Colorectal Cancer Clinical Trial
Official title:
CWRU 1296: Biochemical and Pharmacokinetic Predictors of Colon Cancer Response to a Topoisomerase I Directed Treatment With Irinotecan
RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so
they stop growing or die.
PURPOSE: Phase II trial to study the effectiveness of irinotecan in treating patients who
have metastatic or recurrent colorectal cancer.
OBJECTIVES: I. Confirm the greater than 20% response rate to irinotecan in patients with
metastatic or recurrent colorectal cancer who have not receive prior chemotherapy for their
advanced disease. II. Characterize pharmacokinetic parameters of irinotecan and its
metabolite SN-38 and their relationship to response and toxic effect. III. Characterize tumor
samples for topoisomerase I activity, proliferative fraction (ki67 expression), and p53
expression and determine whether clinical response is related to these tumor characteristics
in patient population. IV. Determine the in vitro inhibition of topoisomerase I activity by
irinotecan, SN-38, and other camptothecin analogs and evaluate whether the degree of in vitro
sensitivity to irinotecan and/or SN-38 is associated with clinical response in these
patients. VII. Determine the frequency of somatic mutations following irinotecan and
correlate this with pharmacologic parameters.
OUTLINE: Patients receive irinotecan IV at a starting dose weekly for 4 weeks followed by 2
weeks of rest. Treatment continues in the absence of disease progression or unacceptable
toxicity. Tumor status is reassessed every 12 weeks during study. Patients attaining a
complete response may receive additional courses of treatment. Patients are followed until
death.
PROJECTED ACCRUAL: A total of 54 patients will be accrued into this study at a rate of 25
patients per year.
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