100 Participants Needed

Fluoropyrimidine Dose-Adjustment for Colorectal Cancer

Recruiting at 12 trial locations
HS
CF
Overseen ByChristian F Misdary
Age: 18+
Sex: Any
Trial Phase: Phase 4
Sponsor: Rutgers, The State University of New Jersey
Must be taking: 5-FU, Capecitabine
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Prior Safety DataThis treatment has passed at least one previous human trial

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests ways to safely adjust the dosage of certain cancer drugs, such as Fluorouracil and Xeloda, for people with colorectal cancer. The researchers aim to determine if patients with a specific genetic variant (DPYD) experience fewer severe side effects with lower doses compared to the standard dose. Individuals diagnosed with cancer who require treatment with these drugs and have a genetic test showing one DPYD variant might be suitable for this trial. Participants will receive either a reduced dose or the standard dose to compare outcomes. As a Phase 4 trial, this research focuses on understanding how the already FDA-approved and effective treatment can benefit more patients.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What is the safety track record for Fluorouracil and Xeloda?

Studies have shown that adjusting the dose of fluorouracil can lower the risk of severe side effects in patients with colorectal cancer. Patients might experience fewer issues like nausea, vomiting, or mouth sores when their dose is carefully managed. Research indicates that higher amounts of fluorouracil can lead to more harmful effects, so precise dosing is crucial for safety.

For Xeloda, also known as capecitabine, safety information comes from studies involving over 3,000 patients. This research shows that the drug is generally safe but can cause side effects like diarrhea, nausea, and hand-foot syndrome, which causes redness and swelling in the hands and feet. Adjusting the dose can help manage these side effects, especially in individuals with kidney problems.

Both treatments have been used in cancer care for a long time, providing extensive information on their safety. The key takeaway is that adjusting doses based on individual needs can enhance the safety of these treatments for patients.12345

Why are researchers enthusiastic about this study treatment?

Researchers are excited about this trial because it explores how adjusting the doses of fluoropyrimidine treatments, like Fluorouracil and Xeloda, based on genetic differences can improve safety for colorectal cancer patients. Unlike traditional approaches where everyone receives the same dose, this trial examines if patients with a specific genetic variant (DPYD heterozygotes) can safely receive lower doses, reducing the risk of severe side effects. This personalized approach could lead to more effective and safer treatments, tailoring therapy to each patient's genetic makeup and potentially setting a new standard for colorectal cancer treatment.

What evidence suggests that this trial's treatments could be effective for colorectal cancer?

This trial will compare dose adjustments of fluorouracil (5-FU) and Xeloda (capecitabine) for colorectal cancer based on genetic variations. Research has shown that adjusting the dose of fluorouracil according to individual patient needs can enhance safety and effectiveness. Studies have found that customizing the dosage can lead to better treatment outcomes and fewer side effects. Similarly, Xeloda, a chemotherapy pill, effectively manages colorectal cancer. Even when the dose is lowered to reduce side effects, it remains effective in controlling disease progression. Both treatments have proven effective in colorectal cancer care, especially with careful dose management. Participants in this trial will be assigned to different arms based on their genetic profile to evaluate these dose adjustments.15678

Who Is on the Research Team?

HS

Howard S. Hochster, MD

Principal Investigator

Study Principal Investigator

Are You a Good Fit for This Trial?

This trial is for adults with certain cancers (breast, colorectal, neck, head and neck, gastrointestinal) who need first-line therapy with fluoropyrimidines. Participants must have either one DPYD gene variant or normal DPYD genes. They should be physically able to perform daily activities (ECOG 0-2), and can have measurable or non-measurable disease.

Inclusion Criteria

DPYD testing results falling into one of the following cohorts for first-line therapy with a fluoropyridine: Study Cohort: Patients with one DPYD variant in one gene (heterozygotes), Control Arm: Patients with normal or wild-type DPYD genes, for comparison, will be treated at the usual 100% dose, FOLFOX regimen (N=50), ECOG Performance Status 0-2, Measurable disease or non-measurable disease allowed, including adjuvant 5-FU-based regimens
My cancer treatment plan includes starting with 5-FU or Capecitabine.
My DPYD test results are available and were done in a certified lab.

Exclusion Criteria

5-FU or Capecitabine is not suitable for me as per my doctor.
I do not have two harmful DPYD gene variants.
I am not pregnant and I am not a child.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive DPYD-guided dosing strategies for fluoropyrimidine therapy, with dose adjustments based on DPYD variant status

up to 24 months

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

  • Fluorouracil
  • Xeloda
Trial Overview The study tests if adjusting the dose of cancer drugs Fluorouracil or Xeloda based on a patient's specific DPYD gene variant reduces severe side effects. Patients are divided into two groups: those with a DPYD variant receive reduced doses; those without variants get standard doses.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Active Control
Group I: Patients with One DPYD Variant (Heterozygotes)Experimental Treatment2 Interventions
Group II: Normal DPYD Patients (Control Arm)Active Control2 Interventions

Find a Clinic Near You

Who Is Running the Clinical Trial?

Rutgers, The State University of New Jersey

Lead Sponsor

Trials
471
Recruited
81,700+

Citations

Determining the optimal 5-FU therapeutic dosage in ...Physicians have shown greatly improved clinical response and reduced toxicity by adjusting the dose of 5-FU in patients with colorectal cancer based on ...
Pharmacokinetically Guided Dose Adjustment of 5-FluorouracilWe review the data on pharmacokinetically guided dose adjustment of 5-FU and discuss the potential of this approach to advance therapeutic outcomes.
Efficacy of 5-fluorouracil-based chemotherapy in elderly ...In both age groups, infusional 5-FU resulted in significantly increased response rates, overall survival and progression-free survival compared with bolus 5-FU.
Weekly 5-fluorouracil and leucovorin: achieving lower ...Median delivered dose intensity (DI) was 96% of planned (407 mg/m2/week) during treatment, and 91% of planned (385 mg/m2/week) over the full 24 week treatment ...
Comparative Effectiveness of 5-Fluorouracil with and ...The improvement we observed in adjusted three-year survival outcomes of CRC patients treated with i.v. versus oral 5-FU-based regimens in practice, is ...
Fluorouracil Dosage Guide + Max Dose, Adjustments400 mg/m2 by IV bolus on Day 1, followed by 2400 to 3000 mg/m2 as a continuous IV infusion over 46 hours every 2 weeks.
Adrucil (fluorouracil) dosing, indications, interactions, ...Colon and Rectum Cancer. Indicated for adenocarcinoma of the colon and rectum. 400 mg/m² IVP on Day 1, followed by 2400-3000 mg/m² IV as a continuous ...
Fluorouracil: uses, dosing, warnings, adverse events, ...Fluorouracil is used for the treatment of adenocarcinoma of the colon, rectum, breast, stomach, and pancreas. The drug also is used as an adjunct to surgery ...
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