Rectal Cancer Clinical Trial
Official title:
Phase II Study Evaluating the Efficacy of the Combination of Metformin to Neoadjuvant Radiochemotherapy in the Treatment of Locally Advanced Rectal Cancer.
Metformin is an oral antidiabetic of the biguanide class derived from galega officinalis.
Historical cohort of patients with diabetes have shown that diabetics on Metformin had a
better chance of survival than diabetics not on Metformin. These observations have led to in
vitro studies of metformin on cancer cells. It was thus demonstrated that Metformin has
anti-proliferative properties.
The aim of our study is to evaluate the efficacy of metformin in combination with neoadjuvant
radiochemotherapy in the treatment of locally advanced rectal cancer.
Patients eligible for the trial and having signed their consent to participate will undergo a
dosimetric scan at baseline. 48 hours later (minimum), a Metformin therapy will be started at
a dosage of 850 mg 2 times / day ( = 1700 mg / day). Seven days later (minimum) and up to 48
hours before surgery, the dosage of Metformin will be increased to 850 mg 3 times / day ( =
2550 mg / day). This very same day (J10), patients will start a radiochemotherapy. For 5
weeks, 5 days out of 7, patients will receive 800 mg/m² of Capecitabine 2 times / day (on
morning and evening) ( = 1600 mg / m² / day) and a 3D irradiation or an Intensity-Modulated
Radiation Therapy (IMRT) of a total dose of 50 Gy (5 sessions of 2 Gy per week). 6 to 8 weeks
after completion of the chemoradiotherapy, surgery will be scheduled. It will consist of a
tumor resection with total resection of the meso rectum.
Prior to the start of treatment, patients will have a clinical and a paraclinical examination
and will undergo a laboratory examination. Once a week during the radiochemotherapy, patients
will have a clinical examination and will undergo a laboratory examination. Three weeks after
the end of the radiochemotherapy, patients will have a clinical examination. Before surgery,
patients will have a clinical and a paraclinical examination. Finally, at the end of the
study, patients will have a clinical examination.
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