Academic Journal

Intraperitoneal irinotecan with concomitant FOLFOX and bevacizumab for patients with unresectable colorectal peritoneal metastases: protocol of the multicentre, open-label, phase II, INTERACT-II trial

التفاصيل البيبلوغرافية
العنوان: Intraperitoneal irinotecan with concomitant FOLFOX and bevacizumab for patients with unresectable colorectal peritoneal metastases: protocol of the multicentre, open-label, phase II, INTERACT-II trial
المؤلفون: Jacobus W A Burger, Cornelis Verhoef, Eva V E Madsen, Robin J Lurvink, Joost Nederend, Onno Kranenburg, Geert-Jan M Creemers, Simon W Nienhuijs, Alexandra R M Brandt-Kerkhof, Esther van Meerten, Stijn L W Koolen, Ignace H J T de Hingh, Ron H J Mathijssen, Niels A D Guchelaar, Vincent C J van de Vlasakker, Teun B M van den Heuvel, Ramon J F Bax, Irene E G van Hellemond
المصدر: BMJ Open, Vol 14, Iss 1 (2024)
بيانات النشر: BMJ Publishing Group, 2024.
سنة النشر: 2024
المجموعة: LCC:Medicine
مصطلحات موضوعية: Medicine
الوصف: Introduction The peritoneum is the second most affected organ for the dissemination of colorectal cancer (CRC). Patients with colorectal peritoneal metastases (CPM) face a poor prognosis, despite the majority of patients being treated with palliative systemic therapy. The efficacy of palliative systemic therapy is limited due to the plasma-peritoneum barrier. The poor prognosis of unresectable CPM patients has resulted in the development of new treatment strategies where systemic therapy is combined with local, intraperitoneal chemotherapy. In the recently published phase I study, the maximum tolerated dose and thus the recommended phase II dose of intraperitoneal irinotecan was investigated and determined to be 75 mg. In the present study, the overall survival after treatment with 75 mg irinotecan with concomitant mFOLFOX4 and bevacizumab will be investigated.Materials and methods In this single-arm phase II study in two Dutch tertiary referral centres, 85 patients are enrolled. Eligibility criteria are an adequate performance status and organ function, histologically confirmed microsatellite stable and unresectable CPM, no previous palliative therapy for CRC, no systemic therapy20, too extensive small bowel involvement), a peritoneal access port and a port-a-cath are placed for administration of intraperitoneal and intravenous chemotherapy, respectively. Patients may undergo up to 12 cycles of study treatment. Each cycle consists of intravenous mFOLFOX4 with bevacizumab and concomitant intraperitoneal irinotecan (75 mg), which is repeated every 2 weeks, with a maximum of 12 cycles. Modified FOLFOX-4 regimen consists of 85 mg/m2 oxaliplatin plus 200 mg/m2 LV and 5-FU 400 mg/m2 bolus on day 1 followed by 1600 mg/m2 5-FU as a 46 hours infusion. Study treatment ends after the 12th cycle, or earlier in case of disease progression or unacceptable toxicity. The primary outcome is overall survival and key secondary outcomes are progression-free survival, safety (measured by the amount of grade ≥3 adverse events (Common Terminology Criteria for Adverse Events V.5.0)), patient-reported outcomes and pharmacokinetics of irinotecan. It is hypothesised that the trial treatment will lead to a 4 month increase in overall survival; from a median of 12.2 to 16.2 months.Ethics and dissemination This study is approved by the Dutch Authority (CCMO, the Hague, the Netherlands), by a central medical ethics committee (MEC-U, Nieuwegein, the Netherlands) and by the institutional research boards of both research centres. Results will be submitted for publication in peer-reviewed medical journals and presented to patients and healthcare professionals.Trial registration number NCT06003998.
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 2044-6055
Relation: https://bmjopen.bmj.com/content/14/1/e077667.full; https://doaj.org/toc/2044-6055
DOI: 10.1136/bmjopen-2023-077667
URL الوصول: https://doaj.org/article/877cd15e67af4bc4a42c3f8c7e9ff4ae
رقم الانضمام: edsdoj.877cd15e67af4bc4a42c3f8c7e9ff4ae
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:20446055
DOI:10.1136/bmjopen-2023-077667