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Chemotherapy Alone Versus Surgery Plus Chemotherapy for Distal Gastric Cancer With One Non-curable Factor

8. januar 2018 opdateret af: Dazhi Xu, Sun Yat-sen University

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

Our study aims to compare the efficacy and safety of Chemotherapy Alone Versus D2 distal gastrectomy and metastasectomy plus Chemotherapy for gastric cancer (GC) with one non-curable Factor

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

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.

Undersøgelsestype

Interventionel

Tilmelding (Forventet)

120

Fase

  • Fase 2
  • Fase 3

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Studiesteder

  • Kina
      • Tianjin, Kina
        • Rekruttering
        • Tianjin Medical University Cancer Institute and Hospital
        • Kontakt:
          • Rupeng Zhang
          • Telefonnummer: 13920561244
    • Anhui
      • Anqing, Anhui, Kina
        • Rekruttering
        • Anqing Municipal Hospital
        • Kontakt:
          • Yaming Zhang
        • Kontakt:
          • Daibin Tang
          • Telefonnummer: 13865176528
      • Hefei, Anhui, Kina
        • Rekruttering
        • The First Affiliated Hospital of Anhui Medical University
        • Kontakt:
          • Aman Xu
          • Telefonnummer: 13705695470
        • Kontakt:
          • Fei Zhong
          • Telefonnummer: 18226616729
      • Hefei, Anhui, Kina
        • Rekruttering
        • Anhui Provincial Hospital
        • Kontakt:
          • Xuhui Zhao
          • Telefonnummer: 18963789289
        • Kontakt:
          • Yifu He
          • Telefonnummer: 13485691976
      • Wuhu, Anhui, Kina
        • Rekruttering
        • First Affiliated Hospital of Wannan Medical College
        • Kontakt:
          • Lianghui Shi
          • Telefonnummer: 13956159006
    • Guangdong
      • Guangzhou, Guangdong, Kina
        • Rekruttering
        • Yuebei People's Hospital
        • Kontakt:
          • Tao Tao Zhang
          • Telefonnummer: 13500206389
      • Guangzhou, Guangdong, Kina
        • Rekruttering
        • Cancer center of Sun Yat-sen University
        • Kontakt:
        • Kontakt:
    • Jiangxi
      • Nanchang, Jiangxi, Kina
        • Rekruttering
        • Jiangxi Provincial Cancer Hospital
        • Kontakt:
          • Huamin Rao
          • Telefonnummer: 13879100685
    • Zhejiang
      • Hangzhou, Zhejiang, Kina
        • Rekruttering
        • Second Affiliated Hospital, School of Medicine, Zhejiang University
        • Kontakt:
          • Li Chen
          • Telefonnummer: 13958092350

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år til 75 år (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  1. Lower age limit of research subjects 18 years old and upper age limit of 75 years old.
  2. PS (ECOG) of 0 or 1.
  3. Without any other malignancies.
  4. Written informed consent from the patient.
  5. Standard gastrectomy with D2 lymphadenectomy for primary cancer

  6. 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

  7. 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:

  1. Female in pregnancy or lactation.
  2. Supraclavicular lymph nodes metastases，lung and bone metastases.
  3. Massive ascites or cachexia.
  4. Extensive cancer metastases of liver, peritoneal metastasis,para-aortic lymph node
  5. Patients participating in any other clinical trails currently，or participated in other trails within 1 months.
  6. Suffering from other serious diseases, including cardiovascular, respiratory, kidney, or liver disease, complicated by poorly controlled hypertension, diabetes, mental disorders or diseases.
  7. Poor treatment compliance of patients
  8. The group of chemotherapy alone accepts gastrectomy for bleeding or obstruction
  9. Failure of R0 or R1 metastasectomy and gastrectomy with D2 lymphadenectomy

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Aktiv komparator: 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
Medicin: chemotherapy
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
Andre navne:
  • XELOX
Eksperimentel: 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
Medicin: chemotherapy
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
Andre navne:
  • XELOX
Procedure: surgery
D2 gastrectomy + metastasectomy

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Overall survival
Tidsramme: 5-year
OS
5-year

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
progression free survival
Tidsramme: 3-year
PFS
3-year

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Sun Yat-sen University

Efterforskere

  • Ledende efterforsker: Dazhi Xu, PHD, Sun Yat-sen University

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

10. december 2017

Primær færdiggørelse (Forventet)

1. november 2022

Studieafslutning (Forventet)

1. december 2025

Datoer for studieregistrering

Først indsendt

8. januar 2018

Først indsendt, der opfyldte QC-kriterier

8. januar 2018

Først opslået (Faktiske)

16. januar 2018

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

16. januar 2018

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

8. januar 2018

Sidst verificeret

1. januar 2018

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • GCGC004

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

Studerer et amerikansk FDA-reguleret lægemiddelprodukt

Ingen

Studerer et amerikansk FDA-reguleret enhedsprodukt

Ingen

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CROs by country

CROs in Greece

Betingelser

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Narkotikainterventioner

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Sponsor / samarbejdspartnere

Placeringer

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