Trial Search Results

Vitamin D3 With Chemotherapy and Bevacizumab in Treating Patients With Advanced or Metastatic Colorectal Cancer

This phase III trial studies how well vitamin D3 given with standard chemotherapy and bevacizumab works in treating patients with colorectal cancer that has spread to other parts of the body. Vitamin D3 helps the body use calcium and phosphorus to make strong bones and teeth. Drugs used in chemotherapy, such as leucovorin calcium, fluorouracil, oxaliplatin, and irinotecan hydrochloride, work in different ways to stop the growth of tumor cells by killing the cells, by stopping them from dividing, or by stopping them from spreading. Immunotherapy with monoclonal antibodies, such as bevacizumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Giving vitamin D3 with chemotherapy and bevacizumab may work better in shrinking or stabilizing colorectal cancer. It is not yet known whether giving high-dose vitamin D3 in addition to chemotherapy and bevacizumab would extend patients' time without disease compared to the usual approach (chemotherapy and bevacizumab).

Stanford is currently accepting patients for this trial.

Lead Sponsor:

Alliance for Clinical Trials in Oncology

Collaborator: National Cancer Institute (NCI)

Stanford Investigator(s):

Intervention(s):

  • Drug: Bevacizumab
  • Drug: Oxaliplatin
  • Drug: Leucovorin Calcium
  • Drug: Fluorouracil
  • Drug: Irinotecan Hydrochloride
  • Drug: Irinotecan
  • Dietary Supplement: Cholecalciferol
  • Other: Quality-of-Life Assessment
  • Other: Questionnaire Administration

Phase:

Phase 3

Eligibility


Inclusion Criteria:

   - Histologically confirmed advanced/metastatic colorectal adenocarcinoma for which
   metastasectomy is not planned.

   - No mismatch repair deficiency (dMMR) or high-frequency microsatellite instability
   (MSI-H) disease.

   - Measurable disease per Response Evaluation Criteria in Solid Tumors (RECIST) version
   (v) 1.1.

   - No prior systemic treatment for metastatic disease.

   - Patients may have received prior neoadjuvant or adjuvant chemotherapy and/or
   chemoradiation. The last course of adjuvant therapy must have been completed > 12
   months prior to colorectal cancer recurrence.

   - Patients may have received prior standard rectal cancer chemoradiation so long as
   prior radiotherapy was to =< 25% of bone marrow. Previous radiation therapy must have
   been completed >= 4 weeks prior to registration.

   - No continuous daily use of vitamin D supplements >= 2,000 IU per day for the 12 months
   prior to registration. Patients may have had continuous daily use of vitamin D
   supplements >= 2,000 IU per day if total duration < 12 months in the 12 months prior
   to registration. Patients may have had continuous daily use of vitamin D supplements <
   2,000 IU per day for any duration prior to registration.

   - Patients must have completed any major surgery or open biopsy >= 4 weeks prior to
   registration and must have completed any minor surgery or core biopsy >= 1 week prior
   to registration. (Note: insertion of a vascular access device is not considered major
   or minor surgery.) Patients must have recovered from the effects of any surgery (e.g.
   wound is healed, no active infection, no drains, etc.) prior to registration.

   - Not pregnant and not nursing. This study involves an agent that has known genotoxic,
   mutagenic, and teratogenic effects. Therefore, for women of childbearing potential
   only, a negative serum or urine pregnancy test done =< 14 days prior to registration
   is required.

   - Eastern Cooperative Oncology Group (ECOG) performance status: 0-1.

   - Absolute neutrophil count >= 1,500/mm^3.

   - Platelet count >= 100,000/mm^3.

   - Hemoglobin >= 9 g/dL.

   - Creatinine =< 1.5 x upper limit of normal (ULN) OR calculated (Calc.) creatinine
   clearance (CrCl) > 30 mL/min.

   - Calcium =< 1.0 x ULN.

   * Corrected for albumin level if albumin not within institutional limits of normal.

   - Total bilirubin =< 1.5 x ULN.

   * If Gilbert's disease, use direct bilirubin instead of total bilirubin; direct
   bilirubin =< 1.5 x ULN if patient to receive FOLFIRI; direct bilirubin =< 3.0 x ULN if
   patient to receive leucovorin, infusional fluorouracil, and oxaliplatin (modified
   [m]FOLFOX6).

   - Aspartate aminotransferase (AST)/alanine aminotransferase (ALT) =< 2.5 x ULN.

   * AST/ALT < 5 x ULN if clearly attributable to liver metastases.

   - Urine protein to creatinine (UPC) ratio < 1 OR urine protein =< 1.

   - No resectable metastatic disease for which potentially curative metastasectomy is
   planned.

   - No "currently active" second malignancy other than non-melanoma skin cancers or
   cervical carcinoma in situ. Patients are not considered to have a "currently active"
   malignancy if they have completed therapy and have been free of disease for >= 3
   years.

   - No significant history of bleeding events or bleeding diathesis =< 6 months of
   registration unless the source of bleeding has been resected.

   - No history of arterial thrombotic events, including, but not limited to, transient
   ischemic attack, cerebrovascular accident, unstable angina, angina requiring surgical
   or medical intervention, or myocardial infarction =< 6 months of registration.

   - No history of clinically significant peripheral artery disease =< 6 months of
   registration.

   - No history of uncontrolled congestive heart failure defined as New York Heart
   Association (NYHA) class III or greater.

   - No history of gastrointestinal (GI) perforation =< 12 months of registration except
   for GI perforation related to a primary colorectal tumor that has since been fully
   resected.

   - No history of malabsorption, uncontrolled vomiting or diarrhea, or any other disease
   significantly affecting GI function that could interfere with the absorption of oral
   agents.

   - No history of allergic reaction attributed to compounds of similar chemical or
   biological composition to the study agents.

   - No uncontrolled hypertension (defined as blood pressure [BP] > 160/90).

   - No serious or non-healing wound, ulcer, or bone fracture.

   - No uncontrolled intercurrent illness, including, but not limited to, psychiatric
   illness/social situations that, in the opinion of the treating physician, may increase
   the risks associated with participation or treatment on the study or may interfere
   with the conduct of the study or interpretation of the study results.

   - Patients positive for human immunodeficiency virus (HIV) are eligible only if they
   meet all of the following:

      - On effective anti-retroviral therapy

      - Undetectable HIV viral load by standard clinical assay =< 6 months of
      registration.

   - No known pre-existing hypercalcemia =< 6 months of registration.

   - No known active hyperparathyroid disease or other serious disturbance of calcium
   metabolism =< 5 years of registration.

   - No predisposing colonic or small bowel disorders in which symptoms are uncontrolled as
   indicated by > 3 watery or soft stools daily in patients without a colostomy or
   ileostomy. Patients with a colostomy or ileostomy are allowed per treating physician
   discretion.

   - No symptomatic genitourinary stones =< 12 months of registration.

   - Patients with treated brain metastases are eligible if follow-up imaging after central
   nervous system (CNS)-directed therapy shows no evidence of progression >= 28 days
   prior to registration.

   - Patients with new or progressive brain metastases (active brain metastases) or
   leptomeningeal disease are eligible if the treating physician determines that
   immediate CNS-specific treatment is not required and is unlikely to be required during
   the first cycle of protocol-specified therapy after registration.

   - No uncontrolled seizure disorders.

   - No grade >=2 peripheral neuropathy, neurosensory toxicity, or neuromotor toxicity per
   Common Terminology Criteria for Adverse Events (CTCAE) v5.0 regardless of causality.

   - Patients must be able to swallow oral formulations of the agent.

   - Concurrent use of supplemental calcium and/or vitamin D is not permitted. Patients
   must discontinue the supplement(s) at least 7 days prior to registration.

   - Concurrent use of thiazide diuretics (e.g. hydrochlorothiazide) is not permitted.
   Patients must discontinue the drug(s) or switch to an alternative anti-hypertensive
   agent at least 7 days prior to registration.

   - Chronic concomitant treatment with oral corticosteroids, lithium, phenytoin,
   quinidine, isoniazid, and/or rifampin are not permitted. Patients must discontinue the
   agent(s) at least 7 days prior to registration. Short-term use of corticosteroids as
   antiemetic therapy is acceptable.

   - Concurrent use of other anti-cancer therapy including chemotherapy, targeted, and/or
   biological agents is not permitted.

Ages Eligible for Study

18 Years - N/A

Genders Eligible for Study

All

Now accepting new patients

Contact Information

Stanford University
School of Medicine
300 Pasteur Drive
Stanford, CA 94305
Elizabeth Jacobs
650-721-3541
Recruiting