
“I think it’s really important that people keep signing up to these type of trials to push research forward.”
This study looked at cediranib and selumetinib for rectal cancer that has grown into the area around the rectum (back passage). It was supported by Cancer Research UK.
The trial was open for people to join between 2010 and 2012, and the research team published the results in 2019
Doctors often treat cancer of the rectum with radiotherapy and chemotherapy at the same time, followed by surgery. When you have chemotherapy and radiotherapy together it is called chemoradiotherapy.
The researchers wanted to find out if adding a targeted cancer drug to chemotherapy would make treatment work better.
The two targeted drugs they looked at were cediranib (AZD2171) and selumetinib (AZD6244). These are both types of cancer growth blockers. They stop the signals that cancer cells use to divide and grow.
The main aims of this trial were to:
The research team found that cediranib may be a useful treatment for rectal cancer, but that selumetinib caused too many side effects.
Trial design
The research team ran this as a dual study, looking at two treatments at the same time. It was also what’s called a phase 1 dose escalation study.
The first few people who took part had the lowest dose of cediranib. When they finished treatment, the next few people taking part had selumetinib. And when they finished treatment, the next few people had cediranib again, but at a higher dose. And so on, until they found the best dose of each treatment to give without causing too many side effects.
A total of 30 people joined the study:
Cediranib results
A total of 18 people had cediranib as part of this trial, in 3 groups. Each group had a different dose.
People who had the highest dose had more severe side effects including diarrhoea and extreme tiredness (fatigue). So the research team concluded that the middle dose was the best dose to use.
The research team looked at how well the treatment worked for 17 of the people who took part. They found that the cancer got smaller in 9 of them (53%). This is higher than expected with standard chemoradiotherapy.
The researchers measured the amount of different proteins in blood samples from those who took part. They found that treatment tended to work better for people with less of a protein called tumour necrosis factor (TNF).
Selumetinib results
A total of 12 people had selumetinib as part of this trial, in 2 groups:
Some people in both groups had severe side effects such as diarrhoea. And this meant some people needed to have a lower dose of either chemotherapy or radiotherapy than normal. So the research team decided not to continue looking at selumetinib as part of this trial.
When the research team looked at how well the treatment had worked, they found the cancer had got smaller in 2 out of 12 people (17%).
Conclusion
The trial team concluded that:
Where this information comes from
We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists () and published in a medical journal. The figures we quote above were provided by the trial team who did the research. We have not analysed the data ourselves.
Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.
Dr Mark Saunders
AstraZeneca
Cancer Research UK
Experimental Cancer Medicine Centre (ECMC)
The Christie NHS Foundation Trust
This is Cancer Research UK trial number CRUKD/10/013.
If you have questions about the trial please contact our cancer information nurses
Freephone 0808 800 4040
“I think it’s really important that people keep signing up to these type of trials to push research forward.”