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Completed

NCT Number: NCT04457297

Initial Attack on Latent Metastasis Using TAS-102 for ct DNA Identified Colorectal Cancer Patients After Curative Resection

This trial is a randomized, double-blind, multinational Phase III study to evaluate the efficacy and safety of preemptive treatment with FTD/TPI compared with administration of placebo as follow-up, which is the standard of care, in patients who underwent curative resection of colorectal cancer and then tested positive for ctDNA.

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Key information

Age range

20 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 3

Primary location

Aichi Cancer Center Hospital, Nagoya, Aichi-ken, Japan

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Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Patients who have been histopathologically diagnosed with colorectal adenocarcinoma
  • Patients who have undergone radical curative resection of the primary and metastatic tumors
  • Patients with colon or rectal cancer of Stage III based on final findings (T any N1/2 M0) (UICC TNM Classification, 8th Edition) who have a past history of standard postoperative chemotherapy
  • Patients who tested positive for ctDNA using SignateraTM by an analysis of the latest blood samples collected within 3 months prior to enrollment
  • Patients with no obvious relapse confirmed by chest, abdominal, and pelvic CT scans, etc.
  • Patients who are capable of oral ingestion
  • Patients aged 20 years or older at the time of informed consent
  • Patients with an Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0 or 1
  • Patients who have no severe disorder in major organs (such as the bone marrow, heart, lungs, liver, and kidneys) and meet the following criteria (Data obtained most recently and within 14 days of the date of enrollment will be used for enrollment. Data obtained 2 weeks before the date of enrollment, on the same day of the week as the enrollment date, may be used for enrollment.)
  • Neutrophil count ≥ 1,500/mm3
  • Platelet count ≥ 100,000/mm3
  • Hemoglobin ≥ 8.0 g/dL
  • Serum creatinine ≤ 1.5 mg/dL
  • Total bilirubin ≤ 1.5 mg/dL
  • ALT and AST ≤ 100 U/L
  • Patients with no diarrhea or stomatitis of Grade 2 or severer according to Common Terminology Criteria for Adverse Events (CTCAE) v5.0
  • Patients who voluntarily gave written consent to participate in the trial after receiving a thorough explanation of the trial before enrolling in the trial

Exclusion criteria

  • Patients with a history of treatment with FTD/TPI
  • Patients with a history of treatment with 2 or more regimens of postoperative adjuvant chemotherapy (Preoperative chemotherapy will not be counted as a regimen.)
  • Patients with a past history of a malignant tumor
  • Patients with a local or systemic active infection requiring intervention
  • Patients who are positive for HBs antigen or positive for HCV antibody
  • Patients who are positive for HIV antibody (Patients who have not been tested for HIV antibody may be enrolled.)
  • Patients with poorly controlled infections or diabetes
  • Patients with a past history of interstitial lung diseases (such as interstitial pneumonia and pulmonary fibrosis) requiring treatment or extensive findings of these diseases on CT
  • Patients with a serious complication
  • Patients who have been receiving systemic administration (oral or intravenous) of steroids (for 2 weeks or more at a dose of the equivalent of ≥ 10 mg/day of prednisolone)
  • Patients for whom enrollment in the trial is difficult because of clinically problematic psychiatric disorders
  • Pregnant or lactating women
  • Patients with reproductive potential who do not wish to use adequate contraceptive measures during the period of participation in the trial and during the contraception period
  • Patients who are judged by the attending physician to be ineligible for enrollment in the trial for other reasons

Treatment and study plan

Trifluridine and Tipiracil

Drug

Trifluridine and tipiracil will be orally administered twice daily on Days 1 to 5 and Days 8 to 12. The administration will be repeated until completion of 6 courses(one course consists of 28 days) or until any discontinuation criterion is met.

Placebo

Drug

Placebo will be orally administered twice daily on Days 1 to 5 and Days 8 to 12. The administration will be repeated until completion of 6 courses(one course consists of 28 days) or until any discontinuation criterion is met.

Primary outcomes

  1. Disease-free Survival 1 (DFS1)

    Time frame: Up to 3 years

    The time from the date of enrollment to any of the following events, whichever occurs first: a relapse, the first development of a secondary colorectal cancer lesion other than a relapse and death from any cause.

Secondary outcomes

  1. Rate of Conversion to Negative ctDNA

    Time frame: Up to 2 years

    This rate is defined as the proportion of subjects who became negative for ctDNA at the test immediately after completion of study treatment.

  2. Disease-free Survival 2 (DFS2)

    Time frame: Up to 3 years

    The time from the date of enrollment to any of the following events, whichever occurs first: a relapse, development of a cancer lesion other than a relapse (secondary cancer), and death from any cause. For survives with no evidence of recurrence, DFS2 data will be censored at the last imaging date of confirmed no recurrence. Subjects for which no imaging have been performed, DFS2 data will be censored at the date of enrollment.

  3. Overall Survival (OS)

    Time frame: Up to 3 years

    The time from the date of enrollment to the date of death from any cause. In surviving subjects, the last date of confirmation of survival will be treated as the end of this period. In subjects lost to follow-up, the last date of confirmation of survival before loss to follow-up will be treated as the end of this period.

  4. Treatment Completion Rate

    Time frame: Up to 3 years

    This rate had calculated for each eligible subject in accordance with the following equation: Treatment completion rate (%) = number of treatment courses completed/6 × 100

  5. QOL (Week 24 Only)

    Time frame: Up to 1 year

    Measure Description:

    Quality of Life was assessed using two validated instruments:

    EORTC QLQ-C30 (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30) evaluates cancer-specific HRQoL across domains:

    Global Health Status/QoL (range: 0-100, higher = better global health/QoL), Functional Scales (Physical, Role, Emotional, Cognitive, Social; each range: 0-100, higher = better functioning), Symptom Scales (Fatigue, Nausea/vomiting, Pain, Dyspnoea, Insomnia, Appetite loss, Constipation, Diarrhoea, Financial difficulties): each 0-100 (higher = worse/more severe symptoms).

    Scores are linearly transformed; subscales are reported individually (not summed).

    EQ-5D-5L (EuroQOL 5-Dimension 5-Level) measures general health across five dimensions:

    Index Score (range: -1.000 to 1.000, higher = better health), Visual Analogue Scale (VAS) (range: 0-100, higher = better health). Unit of Measure: scores on a scale. Note: Only Week 24 results are presented.

Sponsors and collaborators

Lead sponsor

National Cancer Center Hospital East

Other

Collaborators

  • Alpha-A, Inc.

Registry information

Official study title

A Randomized, Double-Blind, Phase III Study Comparing FTD/TPI Therapy Versus Placebo in Patients Who Are Positive for Blood Circulating Tumor DNA After Curative Resection of Colorectal Cancer

Acronym: ALTAIR

Important dates

Study start
2020
Primary completion
2024
Study completion
2024
First posted
Jul 7, 2020
Registry last updated
Jan 21, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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