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Last Modified: 12/26/2007     First Published: 4/23/2003  
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Phase I Adjuvant Study of Hepatic Arterial Infusion of Floxuridine and Dexamethasone in Combination With Intravenous Oxaliplatin, Fluorouracil, and Leucovorin Calcium in Patients With Resectable Hepatic Metastases Secondary to Colorectal Adenocarcinoma

Alternate Title
Basic Trial Information
Objectives
Entry Criteria
Expected Enrollment
Outcomes
Outline
Trial Contact Information
Registry Information

Alternate Title

Adjuvant Hepatic Arterial Infusion and Combination Chemotherapy in Treating Patients With Resectable Hepatic Metastases From Colorectal Cancer

Basic Trial Information

Phase
Type
Status
Age
Sponsor
Protocol IDs

Phase I


Treatment


Active


18 and over


NCI


MSKCC-03005
NCT00059930

Objectives

  1. Determine the maximum tolerated dose of intravenous oxaliplatin and fluorouracil when administered with leucovorin calcium in combination with hepatic arterial infusion of floxuridine and dexamethasone in patients with resectable hepatic metastases secondary to colorectal adenocarcinoma.
  2. Correlate thymidylate synthase, dihydropyrimidine dehydrogenase, and excision repair cross-complementing genes in normal and tumor liver tissue with survival and recurrence in patients treated with this regimen.

Entry Criteria

Disease Characteristics:

  • Histologically confirmed colorectal adenocarcinoma metastatic to the liver
    • No clinical or radiographic evidence of extrahepatic disease


  • Potentially completely resectable hepatic metastases without current evidence of other metastatic disease


  • No ascites


Prior/Concurrent Therapy:

Biologic therapy

  • Not specified

Chemotherapy

  • At least 3 weeks since prior chemotherapy
  • No prior oxaliplatin
  • No prior cisplatin
  • No prior hepatic arterial infusion of floxuridine

Endocrine therapy

  • Not specified

Radiotherapy

  • At least 4 weeks since prior radiotherapy to the pelvis
  • No prior radiotherapy to the liver

Surgery

  • Not specified

Patient Characteristics:

Age

  • 18 and over

Performance status

  • Karnofsky 60-100%

Life expectancy

  • Not specified

Hematopoietic

  • WBC at least 3,000/mm3
  • Absolute neutrophil count at least 1,500/mm3
  • Platelet count at least 100,000/mm3

Hepatic

  • Bilirubin no greater than 1.5 mg/dL
  • No hepatic encephalopathy

Renal

  • Not specified

Other

  • Not pregnant or nursing
  • Negative pregnancy test
  • No active infection

Expected Enrollment

78

A total of 2-78 patients will be accrued for this study within 12-16 months.

Outcomes

Primary Outcome(s)

Maximum tolerated dose
Correlate thymidylate synthase, dihydropyrimidine dehydrogenase, and ERCC-1 with survival and recurrence as measured by normal and tumor liver tissue

Outline

This is a dose-escalation study of oxaliplatin and fluorouracil.

Patients undergo surgery for resection of the liver and placement of the hepatic artery pump.

  • Hepatic arterial infusion (HAI) therapy: Approximately 4 weeks after surgery, patients receive HAI therapy comprising floxuridine and dexamethasone on day 1.


  • Systemic chemotherapy: Patients receive oxaliplatin IV and leucovorin calcium IV over 120 minutes and fluorouracil IV bolus (followed by a 48-hour infusion of fluorouracil) on days 15 and 29.

    Cohorts of 3-6 patients receive escalating doses of oxaliplatin and fluorouracil until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity.



Treatment repeats every 36 days for up to 6 courses in the absence of disease recurrence or unacceptable toxicity.

Patients are followed every 3 months after the completion of treatment.

Trial Contact Information

Trial Lead Organizations

Memorial Sloan-Kettering Cancer Center

Nancy Kemeny, MD, Protocol chair
Ph: 212-639-8068; 800-525-2225

Trial Sites

U.S.A.
New Jersey
  New Brunswick
 Cancer Institute of New Jersey at UMDNJ - Robert Wood Johnson Medical School
 Clinical Trials Office - Cancer Institute of New Jersey
Ph: 732-235-8675
New York
  New York
 Memorial Sloan-Kettering Cancer Center
 Nancy Kemeny, MD
Ph: 212-639-8068
800-525-2225
 William Jarnagin, MD
Ph: 212-639-7601
800-525-2225
 Email: jarnagiw@mskcc.org
 Yuman Fong, MD
Ph: 212-639-2016
800-525-2225
 Email: fongy@mskcc.org

Registry Information
Official Title A Phase I Study Of Hepatic Arterial Infusion With Floxuridine And Dexamethasone In Combination With Intravenous Oxaliplatin Plus 5-Fluorouracil And Leucovorin As Adjuvant Treatment After Resection Of Hepatic Metastases From Colorectal Cancer
Trial Start Date 2003-01-28
Trial Completion Date 2008-06-30 (estimated)
Registered in ClinicalTrials.gov NCT00059930
Date Submitted to PDQ 2003-03-12
Information Last Verified 2008-12-14
NCI Grant/Contract Number CA08748

Note: The purpose of most clinical trials listed in this database is to test new cancer treatments, or new methods of diagnosing, screening, or preventing cancer. Because all potentially harmful side effects are not known before a trial is conducted, dose and schedule modifications may be required for participants if they develop side effects from the treatment or test. The therapy or test described in this clinical trial is intended for use by clinical oncologists in carefully structured settings, and may not prove to be more effective than standard treatment. A responsible investigator associated with this clinical trial should be consulted before using this protocol.

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