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. 2018 Aug 31;2018(8):CD008831. doi: 10.1002/14651858.CD008831.pub3

NCT00197873.

Trial name or title Randomised, double‐blind, placebo‐controlled, cross‐over phase II study on the effects of Lactobacillus rhamnosus GG supplementation in patients on 1st line XELOXA treatment for metastatic colorectal cancer
Methods Allocation: randomised
Endpoint classification: efficacy study
Intervention model: cross‐over assignment
Masking: double‐blind (subject, caregiver, investigator, outcomes assessor)
Primary purpose: prevention
Participants Estimated enrolment: 84
Ages eligible for study: ≥ 18 years (adult, senior)
Genders eligible for study: both
Accepts healthy volunteers: no
Inclusion criteria:
  • Patients with histologically confirmed diagnosis of CRC, chemotherapy naïve for metastatic disease (prior adjuvant chemotherapy for CRC allowed), scheduled to start capecitabine treatment as first‐line chemotherapy for metastatic disease

  • Age ≥ 18 years

  • Measurable or non‐measurable metastatic disease

  • ECOG performance status 0 to 2

  • Life expectancy > 3 months

  • Thrombocytes ≥ 100,000/µL, neutrophils ≥ 1500/µL, aspartate amino transferase/alanine amino transferase ≤ 2.5 × upper limit of normal (ULN) (< 5 × ULN if liver metastases present), alkaline phosphatase ≤ 2.5 × ULN (< 5 × ULN if liver metastases present), serum bilirubin ≤ 1.5 × ULN, serum creatinine ≤ 1.5 × ULN, urine dipstick of proteinuria < 2+ (or U‐Prot < 100 mg/dL). Patients discovered to have 2+ or greater proteinuria on dipstick urinalysis at baseline must undergo a 24‐hour urine collection and must have ≤ 1 g of protein/24 hours

  • Women of childbearing potential must have a negative serum pregnancy test done before administration of bevacizumab. Patients and their partners should prevent pregnancy (oral contraceptives, intrauterine contraceptive device, barrier method of contraception in conjunction with spermicidal jelly or surgically sterile) up to at least 6 months after last treatment completion or last drug dose, whichever happens first

  • Signed written informed consent according to ICH/GCP and local regulations (approved by independent ethics committee (IEC)) will be obtained before any study‐specific screening procedures are performed

  • Patient must be able to comply with the protocol


Exclusion criteria:
  • Prior treatment with first‐line chemotherapy for metastatic CRC

  • Adjuvant treatment with bevacizumab within 12 months

  • Acute or chronic diarrhea or colostomy

  • Major surgical procedure, open biopsy, or significant traumatic injury within 28 days before day 0 (patients must have recovered from any major surgery)

  • Near future planned radiotherapy for underlying disease (prior completed radiotherapy treatment allowed)

  • Clinical or radiological evidence of CNS metastases

  • Past or current history within past 5 years of malignancy, except for the indication under this study and curatively treated basal and squamous cell carcinoma of the skin or in situ carcinoma of the cervix

  • Serious non‐healing wound or ulcer

  • Evidence of bleeding diathesis or coagulopathy

  • Uncontrolled hypertension

  • Clinically significant (i.e. active) cardiovascular disease, for example, cerebrovascular accidents (≤ 6 months), myocardial infarction (≤ 6 months), unstable angina, New York Heart Association (NYHA) grade II or greater congestive heart failure, serious cardiac arrhythmia requiring medication

  • Treatment with any investigational drug (including IMMP, EGFR inhibitors) or participation in another investigational study within 30 days before enrolment

  • Evidence of other disease, metabolic dysfunction, physical examination findings, or clinical laboratory findings giving reasonable suspicion of a disease or condition that contraindicates the treatment, or patient at high risk of treatment complications

  • Ongoing treatment with aspirin (> 325 mg/d), continuous high‐dose NSAIDs or other medications known to predispose to gastrointestinal ulceration

  • Pregnancy (positive serum pregnancy test) and lactation

  • Any other serious or uncontrolled illness that, in the opinion of the investigator, makes it undesirable for the patient to enter the trial

Interventions Lactobacillus rhamnosus supplementation: Lactophilus supplementation is administered during chemotherapy
Placebo is administered during chemotherapy
Outcomes Primary outcome measures: effect on treatment‐related grade 2 to 4 diarrhoea [Time Frame: 18 weeks] [Designated as safety issue: No]
Secondary outcome measures: effect on treatment‐related toxicity other than diarrhoea [Time Frame: 18 weeks] [Designated as safety issue: No]
Association between supplementation and response [Time Frame: 18 weeks] [Designated as safety issue: No]
  • Effect on resectability of liver metastases [Time Frame: 1 year] [Designated as safety issue: No]

  • Effect on serum growth factor levels [Time Frame: 18 weeks] [Designated as safety issue: No]

Starting date ClinicalTrials.gov Identifier: NCT00197873
Study start date: September 2005
Estimated primary completion date: October 2016
Contact information Heikki Joensuu, Professor, Helsinki University
Notes