E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Patients with inoperable locally advanced or metastatic colorectal cancer, who have not previosly received systemic treatment for metastatic disease. |
Pazienti con carcinoma colorettale primario localmente avanzato non operabile, o metastatico, non pretrattati per malattia metastatica. |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 14.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10061451 |
E.1.2 | Term | Colorectal cancer |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To assess the preliminary antitumor activity in terms of overall response rate (complete and partial responses) of the combination of bevacizumab and capecitabine plus oxaliplatin in patients with advanced colorectal cancer. |
Determinare il tasso globale di risposte obiettive (complete e parziali) in pazienti con carcinoma colorettale avanzato trattati con bevacizumab e capecitabina piu' oxaliplatino. |
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E.2.2 | Secondary objectives of the trial |
To evaluate toxicity and the safety profile of the combination To evaluate duration of response (DR), time to progression (TTP), time to treatment failure (TTF), and overall survival (OS) at the end of the study. |
Valutare il profilo di tossicita` e di safety di bevacizumab e capecitabina piu` oxaliplatino.Valutare la durata delle risposte (DR),il tempo alla progressione (TTP),il tempo al fallimento terapeutico (TTF),e la sopravvivenza globale fino al termine dello studio. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Histologically or cytologically proven diagnosis of colorectal cancer 2. Locally advanced or metastatic colorectal cancer not previously treated with chemotherapy for metastatic disease 3. Age >= 18 4. ECOG Performance Status 0-1 5. Life expectancy of at least 12 weeks 6. Measurable and/or evaluable lesions according to RECIST criteria 7. Laboratory requirements: Neutrophils >= 1.5 x 109/L and Platelets >= 100 x 109/L Total bilirubin <= 1.5 time the upper-normal limits (UNL) of the Institutional normal values and ASAT (SGOT) and/or ALAT (SGPT) <= 2.5 x UNL, or <= 5 x UNL in case of liver metastases, alkaline phosphatase <= 2.5 x UNL, <= 5 x UNL in case of liver metastases. Creatinine clearance >50 mL/min or serum creatinine <= 1.5 x UNL Urine dipstick of proteinuria <2+. Patients discovered to have >= 2+ proteinuria on dipstick urinalysis at baseline, should undergo a 24-hour urine collection and must demonstrate <= 1 g of protein/24 hr. 8. Written informed consent. 9. Patients must be accessible for treatment and follow up. Patients registered on this trial must be treated and followed at the participating Center. |
1. Pazienti con diagnosi confermata istologicamente o citologicamente di carcinoma colorettale, 2. Pazienti con malattia localmente avanzata, non operabile, o metastatica, non pretrattati con chemioterapia per la malattia metastatica. 3. Eta` >= 18 anni 4. Performance Status ECOG 0-1 5. Attesa di vita di almeno 12 settimane 6. Lesioni misurabili e/o valutabili secondo i criteri RECIST 7. Parametri di Laboratorio: Neutrofili >= 1.5 x 109/L e Piastrine >= 100 x 109/L Bilirubina totale <= 1.5 il limite superiore normale (LSN) del range dei valori normali del Centro e ASAT (SGOT) e/o ALAT (SGPT) <= 2.5 x LSN, o <= 5 x LSN in caso di metastasi epatiche, fosfatasi alcalina <= 2.5 x UNL, <= 5 x LSN in caso di metastasi epatiche, <= 10 x LSN in caso di metastasi ossee. Clearance della Creatinina >50 mL/min o creatinina serica <=1.5 x LSN) Proteinuria (dipstick) <2+. Pazienti con proteinuria >= 2+ al basale, devono sottoporsi a raccolta urine di 24 ore e devono avere <= 1 g di proteine/24 ore. 8. Consenso Informato scritto. 9. Accessibilita` geografica per il trattamento e follow up. Pazienti arruolati in questo studio devono essere trattati e seguiti nel Centro partecipante. |
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E.4 | Principal exclusion criteria |
1. Radiotherapy to any site within 4 weeks before the study. 2. Untreated brain metastases or spinal cord compression or primary brain tumours. 3. History or evidence upon physical examination of CNS disease unless adequately treated (e.g., seizure not controlled with standard medical therapy or history of stroke). 4. History of inflammatory bowel disease and/or acute/subacute bowel occlusion. 5. Serious, non-healing wound, ulcer, or bone fracture. 6. Evidence of bleeding diathesis or coagulopathy. 7. Uncontrolled hypertension. 8. Clinically significant (i.e. active) cardiovascular disease for example cerebrovascular accidents (≤6 months), myocardial infarction (≤ 6 months), unstable angina, New York Heart Association (NYHA) grade II or greater congestive heart failure, serious cardiac arrhythmia requiring medication. 9. Current or recent (within 10 days prior to study treatment start) ongoing treatment with anticoagulants for therapeutic purposes. 10. Chronic, daily treatment with high-dose aspirin (>325 mg/day). 11. Treatment with any investigational drug within 30 days prior to enrolment. 12. Patients with known allergy to Chinese hamster ovary cell proteins, or any of the components of the study medications. 13. Other co-existing malignancies or malignancies diagnosed within the last 5 years with the exception of basal and squamous cell carcinoma or cervical cancer in situ. 14. Major surgical procedure, open biopsy, or significant traumatic injury within 28 days prior to study treatment start, or anticipation of the need for major surgical procedure during the course of the study. 15. Lack of physical integrity of the upper gastrointestinal tract, malabsorption syndrome, or inability to take oral medication. 16. Pregnant or lactating women. Women of childbearing potential with either a positive or no pregnancy test at baseline. Postmenopausal women must have been amenorrheic for at least 12 months to be considered of non-childbearing potential. Sexually active males and females (of childbearing potential) unwilling to practice contraception during the study. 17. Symptomatic peripheral neuropathy ≥grade 1 according the NCI Common Toxicity Criteria. |
1. Radioterapia su qualsiasi sede nelle precedenti 4 settimane. 2. Metastasi cerebrali sintomatiche e/o instabili o metastasi leptomeningee che richiedono trattamento. 3. Anamnesi o evidenza clinica di malattia al Sistema Nervoso Centrale (SNC) a meno che non sia adeguatamente trattata (es. crisi non controllata con una terapia medica standard oppure anamnesi di infarto) 4. Storia di malattia infiammatoria intestinale e/o occlusione intestinale acuta/subacuta. 5. Ulcera, ferita non rimarginata grave o frattura ossea. 6. Evidenza di diatesi emorragica o coagulopatia. 7. Ipertensione non controllata. 8. Malattia cardiovascolare clinicamente significativa (attiva): per esempio, accidente cerebrovascolare (≤6 mesi), infarto miocardico (≤6 mesi), angina instabile, insufficienza cardiaca congestizia di grado II o maggiore secondo la New York Heart Association (NYHA), aritmia cardiaca grave che richiede trattamento. 9. Trattamento recente (nei 10 giorni precedenti l`inizio del trattamento) o in corso con anticoagulanti somministrati a scopo terapeutico. 10. Trattamento cronico, giornaliero, con aspirina ad alte dosi (>325 mg/die) o con altri farmaci che possano predisporre all`ulcera gastroinestinale. 11. Trattamento con qualsiasi farmaco sperimentale nei 30 giorni precedenti l`arruolamento. 12. Pazienti con allergia confermata alle proteine delle cellule ovariche di criceto cinese, o a uno qualsiasi dei componenti dei farmaci dello studio. 13. Altre concomitanti patologie neoplastiche diagnosticate negli ultimi 5 anni con l`eccezione del carcinoma basocellulare e del carcinoma cervicale in situ. 14. Intervento di chirurgia maggiore, biopsia a cielo aperto, o lesione traumatica significativa nei 28 giorni precedenti l`inizio del trattamento, o previsione della necessita` di un intervento di chirurgia maggiore durante il corso dello studio. 15. Assenza di integrita` fisica del tratto gastrointestinale superiore, sindrome da malassorbimento, o inabilita` ad assumere farmaci orali. 16. Donna in gravidanza o in allattamento. Donna senza test di gravidanza o con un test di gravidanza positivo al basale. La donna in postmenopausa e` considerata non fertile se amenorroica da almeno 12 mesi. Donne e maschi sessulamente attivi (o potenzialmente fertili) che non praticano un metodo contraccettivo durante lo studio. 17. Neuropatia periferica di grado ≥1 secondo i criteri di valutazione della tossicita` del NCI. |
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E.5 End points |
E.5.1 | Primary end point(s) |
- Complete remission (CR): complete disappearance of all previously detectable disease for a period of at least 28 days, and no new lesions. - Adverse events, laboratory parameters. All toxicity will be graded using the NCI common toxicity criteria version 3.0. |
- Remissione completa (CR): scomparsa completa della malattia precedentemente rilevabile per un periodo di almeno 28 giorni e assenza di nuove lesioni. - Eventi avversi, parametri di Laboratorio. Tutti gli eventi avversi saranno classificati usando i criteri di valutazione della tossicita` del NCI, versione 3.0. |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | Yes |
E.8.1.7.1 | Other trial design description |
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E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Information not present in EudraCT |
E.8.2.2 | Placebo | Information not present in EudraCT |
E.8.2.3 | Other | Information not present in EudraCT |
E.8.2.4 | Number of treatment arms in the trial | 1 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 8 |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 5 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |