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TerminatedNCT00268463Updated May 15, 2013Results posted

Oxaliplatin and Capecitabine With or Without an Hepatic Arterial Infusion With Floxuridine in Treating Patients Who Are Undergoing Surgery and/or Ablation for Liver Metastases Due to Colorectal Cancer

A Phase 3 interventional study of capecitabine and floxuridine in Colorectal Cancer and Metastatic Cancer, sponsored by NSABP Foundation Inc. Terminated at 31 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2013-05-15.

Sponsored by NSABP Foundation Inc · Phase 3, Interventional, and Treatment

Why this study was terminated
The study was terminated due to low accrual.
Phase
Phase 3
Study type
Interventional
Enrollment
22
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

RATIONALE: Drugs used in chemotherapy, such as oxaliplatin, capecitabine, and floxuridine, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Hepatic arterial infusion uses a catheter to carry tumor-killing substances, such as chemotherapy, directly into the liver. Giving chemotherapy in different ways may kill more tumor cells. It is not yet known whether giving oxaliplatin and capecitabine together with an hepatic arterial infusion with floxuridine is more effective than giving oxaliplatin and capecitabine alone in treating patients who are undergoing surgery and/or ablation for liver metastases due to colorectal cancer.

PURPOSE: This randomized phase III trial is studying oxaliplatin, capecitabine, and an hepatic arterial infusion with floxuridine to see how well they work compared to oxaliplatin and capecitabine in treating patients who are undergoing surgery and/or ablation for liver metastases due to colorectal cancer.

Read the detailed description

OBJECTIVES:

Primary

  • Compare progression-free interval (PFI) in patients undergoing surgical resection and/or ablation for hepatic metastases from colorectal cancer treated with adjuvant therapy comprising oxaliplatin and capecitabine with vs without hepatic arterial infusion of floxuridine.

Secondary

  • Compare overall survival and liver PFI between the two treatment groups.
  • Assess toxicity in each of the treatment regimens.
  • Compare self-reported symptoms between two treatment groups.
  • Compare quality of life in each of the treatment regimens.

Tertiary

  • Examine the prognostic worth, in terms of PFI, of specific molecular markers in hepatic metastases.

OUTLINE: This is a randomized study. Patients are stratified according to intended surgical technique (surgical resection alone vs cryoablation or radiofrequency ablation [RFA] alone vs combination of resection and ablation) and prior adjuvant chemotherapy regimen (chemotherapy with vs without oxaliplatin vs no chemotherapy). Patients are randomized to 1 of 2 treatment arms.

All patients undergo surgical resection and/or hepatic cryoablation or RFA to remove a maximum of 6 colorectal hepatic metastases. Patients randomized to arm II also undergo intra-arterial catheter and if applicable, pump placement.

  • Arm 1 (oxaliplatin and capecitabine): Within 4-6 weeks after surgery and/or ablation, patients receive oxaliplatin IV over 2 hours on day 1 and oral capecitabine twice daily on days 1-14. Treatment repeats every 21 days for 8 courses in the absence of disease progression or unacceptable toxicity.
  • Arm 2 (oxaliplatin, capecitabine, and hepatic arterial infusion of floxuridine): Within 4-6 weeks after surgery and/or ablation, patients receive a continuous hepatic arterial infusion of floxuridine on days 1-14, oxaliplatin IV over 2 hours on day 22, and oral capecitabine twice daily on days 22-35. Treatment repeats every 42 days for 4 courses in the absence of unacceptable toxicity. Beginning with course 5, patients receive oxaliplatin IV over 2 hours on day 1 and oral capecitabine twice daily on days 1-14. Treatment with oxaliplatin and capecitabine repeats every 21 days for 4 courses in the absence of disease progression or unacceptable toxicity.

Quality of life is assessed at baseline, 4-6 weeks after surgery or ablation, approximately 18 weeks after beginning of chemotherapy, and 4-6 weeks after beginning the last cycle of chemotherapy.

After completion of study treatment, patients are followed periodically.

PROJECTED ACCRUAL: A total of 400 patients will be accrued for this study.

02

Conditions studied

  • Colorectal Cancer
  • Metastatic Cancer

Keywords

  • liver metastases
  • stage IV colon cancer
  • stage IV rectal cancer
  • adenocarcinoma of the colon
  • adenocarcinoma of the rectum
03

In context

Colorectal Neoplasms

5,599 studies on the registry are indexed under Colorectal Neoplasms; 1,459 are open to participants now.

This study's enrollment of 22 is below the median of 77 across 4,123 interventional studies indexed under Colorectal Neoplasms.

Browse Colorectal Neoplasms studies →

Lead sponsor

NSABP Foundation Inc is the lead sponsor of 64 studies on the registry; 1 is open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Eligibility criteria

DISEASE CHARACTERISTICS:

  • Histologically* or cytologically confirmed colorectal adenocarcinoma

    • No other cellular type (e.g., sarcoma, lymphoma, or carcinoid) NOTE: *If the primary colorectal tumor and the hepatic lesions have been identified at the same time and it is not possible to biopsy the colorectal lesion, the patient will be eligible without histologic confirmation of the colorectal primary cancer as long as other radiographic studies or scans document the characteristics of a colorectal cancer
  • Synchronous or metachronous metastatic disease confined to the liver

    • No more than 6 hepatic metastatic lesions that can potentially be resected or ablated
    • For patients presenting with synchronous lesion(s) in the colon and/or rectum, the primary tumors must, in the opinion of the investigator, appear to be completely resectable
  • Must be able to undergo surgery and/or ablation within 28 days following randomization
  • No evidence of extrahepatic metastases
  • No prior colorectal metastases
  • No recurrent colorectal cancer concurrent with hepatic metastases

PATIENT CHARACTERISTICS:

  • Life expectancy ≥ 5 years, excluding their colorectal cancer
  • Eastern Cooperative Oncology Group (ECOG) (Zubrod) performance status 0-1
  • No other malignancy within the past 5 years except carcinoma in situ of the cervix, melanoma in situ, basal cell or squamous cell skin cancer, or carcinoma of the colon or rectum
  • Absolute granulocyte count ≥ 1,200/mm\^3
  • Platelet count ≥ 100,000/mm\^3
  • PT/international normalized ratio (INR) ≤ 1.5 unless patient is on therapeutic doses of anticoagulant medication
  • Total bilirubin ≤ upper limit of normal (ULN)
  • Alkaline phosphatase ≤ 2.5 ULN
  • aspartate aminotransferase (AST) ≤ 2.5 times ULN
  • Calculated creatinine clearance > 50 mL/min
  • Not pregnant or lactating
  • Negative pregnancy test
  • Patients with child bearing potential must agree to use adequate contraception
  • Able to swallow oral medication
  • No preexisting chronic hepatic disease (e.g., chronic active hepatitis or cirrhosis)
  • No grade 3 or 4 anorexia or nausea
  • No vomiting ≥ grade 2
  • No clinically significant peripheral neuropathy defined as ≥ grade 2 neurosensory or neuromotor toxicity
  • No psychiatric or addictive disorders or other condition that, in the opinion of the investigator, would preclude study participation

PRIOR CONCURRENT THERAPY:

  • Prior adjuvant fluorouracil alone or in combination with levamisole, leucovorin calcium, irinotecan hydrochloride, or oxaliplatin allowed if these regimens were completed > 6 months ago
  • No prior resection/ablation, hepatic arterial infusion therapy, or any systemic chemotherapy for metastatic disease

    • Prior excisional biopsy allowed
  • No prior radiotherapy to the liver
  • No concurrent bevacizumab in patients who have had pump/catheter placement receiving hepatic arterial infusion of floxuridine

    • Patients who meet specific situations outlined in the protocol and who have not had pump placement may receive bevacizumab at the physician's discretion
  • No concurrent halogenated antiviral agents such as sorivudine or brivudine in patients receiving fluorouracil, floxuridine, or capecitabine
  • No concurrent filgrastim (G-CSF), pegfilgrastim, or sargramostim (GM-CSF) as primary prophylaxis for neutropenia

    • Following neutropenic events, these drugs may be used at the physician's discretion during subsequent cycles
  • No other concurrent cancer therapy
  • No other concurrent investigational agents
05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
22 participants (actual)

Study arms

  • Active comparator
    Arm 1: Capecitabine + Oxaliplatin

    Within 4-6 weeks after surgery and/or ablation, patients receive oxaliplatin IV over 2 hours on day 1 and oral capecitabine twice daily on days 1-14. Treatment repeats every 21 days for 8 cycles in the absence of disease progression or unacceptable toxicity.

    Drug: capecitabine · Drug: oxaliplatin

  • Experimental
    Arm 2: Floxuridine + Oxaliplatin + Capecitabine

    Within 4-6 weeks after surgery and/or ablation, patients receive a continuous hepatic arterial infusion of floxuridine on days 1-14, oxaliplatin IV over 2 hours on day 22, and oral capecitabine twice daily on days 22-35. Treatment repeats every 42 days for 4 cycles in the absence of unacceptable toxicity. Beginning with cycle 5, patients receive oxaliplatin IV over 2 hours on day 1 and oral capecitabine twice daily on days 1-14. Treatment with oxaliplatin and capecitabine repeats every 21 days for 4 cycles.

    Drug: capecitabine · Drug: floxuridine · Drug: oxaliplatin

Interventions

  • Drugcapecitabine

    Oral capecitabine 850 mg/m2 twice daily on days 1-14 every 21 days for 8 cycles: Arm 1 Oral capecitabine 850 mg/m2 twice daily on days 22-35 every 42 days for 4 cycles and then on days 1-14 every 21 days for 4 cycles: Arm 2

    Also known as: Xeloda

  • Drugfloxuridine

    Continuous hepatic arterial infusion of floxuridine 0.2 mg/kg on days 1-14 every 42 days for 4 cycles

    Also known as: FUDR

  • Drugoxaliplatin

    Oxaliplatin 130 mg/m2 IV over 2 hours on day 1 every 21 days for 8 cycles: Arm 1 Oxaliplatin 130 mg/m2 IV over 2 hours on day 22 every 42 days for 4 cycles and then on day 1 every 21 days for 4 cycles: Arm 2

    Also known as: Eloxatin

06

What researchers measure

Primary outcomes

  1. Progression-free Interval (PFI)

    Time to first recurrence of colon cancer at any site

    Time frame: Time from randomization through year 5

Secondary outcomes

  1. Liver PFI as Measured by Time to Hepatic Progression.

    Time frame: Time from randomization through year 5

  2. Survival as Measured by Time to Death From Any Cause.

    Time frame: Time from randomization through year 5

  3. Scales Specific to Social/Family, Emotional, and Functional Well-being, Perceived Convenience of Care, and Self-reported Symptoms

    Time frame: Prior to randomization, 4-6 weeks after surgery, 18 weeks after starting chemotherapy and after completion of chemotherapy

  4. Quality of Life as Measured by the Functional Assessment of Cancer Therapy Trial Outcome Index at Baseline, at 4-6 Weeks Following Surgery (Before Initiation of Chemotherapy), and Periodically During Study

    Time frame: Prior to randomization, 4-6 weeks after surgery, 18 weeks after the start of chemotherapy and after completion of chemotherapy

07

Results

Posted Mar 15, 2013

Participant flow

Participant flow — Overall Study
MilestoneArm 1: Capecitabine + OxaliplatinArm 2: Floxuridine + Oxaliplatin + Capecitabine
Started1012
Completed00
Not completed1012
Withdrew: Study terminated due to low accrual1012

Outcome measures

PrimaryProgression-free Interval (PFI)

Time to first recurrence of colon cancer at any site

Time frame:
Time from randomization through year 5

No measurements were reported for this outcome.

SecondaryLiver PFI as Measured by Time to Hepatic Progression.
Time frame:
Time from randomization through year 5

Results for this outcome have not been posted.

SecondarySurvival as Measured by Time to Death From Any Cause.
Time frame:
Time from randomization through year 5

Results for this outcome have not been posted.

SecondaryScales Specific to Social/Family, Emotional, and Functional Well-being, Perceived Convenience of Care, and Self-reported Symptoms
Time frame:
Prior to randomization, 4-6 weeks after surgery, 18 weeks after starting chemotherapy and after completion of chemotherapy

Results for this outcome have not been posted.

SecondaryQuality of Life as Measured by the Functional Assessment of Cancer Therapy Trial Outcome Index at Baseline, at 4-6 Weeks Following Surgery (Before Initiation of Chemotherapy), and Periodically During Study
Time frame:
Prior to randomization, 4-6 weeks after surgery, 18 weeks after the start of chemotherapy and after completion of chemotherapy

Results for this outcome have not been posted.

Adverse events

Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Capecitabine + Oxaliplatin—0/8 (0%)6/8 (75%)
Floxuridine + Oxaliplatin + Capecitabine—0/6 (0%)3/6 (50%)
Most frequent other events
Showing 10 of 23
Most frequent other events
EventCapecitabine + OxaliplatinFloxuridine + Oxaliplatin + Capecitabine
NauseaGastrointestinal disorders3/81/6
Peripheral sensory neuropathyNervous system disorders3/81/6
Abdominal painGastrointestinal disorders0/82/6
FatigueGeneral disorders0/82/6
VomitingGastrointestinal disorders2/82/6
HyperglycemiaMetabolism and nutrition disorders2/80/6
Neutrophil count decreasedInvestigations2/81/6
Alanine aminotransferase increased (ALT/SGPT)Investigations0/81/6
AnorexiaMetabolism and nutrition disorders1/81/6
Aspartate aminotransferase increased (AST/SGOT)Investigations0/81/6

Baseline characteristics

Age Continuous
Age Continuous(years)Capecitabine + OxaliplatinFloxuridine + Oxaliplatin + CapecitabineTotal
Mean60 ± 10.459 ± 9.459 ± 9.7
Sex/Gender, Customized
Sex/Gender, Customized(participants)Capecitabine + OxaliplatinFloxuridine + Oxaliplatin + CapecitabineTotal
Female347
Male7714
Unknown011
08

Study locations

31 sites
  • Cancer Care Center at John Muir Health - Concord Campus
    Concord, California 94524-4110, United States
  • City of Hope Comprehensive Cancer Center
    Duarte, California 91010-3000, United States
  • Veterans Affairs Medical Center - Loma Linda (Pettis)
    Loma Linda, California 92357, United States
  • Kaiser Permanente Medical Center - Walnut Creek
    Walnut Creek, California 94596, United States
  • John Muir/Mt. Diablo Comprehensive Cancer Center
    Walnut Creek, California 94598, United States
  • CCOP - Christiana Care Health Services
    Newark, Delaware 19713, United States
  • Washington Cancer Institute at Washington Hospital Center
    Washington, District of Columbia 20010, United States
  • Curtis & Elizabeth Anderson Cancer Institute at Memorial Health University Medical Center
    Savannah, Georgia 31403-3089, United States
  • Via Christi Cancer Center at Via Christi Regional Medical Center
    Wichita, Kansas 67214, United States
  • Central Baptist Hospital
    Lexington, Kentucky 40503-9985, United States
  • Louisville Oncology at Norton Cancer Center
    Louisville, Kentucky 40202, United States
  • CCOP - Ochsner
    New Orleans, Louisiana 70121, United States
  • Harry & Jeanette Weinberg Cancer Institute at Franklin Square Hospital Center
    Baltimore, Maryland 21237, United States
  • Saint Joseph Mercy Cancer Center
    Ann Arbor, Michigan 48106-0995, United States
  • Borgess Medical Center
    Kalamazoo, Michigan 49001, United States
  • West Michigan Cancer Center
    Kalamazoo, Michigan 49007-3731, United States
  • Bronson Methodist Hospital
    Kalamazoo, Michigan 49007, United States
  • Mayo Clinic Cancer Center
    Rochester, Minnesota 55905, United States
  • Wake Forest University Comprehensive Cancer Center
    Winston-Salem, North Carolina 27157-1096, United States
  • Altru Cancer Center at Altru Hospital
    Grand Forks, North Dakota 58201, United States
  • Natalie Warren Bryant Cancer Center at St. Francis Hospital
    Tulsa, Oklahoma 74136, United States
  • Legacy Good Samaritan Hospital & Medical Center Comprehensive Cancer Center
    Portland, Oregon 97210, United States
  • CCOP - Columbia River Oncology Program
    Portland, Oregon 97225, United States
  • Providence St. Vincent Medical Center
    Portland, Oregon 97225, United States
  • St. Luke's Cancer Network at St. Luke's Hospital
    Bethlehem, Pennsylvania 18015, United States
  • Geisinger Medical Center
    Danville, Pennsylvania 17822-0001, United States
  • UMC Southwest Cancer and Research Center
    Lubbock, Texas 79415-3364, United States
  • Fletcher Allen Health Care - University Health Center Campus
    Burlington, Vermont 05401, United States
  • Virginia Oncology Associates - Hampton
    Hampton, Virginia 23666, United States
  • Mary Babb Randolph Cancer Center at West Virginia University Hospitals
    Morgantown, West Virginia 26506, United States
  • University of Wisconsin Paul P. Carbone Comprehensive Cancer Center
    Madison, Wisconsin 53792-6164, United States
09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on May 15, 2013, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT00268463
Lead sponsor
NSABP Foundation Inc
Collaborators
National Cancer Institute (NCI)
Responsible party
Sponsor
First posted
Dec 22, 2005
Start date
Jan 2006
Primary completion
Jun 2008
Completion
Jun 2008
Results posted
Mar 15, 2013
Last update
May 15, 2013

Study contacts

Norman Wolmark, MD
principal investigator · NSABP Foundation Inc

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

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