Status:

RECRUITING

Efficacy and Safety of Conventional Neoadjuvant Therapy Versus Total Neoadjuvant Therapy in Older Patients With Locally Advanced Rectal Cancer

Lead Sponsor:

Jules Bordet Institute

Conditions:

Locally Advanced Rectal Cancer

Older People

Eligibility:

All Genders

70+ years

Phase:

NA

Brief Summary

The SHAPERS study is a multicentre, open-label, randomised, pragmatic clinical trial, comparing standard-of-care neoadjuvant treatment options for older (i.e., ≥70 years) subjects with high-risk stage...

Detailed Description

The SHAPERS study is a multicentre, open-label, randomised, pragmatic clinical trial, comparing standard-of-care neoadjuvant treatment options for older (i.e., ≥70 years) subjects with high-risk stage...

Eligibility Criteria

Inclusion

  • Age ≥ 70 years old
  • ECOG performance status (PS):
  • ≤1 if age \> 75 years old
  • ≤2 if age ≤ 75 years old
  • Histologically or cytologically confirmed adenocarcinoma of the rectum
  • Distal border of the tumour below the peritoneal reflection and within 15 cm of the anal verge
  • Operable stage III or high-risk stage II rectal cancer (high-risk tumours defined as those having ≥1 of the following features: T4, mesorectal fascia (MRF) involvement/threatening \[i.e.,tumour within 1 mm of the MRF\], extramural venous invasion). Patient with involvement of lateral pelvic lymph nodes are also eligible.
  • Adequate bone marrow function as defined below:
  • Absolute neutrophil count ≥1,500/µL
  • Haemoglobin ≥9 g/dL
  • Platelets ≥100,000/µL
  • Adequate liver function as defined below:
  • Serum total bilirubin ≤1.5 x ULN. In case of known Gilbert's syndrome \<3xUNL is allowed
  • AST (SGOT) and ALT (SGPT) ≤2.5 x ULN
  • Alkaline phosphatase ≤2.5 x ULN
  • Adequate renal function as defined by estimated glomerular filtration rate (GFR) ≥30 mL/min/1.73m² (according to the CKD-EPI 2021 equation).
  • Absence of clinical conditions that in the opinion of the investigator, would contraindicate neoadjuvant therapy and/or surgery.
  • Signed Informed Consent form (ICF) obtained prior to any study related procedure.
  • Male subjects with partners of childbearing potential must agree to use condom during the course of this study and for at least 6 months after the last administration of study drugs.

Exclusion

  • Extensive growth into cranial part of the sacrum (above S2/3 junction) or the lumbosacral nerve roots indicating that surgery will never be possible even if substantial tumour down-sizing is achieved.
  • Presence of metastatic disease or recurrent rectal tumour.
  • Presence of grade ≥2 peripheral neuropathy according to the Common Toxicity Criteria for Adverse Events (CTCAE) v.5.0.
  • Significant medical, neuro-psychiatric, or surgical condition, currently uncontrolled by treatment, which, in the principal investigator's opinion, may interfere with completion of the study.
  • Any contraindication to pelvic irradiation as evaluated by the investigator.
  • Known hypersensitivity reactions to the study drugs or to any excipients, premedications or non-investigational medicinal products or concomitant medications.
  • Any investigational anti-cancer therapy other than the protocol specified therapies (participation in other prospective studies which do not imply any specific intervention may be allowed after discussion with the Study Chair).
  • Patients with a prior or concurrent malignancy whose natural history or treatment has the potential to interfere with the safety or efficacy assessment.
  • Clinically significant (i.e., active) cardiovascular disease: cerebral vascular accident/stroke, myocardial infarction, unstable angina, congestive heart failure (grade III or IV as classified by the New York Heart Association), or serious cardiac arrhythmia requiring medication within the past 6 months.
  • Complete dihydropyrimidine dehydrogenase (DPD) deficiency.
  • Any previous treatment for rectal cancer.
  • Use of brivudine, sorivudine or their chemically related analogues.

Key Trial Info

Start Date :

February 7 2024

Trial Type :

INTERVENTIONAL

Allocation :

ESTIMATED

End Date :

December 1 2033

Estimated Enrollment :

230 Patients enrolled

Trial Details

Trial ID

NCT06052332

Start Date

February 7 2024

End Date

December 1 2033

Last Update

December 5 2025

Active Locations (19)

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Page 1 of 5 (19 locations)

1

ZAS Antwerpen

Antwerp, Antwerpen, Belgium, 2610

2

UZA Antwerpen

Edegem, Antwerpen, Belgium, 2650

3

AZ Turnhout

Turnhout, Antwerpen, Belgium, 2300

4

Institut Jules Bordet

Anderlecht, Brussels Capital, Belgium, 1070