Ignite Creation Date:
2024-05-06 @ 3:33 AM
Last Modification Date:
2024-10-26 @ 11:35 AM
Study NCT ID:
NCT02319304
Status:
TERMINATED
Last Update Posted:
2021-11-04
First Post:
2014-12-10
Brief Title:
Pelvic Radiotherapy With Concurrent Neoadjuvant FOLFOX for Patients With Newly Diagnosed Rectal Adenocarcinoma
Sponsor:
University of Maryland Baltimore
Organization:
University of Maryland Baltimore
Study Overview
Official Title:
Phase II Trial of Low Dose Whole Pelvic Radiotherapy With Concurrent Neoadjuvant FOLFOX for Patients With Newly Diagnosed T3N0M0 T2N1M0 or T3N1M0 Rectal Adenocarcinoma
Status:
TERMINATED
Status Verified Date:
2021-10
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Slow accrual PI left instituion
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
GCC 1314
Brief Summary:
The purpose of this study is to assess the effects both good and bad of adding very low dose fractionated radiation therapy LDFRT to the pelvis with FOLFOX chemotherapy prior to surgery Standard pelvic radiation therapy given once a day Monday through Friday over approximately 55 weeks is not given in this study You will receive 6 cycles of FOLFOX each cycle is 2 weeks and you will also get an LDFRT to your pelvis given twice a day on the first two days of each cycle
Detailed Description:
The current standard of care for treatment of locally advanced rectal cancer consists of neoadjuvant whole pelvic RT with radiosensitizing single-agent 5-FU followed by surgery and adjuvant full dose chemotherapy typically FOLFOX For all clinical T3 T4 andor lymph node positive rectal cancer patients the standard neoadjuvant radiation dose per fraction is 180 cGy delivered on consecutive weekdays over 55 weeks for a total of 5040 cGy A potentially paradigm-changing approach is currently being investigated in a phase IIIII trial in which neoadjuvant RT is omitting in favor of using full dose FOLFOX chemotherapy based on provocative data published from Memorial Sloan Kettering Cancer Center We hypothesize that whole pelvic LDFRT using 40 cGy fractions for a total of 960 cGy can be safely added concurrently to neoadjuvant full dose FOLFOX as an alternative to standard neoadjuvant 5-FU chemoradiation We further hypothesize that using LDFRT as a chemopotentiatior will significantly increase the pCR rate as reported by the Memorial Sloan Kettering pilot study of 27 Lastly due to the significantly lower radiation dose per fraction and lower total radiation dose we expect that this novel strategy will not cause higher rates of severe toxicity compared to neoadjuvant FOLFOX alone
Specifically this phase II trial intends to determine whether 6 cycles of neoadjuvant FOLFOX with concurrent LDFRT followed by comprehensive restaging and TME achieves favorable outcomes for patients with T3N0M0 T3N1M0 or T2N1M0 rectal cancer As mentioned above the current standard of care for all locally advanced rectal cancer patients includes radiosensitizing 5-FU and concurrent whole pelvic RT to 5040 Gy in 180 Gy once daily fractions Per the proposed protocol T3N0M0 T3N1M0 or T2N1M0 rectal cancer patients who are eligible to undergo a low anterior resection would receive whole pelvic RT to 960 cGy in 40 cGy fractions delivered twice daily on days 1-2 of each cycle of FOLFOX chemotherapy for a total of 6 cycles
Eligible study subjects include adults who are candidates for curative intent sphincter-sparing surgery and who lack high-risk features particularly tumor encroaching upon the mesorectal fascia within 3 mm as determined by pre-treatment endoscopic ultrasound EUS andor magnetic resonance imaging MRI or distal rectal tumors 5 cm from the anal verge
Specifically this phase II trial intends to determine whether 6 cycles of neoadjuvant FOLFOX with concurrent LDFRT followed by comprehensive restaging and TME achieves favorable outcomes for patients with T3N0M0 T3N1M0 or T2N1M0 rectal cancer As mentioned above the current standard of care for all locally advanced rectal cancer patients includes radiosensitizing 5-FU and concurrent whole pelvic RT to 5040 Gy in 180 Gy once daily fractions Per the proposed protocol T3N0M0 T3N1M0 or T2N1M0 rectal cancer patients who are eligible to undergo a low anterior resection would receive whole pelvic RT to 960 cGy in 40 cGy fractions delivered twice daily on days 1-2 of each cycle of FOLFOX chemotherapy for a total of 6 cycles
Eligible study subjects include adults who are candidates for curative intent sphincter-sparing surgery and who lack high-risk features particularly tumor encroaching upon the mesorectal fascia within 3 mm as determined by pre-treatment endoscopic ultrasound EUS andor magnetic resonance imaging MRI or distal rectal tumors 5 cm from the anal verge
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
None
Is a FDA Regulated Device?:
None
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None