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Study Summary
No. 2009-0625:.......Colorectum......Michael Overman......Gastrointestinal Medical Oncology
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Study Summary Title
Study Summary
Number:
2009-0625
Study Title:Phase I/II Study of Azacitidine and CAPOX (Capecitabine + Oxaliplatin) in Metastatic Colorectal Cancer Patients Enriched for Hypermethylation of CpG Promoter Islands
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Physician New Patient Referral
Name:Michael OvermanPatients Call:800-392-1611 (in U.S.A.) 713-792-6161 (outside U.S.A.)
Dept:Gastrointestinal Medical OncologyReferring MD
Call:
800-392-1611 (in U.S.A.) 713-792-6161 (outside U.S.A.)
Phone:713-792-2828
Contact us about clinical trials
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General Information
Disease Group:ColorectumSupported By:Celgene
Phase of Study:Phase I/Phase IIReturn
Visit:
Every 3 weeks.
Treatment
Agents:
Azacitidine
Capecitabine
Oxaliplatin
Home Care:NA
Treatment Loc:Only at MDACC
Estimated
Length of Stay
in Houston:
NA
Description/
Intervention:
The goal of the Phase I portion of this study is to find the highest tolerable
dose of azacitidine combined with capecitabine and oxaliplatin (CAPOX) that can
be given to patients with metastatic colorectal cancer.

The goal of the Phase II portion of this study is to learn if azacitidine,
given in combination with CAPOX, can help to control metastatic colorectal
cancer. The safety of this drug combination will also be studied.
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Study Objectives / Outcomes
Phase 1 Study Objectives
1. To determine the dose limiting toxicity (DLT) of azacitidine combined with capecitabine and oxaliplatin (CAPOX) in patients with refractory metastatic colorectal cancer
2. To determine the maximum tolerated dose (MTD) for the combination of azacitidine and CAPOX in patients with refractory metastatic colorectal cancer

Phase II Study Objectives
A. Primary
1. To determine the response rate by RECIST version 1.1 criteria at the MTD for patients with CpG island methylator phenotype (CIMP)-high refractory metastatic colorectal cancer

B. Secondary
1. To determine the progression-free survival (PFS)
2. To determine the duration of tumor response (DR)
3. To determine the overall survival (OS)
4. To determine the safety profile and tolerability of this regimen in this patient population
5. To correlate peripheral blood mononuclear cell methylation changes with treatment outcomes
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Study Status Information
Study Activation / Registration Date:08/19/2010
IRB Review and Approval Date:08/19/2010
Study Type:Phase Ii Or Phase I/Ii
Recruitment Status:Open
Projected Accrual:N/A
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Enrollment Eligibility
If you do not meet the enrollment eligibility, there may be other treatment options for you. Please Contact the Referral Office for more information.

Inclusion Criteria:1) Phase I: Patient must have histologically or cytologically confirmed colorectal adenocarcinoma with metastatic disease documented on diagnostic imaging studies. Disease may be measurable or non-measurable as per RECIST version 1.1.

2) ECOG performance status 0-2

3) For patients on full-dose low-molecular weight anticoagulation, no active bleeding or pathological condition that carries a high risk of bleeding (e.g., tumor involving major vessels or know varices) is allowed.

4) Serum bilirubin levels </= 1.5 times the upper limit of the normal range for the laboratory (ULN)

5) Serum aspartate aminotransferase (AST) or serum alanine aminotransferase (ALT) levels </= 2.5 x ULN and </= 5 x ULN in patients with liver metastases

6) Serum creatinine levels </= 1.5 x ULN

7) Absolute neutrophil count of >/=1,500/mm^3 (ie, >/=1.5 x 10^9/L by International Units [IU]).

8) Platelet count >/=100,000/mm^3 (IU: ≥100 x 10^9/L).

9) Hemoglobin value of >/=9.0 g/dL.

10) No limit to number of prior therapies.

11) Women of childbearing potential must have a negative serum pregnancy test and must be advised to avoid becoming pregnant. Men should be advised to not father a child while receiving treatment. Sexually active women of childbearing potential and men must use an effective method of birth control during the course of the study, in a manner such that risk of failure is minimized.

12) Patient must be refractory to treatment with 5-FU (either intravenous 5-FU or as the oral prodrug, capecitabine) and oxaliplatin, defined as previous clinical or radiographic progression on or within 3 months of treatment with 5-FU and oxaliplatin. There is no limit to the number of prior lines of therapy.

13) Phase II: Patient must have histologically or cytologically confirmed colorectal adenocarcinoma with measurable metastatic disease documented on diagnostic imaging studies by RECIST version 1.1 criteria

14) Phase II: Patient must be known to have CpG island methylator phenotype.

Exclusion Criteria:1) Patients with known brain metastases or carcinomatous meningitis

2) Patients unable to swallow oral medications or with gastrointestinal disorders that might interfere with proper absorption of oral drugs.

3) Known dihydropyrimidine (DPD) deficiency

4) Grade 3 or more peripheral neuropathy

5) Chemotherapy or any other investigational agents within 14 days of first receipt of study treatment, or major surgery within 28 days of first receipt of study treatment, or palliative radiation within 7 days of first receipt of study treatment.

6) Concurrent severe and/or uncontrolled medical conditions which could compromise participation in the study such as unstable angina, myocardial infarction within 6 months, unstable symptomatic arrhythmia, uncontrolled diabetes, serious active or uncontrolled infection.

7) Known or suspected hypersensitivity to azacitidine or mannitol

8) Pregnant or breast feeding

9) Because of the interaction between coumadin and capecitabine patients taking therapeutic doses of coumarin-derivative anticoagulants, are not eligible. Low-dose Coumadin (e.g. 1 mg PO per day) in patients with in-dwelling venous access devices is allowed but increased frequency of INR monitoring is recommended.

10) Interstitial pneumonia or extensive and symptomatic interstitial fibrosis of the lung.

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Links
Registration Number: NCT01193517
Study Information on Clinical Trials Registry (clinicaltrials.gov)

Other Links:
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Results


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