Hitchcock, Kathryn E, Miller, Eric D, Shi, Qian, Dixon, Jesse G, Gholami, Sepideh, White, Sarah B, Wu, Christina, Goulet, Christopher C, George, Manju, Jee, Kyung-Wook, Wright, Chadwick L, Yaeger, Rona, Shergill, Ardaman, Hong, Theodore S, George, Thomas J, O'Reilly, Eileen M, Meyerhardt, Jeffrey A, Romesser, Paul B (February 2024) Alliance for clinical trials in Oncology (Alliance) trial A022101/NRG-GI009: a pragmatic randomized phase III trial evaluating total ablative therapy for patients with limited metastatic colorectal cancer: evaluating radiation, ablation, and surgery (ERASur). BMC Cancer, 24 (1). p. 201. ISSN 1471-2407
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Alliance for clinical trials in Oncology (Alliance) trial A022101NRG-GI009 a pragmatic randomized phase III trial evaluating.pdf - Published Version Available under License Creative Commons Attribution. Download (1MB) | Preview |
Abstract
BACKGROUND: For patients with liver-confined metastatic colorectal cancer (mCRC), local therapy of isolated metastases has been associated with long-term progression-free and overall survival (OS). However, for patients with more advanced mCRC, including those with extrahepatic disease, the efficacy of local therapy is less clear although increasingly being used in clinical practice. Prospective studies to clarify the role of metastatic-directed therapies in patients with mCRC are needed. METHODS: The Evaluating Radiation, Ablation, and Surgery (ERASur) A022101/NRG-GI009 trial is a randomized, National Cancer Institute-sponsored phase III study evaluating if the addition of metastatic-directed therapy to standard of care systemic therapy improves OS in patients with newly diagnosed limited mCRC. Eligible patients require a pathologic diagnosis of CRC, have BRAF wild-type and microsatellite stable disease, and have 4 or fewer sites of metastatic disease identified on baseline imaging. Liver-only metastatic disease is not permitted. All metastatic lesions must be amenable to total ablative therapy (TAT), which includes surgical resection, microwave ablation, and/or stereotactic ablative body radiotherapy (SABR) with SABR required for at least one lesion. Patients without overt disease progression after 16-26 weeks of first-line systemic therapy will be randomized 1:1 to continuation of systemic therapy with or without TAT. The trial activated through the Cancer Trials Support Unit on January 10, 2023. The primary endpoint is OS. Secondary endpoints include event-free survival, adverse events profile, and time to local recurrence with exploratory biomarker analyses. This study requires a total of 346 evaluable patients to provide 80% power with a one-sided alpha of 0.05 to detect an improvement in OS from a median of 26 months in the control arm to 37 months in the experimental arm with a hazard ratio of 0.7. The trial uses a group sequential design with two interim analyses for futility. DISCUSSION: The ERASur trial employs a pragmatic interventional design to test the efficacy and safety of adding multimodality TAT to standard of care systemic therapy in patients with limited mCRC. TRIAL REGISTRATION: ClinicalTrials.gov: NCT05673148, registered December 21, 2022.
| Item Type: | Paper |
|---|---|
| Subjects: | diseases & disorders diseases & disorders > neoplasms organism description > animal organism description > animal > mammal > primates > hominids organism description > animal > mammal > primates > hominids > human organism description > animal > mammal organism description > animal > mammal > primates |
| CSHL Authors: | |
| Communities: | CSHL labs > Gholami Lab |
| SWORD Depositor: | CSHL Elements |
| Depositing User: | CSHL Elements |
| Date: | 13 February 2024 |
| Date Deposited: | 11 Apr 2024 18:26 |
| Last Modified: | 11 Apr 2024 18:26 |
| PMCID: | PMC10863118 |
| Related URLs: | |
| URI: | https://repository.cshl.edu/id/eprint/41509 |
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