- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01307956
Panitumumab, Combination Chemotherapy, & Radiation Therapy in Esophageal or Gastroesophageal Junction Cancer
A Phase II Study of Neo-adjuvant Therapy With Oxaliplatin, Leucovorin, 5-Fluorouracil, Panitumumab (Vectibix) and Radiation in Patients With Locally Advanced Adenocarcinoma of the Esophagus or Gastroesophageal Junction
Study Overview
Status
Conditions
Detailed Description
PRIMARY OBJECTIVES:
I. To determine the pathologic complete response rate of a modified FOLFOX-6 regimen (leucovorin calcium, fluorouracil, and oxaliplatin) given with panitumumab at two-week intervals x 4 cycles in combination with external beam radiation therapy for patients with locally advanced adenocarcinoma of the esophagus.
SECONDARY OBJECTIVES:
I. To determine the toxicities and ability to complete the planned treatment. II. To determine the achieved steady-state plasma concentrations of 5-FU (fluorouracil) and correlate these with clinical toxicity.
III. To assess the potential importance of polymorphic variations in genomic deoxyribonucleic acid (DNA) of pertinent genes whose protein products are the targets of the anti-neoplastic drugs used in the clinical protocol on response and toxicity to therapy.
OUTLINE:
Patients receive panitumumab intravenously (IV) over 1 hour on day 1. Patients also receive oxaliplatin IV and leucovorin calcium IV over 2 hours, and fluorouracil IV continuously over 46 hours on day 1 (FOLFOX chemotherapy). Treatment repeats every 2 weeks for 4 courses in the absence of disease progression or unacceptable toxicity. Within 24 hours of the start of chemotherapy, patients undergo radiation therapy 5 days a week for 5.5 weeks. Patients then undergo surgery within 6-8 weeks after completion of radiation therapy. Patients with residual disease receive 4 additional courses of FOLFOX chemotherapy on days 1, 15, 29, and 42.
After completion of study treatment, patients are followed up every 3 months for 2 years and then annually thereafter.
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
Nebraska
-
Omaha, Nebraska, United States, 68198
- University of Nebraska Medical Center
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Patients must have resectable adenocarcinoma of the esophagus or GE-junction and are medically fit to undergo surgery; patients must have no evidence of distant metastasis based on imaging studies
- Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
- Absolute neutrophil count (ANC) of at least 2000 per mcL
- Platelet count of at least 100,000 per mcL
- Serum creatinine less than or equal to 2.0 mg/dL
- Serum magnesium greater than or equal to 1.8 mg/dL
- Total bilirubin less than or equal to 2.0 mg per dL
- Measurable disease is not required for this study, since the primary endpoint is complete pathologic response
- The patient must be aware of the neoplastic nature of his/her disease and willingly provide written, informed consent after being informed of the procedure to be followed, the experimental nature of the therapy, alternatives, potential benefits, side-effects, risks, and discomforts
Exclusion Criteria:
- Prior therapy: patients with prior history of mediastinal radiation exposure will be ineligible; patients may not have received prior chemotherapy, or antibody therapy for esophageal or GE-junction adenocarcinoma
- History of allergy to platinum compounds or to antiemetics appropriate for administration in conjunction with protocol-directed chemotherapy
- Patients with a prior history of marked intolerance to 5-fluoropyrimidines (5-FU, floxuridine, capecitabine, 5-fluorocytosine [flucytosine]), since such patients may have deficiency of dihydropyrimidine dehydrogenase, which places them at risk for severe and life-threatening toxicity with 5-FU
- Uncontrolled inter-current illness including, but not limited to ongoing or active infection requiring intravenous antibiotics, ongoing immunosuppressive therapy (except for replacement steroids), active human immunodeficiency virus (HIV) infection, that might jeopardize the ability of the patient to receive the chemotherapy program outlined in this protocol with reasonable safety
- Clinically significant cardiac disease (including symptomatic congestive heart failure, myocardial infarction, unstable angina pectoris, or serious, uncontrolled cardiac arrhythmia) within 1 year of study enrollment
- Pregnant and nursing women, or women planning to become pregnant within 6 months after the end of treatment, are excluded from this study; a negative pregnancy test will be required of women of child-bearing age within 72 hours of study enrollment; subjects (male or female) who are not willing to use highly effective methods of contraception (per institutional standard) during treatment and for 6 months (male or female) after the end of treatment are excluded
- History of interstitial lung disease e.g. pneumonitis or pulmonary fibrosis or evidence of interstitial lung disease on baseline chest computed tomography (CT) scan
- Patients with prior malignancy will be excluded except for adequately treated basal cell or squamous cell skin cancer, adequately treated noninvasive carcinomas, or other cancers from which the patient has been disease-free for at least 5 years
- Patients receiving an investigational agent within 30 days before enrollment
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Treatment (panitumumab, chemotherapy, radiation)
Patients receive panitumumab IV over 1 hour on day 1.
Patients also receive oxaliplatin IV and leucovorin calcium IV over 2 hours, and fluorouracil IV continuously over 46 hours on day 1 (FOLFOX chemotherapy).
Treatment repeats every 2 weeks for 4 courses in the absence of disease progression or unacceptable toxicity.
Within 24 hours of the start of chemotherapy, patients undergo radiation therapy 5 days a week for 5.5 weeks.
Patients then undergo surgery within 6-8 weeks after completion of radiation therapy.
Patients with residual disease receive 4 additional courses of FOLFOX chemotherapy on days 1, 15, 29, and 42.
|
Correlative studies
Correlative studies
Given IV
Other Names:
Undergo radiation therapy
Other Names:
Given IV
Other Names:
Given IV
Other Names:
Given IV
Other Names:
Undergo surgical resection
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Complete Pathological Response (pCR) Rate
Time Frame: Up to 8 weeks
|
Based on the proportion who achieve pCR based on the first 4 courses of protocol treatment.
Evaluated using the Response Evaluation Criteria In Solid Tumors (RECIST) version 1.1 guidelines.
Means (with associated standard errors), medians (with ranges), percentages and 95% confidence intervals will be reported as appropriate.
|
Up to 8 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Number of Patients Who Can Undergo Resection
Time Frame: 4 weeks after completion of the radiation
|
Restaging with repeat imaging studies will be performed.
If no contraindication for surgical resection is identified, resection will be performed.
Means (with associated standard errors), medians (with ranges), percentages and 95% confidence intervals will be reported as appropriate.
|
4 weeks after completion of the radiation
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Progression-free Survival
Time Frame: Patients were followed from time of consent until the date of first documented progession or date of death from any cause, whichever came first, assessed up to 100 months.
|
Descriptively summarized using the method of Kaplan-Meier.
Response and disease progression were assessed using RECIST criteria version 1.1
|
Patients were followed from time of consent until the date of first documented progession or date of death from any cause, whichever came first, assessed up to 100 months.
|
Overall Survival
Time Frame: From the first date of therapy until the date the patient dies, assessed up to 100 months
|
Descriptively summarized using the method of Kaplan-Meier.
|
From the first date of therapy until the date the patient dies, assessed up to 100 months
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Jean L Grem, MD, University of Nebraska
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimated)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Digestive System Diseases
- Neoplasms by Histologic Type
- Neoplasms
- Neoplasms by Site
- Carcinoma
- Neoplasms, Glandular and Epithelial
- Gastrointestinal Neoplasms
- Digestive System Neoplasms
- Gastrointestinal Diseases
- Head and Neck Neoplasms
- Esophageal Diseases
- Adenocarcinoma
- Esophageal Neoplasms
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Antimetabolites, Antineoplastic
- Antimetabolites
- Antineoplastic Agents
- Immunosuppressive Agents
- Immunologic Factors
- Protective Agents
- Micronutrients
- Vitamins
- Bone Density Conservation Agents
- Calcium-Regulating Hormones and Agents
- Antidotes
- Vitamin B Complex
- Hematinics
- Antibodies
- Fluorouracil
- Oxaliplatin
- Immunoglobulins
- Leucovorin
- Calcium
- Levoleucovorin
- Antibodies, Monoclonal
- Antineoplastic Agents, Immunological
- Folic Acid
- Calcium, Dietary
- Panitumumab
Other Study ID Numbers
- 0221-09-FB
- P30CA036727 (U.S. NIH Grant/Contract)
- NCI-2010-02056 (Registry Identifier: CTRP (Clinical Trial Reporting Program))
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.
Clinical Trials on Esophageal Adenocarcinoma
-
Case Comprehensive Cancer CenterNational Cancer Institute (NCI)TerminatedStage IIIA Esophageal Adenocarcinoma | Stage IIIB Esophageal Adenocarcinoma | Stage IIIC Esophageal Adenocarcinoma | Stage IIB Esophageal Adenocarcinoma | Stage IB Esophageal Adenocarcinoma | Stage IIA Esophageal AdenocarcinomaUnited States
-
M.D. Anderson Cancer CenterNational Cancer Institute (NCI)RecruitingGastroesophageal Junction Adenocarcinoma | Clinical Stage II Esophageal Adenocarcinoma AJCC v8 | Clinical Stage IIA Esophageal Adenocarcinoma AJCC v8 | Clinical Stage III Esophageal Adenocarcinoma AJCC v8 | Pathologic Stage II Esophageal Adenocarcinoma AJCC v8 | Pathologic Stage IIA Esophageal... and other conditionsUnited States
-
Academic and Community Cancer Research UnitedNational Cancer Institute (NCI)TerminatedAdenocarcinoma of the Gastroesophageal Junction | Stage IIIA Esophageal Adenocarcinoma | Stage IIIB Esophageal Adenocarcinoma | Stage IIIC Esophageal Adenocarcinoma | Stage IIB Esophageal AdenocarcinomaUnited States
-
M.D. Anderson Cancer CenterNational Cancer Institute (NCI)TerminatedGastroesophageal Junction Adenocarcinoma | Stage IB Esophageal Adenocarcinoma AJCC v7 | Stage II Esophageal Adenocarcinoma AJCC v7 | Stage IIA Esophageal Adenocarcinoma AJCC v7 | Stage IIB Esophageal Adenocarcinoma AJCC v7 | Stage IIIA Esophageal Adenocarcinoma AJCC v7 | Stage IIIB Esophageal...United States
-
Roswell Park Cancer InstituteUnited States Department of DefenseRecruitingClinical Stage III Gastroesophageal Junction Adenocarcinoma AJCC v8 | Clinical Stage IV Gastroesophageal Junction Adenocarcinoma AJCC v8 | Metastatic Gastroesophageal Junction Adenocarcinoma | Unresectable Gastroesophageal Junction Adenocarcinoma | Locally Advanced Gastroesophageal Junction... and other conditionsUnited States
-
Memorial Sloan Kettering Cancer CenterRecruitingMetastatic Gastric Adenocarcinoma | Metastatic Gastroesophageal Junction Adenocarcinoma | Unresectable Gastric Adenocarcinoma | Unresectable Gastroesophageal Junction Adenocarcinoma | Metastatic Gastric Cancer | Unresectable Esophageal Cancer | Metastatic Esophageal Carcinoma | Metastatic Gastric... and other conditionsUnited States
-
National Cancer Institute (NCI)Not yet recruitingClinical Stage III Gastric Cancer AJCC v8 | Clinical Stage III Gastroesophageal Junction Adenocarcinoma AJCC v8 | Clinical Stage IV Gastric Cancer AJCC v8 | Clinical Stage IV Gastroesophageal Junction Adenocarcinoma AJCC v8 | Metastatic Gastric Adenocarcinoma | Metastatic Gastroesophageal Junction... and other conditions
-
ECOG-ACRIN Cancer Research GroupNational Cancer Institute (NCI)RecruitingClinical Stage IV Gastric Cancer AJCC v8 | Metastatic Gastric Adenocarcinoma | Clinical Stage IV Esophageal Adenocarcinoma AJCC v8 | Clinical Stage IVA Esophageal Adenocarcinoma AJCC v8 | Clinical Stage IVA Gastric Cancer AJCC v8 | Clinical Stage IVB Esophageal Adenocarcinoma AJCC v8 | Clinical... and other conditionsUnited States
-
Alliance for Clinical Trials in OncologyNational Cancer Institute (NCI)RecruitingClinical Stage III Gastric Cancer AJCC v8 | Clinical Stage III Gastroesophageal Junction Adenocarcinoma AJCC v8 | Clinical Stage IV Gastric Cancer AJCC v8 | Clinical Stage IV Gastroesophageal Junction Adenocarcinoma AJCC v8 | Metastatic Gastric Adenocarcinoma | Metastatic Gastroesophageal Junction... and other conditionsUnited States, Puerto Rico
-
M.D. Anderson Cancer CenterNational Cancer Institute (NCI)RecruitingClinical Stage III Gastroesophageal Junction Adenocarcinoma AJCC v8 | Clinical Stage II Esophageal Adenocarcinoma AJCC v8 | Clinical Stage IIA Esophageal Adenocarcinoma AJCC v8 | Clinical Stage III Esophageal Adenocarcinoma AJCC v8 | Pathologic Stage IB Esophageal Adenocarcinoma AJCC v8 | Pathologic... and other conditionsUnited States
Clinical Trials on Laboratory Biomarker Analysis
-
Children's Oncology GroupNational Cancer Institute (NCI)Completed
-
Alliance for Clinical Trials in OncologyNational Cancer Institute (NCI)Active, not recruitingLeukemia | Acute Lymphoblastic Leukemia | Acute Promyelocytic LeukemiaUnited States
-
Children's Oncology GroupNational Cancer Institute (NCI)CompletedUntreated Adult Acute Lymphoblastic Leukemia | Untreated Childhood Acute Lymphoblastic LeukemiaUnited States, Canada, Australia, New Zealand, Puerto Rico, Switzerland
-
Children's Oncology GroupNational Cancer Institute (NCI)CompletedChildhood Acute Lymphoblastic Leukemia in Remission | Recurrent Childhood Acute Lymphoblastic LeukemiaUnited States
-
Alliance for Clinical Trials in OncologyNational Cancer Institute (NCI)CompletedLung CancerUnited States
-
Alliance for Clinical Trials in OncologyNational Cancer Institute (NCI)Completed
-
Children's Oncology GroupNational Cancer Institute (NCI)WithdrawnClear Cell Renal Cell Carcinoma | Rhabdoid Tumor of the Kidney | Congenital Mesoblastic Nephroma | Childhood Kidney NeoplasmUnited States
-
Gynecologic Oncology GroupNational Cancer Institute (NCI)WithdrawnBreast Carcinoma | BRCA1 Mutation Carrier | BRCA2 Mutation CarrierUnited States
-
Children's Oncology GroupNational Cancer Institute (NCI)CompletedWilms Tumor and Other Childhood Kidney TumorsUnited States
-
Children's Oncology GroupNational Cancer Institute (NCI)CompletedChildhood Acute Monoblastic Leukemia (M5a) | Childhood Acute Monocytic Leukemia (M5b) | Childhood Acute Myeloblastic Leukemia Without Maturation (M1) | Childhood Acute Myelomonocytic Leukemia (M4) | Childhood Acute Myeloid Leukemia/Other Myeloid MalignanciesUnited States