Evidence map›Paper›PMID 27256093›Full record

Trial reportBMJ open2016

Protocol of a randomised phase III clinical trial of sequential capecitabine or 5-fluorouracil plus bevacizumab (Cape/5-FU-Bmab) to capecitabine or 5-fluorouracil plus oxaliplatin plus bevacizumab (CapeOX/mFOLFOX6-Bmab) versus combination CapeOX/mFOLFOX6-Bmab in advanced colorectal cancer: the C-cubed (C3) study.

Takeshi Nagasaka, Hideyuki Mishima, Akira Sawaki, Mototsugu Shimokawa, Michio Inukai, Katsunori Shinozaki, Hiroaki Tanioka, Junichiro Nasu, Tomohiro Nishina, Shoichi Hazama and 2 more

Open access · goldAbstract readClinical Trial, Phase IIIMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.5field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 10 institutions in 1 country.

Takeshi NagasakaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.ORCID 0000-0002-4236-350X
Hideyuki MishimaCancer Center, Aichi Medical University, Yazakokarimata, Japan.
Akira SawakiDepartment of Clinical Oncology, Kawasaki Medical School, Okayama, Japan.
Mototsugu ShimokawaCancer Biostatistics Lab, Clinical Research Institute, National Hospital Organization Kyusyu Cancer Center, Fukuoka, Japan.
Michio InukaiDepartment of Integrated Medicine, Kagawa University Hospital, Kagawa, Japan.
Katsunori ShinozakiDivision of Clinical Oncology, Hiroshima Prefectural Hospital, Hiroshima, Japan.
Hiroaki TaniokaDepartment of Medical Oncology, Okayama Rosai Hospital, Okayama, Japan.
Junichiro NasuDepartment of Internal Medicine, Okayama Saiseikai General Hospital, Okayama, Japan.
Tomohiro NishinaDepartment of Gastrointestinal Medical Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama City, Japan.
Shoichi HazamaDepartment of Digestive Surgery and Surgical Oncology, Yamaguchi University Graduate School of Medicine, Ube, Japan.
Masazumi OkajimaDepartment of Surgery, Hiroshima City Hospital, Hiroshima City, Japan.
Yoshiyuki YamaguchiDepartment of Clinical Oncology, Kawasaki Medical School, Okayama, Japan.
Kawasaki Medical School · JPAichi Medical University · JPHiroshima Prefectural Hospital · JPKagawa University Hospital · JPNational Hospital Organization Kyushu Cancer Center · JPOkayama Rosai Hospital · JPOkayama Saiseikai General Hospital · JPOkayama University · JPShikoku Cancer Center · JPYamaguchi University · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionResults from several randomised trials suggest that the sequential use of cytotoxic agents in patients with metastatic colorectal cancer (mCRC) has the potential to improve overall survival compared with combination chemotherapy. This study is designed to investigate whether sequential treatment with bevacizumab-based first-line treatment with oxaliplatin is superior to combination treatment of mCRC. METHODS AND ANALYSIS: The C-cubed (C(3)) study is a two-arm, multicentre, open-label, randomised phase III trial in Japan comparing the efficacy and safety of sequential capecitabine or 5-fluorouracil plus bevacizumab (Cape/5-FU-Bmab) with escalation to capecitabine or 5-fluorouracil plus oxaliplatin plus bevacizumab (CapeOX/mFOLFOX6-Bmab) versus combination CapeOX/mFOLFOX6-Bmab as the first-line treatment of mCRC. In the sequential arm (Arm A: oxaliplatin 'wait-and-go'), treatment escalation from Cape/5-FU-Bmab to CapeOX/mFOLFOX6-Bmab is recommended in the case of progressive disease. In the combination arm (Arm B: oxaliplatin 'stop-and-go'), de-escalation from CapeOX/mFOLFOX6-Bmab to Cape/5-FU-Bmab is possible after 12 weeks of treatment. Re-escalation to CapeOX/mFOLFOX6-Bmab after progressive disease is considered only for patients who received de-escalation of oxaliplatin after 12 weeks of treatment not caused by oxaliplatin-associated toxicity. A target sample size of 304 evaluable patients is considered sufficient to validate an expected HR for time to failure of strategy of the sequential approach 'wait-and-go' compared to the combination approach 'stop-and go' with 80% power and 2-sided 5% α in case of a true HR<0.69. ETHICS AND DISSEMINATION: This study is conducted according to the standards of Good Clinical Practice and in compliance with the Declaration of Helsinki 2013 and local regulations, and has been submitted and approved by the Ethical Committee of the Non-Profit Organization MINS Institutional Review Board. The protocol and the trial results, even inconclusive, will be presented at international oncology congresses and published in peer-reviewed journals. TRIAL REGISTRATION NUMBER: UMIN000015405, Pre-results.

Indexed as

AdenocarcinomaAdultAgedAntineoplastic Combined Chemotherapy ProtocolsBevacizumabCapecitabineClinical ProtocolsColorectal NeoplasmsFemaleFluorouracilHumansJapanMaleMiddle AgedOrganoplatinum CompoundsOxaliplatinBevacizumabCapecitabineFluorouracilOrganoplatinum CompoundsOxaliplatinbevacizumabCHEMOTHERAPYcombination approachoxaliplatinsequential approachunresectable colorectal cancer

Identifiers

PMID27256093
PMCPMC4893850
OpenAlexW2413389097

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.