דילוג לתוכן הראשי
xMedica

NCT05174169ClinicalTrials.gov

Colon Adjuvant Chemotherapy Based on Evaluation of Residual Disease

מגייסמקבל משתתפים כעת, לפי רשומת המרשם.
יצירת קשר עם המחקר

בקצרה

This Phase II/III trial will evaluate the what kind of chemotherapy to recommend to patients based on the presence or absences of circulating tumor DNA (ctDNA) after surgery for colon cancer.

שלב 2 / שלב 3דרושים 1,912 משתתפים1,077 אתרים3 מדינות

קטגוריות

רשום במרשם אחד

מחקר יחיד יכול להיות רשום בכמה מרשמים. אנו מציגים אותו פעם אחת ומקשרים לכל רשומה שברשותנו.

מידע הניסוי מוצג כפי שפורסם על ידי המרשם, בשפת המקור שלו.

מתעניינים במחקר הזה?

התחברות או צרו חשבון כדי לרשום את התעניינותכם ולעקוב אחר המחקר הזה.

How this study is set up

The points below are drawn from the public registry record for this study. Each one cites the field or sentence it came from. A dash (—) means the record does not state something — not that it is missing or wrong. Many well-run studies, especially small ones, leave some of these blank.

  • Present: Registered before enrolment beganFirst posted 2021-12-30; recorded start 2022-07-08
  • Present: Has a defined primary outcomeA primary outcome measure is listed in the record
  • Present: The primary outcome states a time frameThe primary outcome measure records a time frame
  • Present: Participants are randomly assignedAllocation is recorded as randomised
  • Present: Has a comparison groupThe record lists a placebo or comparator arm, or more than one study arm
  • Not stated: Open label (no blinding)Masking is recorded as none (open label)
  • Not stated: An ethics committee is not stated in the registry recordThis registry's ingested record has no ethics-committee field
  • Not stated: Regulatory oversight (such as an IND or IDE) is not stated in the registry recordThis registry's ingested record has no regulatory-authorisation field
  • Not stated: A data monitoring committee is not stated in the registry recordThis registry's ingested record has no data-monitoring-committee fieldA data monitoring committee is not required for many smaller studies, and its absence here is not unusual.
  • Present: No cost to participants is mentioned in the recordChecked the summary, description and eligibility text; no cost-to-participant phrase found
  • Present: Sponsor has 49 other studies in this databaseCounted from the lead sponsor named in the record (NRG Oncology)
  • Present: Sponsor has posted results for at least one studyBased on the sponsor’s studies in this database
  • The record lists 1 condition.
  • Lead sponsor type recorded as: other.
  • Intervention regulatory context: investigational, within a phased regulatory pathway.

Trial stature

Three independent measures of this study, described from its registry record — not a recommendation about it. A rigorous study by investigators nobody has heard of is better evidence than a weak study led by a famous one. How these are scored.

Methodological rigourSTRONG

A strong methodological design for a phase 3 study, judged from its ClinicalTrials.gov record.

How this score is built
  • Randomised allocation20/20

    Participants are randomly allocated between arms

  • Blinding0/20

    Open-label

  • Control arm15/15

    Active-comparator control arm

  • Primary-outcome specificity10/10

    Named primary outcome with a defined time frame

  • Endpoint type3/10

    Surrogate or intermediate endpoint (conservative default)

  • Multi-centre8/8

    Multi-centre: 1063 sites

  • Data monitoring committee7/7

    A data monitoring committee is in place

  • Prospective registration5/5

    Registered before the study start date

  • Protocol / SAP posted0/5

    No protocol or SAP posted to the registry

ScaleLARGE

A large study, international in scope: 1,912 participants (target), run at 1,077 sites, across 3 countries.

How this score is built
  • Enrolment33/40

    1,912 participants (target)

  • Site count25/25

    1,063 sites

  • Country count7/15

    3 countries

  • Planned duration10/10

    Planned over about 93 months

  • Sponsor scale6/10

    NRG Oncology has led 49 trials in our corpus

Investigator standingUNKNOWN

We have no verifiable track record for the investigator named on this trial. That is common for early-career investigators and for records held outside ClinicalTrials.gov — it is not a negative signal.

How this score is built
  • Investigator standing0/100

    No investigator recorded in the registry for this trial

These describe the registry record only, and today we hold ClinicalTrials.gov data. Absent fields lower a score, and absence often reflects registration practice rather than study quality. A high-stature trial is not necessarily safer or a better choice for you — enrolling in a large definitive trial can mean a higher chance of receiving placebo, while a small early-phase study may be the only route to a new therapy.

תקציר

This Phase II/III trial will evaluate the what kind of chemotherapy to recommend to patients based on the presence or absences of circulating tumor DNA (ctDNA) after surgery for colon cancer.

Currently, there are no biomarkers validated prospectively in randomized studies for resected colon cancer to determine need for adjuvant chemotherapy. However, circulating tumor DNA (ctDNA) shed into the bloodstream represents a highly specific and sensitive approach (especially with serial monitoring) for identifying microscopic or residual tumor cells in colon cancer patients and may outperform traditional clinical and pathological features in prognosticating risk for recurrence. Colon cancer patients who do not have detectable ctDNA (ctDNA-) are at a much lower risk of recurrence and may not need adjuvant chemotherapy. Furthermore, for colon cancer pts with detectable ctDNA (ctDNA+) who are at a very high risk of recurrence, the optimal adjuvant chemotherapy regimen has not been established. We hypothesize that for pts whose colon cancer has been resected, ctDNA status may be used to risk stratify for making decisions about adjuvant chemotherapy.

מצבים רפואיים

  • Stage III Colon Cancer

זכאות

זכאות
מיןהכול
גילאים18 Yearsללא מקסימום
מתנדבים בריאיםלא

זכאות כפי שנכתבה במרשם

Inclusion Criteria: The patient must have an ECOG performance status of 0 or 1. Patients must have histologically/pathologically confirmed Stage IIB, IIC, or Stage III colon adenocarcinoma with R0 resection according to AJCC 8th edition criteria. No radiographic evidence of overt metastatic disease within 45 days prior to Step 1/Study entry (CT with IV contrast or MRI imaging is acceptable and must include chest, abdomen, and pelvis). The distal extent of the tumor must be greater than or equal to 12 cm from the anal verge on colonoscopy or above the peritoneal reflection as documented during surgery or on pathology specimen (i.e., excluding rectal adenocarcinomas warranting treatment with chemoradiation). The patient must have had an en bloc complete gross resection of tumor (curative resection). Patients who have had a two-stage surgical procedure, to first provide a decompressive colostomy and then in a later procedure to have the definitive surgical resection, are eligible. The resected tumor specimen and a blood specimen from patients with Stage IIB, IIC, or Stage III colon cancer must have central testing for ctDNA using the Signatera™ assay by Natera (after Step 1/Study entry and before Step2/Randomization). Patient must have sufficient tissue to meet protocol requirements. This blood specimen for the Signatera assay must be collected after surgery (and recommended at least 14 days post surgery). Tumor must be documented as microsatellite stable or have intact mismatch repair proteins through CLIA-approved laboratory testing. Patients whose tumors are MSI-H or dMMR are excluded. The treating investigator must deem the patient a candidate for all potential agents used in this trial (5FU, LV, oxaliplatin and irinotecan). The interval between surgery (post-operative Day 7) and Step 1/Study entry must be no more than 60 days. NOTE: Step 1/Study Entry may occur as early as post operative Day 7, but it cannot occur beyond 60 days from the actual date of the patient's surgery. Availability and provision of adequate surgical tumor tissue for molecular diagnostics and confirmatory profiling. Adequate hematologic function within 28 days before Step 1/Study entry defined as follows: * Absolute neutrophil count (ANC) must be greater than or equal to 1500/mm3; * Participants with benign ethnic neutropenia (BEN): ANC less than 1300 mm3 are eligible. * BEN (also known as constitutional neutropenia) is an inherited cause of mild or moderate neutropenia that is not associated with any increased risk for infections or other clinical manifestations. BEN is referred to as ethnic neutropenia because of its increased prevalence in people of African descent and other specific ethnic groups. * Platelet count must be greater than or equal to 100,000/mm3; and * Hemoglobin must be greater than or equal to 9 g/dL. Adequate hepatic function within 28 days before Step 1/Study entry defined as follows: * total bilirubin must be less than or equal to ULN (upper limit of normal) for the lab and * alkaline phosphatase must be less than 2.5 x ULN for the lab; and * AST and ALT must be less than 2.5 x ULN for the lab. Adequate renal function within 28 days before Step 1/Study entry defined as serum creatinine less than or equal to 1.5 x ULN for the lab or measured or calculated creatinine clearance greater than or equal to 50 mL/min using the Cockroft-Gault formula for patients with creatinine levels greater than 1.5 x ULN for the lab. For Women Creatinine Clearance (mL/min) = (140 - age) x weight (kg) x 0.85 72 x serum creatinine (mg/dL) For Men Creatinine Clearance (mL/min) = (140 - age) x weight (kg) 72 x serum creatinine (mg/dL) NOTE: Adjusted body weight (AdjBW) should be used for patients that have BMI greater than or equal to 28 (less than or equal to 30% above IBW). HIV-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months are eligible for this trial. Pregnancy test (urine or serum according to institutional standard) done within 14 days before Step 1/Study entry must be negative (for women of childbearing potential only). Patients receiving a coumarin-derivative anticoagulant must agree to weekly monitoring of INR if they are randomized to Arm 1 or Arm 3 and receive capecitabine. Eligibility Criteria for Cohort A Arm-2 patients on Second Randomization Patient must have developed a ctDNA +ve assay during serial monitoring. Patient's willingness to be re-randomized affirmed. The patient must continue to have an ECOG performance status of 0 or 1. No radiographic evidence of overt metastatic disease. Pregnancy test (urine or serum according to institutional standard) done within 14 days before second randomization must be negative (for women of childbearing potential only). Adequate hematologic function within 28 days before second randomization defined as follows: * Absolute neutrophil count (ANC) must be greater than or equal to 1500/mm3; * Participants with benign ethnic neutropenia (BEN): ANC less than 1300 mm3 are eligible. * BEN (also known as constitutional neutropenia) is an inherited cause of mild or moderate neutropenia that is not associated with any increased risk for infections or other clinical manifestations. BEN is referred to as ethnic neutropenia because of its increased prevalence in people of African descent and other specific ethnic groups. * Platelet count must be greater than or equal to 100,000/mm3; and * Hemoglobin must be greater than or equal to 9 g/dL. Adequate hepatic function within 28 days before second randomization defined as follows: * total bilirubin must be less than or equal to ULN (upper limit of normal) for the lab and * alkaline phosphatase must be less than 2.5 x ULN for the lab; and * AST and ALT must be less than 2.5 x ULN for the lab. Adequate renal function within 28 days before second randomization defined as serum creatinine less than or equal to 1.5 x ULN for the lab or measured or calculated creatinine clearance greater than or equal to 50 mL/min using the Cockroft-Gault formula for patients with creatinine levels greater than 1.5 x ULN for the lab. For Women Creatinine Clearance (mL/min) = (140 - age) x weight (kg) x 0.85 72 x serum creatinine (mg/dL) For Men Creatinine Clearance (mL/min) = (140 - age) x weight (kg) 72 x serum creatinine (mg/dL) Exclusion Criteria: Colon cancer histology other than adenocarcinoma (i.e., neuroendocrine carcinoma, sarcoma, lymphoma, squamous cell carcinoma, etc.). Pathologic, clinical, or radiologic overt evidence of metastatic disease. This includes isolated, distant, or non-contiguous intra-abdominal metastases, even if resected. Tumor-related bowel perforation. History of prior invasive colon malignancy, regardless of disease-free interval. History of bone marrow or solid organ transplantation (regardless of current immunosuppressive therapy needs). Bone grafts, skin grafts, corneal transplants and organ/tissue donation are not exclusionary. Any prior systemic chemotherapy, targeted therapy, or immunotherapy; or radiation therapy administered as treatment for colorectal cancer (e.g., primary colon adenocarcinomas for which treatment with neoadjuvant chemotherapy and/or radiation is warranted are not permitted). EXCEPTION: one cycle of chemotherapy (regimen per treating physicians' discretion - 5-FU or capecitabine with or without oxaliplatin) is allowed but not required after consent. The optional cycle of chemotherapy should be started greater than or equal to 4 weeks from surgery and while awaiting Step 2 randomization. Other invasive malignancy within 5 years before Step 1/Study entry. Exceptions are colonic polyps, non-melanoma skin cancer or any carcinoma-in-situ. Synchronous primary rectal and/ or colon cancers. Patients with known history or current symptoms of cardiac disease, or history of treatment with cardiotoxic agents, should have a clinical risk assessment of cardiac function using the New York Heart Association Functional Classification. To be eligible for this trial, patients should be class 2B or better. Sensory or motor neuropathy greater than or equal to grade 2, according to CTCAE v5.0. Blood transfusion within two weeks before collection of blood for central ctDNA testing. Active seizure disorder uncontrolled by medication. Active or chronic infection requiring systemic therapy. Known homozygous DPD (dihydropyrimidine dehydrogenase) deficiency. Patients known to have Gilbert's Syndrome or homozygosity for UGT1A1\*28 polymorphism. Pregnancy or lactation at the time of Step 1/Study entry. Co-morbid illnesses or other concurrent disease that would make the patient inappropriate for entry into this study (i.e., unable to tolerate 6 months of combination chemotherapy or interfere significantly with the proper assessment of safety and toxicity of the prescribed regimens or prevent required follow-up). Ineligibility Criteria for Cohort A Arm-2 patients on Second Randomization Pregnancy or lactation at the time of randomization. No longer a candidate for systemic chemotherapy (FOLFOX, CAPOX, and mFOLFIRINOX) in the opinion of the treating investigator.

זכאות במשפטים פשוטים

הקריטריונים של רשומה זו טרם פורקו למשפטים נפרדים. טקסט המרשם שלמעלה שלם והוא הגרסה המחייבת.

תכנון המחקר

תכנון המחקר
סוג המחקרהתערבותי
שלבשלב 2 / שלב 3
הקצאהאקראי
מודל ההתערבותPARALLEL
מטרה ראשיתTREATMENT
הסתרהNONE (0)
גיוסדרושים 1,912 משתתפים

נותן חסות ושותפים

  • NRG Oncology נותן חסות
  • Natera, Inc. שותפים
  • National Cancer Institute (NCI) שותפים

זרועות והתערבויות

  • Cohort A - Arm 1 (ctDNA-ve)ACTIVE_COMPARATOR

    Oxaliplatin 85 mg/m2 IV + Leucovorin 400mg/m2 IV + 5-Fluorouracil (5-FU) 400mg/m2 bolus + 5-Fluorouracil (5-FU) 2400mg/m2 IV continuous infusion over 46-48 hours (total dose) Day1 every 2 weeks for 6-12 cycles OR Oxaliplatin 130 mg/m2 IV Day 1 every 3 weeks + Capecitabine 1000 mg/m2 BID by mouth days 1-14 every 3 weeks for 4 cycles

  • Cohort A - Arm 2 (ctDNA-ve)EXPERIMENTAL

    Serial ctDNA monitoring no treatment

  • Cohort B - Arm 3 (ctDNA+ve)ACTIVE_COMPARATOR

    Oxaliplatin 85 mg/m2 IV + Leucovorin 400mg/m2 IV + 5-Fluorouracil (5-FU) 400mg/m2 bolus + 5-Fluorouracil (5-FU) 2400mg/m2 IV continuous infusion over 46-48 hours (total dose) Day1 every 2 weeks for 12 cycles OR Oxaliplatin 130 mg/m2 IV Day 1 every 3 weeks + Capecitabine 1000 mg/m2 BID by mouth days 1-14 every 3 weeks for 8 cycles

  • Cohort B - Arm 4 (ctDNA+ve)EXPERIMENTAL

    Oxaliplatin 85 mg/m2 IV + Leucovorin 400mg/m2 IV + Irinotecan 150 mg/m2 IV continuous infusion (30-90 minutes) + 5-Fluorouracil (5-FU) 2400mg/m2 IV continuous infusion over 46-48 hours (total dose) Day1 every 2 weeks for 12 cycles

התערבויות

  • תרופה CAPOX 3 month

    Oxaliplatin 130 mg/m2 IV Day 1 every 3 weeks + Capecitabine 1000 mg/m2 BID by mouth days 1-14 every 3 weeks for 4 cycles

  • תרופה CAPOX 6 month

    Oxaliplatin 130 mg/m2 IV Day 1 every 3 weeks + Capecitabine 1000 mg/m2 BID by mouth days 1-14 every 3 weeks for 8 cycles

  • התקן Signatera test

    Central ctDNA testing for all patients

  • תרופה mFOLFIRINOX

    Oxaliplatin 85 mg/m2 IV + Leucovorin 400mg/m2 IV + Irinotecan 150 mg/m2 IV continuous infusion (30-90 minutes) + 5-Fluorouracil (5-FU) 2400mg/m2 IV continuous infusion over 46-48 hours (total dose) Day1 every 2 weeks for 12 cycles

  • תרופה mFOLFOX6 3-6 month

    Oxaliplatin 85 mg/m2 IV + Leucovorin 400mg/m2 IV + 5-Fluorouracil (5-FU) 400mg/m2 bolus + 5-Fluorouracil (5-FU) 2400mg/m2 IV continuous infusion over 46-48 hours (total dose) Day1 every 2 weeks for 6-12 cycles

  • תרופה mFOLFOX6 6 month

    Oxaliplatin 85 mg/m2 IV + Leucovorin 400mg/m2 IV + 5-Fluorouracil (5-FU) 400mg/m2 bolus + 5-Fluorouracil (5-FU) 2400mg/m2 IV continuous infusion over 46-48 hours (total dose) Day1 every 2 weeks for 12 cycles

מדדי תוצאה

  1. מדד תוצאה ראשוני

    ctDNA positive status (TTPos)

    TTPos is defined as time from randomization until ctDNA positive event: TTPos events are first ctDNA positive result after randomization for the immediate adjuvant chemo arm (Arm 1), 2nd ctDNA positive result after randomization for the delayed adjuvant chemo (Arm 2) and recurrence without a positive ctDNA result for both arms.

    מסגרת זמן Time from randomization to the first TTPos event, a maximum of 3 years

  2. מדד תוצאה ראשוני

    Disease-Free Survival (DFS)

    Time from randomization to first disease-free survival event (recurrence, second primary colorectal cancer or death from any cause).

    מסגרת זמן Time from randomization to disease-free survival event, a maximum of 5 years]

  3. מדד תוצאה משני

    Baseline post-surgery ctDNA positivity rate

    percentage of patients with ctDNA positive results post-surgery at study entry.

    מסגרת זמן At time of randomization

  4. מדד תוצאה משני

    Overall Survival (OS)

    Time from randomization to death of any cause.

    מסגרת זמן Time from randomization to death, a maximum of 5 years.

  5. מדד תוצאה משני

    Recurrence

    Time from randomization to disease recurrence.

    מסגרת זמן Time from randomization to disease recurrence, a maximum of 5 years

  6. מדד תוצאה משני

    Compliance with adjuvant chemotherapy

    number of cycles of chemotherapy received.

    מסגרת זמן from randomization to the last cycle of chemotherapy, a maximum of 6 months.

תאריכים

תאריכים
תאריך התחלה8 ביולי 2022 (בפועל)
סיום ראשוני10 במרץ 2029 (משוער)
סיום10 במרץ 2030 (משוער)
פורסם לראשונה30 בדצמבר 2021 (בפועל)
עודכן לאחרונה2 בספטמבר 2026
התוצאות פורסמולא צוין ברשומת המרשם
המצב אומת לאחרונהספטמבר 2026

בפועל פירושו שהאירוע התרחש. משוער פירושו שנותן החסות צופה אותו. שתי המשמעויות שונות זו מזו.

מיקומים

964 אתרים מגייסים

Canada

Canada
מתקןעירמדינה או אזורמצב
Royal Victoria Regional Health CentreBarrieOntarioמגייס
Arthur J E Child Comprehensive Cancer CentreCalgaryAlbertaמגייס
Cambridge Memorial HospitalCambridgeOntarioמגייס
CSSS Champlain-Charles Le MoyneGreenfield ParkQuebecמגייס
Juravinski Cancer Centre at Hamilton Health SciencesHamiltonOntarioמגייס
Kingston Health Sciences CentreKingstonOntarioמגייס
Waterloo Regional Health NetworkKitchenerOntarioמגייס
London Regional Cancer ProgramLondonOntarioמגייס
Hotel-Dieu De LevisLévisQuebecמגייס
Markham Stouffville HospitalMarkhamOntarioמגייס
Jewish General HospitalMontrealQuebecמגייס
Hopital Du Sacre-Coeur de MontrealMontrealQuebecמגייס
CIUSSSEMTL-Hopital Maisonneuve-RosemontMontrealQuebecמגייס
Stronach Regional Health Centre at SouthlakeNewmarketOntarioמגייס
Lakeridge Health OshawaOshawaOntarioמגייס
Ottawa Hospital and Cancer Center-General CampusOttawaOntarioמגייס
BCCA-Cancer Centre for the NorthPrince GeorgeBritish Columbiaמגייס
CHU de Quebec-L'Hotel-Dieu de Quebec (HDQ)QuébecQuebecמגייס
Allan Blair Cancer CentreReginaSaskatchewanמגייס
Niagara Health System-Saint Catharines GeneralSaint CatharinesOntarioמגייס
Atlantic Health Sciences Corporation-Saint John Regional HospitalSaint JohnNew Brunswickמגייס
Saskatoon Cancer CentreSaskatoonSaskatchewanמגייס
Centre Hospitalier Universitaire de Sherbrooke-FleurimontSherbrookeQuebecמגייס
Doctor H. Bliss Murphy Cancer CentreSt. John'sNewfoundland and Labradorמגייס
Odette Cancer Centre- Sunnybrook Health Sciences CentreTorontoOntarioמגייס
Humber River HospitalTorontoOntarioמגייס
North York General HospitalTorontoOntarioמגייס
Saint Michael's HospitalTorontoOntarioמגייס
BCCA-Vancouver Cancer CentreVancouverBritish Columbiaמגייס
BCCA-Vancouver Island Cancer CentreVictoriaBritish Columbiaמגייס
Windsor Regional Cancer CentreWindsorOntarioמושהה

Puerto Rico

Puerto Rico
מתקןעירמדינה או אזורמצב
Pan American Center for Oncology Trials LLC - CayeyCayeyמגייס
Pan American Center for Oncology Trials LLC - DoradoDoradoמגייס
Doctors Cancer CenterManatiמגייס
Pan American Center for Oncology Trials LLCSan Juanמגייס
Pan American Center for Oncology Trials LLC - MayaguezSan JuanPRמגייס
Centro Comprensivo de Cancer de UPRSan Juanמגייס
PROncologySan Juanמגייס
San Juan City HospitalSan Juanמגייס
Pan American Center for Oncology Trials LLC - CiudadelaSan Juanמגייס

United States

United States
מתקןעירמדינה או אזורמצב
Abbeville General HospitalAbbevilleLouisianaמגייס
UM Upper Chesapeake Hematology and Oncology - AberdeenAberdeenMarylandמגייס
Avera Cancer Institute-AberdeenAberdeenSouth Dakotaמגייס
Cleveland Clinic Akron GeneralAkronOhioמגייס
Summa Health System - Akron CampusAkronOhioמגייס
Phoebe Putney Memorial HospitalAlbanyGeorgiaמגייס
University of New Mexico Cancer CenterAlbuquerqueNew Mexicoמגייס
Presbyterian Kaseman HospitalAlbuquerqueNew Mexicoמגייס
Lehigh Valley Hospital-Cedar CrestAllentownPennsylvaniaמגייס
Aultman Alliance Community HospitalAllianceOhioמגייס

1,027 אתרים נוספים מצוינים ברשומת המרשם.

מסמכי המחקר

לא צורפו מסמכים ברשומת מרשם זו.

שינויים לאורך זמן

  1. 2 בספטמבר 2026

    אתר נוסף

    11 sites added (1077 total)

    10661077

  2. 4 באוגוסט 2026

    אתר נוסף

    3 sites added (1066 total)

    10631066