A Phase II Trial Of Celecoxib (Celebrex) And Capecitabine (Xeloda) Combined With Pelvic Irradiation As Neoadjuvant Treatment Of Stage II or III Adenocarcinoma Of The Rectum
capecitabine
+ celecoxib
+ radiation therapy
Colonic Diseases+9
+ Digestive System Diseases
+ Digestive System Neoplasms
Treatment Study
Summary
Study start date: December 1, 2004
Actual date on which the first participant was enrolled.OBJECTIVES: Primary * Determine the pathological complete response rate in patients with stage II or III adenocarcinoma of the rectum treated with neoadjuvant celecoxib and capecitabine in combination with pelvic irradiation. Secondary * Determine the safety and tolerability of this regimen in these patients. * Determine the rectal function of patients treated with this regimen. * Determine the time to recurrence or progression and survival time of patients treated with this regimen. * Correlate cellular and molecular markers in pretreatment tumor samples with response in patients treated with this regimen. OUTLINE: This is a multicenter study. * Neoadjuvant chemoradiotherapy: Patients receive oral celecoxib twice daily on days 1-7 and oral capecitabine twice daily on days 1-5. Patients undergo pelvic radiotherapy once daily on days 1-5. Courses repeat weekly for 5.5 weeks. * Surgery: Patients undergo surgery 4-6 weeks after completion of neoadjuvant chemoradiotherapy. * Adjuvant chemotherapy: Patients with a curative resection receive oral capecitabine twice daily on days 1-14. Treatment repeats every 21 days for up to 4 courses. Treatment continues in the absence of disease progression or unacceptable toxicity. Patients are followed every 3 months for 1 year and then every 6 months for 4 years.
Protocol
This section provides details of the study plan, including how the study is designed and what the study is measuring.3 patients to be enrolled
Total number of participants that the clinical trial aims to recruit.Treatment Study
Eligibility
Researchers look for people who fit a certain description, called eligibility criteria: person's general health condition or prior treatments.Any sex
Biological sex of participants that are eligible to enroll.Over 18 Years
Range of ages for which participants are eligible to join.Healthy volunteers not allowed
If individuals who are healthy and do not have the condition being studied can participate.Conditions
Pathology
Criteria
DISEASE CHARACTERISTICS: * Histologically confirmed rectal adenocarcinoma * Clinical stage T3, N0, M0 OR any T, N1-3, M0 disease * Treatment with neoadjuvant chemotherapy and pelvic radiotherapy is indicated * All disease must be encompassable within standard pelvic radiotherapy fields * Distal border of the tumor must be at or below\* the peritoneal reflection, defined as within 12 cm of the anal verge by endoscopy NOTE: \*If a portion of the tumor is below the peritoneal reflection at the time of surgery, patients are eligible regardless of the distance of the tumor determined at endoscopy * Tumor must be determined to be clinically resectable * Tumor may not be clinically fixed * Negative margins by routine examination of an unanesthetized patient * Transmural penetration of tumor through the muscularis propria by CT scan, endorectal ultrasound, or MRI * No distant metastatic disease * No evidence of tumor outside the pelvis, including any of the following: * Metastatic inguinal lymphadenopathy * Peritoneal seeding * Liver metastases PATIENT CHARACTERISTICS: Age * 18 and over Performance status * ECOG 0-1 Life expectancy * At least 6 months Hematopoietic * Absolute neutrophil count ≥ 1,500/mm\^3 * Platelet count ≥ 100,000/mm\^3 Hepatic * Bilirubin ≤ upper limit of normal (ULN) * AST ≤ 3 times ULN * Alkaline phosphatase ≤ 4 times ULN if AST \< ULN Renal * Creatinine clearance ≥ 30 mL/min * No renal impairment Cardiovascular * No congestive heart failure * No symptomatic coronary artery disease * No uncontrolled cardiac arrhythmias * No myocardial infarction * No history of transient ischemic attacks or stroke * No other clinically significant cardiac disease Gastrointestinal * No bleeding peptic ulcer disease within the past 12 months * No lack of physical integrity of the upper gastrointestinal tract * No malabsorption syndrome * No active inflammatory bowel disease * Must be able to swallow study drugs Other * No dihydropyrimidine dehydrogenase deficiency * No history of uncontrolled seizures * No CNS disorders * No clinically significant psychiatric illness that would preclude study compliance or giving informed consent * No other malignancy within the past 5 years except basal cell or squamous cell skin cancer or carcinoma in situ of the cervix * No known sensitivity to NSAIDs, sulfonamides, or aspirin * No other serious medical illness that would preclude study treatment * No other conditions that would preclude study participation * Must be able to tolerate major surgery that may include abdominal-perineal resection * Not pregnant or nursing * Negative pregnancy test * Fertile patients must use effective contraception during and for 30 days after study treatment PRIOR CONCURRENT THERAPY: Biologic therapy * Not specified Chemotherapy * See Disease Characteristics * No prior systemic anticancer chemotherapy Endocrine therapy * Not specified Radiotherapy * See Disease Characteristics * No prior radiotherapy to the pelvis Surgery * See Disease Characteristics * More than 3 weeks since prior major surgery and recovered Other * At least 7 days since prior nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin * No other concurrent investigational drugs * No other concurrent anticancer treatment * No concurrent NSAIDs * No concurrent primary prophylactic therapy for hand-foot syndrome * No concurrent loperamide prophylaxis for diarrhea * No concurrent sorivudine or brivudine
Study Plan
Find out more about all the medication administered in this study, their detailed description and what they involve.One single intervention group is designated in this study
This study does not include a placebo group
Treatment Groups
Group I
ExperimentalStudy Objectives
Primary Objectives
Secondary Objectives