500 Boylston Street, Boston, MA 02116 617-419-4700
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RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing
so they stop growing or die. Combining more than one drug may kill more tumor cells. It is
not yet known which regimen of combination chemotherapy is most effective in treating
advanced colorectal cancer.
PURPOSE: Randomized phase III trial to compare the effectiveness of various combination
chemotherapy regimens in treating patients who have advanced, recurrent, or metastatic
colorectal cancer that cannot be treated with surgery or radiation therapy.
Ages:18 and older
DISEASE CHARACTERISTICS: - Histologically or cytologically confirmed locally advanced, locally recurrent, or metastatic colorectal adenocarcinoma not curable by surgery or radiotherapy - Histological or cytological requirement waived in patients who developed radiological or clinical evidence of metastatic cancer after a prior surgical resection unless: - More than 5 years has elapsed since primary surgery OR - Primary cancer was stage I or II - Site of primary lesion must be or have been confirmed endoscopically, radiologically, or surgically to be or have been in the large bowel - Measurable or evaluable disease - No CNS metastases or carcinomatous meningitis PATIENT CHARACTERISTICS: Age: - 18 and over Performance status: - ECOG 0-2 Life expectancy: - At least 12 weeks Hematopoietic: - Absolute granulocyte count at least 1,500/mm^3 - Platelet count at least 100,000/mm^3 - Hemoglobin at least 9.0 g/dL (transfusion allowed) Hepatic: - Bilirubin no greater than 1.5 mg/dL - AST no greater than 5 times upper limit of normal (ULN) - Alkaline phosphatase no greater than 5 times ULN Renal: - Creatinine no greater than 1.5 times ULN Cardiovascular: - No uncontrolled hypertension - No unstable angina - No symptomatic congestive heart failure - No myocardial infarction within the past 6 months - No serious uncontrolled arrhythmia - No New York Heart Association class III or IV cardiac disease Pulmonary: - No interstitial pneumonia or extensive and symptomatic interstitial fibrosis of the lung - No pleural effusion or ascites that cause respiratory compromise (grade 2 or worse dyspnea) Other: - Not pregnant or nursing - Negative pregnancy test - Fertile patients must use effective contraception - No active or uncontrolled infection - No symptomatic sensory peripheral neuropathy - No known allergy to platinum compounds - No history of gastrointestinal bleeding unless it is determined to be acceptable by the enrolling physician - No other prior or concurrent malignancy within the past 3 years except nonmelanoma skin cancer, carcinoma in situ of the uterine cervix, or other resected malignant tumor with less than a 10% probability of tumor relapse within 3 years of diagnosis - No medical or psychiatric conditions that would preclude study - No colonic or small bowel disorders with uncontrolled symptoms of more than 3 loose stools per day - Colostomy or ileostomy allowed at investigator's discretion PRIOR CONCURRENT THERAPY: Biologic therapy: - Prior adjuvant immunotherapy for resected stage II-IV disease allowed if adjuvant therapy concluded at least 1 year before documentation of recurrent disease - No concurrent sargramostim (GM-CSF) Chemotherapy: - No prior chemotherapy for advanced colorectal cancer - No prior standard adjuvant chemotherapy for rectal cancer - Prior adjuvant fluorouracil for resected stage II-IV disease allowed if adjuvant therapy concluded at least 1 year before documentation of recurrent disease Endocrine therapy: - Not specified Radiotherapy: - See Disease Characteristics - At least 4 weeks since prior major radiotherapy (e.g., chest or bone palliative radiotherapy) - No prior radiotherapy to more than 15% of bone marrow - No prior standard adjuvant radiotherapy for rectal cancer Surgery: - See Disease Characteristics - At least 4 weeks since prior major surgery (e.g., laparotomy) (2 weeks for minor surgery) and recovered - Insertion of a vascular access device not considered major or minor surgery Other: - No other concurrent investigational agents
Sponsor: North Central Cancer Treatment Group
Phase: Phase 3
Trial ID: NCT00003594
Not Accepting Healthy Volunteers