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    Clinical Trial Results:
    A phase II Trial to evaluate the efficacy and safety of Bevacizumab in combination with Capecitabine (Xeloda) in frail patients with untreated metastatic colorectal cancer

    Summary
    EudraCT number
    2007-002682-12
    Trial protocol
    IE  
    Global end of trial date
    16 Jan 2017

    Results information
    Results version number
    v1(current)
    This version publication date
    22 Apr 2018
    First version publication date
    22 Apr 2018
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    ICORG 06-11 TORI GI-04
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    -
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Cancer Trials Ireland
    Sponsor organisation address
    Innovation House, Old Finglas Road, Dublin, Ireland, D11 KXN4
    Public contact
    Anna Shevlin, Cancer Trials Ireland, anna.shevlin@cancertrials.ie
    Scientific contact
    Anna Shevlin, Cancer Trials Ireland, anna.shevlin@cancertrials.ie
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    30 Jan 2018
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    16 Jan 2017
    Global end of trial reached?
    Yes
    Global end of trial date
    16 Jan 2017
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    •To determine the anti-tumor activity of bevacizumab plus capecitabine based on time to disease progression •To evaluate the tolerability of bevacizumab plus capecitabine treatment in a patient population that is elderly or frail (poor performance)
    Protection of trial subjects
    This clinical study was designed, implemented, and reported in accordance with the International Conference on Harmonization (ICH) Harmonized Tripartite Guidelines for Good Clinical Practice (GCP), with applicable local regulations SI 190 of 2004 as amend and European Directive 2001/20/EC. The study was approved by the HPRA and SJH/AMNCH Research Ethics Committee.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    20 Oct 2008
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Ireland: 30
    Worldwide total number of subjects
    30
    EEA total number of subjects
    30
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    1
    From 65 to 84 years
    29
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    The first patient was enrolled in Oct 2008, 30 patients were recruited. The last patient was recruited Aug 2012.

    Pre-assignment
    Screening details
    The target population will be all ECOG 2 metastatic colorectal cancer patients who require chemotherapy but are deemed too frail by their oncologist to tolerate combination chemotherapy with either irinotecan or oxaliplatin.

    Period 1
    Period 1 title
    Overall trial (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    Overall trial
    Arm description
    Untreated metastatic colorectal cancer patients who require chemotherapy but are deemed too frail by their oncologist to tolerate combination chemotherapy with either irinotecan or oxaliplatin.
    Arm type
    Experimental

    Investigational medicinal product name
    Bevacizumab
    Investigational medicinal product code
    Other name
    Avastin
    Pharmaceutical forms
    Concentrate for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Bevacizumab 7.5 mg/kg IV will be administered every 3 weeks. Administration will be as a continuous IV infusion.

    Investigational medicinal product name
    Capecitabine
    Investigational medicinal product code
    Other name
    Xeloda
    Pharmaceutical forms
    Film-coated tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Xeloda will be given as standard of care. The dose of Xeloda that will be used in this study is 1000mg/m2 administered orally twice daily (morning and evening, equivalent to 2000mg/m2 per day) for 2 weeks followed by 1 week of rest period given as a 3 week cycles. Xeloda tablets should be swallowed with water within 30 minutes after a meal.

    Number of subjects in period 1
    Overall trial
    Started
    30
    Completed
    30

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Overall trial
    Reporting group description
    -

    Reporting group values
    Overall trial Total
    Number of subjects
    30 30
    Age categorical
    Units: Subjects
        In utero
    0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0
        Newborns (0-27 days)
    0 0
        Infants and toddlers (28 days-23 months)
    0 0
        Children (2-11 years)
    0 0
        Adolescents (12-17 years)
    0 0
        Adults (18-64 years)
    1 1
        From 65-84 years
    29 29
        85 years and over
    0 0
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    76.2 ( 5.1 ) -
    Gender categorical
    Units: Subjects
        Female
    12 12
        Male
    18 18
    Ethnic origin
    Units: Subjects
        Caucasian
    30 30

    End points

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    End points reporting groups
    Reporting group title
    Overall trial
    Reporting group description
    Untreated metastatic colorectal cancer patients who require chemotherapy but are deemed too frail by their oncologist to tolerate combination chemotherapy with either irinotecan or oxaliplatin.

    Primary: Progression-Free Survival

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    End point title
    Progression-Free Survival [1]
    End point description
    End point type
    Primary
    End point timeframe
    Time from registration to the first documented date of disease progression or death due to cancer.
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: The primary objective in this trial was to analyse progression free survival. Only 30/50 planned patients were enrolled in the Irish sites. Due to the reduced sample size, the original planned tests could not be carried out.
    End point values
    Overall trial
    Number of subjects analysed
    30
    Units: Months
        median (confidence interval 95%)
    7.6 (4.3 to 11.2)
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    November 2008 – November 2017 (9 years)
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    20.1
    Reporting groups
    Reporting group title
    Study population
    Reporting group description
    Untreated metastatic colorectal cancer patients who require chemotherapy but are deemed too frail by their oncologist to tolerate combination chemotherapy with either irinotecan or oxaliplatin.

    Serious adverse events
    Study population
    Total subjects affected by serious adverse events
         subjects affected / exposed
    20 / 30 (66.67%)
         number of deaths (all causes)
    29
         number of deaths resulting from adverse events
    0
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Colorectal cancer metastatic
         subjects affected / exposed
    1 / 30 (3.33%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Malignant neoplasm progression
         subjects affected / exposed
    1 / 30 (3.33%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Vascular disorders
    Hypotension
         subjects affected / exposed
    1 / 30 (3.33%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Thrombosis
         subjects affected / exposed
    1 / 30 (3.33%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Surgical and medical procedures
    Salpingo-oophorectomy bilateral
         subjects affected / exposed
    1 / 30 (3.33%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Pyrexia
         subjects affected / exposed
    2 / 30 (6.67%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Chest pain
         subjects affected / exposed
    1 / 30 (3.33%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Pain
         subjects affected / exposed
    1 / 30 (3.33%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Sudden death
         subjects affected / exposed
    1 / 30 (3.33%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Pulmonary embolism
         subjects affected / exposed
    3 / 30 (10.00%)
         occurrences causally related to treatment / all
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    Dyspnoea
         subjects affected / exposed
    1 / 30 (3.33%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Psychiatric disorders
    Confusional state
         subjects affected / exposed
    2 / 30 (6.67%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Depression
         subjects affected / exposed
    1 / 30 (3.33%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Injury, poisoning and procedural complications
    Overdose
         subjects affected / exposed
    2 / 30 (6.67%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Cardiac disorders
    Angina pectoris
         subjects affected / exposed
    1 / 30 (3.33%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Atrioventricular block first degree
         subjects affected / exposed
    1 / 30 (3.33%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Transient ischaemic attack
         subjects affected / exposed
    2 / 30 (6.67%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Haemorrhage intracranial
         subjects affected / exposed
    1 / 30 (3.33%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Lethargy
         subjects affected / exposed
    1 / 30 (3.33%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Neutropenia
         subjects affected / exposed
    1 / 30 (3.33%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Diarrhoea
         subjects affected / exposed
    3 / 30 (10.00%)
         occurrences causally related to treatment / all
    5 / 5
         deaths causally related to treatment / all
    0 / 0
    Abdominal hernia perforation
         subjects affected / exposed
    1 / 30 (3.33%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Abdominal pain
         subjects affected / exposed
    1 / 30 (3.33%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Constipation
         subjects affected / exposed
    1 / 30 (3.33%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorder
         subjects affected / exposed
    1 / 30 (3.33%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Rectal haemorrhage
         subjects affected / exposed
    1 / 30 (3.33%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Small intestinal obstruction
         subjects affected / exposed
    1 / 30 (3.33%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal and urinary disorders
    Renal impairment
         subjects affected / exposed
    1 / 30 (3.33%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Lower respiratory tract infection
         subjects affected / exposed
    5 / 30 (16.67%)
         occurrences causally related to treatment / all
    2 / 5
         deaths causally related to treatment / all
    0 / 0
    Cellulitis
         subjects affected / exposed
    1 / 30 (3.33%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Enteritis infectious
         subjects affected / exposed
    1 / 30 (3.33%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Infection
         subjects affected / exposed
    1 / 30 (3.33%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Upper respiratory tract infection
         subjects affected / exposed
    1 / 30 (3.33%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Metabolism and nutrition disorders
    Dehydration
         subjects affected / exposed
    1 / 30 (3.33%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hyperglycaemia
         subjects affected / exposed
    1 / 30 (3.33%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Study population
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    30 / 30 (100.00%)
    Vascular disorders
    Hypertension
         subjects affected / exposed
    4 / 30 (13.33%)
         occurrences all number
    5
    Hypotension
         subjects affected / exposed
    2 / 30 (6.67%)
         occurrences all number
    2
    General disorders and administration site conditions
    Fatigue
         subjects affected / exposed
    19 / 30 (63.33%)
         occurrences all number
    44
    Pyrexia
         subjects affected / exposed
    6 / 30 (20.00%)
         occurrences all number
    6
    Mucosal inflammation
         subjects affected / exposed
    6 / 30 (20.00%)
         occurrences all number
    7
    Pain
         subjects affected / exposed
    3 / 30 (10.00%)
         occurrences all number
    3
    Chest pain
         subjects affected / exposed
    2 / 30 (6.67%)
         occurrences all number
    2
    Injection site bruising
         subjects affected / exposed
    2 / 30 (6.67%)
         occurrences all number
    2
    Oedema peripheral
         subjects affected / exposed
    2 / 30 (6.67%)
         occurrences all number
    2
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    7 / 30 (23.33%)
         occurrences all number
    13
    Dyspnoea
         subjects affected / exposed
    5 / 30 (16.67%)
         occurrences all number
    6
    Dysphonia
         subjects affected / exposed
    4 / 30 (13.33%)
         occurrences all number
    8
    Epistaxis
         subjects affected / exposed
    4 / 30 (13.33%)
         occurrences all number
    7
    Rhinorrhoea
         subjects affected / exposed
    3 / 30 (10.00%)
         occurrences all number
    3
    Productive cough
         subjects affected / exposed
    2 / 30 (6.67%)
         occurrences all number
    2
    Wheezing
         subjects affected / exposed
    2 / 30 (6.67%)
         occurrences all number
    2
    Psychiatric disorders
    Insomnia
         subjects affected / exposed
    3 / 30 (10.00%)
         occurrences all number
    3
    Depressed mood
         subjects affected / exposed
    2 / 30 (6.67%)
         occurrences all number
    2
    Investigations
    Weight decreased
         subjects affected / exposed
    7 / 30 (23.33%)
         occurrences all number
    8
    Blood bilirubin increased
         subjects affected / exposed
    4 / 30 (13.33%)
         occurrences all number
    9
    Haemoglobin decreased
         subjects affected / exposed
    3 / 30 (10.00%)
         occurrences all number
    4
    Nervous system disorders
    Dysgeusia
         subjects affected / exposed
    4 / 30 (13.33%)
         occurrences all number
    4
    Dizziness
         subjects affected / exposed
    3 / 30 (10.00%)
         occurrences all number
    3
    Headache
         subjects affected / exposed
    3 / 30 (10.00%)
         occurrences all number
    3
    Hypoaesthesia
         subjects affected / exposed
    2 / 30 (6.67%)
         occurrences all number
    2
    Blood and lymphatic system disorders
    Neutropenia
         subjects affected / exposed
    3 / 30 (10.00%)
         occurrences all number
    4
    Eye disorders
    Lacrimation increased
         subjects affected / exposed
    6 / 30 (20.00%)
         occurrences all number
    6
    Eye pain
         subjects affected / exposed
    2 / 30 (6.67%)
         occurrences all number
    2
    Gastrointestinal disorders
    Diarrhoea
         subjects affected / exposed
    15 / 30 (50.00%)
         occurrences all number
    41
    Nausea
         subjects affected / exposed
    13 / 30 (43.33%)
         occurrences all number
    20
    Abdominal pain
         subjects affected / exposed
    9 / 30 (30.00%)
         occurrences all number
    18
    Constipation
         subjects affected / exposed
    9 / 30 (30.00%)
         occurrences all number
    14
    Vomiting
         subjects affected / exposed
    8 / 30 (26.67%)
         occurrences all number
    12
    Dyspepsia
         subjects affected / exposed
    3 / 30 (10.00%)
         occurrences all number
    3
    Stomatitis
         subjects affected / exposed
    3 / 30 (10.00%)
         occurrences all number
    10
    Gastrooesophageal reflux disease
         subjects affected / exposed
    2 / 30 (6.67%)
         occurrences all number
    2
    Mouth ulceration
         subjects affected / exposed
    2 / 30 (6.67%)
         occurrences all number
    2
    Tongue coated
         subjects affected / exposed
    2 / 30 (6.67%)
         occurrences all number
    2
    Toothache
         subjects affected / exposed
    2 / 30 (6.67%)
         occurrences all number
    4
    Skin and subcutaneous tissue disorders
    Palmar-plantar erythrodysaesthesia syndrome
         subjects affected / exposed
    15 / 30 (50.00%)
         occurrences all number
    41
    Rash
         subjects affected / exposed
    5 / 30 (16.67%)
         occurrences all number
    6
    Dry skin
         subjects affected / exposed
    3 / 30 (10.00%)
         occurrences all number
    3
    Pruritus
         subjects affected / exposed
    3 / 30 (10.00%)
         occurrences all number
    3
    Alopecia
         subjects affected / exposed
    2 / 30 (6.67%)
         occurrences all number
    5
    Dermatitis acneiform
         subjects affected / exposed
    2 / 30 (6.67%)
         occurrences all number
    3
    Laceration
         subjects affected / exposed
    2 / 30 (6.67%)
         occurrences all number
    2
    Renal and urinary disorders
    Proteinuria
         subjects affected / exposed
    3 / 30 (10.00%)
         occurrences all number
    3
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    7 / 30 (23.33%)
         occurrences all number
    9
    Arthralgia
         subjects affected / exposed
    5 / 30 (16.67%)
         occurrences all number
    7
    Pain in extremity
         subjects affected / exposed
    4 / 30 (13.33%)
         occurrences all number
    6
    Neck pain
         subjects affected / exposed
    3 / 30 (10.00%)
         occurrences all number
    3
    Muscular weakness
         subjects affected / exposed
    2 / 30 (6.67%)
         occurrences all number
    2
    Musculoskeletal pain
         subjects affected / exposed
    2 / 30 (6.67%)
         occurrences all number
    2
    Infections and infestations
    Lower respiratory tract infection
         subjects affected / exposed
    6 / 30 (20.00%)
         occurrences all number
    7
    Urinary tract infection
         subjects affected / exposed
    5 / 30 (16.67%)
         occurrences all number
    5
    Infection
         subjects affected / exposed
    3 / 30 (10.00%)
         occurrences all number
    3
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    9 / 30 (30.00%)
         occurrences all number
    21
    Dehydration
         subjects affected / exposed
    2 / 30 (6.67%)
         occurrences all number
    2

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    11 Dec 2007
    Amendment #3 First version of the protocol applicable to Ireland
    01 Apr 2008
    Amendment #4: Modifications have been made to comply with HPRA requirements, ICH-GCP guidelines and to reflect procedures relevant to the Irish setting. Study medication, safety reporting of adverse events, retention of records and accrual target revised. Addition of: Study Schema, Study Synopsis, Investigator’s Agreement, List of Abbreviations and Appendices.
    01 Jul 2008
    Amendment #5: Changes to study flow chart, evaluations during treatment and frailty markers.
    25 Nov 2008
    Amendment #6: Inclusion criteria, sample collection section and section 6.1.3 Bevacizumab Dose Modification and Toxicity Management updated. Addition of section 7.4 Follow-up. Administrative changes throughout the protocol.
    20 Aug 2009
    Amendment #7: Protocol updated and re-formatted to reflect updated Sponsor procedures. The translational sub-study, study medications, patient enrollment and safety sections and appendices were updated. Site Withdrawals/Change of PI added.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    The primary objective in this trial was to analyse progression free survival. Only 30/50 planned patients were enrolled in the Irish sites. Due to the reduced sample size, the original planned tests could not be carried out.
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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