Intra-arterial Hepatic Beads Loaded With Irinotecan With Concomitant Chemotherapy With FOLFOX in Patients With Colorectal Cancer With Unresectable Liver Metastases: a Phase II Multicenter Study
HIA DEBIRI + systemic FOLFOX
Colonic Diseases+8
+ Digestive System Diseases
+ Digestive System Neoplasms
Treatment Study
Summary
Study start date: May 1, 2013
Actual date on which the first participant was enrolled.Treatment of patients with colorectal cancer having liver metastases is currently based on systemic chemotherapy. Triple therapy with 5FU, oxaliplatin and irinotecan intravenously was effective in terms of response and secondary resectability, however it is particularly toxic. Hepatic intra-arterial chemotherapy (HIA) has been the subject of several studies. It has shown good efficacy with oxaliplatin and FUDR. However, the procedure is difficult to set up and reserved for experienced centers. The objective of this protocol is to use a triple therapy based on 5FU and oxaliplatin associated to irinotecan which is administered by hepatic intra-arterial route, loaded onto microbeads (DEBIRI). Furthermore, the procedure for chemo-embolization DEBIRI is limited to 2 sessions, and therefore could be more easily generalized.
Protocol
This section provides details of the study plan, including how the study is designed and what the study is measuring.58 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
Inclusion Criteria: Histologically proven colorectal adenocarcinoma, Liver metastases radiologically or histologically proven At least one measurable liver lesions by RECIST v1.1 Age ≥ 18 years WHO Index < or = 2 Life expectancy ≥ 3 months No extrahepatic disease except lung nodules if number < or = 3 and size < 10 mm each Healthy liver <60% Primary tumor resected or still in place No prior chemotherapy for metastases treatment (except a perioperative chemotherapy, if the last cycle was administered at least 12 months ago) Adjuvant chemotherapy after resection of the primary authorized if the last cycle was administered at least 12 months ago Normal hepatic function: total bilirubin ≤ 1.5 N; AST ≤ 5N; ALT ≤ 5N and PAL ≤ 5N TP ≥ 60% Adequate hematologic function: ANC ≥ 1500/mm3, platelets ≥ 100 000/mm3, Hb ≥ 9g/dl Good renal function: creatinine clearance ≥ 60 mL / min No cardiac dysfunction: no cardiovascular events in the last 6 months or no NYHA ≥ 2 Exclusion Criteria: Patient eligible for curative treatment (resection and / or radiofrequency ablation) by a multidisciplinary decision (including the opinion of a liver surgeon) Pregnant or lactating woman or patients of both sexes and of childbearing age not using adequate contraception History of cancer, except skin cancer (other than melanoma), carcinoma in situ of the cervix uteri treated curative. Other cancers treated with curative intent are permitted provided they did not relapse over the last 5 years Peripheral neuropathy Inflammatory Bowel Diseases Intestinal obstruction Chronic liver disease (viral, alcoholic or metabolic) Immune Deficiency Syndromes (history of transplantation, infection with HIV) Known to have contraindications to 5FU, oxaliplatin, folinic acid, irinotecan or to contrast products Patients with known contraindications against hepatic embolization procedures: Presence of biliary-digestive anastomosis or biliary stent Cruoric or tumor thrombosis of the portal vein Patient who for psychological, social, family or geographical reasons could not be followed up regularly Legal disability (persons deprived of liberty or under guardianship) Patient is not affiliated to a social security scheme Participation in another concurrent study investigating the effect of treatment and this until 4 weeks after the end of the concurrent study.
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
Study Centers
These are the hospitals, clinics, or research facilities where the trial is being conducted. You can find the location closest to you and its status.This study has 9 locations
CHU - Hôpital François Mitterand
Dijon, FranceHôpital Prive Jean Mermoz
Lyon, FranceCentre Léon Berard
Lyon, France