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Brief Title: S0713: Oxaliplatin, Capecitabine, Cetuximab, and RT Followed By Surgery in Pts W/Stage II or III Rectal Cancer
Official Title: A Phase II Study of Oxaliplatin, Capecitabine, Cetuximab and Radiation in Pre-Operative Therapy of Rectal Cancer
Study ID: NCT00686166
Brief Summary: RATIONALE: Drugs used in chemotherapy, such as oxaliplatin and capecitabine, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Monoclonal antibodies, such as cetuximab, can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Radiation therapy uses high-energy x-rays to kill tumor cells. Giving chemotherapy and radiation therapy before surgery may make the tumor smaller and reduce the amount of normal tissue that needs to be removed. PURPOSE: This phase II trial is studying the side effects and how well giving oxaliplatin, capecitabine, and cetuximab together with radiation therapy followed by surgery works in treating patients with stage II or stage III rectal cancer.
Detailed Description: OBJECTIVES: * To assess the pathologic complete response rate for the combination of oxaliplatin, capecitabine, and cetuximab alone and concurrently with external beam radiotherapy for patients with adenocarcinoma of the rectum, stages II and III with wild-type K-ras. * To estimate the 3-year disease-free survival probability in this patient population when treated with this regimen. * To assess the frequency and severity of toxicities associated with this regimen in these patients. * To explore, preliminarily, the association between expression levels of genes involved in the DNA repair, EGFR (epidermal growth factor receptor), angiogenesis, and 5-FU pathway (i.e., k-ras, TS \[Thymidylate Synthase\], ERCC-1 \[excision repair cross complementing-1), TP \[Thymidine phosphorylase\], DPD \[Dihydropyrimidine dehydrogenase\], EGFR, VEGF \[vascular endothelial growth factor\], and IL-8 \[interleukin-8\]) and pathologic complete response. (Due to advances in methodology, the translational medicine objectives are being reconsidered. Therefore, results for this objective are not reported) * To explore, preliminarily, the intratumoral gene expression levels of these genes after completion of study treatment.(Due to advances in methodology, the translational medicine objectives are being reconsidered. Therefore, results for this objective are not reported) * To obtain, preliminarily, data on genomic polymorphisms of these genes for correlation with clinical outcome and toxicity. (Due to advances in methodology, the translational medicine objectives are being reconsidered. Therefore, results for this objective are not reported) OUTLINE: This is a multicenter study. * Neoadjuvant therapy (course 1): Patients receive oxaliplatin IV over 2 hours once a week for 5 weeks, oral capecitabine twice daily 5 days a week for 5 weeks, and cetuximab IV over 1-2 hours once a week for 5 weeks. * Neoadjuvant therapy with concurrent radiotherapy (course 2): Beginning two weeks later, patients receive oxaliplatin IV over 2 hours once a week in weeks 1, 2, 4, and 5. Patients also receive capecitabine and cetuximab as in course 1. Patients also undergo external beam radiotherapy 5 days a week for 5 weeks beginning in week 1. Treatment continues in the absence of disease progression or unacceptable toxicity. Patients undergo surgery 3-8 weeks after completion of chemoradiotherapy. Blood samples are collected for germline polymorphism testing and tissue samples are collected and assessed for gene expression analysis. After completion of study treatment, patients are followed every 6 months for 4 years.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
Providence Cancer Center at Providence Hospital, Mobile, Alabama, United States
Arizona Cancer Center at UMC Orange Grove, Tucson, Arizona, United States
Arizona Cancer Center at University Medical Center North, Tucson, Arizona, United States
Arizona Cancer Center at University of Arizona Health Sciences Center, Tucson, Arizona, United States
Alta Bates Summit Comprehensive Cancer Center, Berkeley, California, United States
Peninsula Medical Center, Burlingame, California, United States
USC/Norris Comprehensive Cancer Center and Hospital, Los Angeles, California, United States
Sutter Health - Western Division Cancer Research Group, Novato, California, United States
Desert Regional Medical Center Comprehensive Cancer Center, Palm Springs, California, United States
Sutter Cancer Center at Roseville Medical Center, Roseville, California, United States
Sutter Cancer Center, Sacramento, California, United States
California Pacific Medical Center - California Campus, San Francisco, California, United States
Sutter Pacific Medical Foundation, Santa Rosa, California, United States
Sutter Solano Medical Center, Vallejo, California, United States
Memorial Hospital Cancer Center - Colorado Springs, Colorado Springs, Colorado, United States
Poudre Valley Hospital, Fort Collins, Colorado, United States
Front Range Cancer Specialists, Fort Collins, Colorado, United States
Decatur Memorial Hospital Cancer Care Institute, Decatur, Illinois, United States
Cardinal Bernardin Cancer Center at Loyola University Medical Center, Maywood, Illinois, United States
Regional Cancer Center at Memorial Medical Center, Springfield, Illinois, United States
St. Francis Hospital and Health Centers - Beech Grove Campus, Beech Grove, Indiana, United States
Reid Hospital & Health Care Services, Richmond, Indiana, United States
Cancer Center of Kansas, PA - Chanute, Chanute, Kansas, United States
Cancer Center of Kansas, PA - Dodge City, Dodge City, Kansas, United States
Cancer Center of Kansas - Fort Scott, Fort Scott, Kansas, United States
Hays Medical Center, Hays, Kansas, United States
Hutchinson Hospital Corporation, Hutchinson, Kansas, United States
Cancer Center of Kansas-Independence, Independence, Kansas, United States
Kansas City Cancer Centers - West, Kansas City, Kansas, United States
Kansas Masonic Cancer Research Institute at the University of Kansas Medical Center, Kansas City, Kansas, United States
Cancer Center of Kansas, PA - Kingman, Kingman, Kansas, United States
Lawrence Memorial Hospital, Lawrence, Kansas, United States
Cancer Center of Kansas, PA - Liberal, Liberal, Kansas, United States
Cancer Center of Kansas, PA - Newton, Newton, Kansas, United States
Kansas City Cancer Centers - Southwest, Overland Park, Kansas, United States
Cancer Center of Kansas, PA - Parsons, Parsons, Kansas, United States
Mount Carmel Regional Cancer Center, Pittsburg, Kansas, United States
Cancer Center of Kansas, PA - Pratt, Pratt, Kansas, United States
Cancer Center of Kansas, PA - Salina, Salina, Kansas, United States
Tammy Walker Cancer Center at Salina Regional Health Center, Salina, Kansas, United States
Kansas City Cancer Center - Shawnee Mission, Shawnee Mission, Kansas, United States
St. Francis Comprehensive Cancer Center, Topeka, Kansas, United States
Cancer Center of Kansas, PA - Wellington, Wellington, Kansas, United States
Associates in Womens Health, PA - North Review, Wichita, Kansas, United States
Cancer Center of Kansas, PA - Medical Arts Tower, Wichita, Kansas, United States
Cancer Center of Kansas, PA - Wichita, Wichita, Kansas, United States
CCOP - Wichita, Wichita, Kansas, United States
Via Christi Cancer Center at Via Christi Regional Medical Center, Wichita, Kansas, United States
Wesley Medical Center, Wichita, Kansas, United States
Cancer Center of Kansas, PA - Winfield, Winfield, Kansas, United States
Alvin and Lois Lapidus Cancer Institute at Sinai Hospital, Baltimore, Maryland, United States
University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan, United States
Battle Creek Health System Cancer Care Center, Battle Creek, Michigan, United States
Mecosta County Medical Center, Big Rapids, Michigan, United States
Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, United States
Josephine Ford Cancer Center at Henry Ford Hospital, Detroit, Michigan, United States
Butterworth Hospital at Spectrum Health, Grand Rapids, Michigan, United States
CCOP - Grand Rapids, Grand Rapids, Michigan, United States
Lacks Cancer Center at Saint Mary's Health Care, Grand Rapids, Michigan, United States
Mercy General Health Partners, Muskegon, Michigan, United States
Spectrum Health Reed City Hospital, Reed City, Michigan, United States
Munson Medical Center, Traverse City, Michigan, United States
University of Mississippi Cancer Clinic, Jackson, Mississippi, United States
Regional Cancer Center at Singing River Hospital, Pascagoula, Mississippi, United States
Truman Medical Center - Hospital Hill, Kansas City, Missouri, United States
Kansas City Cancer Centers - South, Kansas City, Missouri, United States
Kansas City Cancer Centers - North, Kansas City, Missouri, United States
Kansas City Cancer Centers - East, Lee's Summit, Missouri, United States
Good Samaritan Cancer Center at Good Samaritan Hospital, Kearney, Nebraska, United States
Interlakes Oncology/Hematology PC, Rochester, New York, United States
James P. Wilmot Cancer Center at University of Rochester Medical Center, Rochester, New York, United States
Presbyterian Cancer Center at Presbyterian Hospital, Charlotte, North Carolina, United States
Wayne Memorial Hospital, Incorporated, Goldsboro, North Carolina, United States
Iredell Memorial Hospital, Statesville, North Carolina, United States
McDowell Cancer Center at Akron General Medical Center, Akron, Ohio, United States
Grandview Hospital, Dayton, Ohio, United States
Good Samaritan Hospital, Dayton, Ohio, United States
David L. Rike Cancer Center at Miami Valley Hospital, Dayton, Ohio, United States
Samaritan North Cancer Care Center, Dayton, Ohio, United States
CCOP - Dayton, Dayton, Ohio, United States
Blanchard Valley Medical Associates, Findlay, Ohio, United States
Middletown Regional Hospital, Franklin, Ohio, United States
Wayne Hospital, Greenville, Ohio, United States
Charles F. Kettering Memorial Hospital, Kettering, Ohio, United States
UVMC Cancer Care Center at Upper Valley Medical Center, Troy, Ohio, United States
Ruth G. McMillan Cancer Center at Greene Memorial Hospital, Xenia, Ohio, United States
AnMed Cancer Center, Anderson, South Carolina, United States
Roper St. Francis Cancer Center at Roper Hospital, Charleston, South Carolina, United States
Bon Secours St. Francis Health System, Greenville, South Carolina, United States
CCOP - Upstate Carolina, Spartanburg, South Carolina, United States
Gibbs Regional Cancer Center at Spartanburg Regional Medical Center, Spartanburg, South Carolina, United States
U.T. Medical Center Cancer Institute, Knoxville, Tennessee, United States
Southwest Regional Cancer Center - Central, Austin, Texas, United States
Texas Oncology, PA at Texas Oncology Cancer Center - Central, Austin, Texas, United States
Texas Oncology, PA at South Austin Cancer Center, Austin, Texas, United States
Texas Oncology, PA - Austin North, Austin, Texas, United States
Texas Oncology, PA - Cedar Park, Cedar Park, Texas, United States
Baylor University Medical Center - Houston, Houston, Texas, United States
Ben Taub General Hospital, Houston, Texas, United States
St. Luke's Texas Cancer Institute at St. Luke's Episcopal Hospital, Houston, Texas, United States
Veterans Affairs Medical Center - Houston, Houston, Texas, United States
Texas Oncology, PA - Seton Williamson, Round Rock, Texas, United States
Texas Oncology, PA at Texas Cancer Center Round Rock, Round Rock, Texas, United States
Texas Oncology, PA - San Marcos, San Marcos, Texas, United States
American Fork Hospital, American Fork, Utah, United States
Sandra L. Maxwell Cancer Center, Cedar City, Utah, United States
Logan Regional Hospital, Logan, Utah, United States
Jon and Karen Huntsman Cancer Center at Intermountain Medical Center, Murray, Utah, United States
Val and Ann Browning Cancer Center at McKay-Dee Hospital Center, Ogden, Utah, United States
Utah Valley Regional Medical Center - Provo, Provo, Utah, United States
Dixie Regional Medical Center - East Campus, Saint George, Utah, United States
LDS Hospital, Salt Lake City, Utah, United States
Island Hospital Cancer Care Center at Island Hospital, Anacortes, Washington, United States
St. Joseph Cancer Center, Bellingham, Washington, United States
Olympic Hematology and Oncology, Bremerton, Washington, United States
Highline Medical Center Cancer Center, Burien, Washington, United States
Swedish Medical Center - Issaquah Campus, Issaquah, Washington, United States
Columbia Basin Hematology, Kennewick, Washington, United States
Skagit Valley Hospital Cancer Care Center, Mount Vernon, Washington, United States
Harrison Poulsbo Hematology and Onocology, Poulsbo, Washington, United States
Harborview Medical Center, Seattle, Washington, United States
Fred Hutchinson Cancer Research Center, Seattle, Washington, United States
Group Health Central Hospital, Seattle, Washington, United States
Swedish Cancer Institute at Swedish Medical Center - First Hill Campus, Seattle, Washington, United States
Polyclinic First Hill, Seattle, Washington, United States
University Cancer Center at University of Washington Medical Center, Seattle, Washington, United States
North Puget Oncology at United General Hospital, Sedro-Woolley, Washington, United States
Cancer Care Northwest - Spokane South, Spokane, Washington, United States
Evergreen Hematology and Oncology, PS, Spokane, Washington, United States
Wenatchee Valley Medical Center, Wenatchee, Washington, United States
Name: Cynthia G. Leichman, MD
Affiliation: Breastlink
Role: STUDY_CHAIR