First-line Treatment of MCapOX + Cetuximab Vs. MFOLFOX6 + Cetuximab for RAS/BRAF Wild-type, MSS, Unresectable Left-Sided MCRC: a Multicenter, Randomized, Controlled, Phase III Study

Trial Title: First-line Treatment of MCapOX + Cetuximab Vs. MFOLFOX6 + Cetuximab for RAS/BRAF Wild-type, MSS, Unresectable Left-Sided MCRC: a Multicenter, Randomized, Controlled, Phase III Study

NCT ID: NCT06616259

Condition: Colorectal Cancer (CRC)
Capecitabine
Cetuximab

Conditions: Official terms:
Colorectal Neoplasms
Cetuximab

Conditions: Keywords:
CAPCET-III

Study type: Interventional

Study phase: Phase 3

Overall status: Not yet recruiting

Study design:

Allocation: Randomized

Intervention model: Parallel Assignment

Primary purpose: Treatment

Masking: None (Open Label)

Intervention:

Intervention type: Drug
Intervention name: mCapOX plus Cetuximab
Description: mCapOX plus Cetuximab Induction therapy：Capecitabine 1000mg/m2 po, bid, D1-7 + Oxaliplatin ivgtt 85mg/m2, D1 + Cetuximab ivgtt 500mg/m2, D1; Q2W. Up to 12 cycle, if no progression, enter maintenance therapy. Maintenance therapy: Capecitabine 1000mg/m2 po, bid, D1-7 + Cetuximab ivgtt 500mg/m2, D1; Q2W. Until disease progression or toxicity is not tolerated. Cetuximab can be discontinued alone if not tolerated. Treatment after progression of maintenance therapy: Participants have the option to accept reintroducing the first-line induction chemotherapy regimen (mCapOx or mFOLFOX6 in combination with cetuximab) or accept second-line therapy.
Arm group label: Arm A

Intervention type: Drug
Intervention name: mFOLFOX6 plus Cetuximab
Description: mFOLFOX6 plus Cetuximab Induction therapy：Oxaliplatin ivgtt 85mg/m2, D1 + Leucovorin ivgtt 400mg/m2, D1 + Fluorouracil iv bolus 400mg/m2, D1 + Fluorouracil 2400mg/m2 continuous infusion for 46-48h + Cetuximab ivgtt 500mg/m2, D1; Q2W. Up to 12 cycle, if no progression, enter maintenance therapy. Maintenance therapy: Capecitabine 1000mg/m2 po, bid, D1-7 + Cetuximab ivgtt 500mg/m2, D1; Q2W. Until disease progression or toxicity is not tolerated. Cetuximab can be discontinued alone if not tolerated. Treatment after progression of maintenance therapy: Participants have the option to accept reintroducing the first-line induction chemotherapy regimen (mCapOx or mFOLFOX6 in combination with cetuximab) or accept second-line therapy.
Arm group label: Arm B

Summary: This multicenter, randomized, controlled, phase III study is conducted to evaluate the efficacy and safety of first line mCapOX plus Cetuximab versus mFOLFOX6 plus Cetuximab for RAS/BRAF wild-type, MSS, Unresectable Left-Sided mCRC.

Detailed description: Study participants who meet the enrollment criteria will be randomly assigned in a 1:1 ratio to either the mCapOX + cetuximab or mFOLFOX6 + cetuximab treatment groups, and those who have achieved control of their disease (Complete response [CR] + Partial response [PR] + Stable disease [SD]) after a maximum of 12 cycles of first-line induction therapy in both groups will continue to receive Capecitabine or Capecitabine + Cetuximab maintenance therapy until disease progression or toxicity is not tolerated or informed consent is withdrawn.

Criteria for eligibility:
Criteria:
Inclusion Criteria: - Able to provide written informed consent and can understand and comply with the requirements of the study. - Men and women ≥ 18 years of age. - Patients with histologically or cytologically confirmed RAS and BRAF wild-type, MSS/pMMR, metastatic left-sided colorectal adenocarcinoma. - Presence of at least one evaluable lesion, as defined in RECIST Version 1.1. - With an Eastern Cooperative Oncology Group (ECOG) performance status of 0-1. - No palliative first-line chemotherapy, targeted, immunotherapy, or prior platinum-based adjuvant chemotherapy, relapse more than 12 months from the end of adjuvant chemotherapy. - According to the imaging findings and surgical assessment of initial unresectable, synchronous metastatic colorectal cancer, no serious complications of the primary tumor (obstruction, perforation, massive hemorrhage that cannot be treated in internal medicine, etc.) . - Requirements for lab indicators: neutrophils ≥ 1.5 × 10^9/L, platelets ≥ 75 × 10^9/L, hemoglobin ≥ 8 g/dL; total bilirubin ≤ 1.5 × upper limit of normal (UNL); ASAT (SGOT) and/or ALAT (SGPT) ≤ 2.5 × UNL (≤ 5 × UNL if liver metastases); alkaline phosphatase ≤ 2.5 × UNL (≤ 5 × UNL if liver metastases, ≤ 10 × UNL if bone metastases); LDH < 1500 U/L; creatinine clearance (calculated according to Cockcroft and Gault formula) > 50 mL/min or serum creatinine ≤ 1.5 × UNL. Exclusion Criteria: - Patients with mCRC who were initially resectable with R0 resection or radiofrequency or SBRT were excluded. - Patients diagnosed with MSI-H or dMMR by PCR or immunohistochemistry - Hypersensitivity to any therapeutic agent. - Patients who received adjuvant chemotherapy containing oxaliplatin and fluorouracil within 12 months before entering the study. - Patients who have failed one or more palliative chemotherapy regimens. - Patients with uncontrolled hepatitis B virus. - Peripheral neuropathy ≥ CTC grade 2. - Neurological or psychiatric disorders affecting cognitive performance. - Patients with central nervous system metastasis could not be controlled with radiotherapy. - Previous enteritis, chronic diarrhea, or recurrent bowel obstruction; uncontrolled bleeding from internal medicine; bowel perforation. - Uncontrolled concomitant diseases within 6 months before the study, including unstable angina, acute myocardial infarction, cerebrovascular accident, etc. - Pregnant or lactating patients, or those of childbearing potential who do not take adequate contraceptive measures. - History of other malignancies, but no disease-free survival longer than 5 years. - Patients concurrently receiving other anti-tumor treatment or participating in other interventional clinical trials. - Patients who are unable to comply with this study for psychological, family or social reasons. - Patients with other serious diseases that the investigator considers not suitable.

Gender: All

Minimum age: 18 Years

Maximum age: N/A

Healthy volunteers: No

Locations:

Facility:
Name: West China Hospital Sichuan University

Address:
City: Chengdu
Zip: 610041
Country: China

Contact:
Last name: Yuwen Zhou, M.D.

Phone: +028 15328007741
Email: drzhouyuwen@163.com

Contact backup:
Last name: Meng Qiu, M.D.

Start date: September 26, 2024

Completion date: September 30, 2029

Lead sponsor:
Agency: Meng Qiu
Agency class: Other

Source: West China Hospital

Record processing date: ClinicalTrials.gov processed this data on November 12, 2024

Source: ClinicalTrials.gov page: https://clinicaltrials.gov/ct2/show/NCT06616259