Colorectal Cancer Clinical Trial
Official title:
A Phase I Study Of Hepatic Arterial Infusion With Floxuridine And Dexamethasone In Combination With Intravenous Oxaliplatin Plus 5-Fluorouracil And Leucovorin In Patients With Unresectable Hepatic Metastases From Colorectal Cancer
RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing
so they stop growing or die. Cryosurgery kills cancer cells by freezing them. Combining more
than one chemotherapy drug with cryosurgery and giving drugs in different ways may kill more
tumor cells.
PURPOSE: Phase I trial to study the effectiveness of intrahepatic and intravenous
combination chemotherapy with or without cryosurgery in treating unresectable liver
metastases from colorectal cancer.
OBJECTIVES:
- Determine the maximum tolerated dose of oxaliplatin and fluorouracil when given with
leucovorin calcium and hepatic intra-arterial floxuridine and dexamethasone with or
without cryosurgery (group I cryosurgery closed to accrual as of 10/13/03) in patients
with unresectable liver metastases from colorectal cancer.
- Determine, preliminarily, the anti-tumor activity of this regimen in these patients.
OUTLINE: This is a dose-escalation study of oxaliplatin and fluorouracil. Patients are
assigned to one of two treatment groups. (Group I closed to accrual as of 10/13/03.)
- Group I (closed to accrual as of 10/13/03): Patients with no more than 8 hepatic
metastases and no metastases greater than 5 cm in diameter undergo cryosurgery prior to
chemotherapy. Chemotherapy is delayed for at least 4 weeks after cryosurgery.
- Group II: Patients with more than 8 hepatic metastases or at least one metastases
greater than 5 cm in diameter do not undergo cryosurgery prior to chemotherapy.
Beginning 2 weeks after pump placement surgery, all patients receive floxuridine and
dexamethasone by hepatic intra-arterial infusion continuously on days 1-14; oxaliplatin IV
over 2 hours and leucovorin calcium IV over 2 hours on days 15 and 29; and fluorouracil IV
continuously over 48 hours on days 15-16 and 29-30. Courses repeat every 36 days in the
absence of disease progression or unacceptable toxicity.
Cohorts of 3-6 patients receive escalating doses of oxaliplatin and fluorouracil until the
maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at
which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity.
PROJECTED ACCRUAL: Approximately 4-72 patients will be accrued for this study within 18
months.
;
Primary Purpose: Treatment
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