Unique ID issued by UMIN | UMIN000002388 |
---|---|
Receipt number | R000002870 |
Scientific Title | A multicenter phase II study of FOLFIRI as first-line chemotherapy for metastatic colorectal cancer with reduced starting dose of irinotecan in patients with homozygous for UGT1A1(FLIGHT1) |
Date of disclosure of the study information | 2009/09/01 |
Last modified on | 2018/09/20 08:20:29 |
A multicenter phase II study of FOLFIRI as first-line chemotherapy for metastatic colorectal cancer with reduced starting dose of irinotecan in patients with homozygous for UGT1A1(FLIGHT1)
A multicenter phase II study of FOLFIRI for metastatic colorectal cancer(FLIGHT1)
A multicenter phase II study of FOLFIRI as first-line chemotherapy for metastatic colorectal cancer with reduced starting dose of irinotecan in patients with homozygous for UGT1A1(FLIGHT1)
A multicenter phase II study of FOLFIRI for metastatic colorectal cancer(FLIGHT1)
Japan |
colorectal cancer
Gastroenterology | Hematology and clinical oncology | Surgery in general |
Gastrointestinal surgery |
Malignancy
YES
The objective of this study is to evaluate the tumor response rate and the incidence and severity of adverse events during first-line chemotherapy with FOLFIRI in patients with metastatic colorectal cancer .
Safety,Efficacy
Exploratory
Pragmatic
Phase II
(1)response rate
(2)incidence and severity of adverse events
(1) Determination of the time to response, the duration of response, the progression-free survival (PFS) time, and the overall survival (OS) time.
(2) Evaluation of the causal relationship of each adverse event with the protocol treatment, its reversibility, its cumulative dose-response relationship, and its course over time.
(3) Detection of genetic variation (when possible) and correlation of genetic variations with the pharmacokinetics of CPT-11, SN-38, and SN-38G as well as with the toxicities of CPT-11 (as an ancillary investigation).
Interventional
Single arm
Non-randomized
Open -no one is blinded
Uncontrolled
1
Treatment
Medicine | Gene |
On Day 1, patients treated with FOLFIRI therapy received a 2-hour intravenous infusion of CPT-11 (150 mg/m2) combined with 1-LV (200 mg/m2), followed by a rapid intravenous infusion of 5-FU (400 mg/m2), and then a 46-hour continuous infusion of 5-FU (2,400 mg/m2). This regimen comprised one course of therapy and was repeated once every 2 weeks. Cycles of treatment will be continued for this study until disease progression (PD) occurs.
Patients will undergo UGT1A1 genotyping before starting to receive the protocol treatment. As recommended in the US prescribing information for Camptosar;, the starting dose of CPT-11 will be reduced to 100 mg/m2 in patients who are homozygous for the *28 allelic variant of UGT1A1 (further reduced to 75 mg/m2 in such patients aged 76-80 years). No dose adjustments will be made in patients who undergo UGT1A1 genotyping after starting to receive the protocol treatment.
20 | years-old | <= |
80 | years-old | >= |
Male and Female
(1) Histopathologically diagnosed colon carcinoma or rectal carcinoma.
(2) Advanced or recurrent disease that is not amenable to curative resection.
(3) No history of chemotherapy, immunotherapy, or radiotherapy (including palliative local radiation).
(4) At least 4 weeks after surgery.
(5) ECOG performance status of 0-1.
(6) Age between 20 and 80 years (inclusive).
(7) Life expectancy of at least 12 weeks.
(8) Presence of at least one measurable lesion (outside the radiation field). A measurable lesion is defined as one that can be measured in a single dimension by palpation (together with a scale-containing radiographic image that permits objective assessment of the lesion size), CT, MRI, or any other radiographic method and which has a larger diameter >=2 cm (or >=1 cm and >=twice the slice width when measured by MRI or spiral CT).
(9) Adequate function of vital organs (e.g., bone marrow, heart, lungs, liver, and kidneys), as demonstrated by laboratory data obtained within 14 days of enrollment that are in the following ranges:
White blood cell count: 3,000-12,000/mm3.
Neutrophil count: >=1,500/mm3
(calculated from the white blood cell count and the differential neutrophil count [%]).
Platelet count: >=100,000/mm3.
Serum bilirubin: =<1.50 mg/dL.
AST and ALT: =<100 IU/L or 100 U/L.
Serum creatinine: =<1.20 mg/dL.
(10) Personally signed and dated written informed consent to participation in this study (including submission of biological specimens) prior to enrollment.
(1) Blood transfusion, administration of blood products, or hematopoietic (e.g., G-CSF) support within 7 days before enrollment.
(2) A history of severe drug allergy.
(3) Pleural effusion, ascites, or pericardial effusion requiring drainage.
(4) Concurrent active (e.g., clinically significant) infection.
(5) Confirmed or clinically suspected brain metastasis.*1
(6) Involvement of the central nervous system.
(7) Presence of bone metastasis as the sole metastasis.
(8) Any other concurrent malignancy, excluding metachronous malignancy that has been confirmed to have been cured.*2
(9) Uncontrolled hypercalcemia.
(10) Uncontrolled hypertension (despite antihypertensive medication).
(11) Uncontrolled diabetes mellitus.
(12) Any significant electrocardiographic abnormality or clinically significant heart disease.*3
(13) Fresh gastrointestinal bleeding.
(14) Intestinal paralysis or obstruction.
(15) Diarrhea (watery stools).*4
(16) Positivity for HIV antibody.
(17) Current treatment with atazanavir sulfate.
(18) Current treatment with phenytoin, warfarin potassium, or flucytosine.
(19) Pregnant or breast-feeding women, women of childbearing potential, women who wish to become pregnant, or men who wish to have a child with their female partners.
(20) Current participation in any other clinical trial/study.
(21) Any other condition that disqualifies the patient from the study in the opinion of the investigator.
50
1st name | |
Middle name | |
Last name | Hideyuki Mishima |
Aichi Medical University
Cancer Center
1-1, Yazakokarimata, Nagakute, Aichi
0561-62-3311
hmishima@aichi-med-u.ac.jp
1st name | |
Middle name | |
Last name | Mai Hatta |
Nagoya University Graduate School of Medicine
Young Leaders'Program
65 Tsurumai Showa-ku Nagoya
052-744-2442
m-hatta@med.nagoya-u.ac.jp
NPO Epidemiological and Clinical Research Information Network
NPO Epidemiological and Clinical Research Information Network
Other
NO
2009 | Year | 09 | Month | 01 | Day |
Published
RESULTS:
After a median follow-up period of 22 months, complete response was achieved in 1.9%, partial response in 38.5 %, stable disease in 51.9% and progressive disease in 3.9%. The overall response rate was 40.4%, the disease control rate was 92.3% and the median overall survival time was 22.3 months. The major toxicity was grade 3-4 neutropenia in 44.2%. There was no definite relation between UGT1A1 28, 6 polymorphisms and toxicity. However, homozygosity for UGT1A1 28 or UGT1A1 6 and double heterozygosity for both UGT1A1 28 and UGT1A1 6 were significantly associated with severe neutropenia in metastatic colorectal cancer patients (P< 0.001).
Completed
2005 | Year | 10 | Month | 21 | Day |
2005 | Year | 11 | Month | 01 | Day |
2009 | Year | 07 | Month | 01 | Day |
2009 | Year | 07 | Month | 01 | Day |
2009 | Year | 07 | Month | 01 | Day |
2009 | Year | 07 | Month | 01 | Day |
Jpn J Clin Oncol. 2011 Apr;41(4):477-82.
Prospective phase II study of FOLFIRI for mCRC in Japan, including the analysis of UGT1A1 28/6 polymorphisms.
Okuyama Y, Hazama S, Nozawa H, Kobayashi M, Takahashi K, Fujikawa K, Kato T, Nagata N, Kimura H, Oba K, Sakamoto J, Mishima H.
2009 | Year | 08 | Month | 26 | Day |
2018 | Year | 09 | Month | 20 | Day |
Value
https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000002870