Colorectal Carcinoma Clinical Trial
Official title:
Phase II Open Label Comparative Study of Cetuximab and Radiation Therapy Vs Surgery Before or After Radiation Therapy in Patients With Stage II to IV Colorectal Carcinoma
RATIONALE: Monoclonal antibodies, such as Cetuximab, can target tumor cells and either kill
them or deliver tumor-killing substances to them without harming normal cells.This is an
anti-cancer drug which has already been approved by the FDA for use in patients who have
Colorectal Cancer. Cetuximab 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. Radiation Therapy uses high-energy x-rays to kill
tumor cells and cause less damage to normal tissue . Giving the drug Cetuximab together with
Radiation Therapy may kill more tumor cells. Surgery is the most common treatment for
Colorectal Cancer to remove the tumor, as well as a small margin of surrounding normal
tissue and possibly nearby lymph nodes. Surgery is usually used in conjunction with other
conventional treatments such as Radiation Therapy. Radiation Therapy before surgery may make
the tumor smaller and reduce the amount of normal tissue that needs to be removed. Radiation
Therapy after surgery may kill any tumor cells that remain after surgery.
Screening test such as Fecal Occult Blood Test (FOBT) and Colonoscopy has to be done. Tumor
markers for Colorectal Carcinoma are Carcinoembryonic antigen (CAE) and CA 19-9 and to
assess the response of tumor markers Carcinoembryonic antigen (CAE) and CA 19-9 will be used
and periodically Colonoscopy has to be done. Colorectal Cancer Surgery are Colon resection
(Colectomy), Rectum resection (Proctectomy), Colostomy, and Radiofrequency ablation.
PURPOSE: Determine the tumor response rate treated with Cetuximab and Radiation Therapy Vs
Surgery before or after Radiation Therapy in patients with Colorectal Cancer from stage II
to IV
OBJECTIVES:
Primary:
- Determine the response rate in patients with Colorectal Cancer treated with Cetuximab
and Radiation Therapy Vs Surgery before or after Radiation Therapy.
Secondary:
- To determine the progression-free survival and overall survival of patients treated
with these regimens.
- Compare the treatment compliance of patients treated with these regimens.
- Compare the safety of these regimens in these patients.
OUTLINE: This is an Open-label, Controlled, Multicenter study. Patients will be assigned
into two different Arms.
Arm I: Patients will receive Cetuximab and Radiation Therapy. Patients will receive a dose
of Cetuximab through Intravenous (IV). The initial dose is 400 mg/m2 administered as a
120-minute intravenous infusion (maximum infusion rate 10 mg/min) and weekly dose is 250
mg/m2 infused over 60 minutes (maximum infusion rate 10 mg/min) until disease progression or
unacceptable toxicity. Radiation treatment for Colorectal Cancer are Intensity Modulated
Radiation Therapy (IMRT). IMRT delivers radiation directly to the tumor and modulates the
intensity of the radiation with laser accuracy.
Arm II: Patients will undergo surgery before or after Radiation Therapy. Colorectal Cancer
Surgery are Colon resection (Colectomy), Rectum resection (Proctectomy), Colostomy, and
Radiofrequency ablation. Radiation treatment for Colorectal Cancer are Intensity Modulated
Radiation Therapy (IMRT). IMRT delivers radiation directly to the tumor and modulates the
intensity of the radiation with laser accuracy.
PROJECTED ACCRUAL: Approximately 450 patients will be accrued for this study within 18 to 24
months.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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