A Randomized Phase III Study Comparing Maintenance Treatment With Fluoropyrimidine + Bevacizumab Versus Fluoropyrimidine After Induction Chemotherapy for a Metastatic Colorectal Cancer

• Status: Recruiting
• Trial end date: 2025-12-01
• Target enrollment: 0
• Participant gender: All

Summary

The aim of BEVAMAINT is to improve benefic effect of maintenance therapy after a first line of induction chemotherapy for patients with colorectal cancer

• Phase: Phase 3
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Centre Hospitalier Universitaire Dijon
• Treatments: Bevacizumab

Criteria

Inclusion Criteria:

• Histologically confirmed metastatic colorectal adenocarcinoma before induction treatment

• Measurable or non-measurable lesion before the induction treatment according to the Response Evaluation Criteria in Solid Tumors (RECIST 1.1)

• Metastatic, unresectable disease according local practice after induction treatment

• ECOG performance status ≤ 2

• Disease control (complete response, partial response or stable disease) after 4-6 months of frontline induction chemotherapy with doublet (fluoropyrimidine + irinotecan or oxaliplatin) or triplet (fluoropyrimidine + irinotecan + oxaliplatin) +/- (cetuximab, panitumumab, bevacizumab) or IAH chemotherapy

• Life expectancy > 3 months

• Age ≥ 18 years

• Patient is at least 4 weeks from any major surgery

• Total bilirubin < 25 µmol/L, ASAT < 3 x ULN, ALAT < 3 x ULN (ASAT , ALAT < 5 x ULN in case of hepatic metastasis) , PT >60% , PAL<2.5 x ULN ( < 5 x ULN in case of hepatic metastasis) - Neutrophils > 1500/mm3, platelets > 100 000/mm3, haemoglobin ≥ 9 g/dL

• Creatinin clearance > 30 ml/min (MDRD) - if creatinin clearance comprised between 30 and 50 ml/min, see smPCs for dose adjustments

• Proteinuria ≤ 2+ (dipstick urinalysis) (if more than 2+, so proteinuria at or ≤1g/24hour must be ≤1g)

• Patient is able to understand, sign, and date the written informed consent

• Evidence of post-menopausal status or negative urinary or serum pregnancy test for premenopausal female patients

• Male and female patients of childbearing potential agree to use a highly effective contraceptive measure

• Patient affiliated to a social security system

Exclusion Criteria:

• Myocardial infarction, severe coronaropathy or severe cardiac dysfunction less than 6 months prior randomization

• Follow-up impossible

• Patients with all metastases resected (R0/R1) after induction chemotherapy

• Patient with a hand-foot syndrome > 1 before maintenance treatment

• Known brain or leptomeningeal metastases

• Other concomitant or previous malignancy, except: adequately treated in situ carcinoma in complete remission for > 5 years

• Uncontrolled hypertension (defined as systolic blood pressure >140 mmHg and/or diastolic blood pressure >90 mmHg), or history of hypertensive crisis, or hypertensive encephalopathy

• Pregnancy or breast feeding

• Treatment with sorivudine or analogs (brivudine)

• Treatment with phenytoin or analogs

• Partial or complete DPD deficiency (Uracilemia ≥ 16 ng/ml)

• Peptic ulcer not healed after treatment

• Any contraindication to bevacizumab or fluoropyrimidine treatments according to the updated SmPC

• Intestinal perforation or intestinal fistula

• Previous or active gastrointestinal bleeding

• Thromboembolic event and/or history of thromboembolic event

• Severe hepatic insufficiency