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Clinical Trial Questions?
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Phase II Study of Irinotecan Hydrochloride, Oxaliplatin, and Capecitabine as First-Line Therapy in Patients With Metastatic or Unresectable Locally Advanced Small Bowel Adenocarcinoma
Alternate Title Basic Trial Information Objectives Entry Criteria Expected Enrollment Outcomes Outline Trial Contact Information Registry Information
Alternate Title
Irinotecan, Oxaliplatin, and Capecitabine as First-Line Therapy in Treating Patients With Metastatic or Unresectable Locally Advanced Small Bowel Cancer
Basic Trial Information
| Phase | Type | Status | Age | Protocol IDs |
|---|
| Phase II | Biomarker/Laboratory analysis, Treatment | Active | 18 and over | NCCTG-N0543 N0543, NCT00433550 |
Objectives Primary - Assess the confirmed tumor response in patients with metastatic or unresectable locally advanced adenocarcinoma of the small bowel treated with irinotecan hydrochloride, oxaliplatin, and capecitabine when dosed according to UGT1A1 genotype.
Secondary - Assess the toxicity of this regimen in these patients.
- Assess, preliminarily, whether celiac disease may affect toxicity and outcome in patients treated with this regimen.
- Assess, preliminarily, whether tumor origin (duodenal, jejunal, or ileal) affects response or survival in these patients.
Entry Criteria Disease Characteristics:
Prior/Concurrent Therapy:
- At least 2 weeks since prior radiotherapy
- At least 4 weeks since prior major surgery
- No prior chemotherapy for advanced small bowel cancer
- Prior adjuvant fluorouracil/leucovorin calcium allowed provided last dose was ≥ 3 months ago
- No prior adjuvant oxaliplatin or irinotecan hydrochloride
- No prior radiotherapy to > 25% of bone marrow
- No concurrent sorivudine, brivudine, lamivudine, or stavudine
- No concurrent sargramostim (GM-CSF) or pegfilgrastim
Patient Characteristics:
- ECOG performance status 0-2
- Life expectancy ≥ 12 weeks
- Absolute neutrophil count ≥ 1,500/mm³
- Platelet count ≥ 100,000/mm³
- AST ≤ 2.5 times upper limit of normal (ULN) (5 times ULN if liver metastasis is present)
- Bilirubin normal for patients with 6/6 genotype (< 2 times ULN for patients with 6/7 or 7/7 genotype)
- Hemoglobin ≥ 9.0 g/dL
- Creatinine ≤ 1.5 times ULN OR creatinine clearance ≥ 60 mL/min
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
- No active or uncontrolled infection
- No other concurrent malignancy, except for nonmelanoma skin cancer
- No preexisting sensory neuropathy ≥ grade 2
- No evidence of serious intercurrent illness, including any of the following:
- Unstable angina
- Symptomatic congestive heart failure
- Serious uncontrolled cardiac arrhythmia
Expected Enrollment 33A total of 33 patients will be accrued for this study. Outcomes Primary Outcome(s)Confirmed tumor response (complete or partial response) after 12 courses of study therapy
Secondary Outcome(s)Overall survival Time to disease progression Duration of response Time to treatment failure Incidence of celiac disease Correlation of celiac disease with incidence of grade 3 or greater gastrointestinal toxicity UGT1A7 and UGT1A9 polymorphism Tumor location Effect of different drug doses on response rates and toxicity
Outline This is a prospective, multicenter study. Patients are assigned to 1 of 3 treatment groups based on UGT1A1 genotype. - Group 1 (6/6 UGT1A1 genotype): Patients receive irinotecan hydrochloride IV over 90 minutes and oxaliplatin IV over 2 hours on day 1 and oral capecitabine twice daily on days 2-15.
- Group 2 (6/7 UGT1A1 genotype): Patients receive irinotecan hydrochloride as in group 1. They also receive oxaliplatin and capecitabine as in group 1 but at lower doses.
- Group 3 (7/7 UGT1A1 genotype): Patients receive irinotecan hydrochloride, oxaliplatin, and capecitabine as in group 1 but at lower doses.
In all groups, treatment repeats every 3 weeks in the absence of disease progression or unacceptable toxicity. Blood and serum samples are collected at baseline for UGT1A1 genotyping, celiac disease testing, and research studies, including translational and pharmacologic studies. After the completion of study treatment, patients are followed every 6 weeks for 2 years and then periodically thereafter.
Trial Contact Information
Trial Lead Organizations North Central Cancer Treatment Group  |  |  | | Robert McWilliams, MD, Protocol chair |  | |  | | Benjamin Marchello, MD, Protocol co-chair |  | |  | | Matthew Goetz, MD, Protocol co-chair |  | |  | | Aminah Jatoi, MD, Protocol co-chair |  | |  | Trial Sites
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| U.S.A. |
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| Indiana |
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Beech Grove |
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| | | | | | | | | St. Francis Hospital and Health Centers - Beech Grove Campus |
| | | Howard Gross, MD | |
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Richmond |
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| | | Reid Hospital & Health Care Services |
| | | Howard Gross, MD | |
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| Iowa |
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Cedar Rapids |
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| | | | Cedar Rapids Oncology Associates |
| | | Clinical Trials Office - Cedar Rapids Oncology Associates | |
| | | Mercy Regional Cancer Center at Mercy Medical Center |
| | | Martin Wiesenfeld, MD | |
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Clive |
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| | | Medical Oncology and Hematology Associates - West Des Moines |
| | | Robert Behrens | |
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Des Moines |
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| | | CCOP - Iowa Oncology Research Association |
| | | Robert Behrens | | Ph: | 515-244-7586 | | 888-244-6061 |
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| | | John Stoddard Cancer Center at Iowa Lutheran Hospital |
| | | Clinical Trials Office - John Stoddard Cancer Center at Iowa Lutheran Hospital | |
| | | John Stoddard Cancer Center at Iowa Methodist Medical Center |
| | | Clinical Trials Office - John Stoddard Cancer Center at Iowa Methodist Medical Center | |
| | | Medical Oncology and Hematology Associates at John Stoddard Cancer Center |
| | | Robert Behrens | |
| | | Medical Oncology and Hematology Associates at Mercy Cancer Center |
| | | Robert Behrens | |
| | | Mercy Cancer Center at Mercy Medical Center - Des Moines |
| | | Robert Behrens | | Ph: | 515-643-8206 | | 888-221-4849 |
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Sioux City |
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| | | Mercy Medical Center - Sioux City |
| | | Donald Wender, MD, PhD | |
| | | Siouxland Hematology-Oncology Associates, LLP |
| | | Donald Wender, MD, PhD | |
| | | St. Luke's Regional Medical Center |
| | | Donald Wender, MD, PhD | |
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| Kansas |
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Anthony |
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| | | | Hospital District Sixth of Harper County |
| | | Shaker Dakhil, MD, FACP | |
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Chanute |
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| | | Cancer Center of Kansas, PA - Chanute |
| | | Shaker Dakhil, MD, FACP | |
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Dodge City |
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| | | Cancer Center of Kansas, PA - Dodge City |
| | | Shaker Dakhil, MD, FACP | |
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El Dorado |
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| | | Cancer Center of Kansas, PA - El Dorado |
| | | Shaker Dakhil, MD, FACP | |
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Fort Scott |
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| | | Cancer Center of Kansas - Fort Scott |
| | | Shaker Dakhil, MD, FACP | |
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Independence |
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| | | Cancer Center of Kansas-Independence |
| | | Shaker Dakhil, MD, FACP | |
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Kingman |
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| | | Cancer Center of Kansas, PA - Kingman |
| | | Shaker Dakhil, MD, FACP | |
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Lawrence |
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| | | Lawrence Memorial Hospital |
| | | Shaker Dakhil, MD, FACP | |
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Liberal |
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| | | Southwest Medical Center |
| | | Shaker Dakhil, MD, FACP | |
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Newton |
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| | | Cancer Center of Kansas, PA - Newton |
| | | Shaker Dakhil, MD, FACP | |
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Parsons |
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| | | Cancer Center of Kansas, PA - Parsons |
| | | Shaker Dakhil, MD, FACP | |
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Pratt |
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| | | Cancer Center of Kansas, PA - Pratt |
| | | Shaker Dakhil, MD, FACP | |
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Salina |
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| | | Cancer Center of Kansas, PA - Salina |
| | | Shaker Dakhil, MD, FACP | |
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Wellington |
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| | | Cancer Center of Kansas, PA - Wellington |
| | | Shaker Dakhil, MD, FACP | |
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Wichita |
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| | | Associates in Womens Health, PA - North Review |
| | | Shaker Dakhil, MD, FACP | |
| | | Cancer Center of Kansas, PA - Wichita |
| | | Shaker Dakhil, MD, FACP | |
| | | Cancer Center of Kansas, PA - Medical Arts Tower |
| | | Shaker Dakhil, MD, FACP | |
| | | CCOP - Wichita |
| | | Shaker Dakhil, MD, FACP | |
| | | Via Christi Cancer Center at Via Christi Regional Medical Center |
| | | Shaker Dakhil, MD, FACP | |
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Winfield |
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| | | Cancer Center of Kansas, PA - Winfield |
| | | Shaker Dakhil, MD, FACP | |
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| Michigan |
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Adrian |
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| | | | Hickman Cancer Center at Bixby Medical Center |
| | | Clinical Trials Office - Hickman Cancer Center at Bixby Medical Center | |
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Ann Arbor |
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| | | CCOP - Michigan Cancer Research Consortium |
| | | Philip Stella, MD | |
| | | Saint Joseph Mercy Cancer Center |
| | | Philip Stella, MD | |
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Dearborn |
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| | | Oakwood Cancer Center at Oakwood Hospital and Medical Center |
| | | Clinical Trials Office - Oakwood Cancer Center at Oakwood Hospital and Medical Center | |
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Escanaba |
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| | | Green Bay Oncology, Limited - Escanaba |
| | | Anthony Jaslowski, MD, FACP | |
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Flint |
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| | | Genesys Hurley Cancer Institute |
| | | Clinical Trials Office - Genesys Hurley Cancer Institute | |
| | | Hurley Medical Center |
| | | Clinical Trials Office - Hurley Medical Center | |
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Grosse Pointe Woods |
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| | | Van Elslander Cancer Center at St. John Hospital and Medical Center |
| | | Clincial Trials Office - Van Elslander Cancer Center at St. John Hospital and Medical Center | |
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Iron Mountain |
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| | | Dickinson County Healthcare System |
| | | Anthony Jaslowski, MD, FACP | |
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Lambertville |
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| | | Haematology-Oncology Associates of Ohio and Michigan, PC |
| | | Paul Schaefer, MD | |
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Lansing |
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| | | Sparrow Regional Cancer Center |
| | | Clinical Trials Office - Sparrow Regional Cancer Center | |
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Livonia |
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| | | St. Mary Mercy Hospital |
| | | Philip Stella, MD | |
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Monroe |
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| | | Community Cancer Center of Monroe |
| | | Paul Schaefer, MD | |
| | | Mercy Memorial Hospital - Monroe |
| | | Paul Schaefer, MD | |
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Pontiac |
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| | | St. Joseph Mercy Oakland |
| | | Philip Stella, MD | |
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Port Huron |
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| | | Mercy Regional Cancer Center at Mercy Hospital |
| | | Philip Stella, MD | |
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Saginaw |
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| | | Seton Cancer Institute at Saint Mary's - Saginaw |
| | | Clinical Trials Office - Seton Cancer Institute - Saginaw | |
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Warren |
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| | | St. John Macomb Hospital |
| | | Philip Stella, MD | |
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| Minnesota |
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Burnsville |
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| | | | Fairview Ridges Hospital |
| | | Patrick Flynn, MD | |
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Coon Rapids |
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| | | Mercy and Unity Cancer Center at Mercy Hospital |
| | | Patrick Flynn, MD | |
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Duluth |
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| | | CCOP - Duluth |
| | | Daniel Nikcevich, MD, PhD | |
| | | Duluth Clinic Cancer Center - Duluth |
| | | Clinical Trials Office - Duluth Clinic Cancer Center - Duluth | |
| | | Miller - Dwan Medical Center |
| | | Daniel Nikcevich, MD, PhD | |
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Edina |
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| | | Fairview Southdale Hospital |
| | | Clinical Trials Office - Fairview Southdale Hospital | |
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Fridley |
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| | | Mercy and Unity Cancer Center at Unity Hospital |
| | | Patrick Flynn, MD | |
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Hutchinson |
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| | | Hutchinson Area Health Care |
| | | Daniel Anderson | | Ph: | 320-234-5000 | | 800-454-3903 |
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Lichfield |
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| | | Meeker County Memorial Hospital |
| | | Clinical Trials Office - Meeker County Memorial Hospital | |
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Maplewood |
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| | | HealthEast Cancer Care at St. John's Hospital |
| | | Daniel Anderson | |
| | | Minnesota Oncology Hematology, PA - Maplewood |
| | | Patrick Flynn, MD | |
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Minneapolis |
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| | | Hennepin County Medical Center - Minneapolis |
| | | Clinical Trials Office - Hennepin County Medical Center - Minneapolis | |
| | | Virginia Piper Cancer Institute at Abbott - Northwestern Hospital |
| | | Clinical Trials Office - Virginia Piper Cancer Institute | |
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Robbinsdale |
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| | | Hubert H. Humphrey Cancer Center at North Memorial Outpatient Center |
| | | Clinical Trials Office - Hubert H. Humphrey Cancer Center at North Memorial Outpatient Center | |
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Rochester |
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| | | Mayo Clinic Cancer Center |
| | | Clinical Trials Office - All Mayo Clinic Locations | |
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Saint Louis Park |
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| | | CCOP - Metro-Minnesota |
| | | Patrick Flynn, MD | |
| | | Park Nicollet Cancer Center |
| | | Patrick Flynn, MD | |
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Saint Paul |
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| | | United Hospital |
| | | Patrick Flynn, MD | |
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Shakopee |
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| | | St. Francis Cancer Center at St. Francis Medical Center |
| | | Patrick Flynn, MD | |
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St. Paul |
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| | | Regions Hospital Cancer Care Center |
| | | Clinical Trials Office - Regions Hospital Cancer Care Center | |
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Waconia |
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| | | Ridgeview Medical Center |
| | | Patrick Flynn, MD | |
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Woodbury |
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| | | Minnesota Oncology Hematology, PA - Woodbury |
| | | Patrick Flynn, MD | |
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| Missouri |
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Saint Louis |
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| | | | Arch Medical Services, Incorporated at Center for Cancer Care and Research |
| | | Alan Lyss, MD | |
| | | Missouri Baptist Cancer Center |
| | | Alan Lyss, MD | |
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| Montana |
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Billings |
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| | | | Billings Clinic - Downtown |
| | | Clinical Trials Office - Billings Clinic - Downtown | |
| | Email:
research@billingsclinic.org |
| | | CCOP - Montana Cancer Consortium |
| | | Benjamin Marchello, MD | |
| | | Hematology-Oncology Centers of the Northern Rockies - Billings |
| | | Benjamin Marchello, MD | |
| | | Northern Rockies Radiation Oncology Center |
| | | Benjamin Marchello, MD | |
| | | St. Vincent Healthcare Cancer Care Services |
| | | Benjamin Marchello, MD | |
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Bozeman |
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| | | Bozeman Deaconess Cancer Center |
| | | Benjamin Marchello, MD | |
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Butte |
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| | | St. James Healthcare Cancer Care |
| | | Benjamin Marchello, MD | |
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Great Falls |
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| | | Benjamin Marchello, MD | |
| | | Great Falls Clinic - Main Facility |
| | | Benjamin Marchello, MD | |
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Havre |
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| | | Northern Montana Hospital |
| | | Benjamin Marchello, MD | |
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Helena |
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| | | St. Peter's Hospital |
| | | Benjamin Marchello, MD | |
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Kalispell |
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| | | Glacier Oncology, PLLC |
| | | Benjamin Marchello, MD | |
| | | Kalispell Medical Oncology at KRMC |
| | | Benjamin Marchello, MD | |
| | | Kalispell Regional Medical Center |
| | | Benjamin Marchello, MD | |
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Missoula |
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| | | Community Medical Center |
| | | Benjamin Marchello, MD | |
| | | Guardian Oncology and Center for Wellness |
| | | Benjamin Marchello, MD | |
| | | Montana Cancer Center at St. Patrick Hospital and Health Sciences Center |
| | | Clinical Trials Office - Montana Cancer Center at St. Patrick Hospital and Health Sciences Center | |
| | | Montana Cancer Specialists at Montana Cancer Center |
| | | Clinical Trials Office - Montana Cancer Specialists at Montana Cancer Center | |
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| North Carolina |
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Rutherfordton |
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| | | | Rutherford Hospital |
| | | James Bearden, MD | |
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| North Dakota |
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Bismarck |
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| | | | Bismarck Cancer Center |
| | | Edward Wos, DO | |
| | | Medcenter One Hospital Cancer Care Center |
| | | Edward Wos, DO | |
| | | Mid Dakota Clinic, PC |
| | | Clinical Trials Office - Mid Dakota Clinic, PC | |
| | | St. Alexius Medical Center Cancer Center |
| | | Clinical Trials Office - St. Alexius Medical Center Cancer Center | |
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Grand Forks |
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| | | Altru Cancer Center at Altru Hospital |
| | | Clinical Trails Office - Altru Cancer Center at Altru Hospital | |
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| Ohio |
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Bowling Green |
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| | | | Wood County Oncology Center |
| | | Paul Schaefer, MD | |
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Clyde |
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| | | North Coast Cancer Care - Clyde |
| | | Paul Schaefer, MD | |
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Dayton |
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| | | CCOP - Dayton |
| | | Howard Gross, MD | |
| | | David L. Rike Cancer Center at Miami Valley Hospital |
| | | Clinical Trials Office - David L. Rike Cancer Center at Miami Valley Hospital | |
| | | Good Samaritan Hospital |
| | | Howard Gross, MD | |
| | | Grandview Hospital |
| | | Howard Gross, MD | |
| | | Samaritan North Cancer Care Center |
| | | Howard Gross, MD | |
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Elyria |
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| | | Hematology Oncology Center |
| | | Paul Schaefer, MD | |
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Findlay |
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| | | Blanchard Valley Medical Associates |
| | | Howard Gross, MD | |
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Franklin |
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| | | Middletown Regional Hospital |
| | | Howard Gross, MD | |
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Greenville |
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| | | Wayne Hospital |
| | | Howard Gross, MD | |
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Kettering |
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| | | Charles F. Kettering Memorial Hospital |
| | | Clinical Trials Office - Charles F. Kettering Memorial Hospital | | Ph: | 937-298-3399 ext. 57556 | | |
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Lima |
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| | | Lima Memorial Hospital |
| | | Paul Schaefer, MD | |
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Maumee |
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| | Paul Schaefer, MD | |
| | | | Northwest Ohio Oncology Center |
| | | Paul Schaefer, MD | |
| | | St. Luke's Hospital |
| | | Paul Schaefer, MD | |
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Oregon |
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| | | St. Charles Mercy Hospital |
| | | Paul Schaefer, MD | |
| | | Toledo Clinic - Oregon |
| | | Paul Schaefer, MD | |
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Sandusky |
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| | | North Coast Cancer Care, Incorporated |
| | | Paul Schaefer, MD | |
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Sylvania |
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| | | Flower Hospital Cancer Center |
| | | Clinical Trials Office - Flower Hospital Cancer Center | |
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Tiffin |
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| | | Mercy Hospital of Tiffin |
| | | Paul Schaefer, MD | |
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Toledo |
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| | | CCOP - Toledo Community Hospital |
| | | Paul Schaefer, MD | |
| | | Medical University of Ohio Cancer Center |
| | | Clinical Trials Office - Medical University of Ohio Cancer Center | |
| | | St. Anne Mercy Hospital |
| | | Paul Schaefer, MD | |
| | | St. Vincent Mercy Medical Center |
| | | Paul Schaefer, MD | |
| | | Toledo Clinic, Incorporated - Main Clinic |
| | | Paul Schaefer, MD | |
| | | Toledo Hospital |
| | | Clinical Trials Office - Toledo Hospital | |
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Troy |
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| | | UVMC Cancer Care Center at Upper Valley Medical Center |
| | | Clinical Trials Office - UVMC Cancer Care Center at Upper Valley Medical Center | |
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Wauseon |
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| | | Fulton County Health Center |
| | | Clinical Trials Office - Fulton County Health Center | |
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Wilmington |
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| | | Clinton Memorial Hospital |
| | | Howard Gross, MD | |
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Xenia |
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| | | Ruth G. McMillan Cancer Center at Greene Memorial Hospital |
| | | Howard Gross, MD | |
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| Pennsylvania |
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Allentown |
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| | | | Morgan Cancer Center at Lehigh Valley Hospital - Cedar Crest |
| | | Suresh Nair, MD | |
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| South Carolina |
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Anderson |
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| | | | AnMed Cancer Center |
| | | Clinical Trials Office - AnMed Cancer Center | |
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Spartanburg |
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| | | CCOP - Upstate Carolina |
| | | Clinical Trials Office - CCOP - Upstate Carolina | |
| | | Gibbs Regional Cancer Center at Spartanburg Regional Medical Center |
| | | Clinical Trials Office - Gibbs Regional Cancer Center | |
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| South Dakota |
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Rapid City |
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| | | | Rapid City Regional Hospital |
| | | Richard Tenglin | |
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Sioux Falls |
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| | | Avera Cancer Institute |
| | | Loren Tschetter, MD | |
| | | Medical X-Ray Center, PC |
| | | Loren Tschetter, MD | |
| | | Sanford Cancer Center at Sanford USD Medical Center |
| | | Clinical Trials Office - Sanford Cancer Center | |
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| Virginia |
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Fredericksburg |
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| | | | Fredericksburg Oncology, Incorporated |
| | | Paul Schaefer, MD | |
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| Wisconsin |
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Green Bay |
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| | | | Green Bay Oncology, Limited at St. Mary's Hospital |
| | | Anthony Jaslowski, MD, FACP | |
| | | Green Bay Oncology, Limited at St. Vincent Hospital Regional Cancer Center |
| | | Anthony Jaslowski, MD, FACP | |
| | | St. Mary's Hospital Medical Center - Green Bay |
| | | Anthony Jaslowski, MD, FACP | |
| | | St. Vincent Hospital Regional Cancer Center |
| | | Clinical Trials Office - St. Vincent Hospital Regional Cancer Center | |
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Marinette |
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| | | Bay Area Cancer Care Center at Bay Area Medical Center |
| | | Anthony Jaslowski, MD, FACP | |
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Oconto Falls |
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| | | Green Bay Oncology, Limited - Oconto Falls |
| | | Anthony Jaslowski, MD, FACP | |
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Sturgeon Bay |
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| | | Green Bay Oncology, Limited - Sturgeon Bay |
| | | Anthony Jaslowski, MD, FACP | |
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| Wyoming |
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Sheridan |
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| | | | Welch Cancer Center at Sheridan Memorial Hospital |
| | | Benjamin Marchello, MD | |
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| Registry Information |  | | Official Title | | A Phase II Trial of Pharmacogenetic-Based Dosing of Irinotecan, Oxaliplatin, and Capecitabine as First-Line Therapy for Advanced Small Bowel Adenocarcinoma |  | | Trial Start Date | | 2007-05-11 |  | | Trial Completion Date | | 2008-09-17 (estimated) |  | | Registered in ClinicalTrials.gov | | NCT00433550 |  | | Date Submitted to PDQ | | 2006-12-18 |  | | Information Last Verified | | 2009-11-05 |  | | NCI Grant/Contract Number | | CA25224 |
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. Back to Top |
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