The trial is a phase III, multicenter, open-labeled randomized trial comparing the association of 5-fluorouracil (5-FU), folinic acid, irinotecan, and oxaliplatin (mFOLFIRINOX) versus oxaliplatin, folinic acid, and 5-FU (mFOLFOX 6) chemotherapy protocols in patients with high-risk stage III colon cancer in the adjuvant setting.
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
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
792
every 14 days, 12 cycles, 24 weeks, new cycle beginning on day 15: irinotecan (Campto®) 180 mg/m² on D1, IV infusion over 90 minutes to begin 30 min after folinic acid infusion is started
every 14 days, 12 cycles, 24 weeks, new cycle beginning on day 15: oxaliplatin (Eloxatin®) 85 mg/m² on D1, IV infusion over 2 hours, followed by folinic acid 400 mg/m² (racemic mixture) (or 200 mg/m² if L-folinic acid) IV infusion over 2 hours 5-FU 2400 mg/m²/h IV continuous infusion over 46 hours starting at the end of folinic acid infusion
The PEI Cancer Treatment Centre Queen Elizabeth Hospital
Charlottetown, Prince Edward Island, Canada
Hopital Charles LeMoyne
Greenfield Park, Quebec, Canada
Disease Free Survival (DFS)
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.
Time frame: 3 YEARS after inclusion
Disease Free Survival
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.
Time frame: 2 YEARS after inclusion
Overall Survival
Overall Survival (OS) is defined as the time from the date of randomization to the date of documented death from any cause
Time frame: 5 YEARS after inclusion
Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability]
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.
Time frame: 2 YEARS after inclusion
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Centre hospitalier de l'Université de Montréal
Montreal, Quebec, Canada
Allan Blair Cancer Centre
Regina, Saskatchewan, Canada
Institut de Cancérologie de l'Ouest -site Paul Papin
Angers, France
CHD de Vendée
La Roche-sur-Yon, France
Ch Emile Roux
Le Puy-en-Velay, France
Hospices civils de Lyon - Hôpital Edouard Herriot
Lyon, France
Hôpital privé Jean Mermoz
Lyon, France
Icm Val D'Aurelle
Montpellier, France
...and 7 more locations