Colorectal Cancer Clinical Trial
Official title:
Neoadjuvant Radiotherapy and Capecitabine With or Without Panitumumab in Patients With Advanced, K-ras Unmutated Rectal Cancer. A Randomized Multicenter Phase II Trial
RATIONALE: Drugs used in chemotherapy, such as capecitabine, work in different ways to stop
the growth of tumor cells, either by killing the cells or by stopping them from dividing.
Giving radiation therapy that uses a 3-dimensional (3-D) image of the tumor to help focus
thin beams of radiation directly on the tumor, and giving radiation therapy in higher doses
over a shorter period of time, may kill more tumor cells and have fewer side effects.
Monoclonal antibodies, such as panitumumab, can block tumor growth in different ways. Some
block the ability of tumor cells to grow and spread. Others find tumor cells and help kill
them or carry tumor-killing substances to them. It is not yet known whether giving
capecitabine together with 3-D conformal radiation therapy is more effective with or without
panitumumab in treating patients with advanced rectal cancer.
PURPOSE: This randomized phase II trial is studying giving capecitabine together with
radiation therapy to see how well it works with or without panitumumab in treating patients
with advanced rectal cancer.
OBJECTIVES:
- To assess the efficacy and safety of neoadjuvant capecitabine and concurrent
3-dimensional conformal radiotherapy with vs without panitumumab in patients with
advanced K-ras unmutated rectal cancer.
OUTLINE: This is a multicenter study. Patients are stratified according to participating
center, T stage (T3 vs T4), tumor localization measured from caudal part of the tumor to the
anocutaneous line (< 10 cm vs ≥ 10 cm), and number of EGFR gene copies (< 2.9 vs ≥ 2.9).
Patients are randomized to 1 of 2 treatment arms.
- Arm I: Patients receive panitumumab IV over 30-90 minutes on days 1, 15, 29, 43, and 57
and oral capecitabine twice daily on days 8-40. Beginning on day 8, patients undergo
daily fractions of 3-D conformal radiotherapy 5 days a week for 5 weeks. Beginning
approximately 6 weeks after completion of panitumumab and chemoradiotherapy, patients
undergo surgery.
- Arm II: Patients receive oral capecitabine twice daily on days 1-33. Patients undergo
concurrent 3-D conformal radiotherapy 5 days a week for 5 weeks. Beginning 6 weeks
after completion of chemoradiotherapy, patients undergo surgery.
After completion of study therapy, patients are followed periodically for up to 3 years.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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