The purpose of the study is to evaluate if the exposure to all the three active cytotoxic agents (FOLFOXIRI regimen) is superior in terms of progression-free survival to conventional chemotherapy with the FOLFOX regimen as first-line treatment of chemo-naive metastatic colorectal cancer patients. A second primary aim is to evaluate the response rate, safety and tolerability of the chemotherapy of FOLFOXIRI regimen in this patient population. Patients will be randomized to two therapy groups: Experimental arm A: Chemotherapy with FOLFOXIRI Standard arm B: Chemotherapy with FOLFOX
Survival of patients with metastatic colorectal cancer is correlated with the proportion of patients who receive all the three active drugs , but not with the proportion of patients who receive any second-line therapy. A superior efficacy in PFS,ORR and OS of FOLFOXIRI has been reported with acceptable toxicity. Moreover,evidence suggests that continuous dosing metronomic chemotherapy may be more efficacious than interval-chemotherapy. Therefore, a way to improve the outcome of metastatic colorectal cancer patients could be to administer a maintenance first-line regimen containing the three active agents.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
162
irinotecan\* 165 mg/m² + oxaliplatin 85 mg/m² + leucovorin 200 mg/m² + 5-FU 3200 mg/m² cont. inf. 46h all on day 1 of each 2 weeks cycle \*reduced in UGT1A1 7/7 patients
oxaliplatin 85 mg/m² + leucovorin 400 mg/m² +5-FU 400mg/m² bolus iv.+ 5-FU 2400 mg/m² cont. inf. 46h all on day 1 of each 2 weeks cycle
Gastrointestinal Hospital, Sun Yat-sen University
Guangzhou, Guangdong, China
RECRUITINGProgression-free survival after induction and maintenance chemotherapy (PFS1)
Progressions are evaluated every 8 weeks according to WHO criteria and reviewed by an independent panel at the end of follow up (36 months).
Time frame: up to 18 months
Progression-free survival after re-introduction of chemotherapy (PFS2)
Time frame: up to 24 months
Response rate during re-introduction of chemotherapy
(CR + PR rate according to RECIST)
Time frame: up to 12 months
Early tumor shrinkage rate in 8 weeks after induction treatment
Time frame: 8 weeks
Overall survival
Time frame: up to 5 years
toxicity and safety
Number of participants with adverse events as a measure of safety and tolerability according to NCI CTC 4.0
Time frame: up to 24 months
QLQ (QLQ C30) - scores according to EORTC QLQ-C30 scoring manual (Quality of life)
Time frame: up to 36 months
Translational research
Time frame: up to 5 years
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