Colorectal Cancer Clinical Trial
Official title:
Efficacy of Neoadjuvant XELOX/AVASTIN Therapy for Nonresectable Colorectal Liver Metastases With Secondary Hepatic Resection/Radiofrequency
RATIONALE: Drugs used in chemotherapy, such as oxaliplatin and capecitabine, work in
different ways to stop the growth of tumor cells, either by killing the cells or by stopping
them from dividing. Monoclonal antibodies, such as bevacizumab, 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. Bevacizumab may also
stop the growth of tumor cells by blocking blood flow to the tumor. Radiofrequency ablation
uses a high-frequency, electric current to kill tumor cells. Giving chemotherapy and
bevacizumab before surgery or radiofrequency ablation may make the tumor smaller and reduce
the amount of normal tissue that needs to be removed.
PURPOSE: This phase II trial is studying how well giving oxaliplatin and capecitabine
together with bevacizumab followed by surgery and/or radiofrequency ablation works in
treating patients with colorectal cancer that has spread to the liver and cannot be removed
by surgery.
OBJECTIVES:
Primary
- Evaluate the conversion rate of nonresectable disease to resectable disease in patients
with nonresectable liver metastases secondary to colorectal adenocarcinoma treated with
neoadjuvant therapy comprising oxaliplatin, capecitabine, and bevacizumab followed by
hepatic resection and/or radiofrequency ablation.
- Evaluate progression-free survival of patients treated with this regimen.
Secondary
- Determine disease-free and overall survival of patients treated with this regimen.
- Determine the toxicities of this regimen in these patients.
OUTLINE:
- Neoadjuvant therapy: Patients receive oxaliplatin IV over 2 hours and bevacizumab IV
over 1 hour on day 1 and oral capecitabine twice daily on days 1-14. Treatment repeats
every 3 weeks for 4-6 courses in the absence of disease progression or unacceptable
toxicity or until conversion to resectable disease.
- Surgery and/or radiofrequency ablation (RFA): Patients undergo hepatic resection (with
or without RFA) when tumor is deemed resectable. Patients with stable (< 8 lesions) and
unresectable disease undergo laparoscopic or percutaneous RFA. RFA repeats once 4-6
weeks later.
- Adjuvant therapy: Beginning 6-8 weeks after surgery and/or RFA, patients may receive
adjuvant therapy comprising oxaliplatin, capecitabine, and bevacizumab, as in
neoadjuvant therapy, for up to 4 courses.
After completion of study treatment, patients are followed every 4 months.
PROJECTED ACCRUAL: A total of 40 patients will be accrued for this study.
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