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    Clinical Trial Results:
    Phase II multicentre non-randomised trial investigating the impact of radio-chemotherapy (65 Gy + cisplatin + 5FU) in combination with cetuximab in patients with locally advanced anal cancer.

    Summary
    EudraCT number
    2007-007029-38
    Trial protocol
    FR  
    Global end of trial date
    04 May 2014

    Results information
    Results version number
    v1(current)
    This version publication date
    05 Jan 2025
    First version publication date
    05 Jan 2025
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    ACCORD 16 / 0708
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    -
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    UNICANCER
    Sponsor organisation address
    101 rue de Tolbiac , Paris, France, 75015
    Public contact
    Nourredine AIT RAHMOUNE, UNICANCER, 33 0171936704, n.ait-rahmoune@unicancer.fr
    Scientific contact
    Nourredine AIT RAHMOUNE, UNICANCER, 33 0171936704, n.ait-rahmoune@unicancer.fr
    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
    13 Apr 2012
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    04 May 2014
    Was the trial ended prematurely?
    Yes
    General information about the trial
    Main objective of the trial
    To evaluate the objective responserate (complete and partial response) 8 weeks after the end of treatment (radio-chemotherapy + anti-EGFR + adjuvant radiotherapy) in locally advanced anal cancer.
    Protection of trial subjects
    To assess the objective tumour response (complete and partial response) 8 weeks after the end of treatment (radio-chemotherapy + anti-EGFR + adjuvant radiotherapy) in locally advanced anal cancer.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    01 Apr 2009
    Long term follow-up planned
    Yes
    Long term follow-up rationale
    Efficacy, Safety
    Long term follow-up duration
    4 Years
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    France: 16
    Worldwide total number of subjects
    16
    EEA total number of subjects
    16
    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)
    15
    From 65 to 84 years
    1
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Recruitment only in France, Date of first inclusion: 01-Apr-2009 Date of last inclusion: 03-May-2010

    Pre-assignment
    Screening details
    All men and women 18-80 years with an histologically confirmed anal cancer, squamous cell disease, locally advanced non metastatic disease.

    Period 1
    Period 1 title
    Overall periode
    Is this the baseline period?
    Yes
    Allocation method
    Non-randomised - controlled
    Blinding used
    Not blinded

    Arms
    Arm title
    Radiochemotherapy+ cetuximab
    Arm description
    Only one arm in this trial Treatments: 65 GY+ CISPLATINUM+5FU+CETUXIMAB
    Arm type
    Experimental

    Investigational medicinal product name
    CETUXIMAB
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Patients received cetuximab IV 400 mg/m² on day 0 and 250 mg/m² on day 7, 14, 21, 28 and 35.

    Investigational medicinal product name
    5-Fluorouracil
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Infusion
    Dosage and administration details
    The patients received 5FU IV (800 mg/m²/d decreased to 600 mg/m²/d after amandment) on day 7-10 and 35-38.

    Investigational medicinal product name
    Cisplatin
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    The patients received Cisplatin IV 80 mg/m² over 2 hours on days 7 and 35.

    Number of subjects in period 1
    Radiochemotherapy+ cetuximab
    Started
    16
    Completed
    5
    Not completed
    11
         Consent withdrawn by subject
    2
         medication error
    1
         Toxicity
    8

    Baseline characteristics

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

    Reporting group values
    Overall periode Total
    Number of subjects
    16 16
    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)
    15 15
        From 65-84 years
    1 1
        85 years and over
    0 0
    Gender categorical
    Units: Subjects
        Female
    14 14
        Male
    2 2
    Performance status
    Units: Subjects
        Performance status 0
    13 13
        Performance status 1
    3 3
    T Stage
    Units: Subjects
        T1
    1 1
        T2
    4 4
        T3
    6 6
        T4
    5 5
    N Stage
    Units: Subjects
        N0
    3 3
        N1
    5 5
        N2
    5 5
        N+
    3 3
    M Stage
    Units: Subjects
        M0
    16 16
    Histological type
    Units: Subjects
        Well differenciated
    7 7
        Moderate differenciated
    2 2
        Poorly differenciated
    5 5
        Without further information
    2 2

    End points

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    End points reporting groups
    Reporting group title
    Radiochemotherapy+ cetuximab
    Reporting group description
    Only one arm in this trial Treatments: 65 GY+ CISPLATINUM+5FU+CETUXIMAB

    Primary: Tumoral response rate

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    End point title
    Tumoral response rate [1]
    End point description
    The primary endpoint was the clinical benefit rate (CBR) defined as the percentage of patients who had a complete response (CR), partial response, or stable disease (SD), 8 weeks after the end of study treatment.comrising radiotheray , chemotheray and cetumaximab followed by additional radiotherapy, according to the RECIST criteria.
    End point type
    Primary
    End point timeframe
    8 weeks after the end of study treatment.
    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: No statiscal analyses for the primary end point.
    End point values
    Radiochemotherapy+ cetuximab
    Number of subjects analysed
    16
    Units: Number
        Complete response
    6
        Partial response
    4
        Stable disease
    0
        Progressive disease
    1
        Non evaluable
    5
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Reporting from the signing of the 1st consent form, until 30 days following the last administration of the experimental treatment
    Adverse event reporting additional description
    For non-serious adverse events, the number of occurrences were not recorded, the number of patient affected were the only value available. Thus, the number of patient affected was entered in both "Subjects affected number" and "Occurrence all number" fields.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    11
    Reporting groups
    Reporting group title
    all patients
    Reporting group description
    -

    Serious adverse events
    all patients
    Total subjects affected by serious adverse events
         subjects affected / exposed
    12 / 16 (75.00%)
         number of deaths (all causes)
    3
         number of deaths resulting from adverse events
    0
    Injury, poisoning and procedural complications
    Anal injury
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Radiation injury
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Headache
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Febrile aplasia
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Febrile neutropenia
         subjects affected / exposed
    2 / 16 (12.50%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Lymphopenia
         subjects affected / exposed
    2 / 16 (12.50%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Neutropenia
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Thrombopenia
         subjects affected / exposed
    2 / 16 (12.50%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    General physical health deterioration
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Diarrhoea
         subjects affected / exposed
    2 / 16 (12.50%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Diarrhoea of presumed infectious origin
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Fistula involving female genital tract
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Hemorrhage rectal
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal and urinary disorders
    Renal failure acute
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Meningitis
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Perineal infection
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Sepsis
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Metabolism and nutrition disorders
    Potassium deficiency
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 1%
    Non-serious adverse events
    all patients
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    15 / 16 (93.75%)
    Investigations
    Gamma-glutamyltransferase
         subjects affected / exposed
    4 / 16 (25.00%)
         occurrences all number
    4
    Potassium
         subjects affected / exposed
    6 / 16 (37.50%)
         occurrences all number
    6
    Calcium
         subjects affected / exposed
    6 / 16 (37.50%)
         occurrences all number
    6
    Sodium
         subjects affected / exposed
    7 / 16 (43.75%)
         occurrences all number
    7
    Albumin
         subjects affected / exposed
    4 / 16 (25.00%)
         occurrences all number
    4
    General disorders and administration site conditions
    Fatigue
         subjects affected / exposed
    11 / 16 (68.75%)
         occurrences all number
    11
    Fever
         subjects affected / exposed
    2 / 16 (12.50%)
         occurrences all number
    2
    Weight loss
         subjects affected / exposed
    3 / 16 (18.75%)
         occurrences all number
    3
    Anorexia
         subjects affected / exposed
    4 / 16 (25.00%)
         occurrences all number
    4
    Epithelitis
         subjects affected / exposed
    10 / 16 (62.50%)
         occurrences all number
    10
    Blood and lymphatic system disorders
    Hemoglobin
         subjects affected / exposed
    12 / 16 (75.00%)
         occurrences all number
    12
    Neutrophils
         subjects affected / exposed
    8 / 16 (50.00%)
         occurrences all number
    8
    Platelets
         subjects affected / exposed
    10 / 16 (62.50%)
         occurrences all number
    10
    Lymphocyte
         subjects affected / exposed
    9 / 16 (56.25%)
         occurrences all number
    9
    Gastrointestinal disorders
    Mucitis
         subjects affected / exposed
    4 / 16 (25.00%)
         occurrences all number
    4
    Vomiting
         subjects affected / exposed
    9 / 16 (56.25%)
         occurrences all number
    9
    Rectorrhagia
         subjects affected / exposed
    2 / 16 (12.50%)
         occurrences all number
    2
    Hemorrhoidal seizure
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Anal incontinence
         subjects affected / exposed
    2 / 16 (12.50%)
         occurrences all number
    2
    Diarrhoea
         subjects affected / exposed
    9 / 16 (56.25%)
         occurrences all number
    9
    Constipation
         subjects affected / exposed
    7 / 16 (43.75%)
         occurrences all number
    7
    Proctitis
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Gastrointestinal pain
         subjects affected / exposed
    9 / 16 (56.25%)
         occurrences all number
    9
    Skin and subcutaneous tissue disorders
    Skin dryness
         subjects affected / exposed
    2 / 16 (12.50%)
         occurrences all number
    2
    Skin eruption
         subjects affected / exposed
    4 / 16 (25.00%)
         occurrences all number
    4
    Hand and foot syndrome
         subjects affected / exposed
    2 / 16 (12.50%)
         occurrences all number
    2
    Rash acneiform
         subjects affected / exposed
    12 / 16 (75.00%)
         occurrences all number
    12
    Pruritis
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Pruritic rash
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Radiodermatitis
         subjects affected / exposed
    5 / 16 (31.25%)
         occurrences all number
    5
    Acne
         subjects affected / exposed
    4 / 16 (25.00%)
         occurrences all number
    4
    Renal and urinary disorders
    Creatinine
         subjects affected / exposed
    3 / 16 (18.75%)
         occurrences all number
    3
    Dysuria
         subjects affected / exposed
    3 / 16 (18.75%)
         occurrences all number
    3
    Pollakiuria
         subjects affected / exposed
    2 / 16 (12.50%)
         occurrences all number
    2
    Cystitis/Urethritis
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Urinary burning
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Infections and infestations
    Neutropenia
         subjects affected / exposed
    3 / 16 (18.75%)
         occurrences all number
    3
    Localized infection
         subjects affected / exposed
    2 / 16 (12.50%)
         occurrences all number
    2
    Anitis
         subjects affected / exposed
    5 / 16 (31.25%)
         occurrences all number
    5

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    05 Dec 2008
    - Correction of an error concerning the dosage for Cetuximab 5 mg/ml: The dosage at 400 mg/m² corresponds to 80 ml/m² and not 200 ml/m². The dosage of 250 mg/m² corresponds to 50 ml/m² and not 125 ml/m². - Clarification regarding renal or neurological toxicity of Cisplatin - In the information note, it is added that premedication with corticosteroids is necessary with monoclonal antibodies. - Information concerning cetuximab 5mg/ml treatment was added: Initially the formulation to be used was 5mg/ml No HT. However, the treatment used will be cetuximab HT, i.e. the one with marketing authorisation. - Investigators’ list update
    23 Jan 2009
    - Investigators’ list update.
    15 Jun 2009
    - Investigators’ list updated
    30 Jul 2009
    - Modification of the method of administration of 5FU - Clarification of the inclusion criterea 1 - Clarification about the administration of Cetuximab if radiotherapy is stopped - The investigators list update - Information file and consent form modification
    24 Aug 2009
    - All inclusion suspended: Following the abnormal occurrence of major toxicities (grade 4 neutropenia, grade 4 thrombocytopenia, grade 3 febrile aplasia) qualified as SUSARs for patients n°01 and n°03, it was decided on 30 July 2009 between the Sponsor, the coordinating investigator and the investigators in charge of patients n°1 and n°3 to suspend inclusion in the trial. A 3 SUSAR concerning patient n°5 was notified on 06 August 2009. -Investigators' list updated
    18 Dec 2009
    - Request for resumption of inclusions: 6 New patients were included despite of 10 planned. - Protocol modification: Reduction in the 5 FU dose from 800 mg/m²/d to 600 mg/m²/d - Modification of the Cetuximab file reference ( SmPC will replace BI) - Re-opening of the first inclusion centres and evaluation of toxicity in the next 10 patients included. - The investigators' list updated
    19 Oct 2010
    - All inculsions suspended on 05-May-2010. - The investigators' list updated
    07 Jun 2011
    -Permanent suspension of the inclusions following the IDMC conducted on 26 November 2010.
    10 Jan 2012
    - Amendment to information in the CT application form - Amendment to the protocol - change of sponsor’s name

    Interruptions (globally)

    Were there any global interruptions to the trial? Yes
    Date
    Interruption
    Restart date
    26 Nov 2010
    The IDMC decided to stop the trial after reviewing the data of the fist 16 patients for a high rate of toxicity and an insufficient efficacy. 5FU+cisplatinum+cetuximab is not recommended combined with RT even in case ol locally advenced disease.
    -

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
    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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