COPPER is an international, multicenter, parallel-arm, phase III randomized controlled trial comparing two local treatment strategies (SABR or metastasectomy) for patients with an indication for local treatment for limited (max. three) colorectal pulmonary metastases
The study is formally endorsed by the Dutch Society of Lung Surgery (NVvL), the Dutch Society of Cardiothoracic Surgery (NVT), the Dutch Society of Radiation Oncology (NVRO). The main objective of the proposed randomized trial is to compare efficacy of SABR to the efficacy of metastasectomy with regards to the primary endpoint (local recurrence free survival at 5 years) in patients with limited colorectal pulmonary metastases. This will determine the most effective local treatment modality. The investigators hypothesize that patients with limited colorectal pulmonary metastases will have non-inferior overall survival after pulmonary metastasectomy compared to SABR, however metastasectomy will result in superior local recurrence free survival at five years when compared to SABR. In addition, the investigators hypothesize that SABR is associated with lower morbidity, comparable quality of life and comparable health care costs compared to metastasectomy. Recurrent metastases are preferably treated by the index treatment to which the patient was randomized, local recurrent metastases are preferably treated by means of cross-over between both arms. Comparing metastasectomy to SABR for patients with colorectal pulmonary metastases will present the international community the evidence needed to better select patients for local radical treatment, while diminishing uncertainty for patients and care givers.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
394
Surgical margin is equal to tumor size, if possible The goal is a parenchymal-sparing resection
Depending on tumor location, 54 Gy in 3 fractions, 55 Gy in 5 fractions, 60 Gy in 8 fractions.
Amsterdam University Medical Center (AUMC)
Amsterdam, Netherlands
Local recurrence-free survival
Time from randomization to local recurrence or death from any cause
Time frame: From date of randomization through study completion, up to 10 years
Overall survival (OS)
Time from randomization to death from any cause
Time frame: 5 years
Progression-free survival (PFS)
Time from randomization to disease progression at any site or death
Time frame: 5 years
Local recurrence rate (LRR) per tumor
Proportion of treated metastases with local recurrence
Time frame: 5 years
Quality of life (QoL) assessment - EuroQoL (EQ-5D-5L)
\[0-5 for 5 dimensions, higher score = worse QoL\]
Time frame: 5 years
Quality of life assessment - Functional Assessment of Cancer Therapy: General (FACT-G)
\[27 questions in 4 subscales, higher score = better QoL\]
Time frame: 5 years
Health economic evaluation - Institute for Medical Technology Assessment (iMTA) - iMTA Medical Cost Questionnaire (iMCQ)
Medical costs \[Euro\]
Time frame: 5 years
Health economic evaluation - iMTA Productivity Cost Questionnaire (iPCQ)
Productivity costs \[Euro\]
Time frame: 5 years
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Tumor patterns of failure
Local, regional and distant disease control based on surveillance imaging
Time frame: 5 years
Rate of adverse events
Frequency of adverse events and serious adverse events
Time frame: 2 years
Multiparameter flow cytometric analyses (FACS)
Peripheral blood mononuclear cell (PBMC) concentration
Time frame: 1 months