Liver Metastases Clinical Trial
Official title:
A Phase II Trial of Radioimmunotherapy (Y-90 M5A) Following Hepatic Resection and FOLFIRI or FOLFOX Chemotherapy [+/-BEVACIZUMAB], or Xelox for Metastatic Colorectal Carcinoma to the Liver
This phase II trial studies how well giving combination chemotherapy and bevacizumab before surgery and radiolabeled monoclonal antibody therapy works in treating liver metastases in patients with metastatic colorectal cancer. Drugs used in chemotherapy, such as leucovorin calcium, fluorouracil, and oxaliplatin (FOLFOX), 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 to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Radiolabeled monoclonal antibodies, such as yttrium Y 90 DOTA anti-CEA monoclonal antibody M5A, can find tumor cells and carry tumor-killing substances to them without harming normal cells. Giving chemotherapy and monoclonal antibody before surgery may make the tumor smaller and reduce the amount of normal tissue that needs to be removed. Giving radiolabeled monoclonal antibody therapy after surgery may kill any tumor cells that remain after surgery
PRIMARY OBJECTIVES:
I. To determine the progression free survival in colorectal cancer patients after hepatic
resection of liver metastases and FOLFOX or leucovorin calcium, fluorouracil, and irinotecan
hydrochloride (FOLFIRI) chemotherapy [+/- Bevacizumab], or capecitabine and oxaliplatin
(XELOX),followed by intravenous (IV) yttrium-90 (90Y) M5A anti-CEA antibody.
SECONDARY OBJECTIVES:
I. To study the feasibility and toxicities of such adjuvant therapy following resection
and/or ablation of liver metastases and FOLFOX chemotherapy.
II. To evaluate the biodistribution, clearance and metabolism of 90Y and 111In (indium-111)
M5A administered IV.
OUTLINE:
FOLFOX* + BEVACIZUMAB CHEMOTHERAPY: Patients receive oxaliplatin IV over 2 hours, leucovorin
calcium IV over 2 hours, fluorouracil IV continuously over 46-48 hours, and bevacizumab IV
over 30-90 minutes. Treatment repeats for up to 12 courses in the absence of disease
progression or unacceptable toxicity.
RADIOIMMUNOTHERAPY (RIT): Within 4-12 weeks after completion of post-hepatic resection
therapy chemotherapy, patients receive yttrium Y 90 DOTA anti-CEA monoclonal antibody M5A IV
over 25 minutes. Treatment repeats every 6-10 weeks for 2 courses in the absence of disease
progression or unacceptable toxicity.
NOTE:*Patients previously failing oxaliplatin regimen receive FOLIFIRI chemotherapy
comprising irinotecan hydrochloride IV over 90 minutes, leucovorin calcium over 2 hours,
fluorouracil IV continuously over 46-48 hours, and bevacizumab IV over 30-90 minutes.
Treatment repeats for up to 6 courses in the absence of disease progression or unacceptable
toxicity.
After completion of study treatment, patients are followed up at 3 and 6 months.
;
Allocation: Non-Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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