Spots Global Cancer Trial Database for TAS-102 With Concurrent Radiation for the Treatment of Untreated Resectable Stage II-III Rectal Cancer

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Trial Identification

Brief Title: TAS-102 With Concurrent Radiation for the Treatment of Untreated Resectable Stage II-III Rectal Cancer

Official Title: Phase 1b Study to Assess the Safety of Neoadjuvant TAS-102 (Trifluridine/Tipiracil) With Concurrent Radiation in Previously Untreated Resectable Stage II and Stage III Rectal Cancer (FIERCE)

Study ID: NCT04104139

Conditions

Rectal Adenocarcinoma

Stage IIA Rectal Cancer AJCC v8

Stage IIB Rectal Cancer AJCC v8

Stage III Rectal Cancer AJCC v8

Stage IIIA Rectal Cancer AJCC v8

Stage IIIB Rectal Cancer AJCC v8

Stage IIIC Rectal Cancer AJCC v8

Interventions

3-Dimensional Conformal Radiation Therapy

Intensity-Modulated Radiation Therapy

Trifluridine and Tipiracil Hydrochloride

Study Description

Brief Summary: This phase 1b trial studies the side effects and best dose of TAS-102 when given together with radiation therapy in treating patients with stage II-III rectal cancer that has not been treated and can be removed by surgery (resectable). Drugs used in chemotherapy, such as TAS-102, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Radiation therapy uses high energy x-rays to kill tumor cells and shrink tumors. This study is being done to find out the safest dose of TAS-102 that can be used with radiation treatment for rectal cancer.

Detailed Description: PRIMARY OBJECTIVE: I. To determine the recommended phase 2 dose of trifluridine and tipiracil hydrochloride (TAS-102) per the proportion of grade 3 or higher adverse events during chemo-radiation therapy (CRT) with concurrent TAS-102 at the maximum tolerated dose by allowing no more than 30% grade 3 or higher adverse events. SECONDARY OBJECTIVES: I. Evaluate safety of participants treated with TAS-102 during radiation therapy (RT). II. Evaluate treatment emergent adverse events (TEAEs) attributable to TAS-102 with RT during fluorouracil/leucovorin calcium/oxaliplatin (FOLFOX) or capecitabine/oxaliplatin (CAPOX) treatment. EXPLORATORY OBJECTIVES: I. To preliminary assess the rates of complete clinical response (cCR) by magnetic resonance imaging (MRI) and by endoscopy after TAS-102 with concurrent CRT. II. To preliminary assess the rates of cCR by MRI and by endoscopy after treatment with FOLFOX. III. To preliminary assess the rates of pCR after standard total mesorectal excision (TME). OUTLINE: This is dose-escalation study of TAS-102. Patients receive TAS-102 orally (PO) twice daily (BID) Monday-Friday on weeks 1, 3, and 5. Patients also undergo intensity modulated radiotherapy (IMRT) or 3-dimensional conformal radiotherapy (3D-CRT) 5 days per week on weeks 1-5. Treatment continues in the absence of disease progression or unacceptable toxicity. Patients then undergo standard of care FOLFOX or CAPOX. After completion of study treatment, patients are followed for up to a total of 16 weeks (3 months) from end of FOLFOX or CAPOX treatment until rectal cancer surgery or death, whichever occurs first. Participants that opt for a non-surgical option at the end of chemotherapy may be followed for a longer period of time.