapy + cetuximab versus chemotherapy alone among patients with untreated, advanced or metastatic colon cancer regardless of tumor status with respect to EGFR.
CALGB 80203 was activated on December 15, 2003. In February 2004, based on the results of the randomized trial of IFL +/- cetuximab showing a significant improvement in overall survival with cetuximab, cetuximab was approved by the FDA for use as front-line therapy for patients with metastatic colon cancer. In response to this action, the Data Safety and Monitoring Board recommended closure of CALGB 80203. CALGB 80203 was subsequently closed to accrual in January 2005 with 238 of the originally targeted 2200 patients enrolled. A final decision was to "replace" CALGB 80203 with a three-treatment arm randomized trial of chemotherapy (FOLFOX or FOLFIRI) with and without cetuximab and/or bevacizumab. The protocol was amended to allow analysis of the data from CALGB 80203 as a randomized phase II trial and reporting of the results. Patients were stratified according to prior adjuvant chemotherapy (yes vs no) and prior pelvic radiation (yes vs no). Patients must have completed any major surgery or radiotherapy (eg, chest or bone palliative RT or pelvic RT) ≥ 4 weeks from registration and completed any minor surgery ≥ 2 weeks from registration. Patients must have fully recovered from the procedure and/or radiotherapy. Patients must have initiated treatment within 7 days of registration. Patients were randomized to 1 of 4 treatment arms, please see a description of the treatment regimens in the "Arms" section. In addition, patients received concomitant and supportive therapy as appropriate per the protocol. OBJECTIVES: Primary 1\. To determine if the addition of C225 to FOLFIRI or FOLFOX chemotherapy prolongs survival of patients with untreated, advanced or metastatic colorectal cancer. Secondary 1. To determine if the FOLFIRI and FOLFOX regimens are equivalent in terms of survival as front-line therapy for advanced colorectal patients. 2. To determine the level of EGFR expression in patients with metastatic colorectal cancer. Patients were followed up to 3 years post-treatment.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
238
Overall survival
Time frame: Up to 3 years of follow up
Progression-free survival
Time frame: Up to 18 months of follow up
Complete response
Time frame: Up to 18 months of follow up
Partial response
Time frame: Up to 18 months of follow up
Proportion of patients experiencing ≥ Grade 3 diarrhea
Time frame: Up to 30 days post-treatment
Proportion of patients experiencing ≥ Grade 3 ANC
Time frame: Up to 30 days post-treatment
Percent of total dose administered
Time frame: Up to 30 days post-treatment
Proportion of patients experiencing ≥ Grade 4 toxicity on each cetuximab treatment arm
Time frame: Up to 30 days post-treatment
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Northeast Alabama Regional Medical Center
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Rebecca and John Moores UCSD Cancer Center
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Cedars-Sinai Comprehensive Cancer Center at Cedars-Sinai Medical Center
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Naval Medical Center - San Diego
San Diego, California, United States
Veterans Affairs Medical Center - San Diego
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UCSF Comprehensive Cancer Center
San Francisco, California, United States
Veterans Affairs Medical Center - San Francisco
San Francisco, California, United States
CCOP - Christiana Care Health Services
Newark, Delaware, United States
Lombardi Cancer Center at Georgetown University Medical Center
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Walter Reed Army Medical Center
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