Chemotherapy Alone Versus Surgery Plus Chemotherapy for Distal Gastric Cancer With One Non-curable Factor
A Prospective,Multicentral,Open-label,Randomized,Controlled,Phase III Clinical Trial of Chemotherapy Alone Versus D2 Gastrectomy and Metastasectomy Plus Chemotherapy for Distal Gastric Cancer With One Non-curable Factor
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Gastric cancer is the fourth most common malignancy worldwide and the second leading cause of cancer-related deaths, with the highest mortality rates reported in East Asia, including China. Many patients are diagnosed at an advanced stage of gastric cancer because of late onset and nonspecific symptoms. The prognosis of patients with advanced gastric cancer with non-curable factors, such as hepatic, peritoneal, or distant lymph node metastases, is poor. Chemotherapy is the standard of care for these patients. Palliative resection or bypass surgery is generally indicated in the presence of major symptoms such as bleeding or obstruction for incurable advanced gastric cancer. The usefulness of gastrectomy and metastasectomy is still unclear.
The REGATTA trial is the first clinical trial to explore the significance of surgery for incurable advanced gastric cancer. However, it concluded an opposite conclusion that gastrectomy followed by chemotherapy did not show any survival benefit compared with chemotherapy alone in advanced gastric cancer with a single non-curable factor. Interestingly, there was a significant interaction between treatment effect and tumor location in subgroup analyses of overall survival. Gastrectomy plus chemotherapy was associated with significantly worse overall survival in patients with upper-third tumors for less chemotherapy cycles. This finding raises the question whether inclusion criteria were restricted to the patients with lower-third tumor, findings of study might have been positive. So we raise this new trail to assess the significance of Gastrectomy and Metastasectomy for Distal Gastric Cancer With One Non-curable Factor.
Study Type
Study Type
Enrollment (Anticipated)
Enrollment
Phase
Phase
- Phase 2
- Phase 3
Contacts and Locations
Study Contact
Study Contact
- Name: Dazhi Xu, PHD
- Phone Number: (+86) 020-87343737
- Email: xudzh@sysucc.org.cn
Study Locations
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-
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Tianjin, China
- Recruiting
- Tianjin Medical University Cancer Institute and Hospital
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Contact:
- Rupeng Zhang
- Phone Number: 13920561244
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Anhui
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Anqing, Anhui, China
- Recruiting
- Anqing Municipal Hospital
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Contact:
- Yaming Zhang
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Contact:
- Daibin Tang
- Phone Number: 13865176528
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Hefei, Anhui, China
- Recruiting
- The First Affiliated Hospital of Anhui Medical University
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Contact:
- Aman Xu
- Phone Number: 13705695470
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Contact:
- Fei Zhong
- Phone Number: 18226616729
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Hefei, Anhui, China
- Recruiting
- Anhui Provincial Hospital
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Contact:
- Xuhui Zhao
- Phone Number: 18963789289
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Contact:
- Yifu He
- Phone Number: 13485691976
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Wuhu, Anhui, China
- Recruiting
- First Affiliated Hospital of Wannan Medical College
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Contact:
- Lianghui Shi
- Phone Number: 13956159006
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Guangdong
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Guangzhou, Guangdong, China
- Recruiting
- Yuebei People's Hospital
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Contact:
- Tao Tao Zhang
- Phone Number: 13500206389
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Guangzhou, Guangdong, China
- Recruiting
- Cancer center of Sun Yat-sen University
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Contact:
- Dazhi Xu
- Phone Number: 86(020)87343737
- Email: xudzh@sysucc.org.cn
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Contact:
- Youqing Zhan
- Phone Number: 86(020)87343910
- Email: Zhanyq@sysucc.org.cn
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Jiangxi
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Nanchang, Jiangxi, China
- Recruiting
- Jiangxi Provincial Cancer Hospital
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Contact:
- Huamin Rao
- Phone Number: 13879100685
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Zhejiang
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Hangzhou, Zhejiang, China
- Recruiting
- Second Affiliated Hospital, School of Medicine, Zhejiang University
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Contact:
- Li Chen
- Phone Number: 13958092350
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Lower age limit of research subjects 18 years old and upper age limit of 75 years old.
- PS (ECOG) of 0 or 1.
- Without any other malignancies.
- Written informed consent from the patient.
- Standard gastrectomy with D2 lymphadenectomy for primary cancer
A single non-curable factor was defined by preoperative CT :
hepatic metastasis (H1 or H2; maximum diameter ≤4 cm, number ≤4); peritoneal metastasis (R0 or R1 resection) para-aortic lymph node metastasis (number ≤4) ovarian metastasis adrenal metastasis renal metastasis
- No contraindications to chemotherapy, including normal peripheral blood routine, liver and kidney function and electrocardiogram (WBC≥4.0 x 109 /L, NEU≥1.5 x 109 /L,PLT≥100 x 109 /L and HGB≥90g/L)
Exclusion Criteria:
- Female in pregnancy or lactation.
- Supraclavicular lymph nodes metastases,lung and bone metastases.
- Massive ascites or cachexia.
- Extensive cancer metastases of liver, peritoneal metastasis,para-aortic lymph node
- Patients participating in any other clinical trails currently,or participated in other trails within 1 months.
- Suffering from other serious diseases, including cardiovascular, respiratory, kidney, or liver disease, complicated by poorly controlled hypertension, diabetes, mental disorders or diseases.
- Poor treatment compliance of patients
- The group of chemotherapy alone accepts gastrectomy for bleeding or obstruction
- Failure of R0 or R1 metastasectomy and gastrectomy with D2 lymphadenectomy
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Chemotherapy
chemotherapy with capecitabine and oxaliplatin (eight 3-week cycles of oral capecitabine 1000 mg/m² twice daily on days 1-14 plus intravenous oxaliplatin 130 mg/m² on day 1) for 6 months or progress of disease
|
capecitabine and oxaliplatin (eight 3-week cycles of oral capecitabine 1000 mg/m² twice daily on days 1-14 plus intravenous oxaliplatin 130 mg/m² on day 1) for 6 months or progress of disease
Other Names:
|
|
Experimental: Surgery+Chemotherapy
D2 Gastrectomy and Metastasectomy + chemotherapy with capecitabine and oxaliplatin (eight 3-week cycles of oral capecitabine 1000 mg/m² twice daily on days 1-14 plus intravenous oxaliplatin 130 mg/m² on day 1) for 6 months or progress of disease
|
capecitabine and oxaliplatin (eight 3-week cycles of oral capecitabine 1000 mg/m² twice daily on days 1-14 plus intravenous oxaliplatin 130 mg/m² on day 1) for 6 months or progress of disease
Other Names:
D2 gastrectomy + metastasectomy
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Overall survival
Time Frame: 5-year
|
OS
|
5-year
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
progression free survival
Time Frame: 3-year
|
PFS
|
3-year
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Dazhi Xu, PHD, Sun Yat-sen University
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Anticipated)
Primary Completion
Study Completion (Anticipated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- GCGC004
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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