Colorectal Cancer Clinical Trial
— EFFIPECOfficial title:
EFFIPEC - Efficacy of Hyperthermic Intraperitoneal Chemotherapy, Single-arm Phase I Study, Followed by an Open-label, Randomized, Controlled Registry-based Phase III Trial
A dose titration study and a combined superiority registry-based open-label randomized control trial is planned to answer the trial objectives. The study will be registry-based to allow simpler and more comprehensive follow-up. Patients with colorectal cancer will be treated with cytoreductive surgery (CRS) together with either standard oxaliplatin HIPEC (the control for the efficacy study) or oxaliplatin/irinotecan HIPEC in combination with 5-FU 24-hour EPIC. The 5-FU will be administered postoperatively when the abdomen is completely sutured. The drug is divided equally into 2 injections of 200 ml each and injected through two abdominal drains that are clamped for 16 hours. For dose escalation, the titration groups (á 3 or 6 patients) are followed for 30 days postoperatively after which the Data Monitoring Committee (DMC) will determine whether or not to increase the 5-FU dose for the following group of patients. To study efficacy, randomization is performed intraoperatively. The patient is followed up postoperatively for a total of 3 years for the secondary endpoints which may be extended by the study committee to 5 years. Since the trial is registry based, the long-term follow-up does not require separate eCRF evaluations. These evaluations can be automatically retrieved from the registry - both recurrence data, quality of life, and morbidity data. Some specific eCRF evaluations will be integrated as a separate study part of the HIPEC registry, such as inclusion/exclusion criteria and adverse event reporting (including SUSAR reporting).
Status | Recruiting |
Enrollment | 356 |
Est. completion date | December 2029 |
Est. primary completion date | December 2025 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years to 74 Years |
Eligibility | Inclusion Criteria: - Provision of written informed consent prior to any study specific procedures. - ECOG Performance Status Score 0,1 or 2 - Adequate kidney, liver, bone marrow function according to laboratory tests - For females of childbearing potential, a negative pregnancy test must be documented - = 18 years old and <75 years old - Colorectal cancer with peritoneal metastases - All patients deemed eligible for CRS and HIPEC according to clinical routine management during a HIPEC multidisciplinary board at each respective hospital can be included. Exclusion Criteria: - Previous severe toxicity/allergic reactions to systemic chemotherapy agents oxaliplatin or irinotecan or 5-fluorouracil - Unable to tolerate intensified HIPEC treatment due to comorbidity - Metastasis other than peritoneum - Pregnant or lactating (nursing) women - Active infections requiring antibiotics - Active liver disease with positive serology for active hepatitis B, C, or known HIV - Concurrent administration of any cancer therapy other than planned study treatment within 4 weeks prior to and up to 4 weeks after study treatment - Incomplete cytoreduction defined as completeness of cytoreduction score 1-3 - Histopathology of other origin than colorectal cancer |
Country | Name | City | State |
---|---|---|---|
Sweden | Sahlgrenska östra sjukhuset | Gothenburg | |
Sweden | Skånes universitetssjukhus | Malmö | |
Sweden | Karolinska sjukhuset | Stockholm | |
Sweden | Akademiska sjukhuset | Uppsala |
Lead Sponsor | Collaborator |
---|---|
Uppsala University |
Sweden,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Recurrence-free survival | To study the recurrence-free survival (RFS) of patients | 12 months after treatment | |
Secondary | Overall survival | Survival is followed through the HIPEC registry. | 5 years after treatment | |
Secondary | Recurrence-free survival | Survival is followed through the HIPEC registry. The RECIST criteria are used to determine recurrence and site of first recurrence | 5 years after treatment | |
Secondary | Postoperative complication rate | Morbidity is registered in the HIPEC registry within 30 days of treatment administration. | Within 30 days after treatment | |
Secondary | Patient evaluations of quality of life | EORTC QLQ questionnaire filled out at baseline, 12 and 36 months after surgery using the established QoL database. | 3 years after treatment |
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