E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
locally advanced rectal cancer |
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MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 9.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10038049 |
E.1.2 | Term | Rectal cancer stage II |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 9.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10038050 |
E.1.2 | Term | Rectal cancer stage III |
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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 |
This phase II trial assesses the activity of bevacizumab (Avastin) in combination with capecitabine (Xeloda) and radiation therapy with or without oxaliplatin (Eloxatin) in the pre-operative treatment of locally advanced rectal cancer, followed by TME resection, in a multicenter setting. |
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E.2.2 | Secondary objectives of the trial |
Secondary endpoints are:
Histopathologic negative CRM resection rate Pathologic downstaging (yp T0-2 N0) rate Tumor regression grade (TRG) Clinical response rate (RECIST) at time of surgery Quality of mesorectal excision One month surgical complication rate Toxicity Loco-regional and distant recurrence rates Progression-free and overall survival.
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
• Patient is at least 18 years of age. • Patient’s body weight is ≤ 120 kg. • Histologically proven and evaluable (according to RECIST criteria) adenocarcinoma of the rectum (tumor ≤ 12 cm from the anal verge). • Patient is considered locally advanced by MRI; the following are eligible: Tumor beyond mesorectal fascia (T4) or Tumor ≤ 2 mm from mesorectal fascia or T3 tumor < 5 cm from anal verge
All radiology studies must be performed within 28 days prior to randomization. • WHO PS ≤ 2 • Adequate bone marrow, hepatic and renal function (assessed within 14 days prior to study entry) • INR ≤ 1.5 . • Ability to swallow tablets. • Presence of adequate contraception in fertile patients. Adequate methods of contraception are: intra-uterine device, hormonal contraception, condom use with spermicide. • Written informed consent must be given according to ICH/GCP and national/local regulations
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E.4 | Principal exclusion criteria |
• Evidence of distant metastases. • Prior chemotherapy or radiotherapy for rectal cancer. • Pregnant or breastfeeding women. • Presence of peripheral neuropathy > grade 1, according to CTCAE v3.0 • Presence of significant impairment of intestinal resorption (e.g. chronic diarrhea, inflammatory bowel disease). • History or presence of allergy or any other adverse reaction to any of the study drugs or to any related compound, including hypersensitivity to chinese hamster ovary cell products or other recombinant human or humanised antibodies. • Known dihydropyrimidine dehydrogenase (DPD) deficiency. • History of arterial thrombo-embolic events, including transient ischemic attack (TIA), cerebro-vascular accident (CVA), and myocardial infarction within 6 months prior to randomisation. Presence of clinically significant peripheral artery disease or hemorrhagic events. • Clinically significant (i.e. active) cardiac disease (e.g. congestive heart failure, symptomatic coronary artery disease and cardiac arrhythmia not well controlled with medication or history of myocardial infarction within the last 12 months. • Presence of uncontrolled hypertension (defined as a systolic blood pressure more than 140 mmHg and diastolic blood pressure more than 90 mmHg). If the patient is unaware of his/her blood pressure and hypertension is detected, a cardiologic check-up prior to inclusion in this trial is mandatory. • Treatment with full dose of anticoagulants (coumarine or heparin). Patients with prophylactic dose of low molecular weight heparin are eligible. • Major surgical procedure or significant traumatic injury within 28 days before day 1 or patients in whom a surgical wound is not fully healed • Presence of other uncontrolled concomitant illness, including serious uncontrolled intercurrent infection. • Previous or concurrent malignancies at other sites with the exception of surgically cured or adequately treated carcinoma in-situ of the cervix and non-melanoma skin cancer. • Presence of organ allografts requiring immunosuppressive therapy. • Requirement for concurrent use of the antiviral agent sorivudine or chemically related analogues, such as brivudine. Patients must be off these drugs for 4 weeks before enrollment. • History of uncontrolled seizures, central nervous system disorders or psychiatric disability judged by the investigator to be clinically significant precluding informed consent or interfering with compliance for oral drug intake. • Administration of any investigational drug or agent/procedure, i.e. participation in another trial within 4 weeks before beginning treatment with study drug. • Presence of any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule; those conditions should be discussed with the patient before registration in the trial.
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E.5 End points |
E.5.1 | Primary end point(s) |
Pathologic Complete Response Rate |
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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 | Yes |
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 | Information not present in EudraCT |
E.8.1.2 | Open | Information not present in EudraCT |
E.8.1.3 | Single blind | Information not present in EudraCT |
E.8.1.4 | Double blind | Information not present in EudraCT |
E.8.1.5 | Parallel group | Information not present in EudraCT |
E.8.1.6 | Cross over | Information not present in EudraCT |
E.8.1.7 | Other | Information not present in EudraCT |
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.8.3 |
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 | 10 |
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 | Information not present in EudraCT |
E.8.7 | Trial has a data monitoring committee | Yes |
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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– in the protocol. End of study is 30 days after surgery. If surgery is not performed, 30 days after the last treatment (chemoradiotherapy). |
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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 | 1 |
E.8.9.1 | In the Member State concerned months | 6 |
E.8.9.1 | In the Member State concerned days | |