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복강 환자의 화학 요법과 결합 된 복강 내에 투여 된 파클리탁셀의 첨가 테스트 복강으로 퍼짐 (STOPGAP II)

2026년 11월 11일 업데이트: ECOG-ACRIN Cancer Research Group

프로토콜 EA2234 : 복강 내 파클리탁셀 플러스 전신 치료 대 위 암종 증에서의 전신 치료 대의 무작위 II/III 시험 -STOPGAP II

This study is being done to answer the following questions:

Can we lower the chance of your gastric cancer from growing or spreading by administering paclitaxel chemotherapy directly into your abdominal cavity in addition to chemotherapy given through a vein in your arm? Will administering paclitaxel chemotherapy directly into your abdominal cavity, in addition to chemotherapy given through a vein in your arm help you live longer? We are doing this study because we want to find out if this approach is better or worse than the usual approach for your gastric cancer. The usual approach is defined as care most people get for gastric cancer.

If you decide to take part in this study, you will first receive a surgical procedure called a diagnostic laparoscopy. This will help the study doctors learn more about your gastric cancer. Laparoscopy is a minimally invasive surgery for which you will be placed under general anesthesia. Then the surgeon will make small incisions (5mm) on your belly through which a camera and thin instruments are introduced to evaluate the abdomen. This procedure takes about 1 hour to complete. Your study group will be assigned during the surgery. The study groups are described further in the 'What are the study groups?' section below.

If you are placed into the study group 1, you will not have an intraperitoneal port (a small device which is placed under the skin and fat of your upper abdomen and a tube that is placed into the abdomen).

If you are placed into the study group 2, you will have an intraperitoneal port placed. The reason is that in addition to standard chemotherapy, which is given through a vein in your arm, this port will be used to deliver the medication paclitaxel directly inside your abdomen when you are ready to start study treatment.

It is important to know that you will not know your study group until after the surgery is over. This is because information that is learned during the surgery will help determine which study group you are put in.

Once you have fully healed from this surgery, you will start study treatment. Depending on which study group you are assigned, you will either receive a standard chemotherapy regimen (the regimen will be chosen by you and your doctor) if you are in study group 1, or paclitaxel through a tube in your belly plus chemotherapy given through a vein in your arm if you are in study group 2. All participants will get treatment for three (3) months after which you will undergo reevaluation. If the disease is under control or responding to treatment, you may continue the assigned treatment until your disease gets worse, the side effects become too severe, or you may be offered a surgical procedure to remove the cancer if the amount of disease is low and can be completely removed as determined by a surgeon.

There is a very small chance that during the laparoscopy surgical procedure, the doctor might find something called "intra-abdominal adhesions". These are areas where the stomach has healed previously and created scar tissue. If this scar tissue prevents the surgeon from being able to place a port in the correct area, you would be ineligible to receive the study treatment. If this happens, you may still receive standard of care therapy after your surgery, but you will not be able to continue on the study. If you have more questions about this, you can ask your surgeon or the study team to help.

After you finish your study treatment, your doctor or study team will watch you for side effects. They will continue to follow your condition every three (3) months during the first two (2) years, then every six (6) months until year 5. You may be reevaluated with Chest/Abdomen/Pelvis scans every three-six (3-6) months for up to five (5) years if decided by your doctor.

연구 개요

상태

모병

정황

개입 / 치료

상세 설명

PRIMARY OBJECTIVES:

I. In the phase II portion, to determine the progression free survival (PFS) from randomization.

II. In the phase III portion, to determine overall survival (OS) from randomization.

SECONDARY OBJECTIVE:

I. To compare the safety and tolerability of the intraperitoneal chemotherapy + systemic therapy regimen vs the systemic therapy alone regimen.

OUTLINE:

STEP 0: Patients undergo diagnostic laparoscopy within 4 weeks of study registration.

STEP 1: Patients are randomized to 1 of 2 arms at the time of Step 0 diagnostic laparoscopy.

ARM A: Patients receive standard of care systemic therapy per physician's choice. Patients with stable disease or a response after 12 weeks may continue to receive standard of care treatment in the absence of disease progression or unacceptable toxicity. Patients undergo blood sample collection and computed tomography (CT) and/or magnetic resonance imaging (MRI) throughout the study and may undergo additional diagnostic laparoscopies as clinically indicated.

ARM B: Patients undergo placement of an intraperitoneal port. Patients receive leucovorin calcium intravenously (IV) over 15-30 minutes, fluorouracil IV push, paclitaxel IV over 1-2 hours and paclitaxel intraperitoneally (IP) on days 1 and 8 of each cycle. Cycles repeat every 21 days for up to 4 cycles in the absence of disease progression or unacceptable toxicity. Patients with stable disease or a response after 12 weeks may continue to receive treatment in the absence of disease progression or unacceptable toxicity. Patients undergo blood sample collection and CT and/or MRI throughout the study and may undergo additional diagnostic laparoscopies as clinically indicated.

After completion of study treatment, patients are followed up every 3 months for 2 years then every 6 months for up to 5 years after Step 1 randomization.

연구 유형

중재적

등록 (추정된)

148

단계

  • 2 단계
  • 3단계

연락처 및 위치

이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.

연구 장소

  • 미국
    • California
      • Irvine, California, 미국, 92612
        • 모병
        • UCI Health - Chao Family Comprehensive Cancer Center and Ambulatory Care
        • 연락하다:
          • Site Public Contact
          • 전화번호: 877-827-8839
          • 이메일: ucstudy@uci.edu
        • 수석 연구원:
          • Maheswari Senthil
      • Los Angeles, California, 미국, 90048
        • 모병
        • Cedars-Sinai Medical Center
        • 수석 연구원:
          • Alexandra Gangi
        • 연락하다:
      • Orange, California, 미국, 92868
        • 모병
        • UC Irvine Health/Chao Family Comprehensive Cancer Center
        • 연락하다:
          • Site Public Contact
          • 전화번호: 877-827-8839
          • 이메일: ucstudy@uci.edu
        • 수석 연구원:
          • Maheswari Senthil
      • Palo Alto, California, 미국, 94304
        • 모병
        • Stanford Cancer Institute Palo Alto
        • 연락하다:
        • 수석 연구원:
          • Byrne Lee
    • Colorado
      • Aurora, Colorado, 미국, 80045
        • 모병
        • UCHealth University of Colorado Hospital
        • 연락하다:
          • Site Public Contact
          • 전화번호: 720-848-0650
        • 수석 연구원:
          • Sunnie S. Kim
    • Connecticut
      • Derby, Connecticut, 미국, 06418
        • 모병
        • Smilow Cancer Hospital-Derby Care Center
        • 연락하다:
        • 수석 연구원:
          • Raghav Sundar
      • Fairfield, Connecticut, 미국, 06824
        • 모병
        • Smilow Cancer Hospital Care Center-Fairfield
        • 연락하다:
        • 수석 연구원:
          • Raghav Sundar
      • Greenwich, Connecticut, 미국, 06830
        • 모병
        • Smilow Cancer Hospital Care Center at Greenwich
        • 연락하다:
        • 수석 연구원:
          • Raghav Sundar
      • Guilford, Connecticut, 미국, 06437
        • 모병
        • Smilow Cancer Hospital Care Center - Guilford
        • 연락하다:
        • 수석 연구원:
          • Raghav Sundar
      • New Haven, Connecticut, 미국, 06520
        • 모병
        • Yale University
        • 연락하다:
        • 수석 연구원:
          • Raghav Sundar
      • North Haven, Connecticut, 미국, 06473
        • 모병
        • Yale-New Haven Hospital North Haven Medical Center
        • 연락하다:
        • 수석 연구원:
          • Raghav Sundar
      • Stamford, Connecticut, 미국, 06902
        • 모병
        • Smilow Cancer Hospital Care Center at Long Ridge
        • 연락하다:
        • 수석 연구원:
          • Raghav Sundar
      • Torrington, Connecticut, 미국, 06790
        • 모병
        • Smilow Cancer Hospital-Torrington Care Center
        • 연락하다:
        • 수석 연구원:
          • Raghav Sundar
      • Trumbull, Connecticut, 미국, 06611
        • 모병
        • Smilow Cancer Hospital Care Center-Trumbull
        • 연락하다:
        • 수석 연구원:
          • Raghav Sundar
      • Waterbury, Connecticut, 미국, 06708
        • 모병
        • Smilow Cancer Hospital-Waterbury Care Center
        • 연락하다:
        • 수석 연구원:
          • Raghav Sundar
      • Waterford, Connecticut, 미국, 06385
        • 모병
        • Smilow Cancer Hospital Care Center - Waterford
        • 연락하다:
        • 수석 연구원:
          • Raghav Sundar
    • Florida
      • Gainesville, Florida, 미국, 32610
        • 모병
        • UF Health Cancer Institute - Gainesville
        • 연락하다:
          • Site Public Contact
          • 전화번호: 352-273-8010
        • 수석 연구원:
          • Lakshmi Balasubramanian
    • Georgia
      • Atlanta, Georgia, 미국, 30322
        • 모병
        • Emory University Hospital/Winship Cancer Institute
        • 연락하다:
          • Site Public Contact
          • 전화번호: 404-778-1868
        • 수석 연구원:
          • Seth Concors
      • Atlanta, Georgia, 미국, 30308
        • 모병
        • Emory University Hospital Midtown
        • 연락하다:
          • Site Public Contact
          • 전화번호: 888-946-7447
        • 수석 연구원:
          • Seth Concors
      • Atlanta, Georgia, 미국, 30342
        • 모병
        • Emory Saint Joseph's Hospital
        • 연락하다:
          • Site Public Contact
          • 전화번호: 404-851-7115
        • 수석 연구원:
          • Seth Concors
    • Illinois
      • Chicago, Illinois, 미국, 60637
        • 모병
        • University of Chicago Comprehensive Cancer Center
        • 연락하다:
        • 수석 연구원:
          • Mecker G. Moller
      • Chicago, Illinois, 미국, 60611
        • 모병
        • Northwestern University
        • 연락하다:
        • 수석 연구원:
          • Brett L. Ecker
      • Chicago, Illinois, 미국, 60641
      • DeKalb, Illinois, 미국, 60115
        • 모병
        • Northwestern Medicine Cancer Center Kishwaukee
        • 연락하다:
        • 수석 연구원:
          • Brett L. Ecker
      • Geneva, Illinois, 미국, 60134
        • 모병
        • Northwestern Medicine Cancer Center Delnor
        • 연락하다:
        • 수석 연구원:
          • Brett L. Ecker
      • Oak Brook, Illinois, 미국, 60523
      • Shiloh, Illinois, 미국, 62269
        • 모병
        • Memorial Hospital East
        • 연락하다:
        • 수석 연구원:
          • Ramon Jin
      • Warrenville, Illinois, 미국, 60555
        • 모병
        • Northwestern Medicine Cancer Center Warrenville
        • 연락하다:
        • 수석 연구원:
          • Brett L. Ecker
    • Kentucky
      • Lexington, Kentucky, 미국, 40536
        • 모병
        • University of Kentucky/Markey Cancer Center
        • 연락하다:
          • Site Public Contact
          • 전화번호: 859-257-3379
        • 수석 연구원:
          • Prakash K. Pandalai
    • Louisiana
      • New Orleans, Louisiana, 미국, 70112
        • 모병
        • University Medical Center New Orleans
        • 연락하다:
        • 수석 연구원:
          • Kevin M. Sullivan
    • Maryland
      • Baltimore, Maryland, 미국, 21201
        • 모병
        • University of Maryland/Greenebaum Cancer Center
        • 연락하다:
          • Site Public Contact
          • 전화번호: 800-888-8823
        • 수석 연구원:
          • Jeremy L. Davis
    • Michigan
      • Ann Arbor, Michigan, 미국, 48109
        • 모병
        • University of Michigan Rogel Cancer Center
        • 수석 연구원:
          • Thomas Enzler
        • 연락하다:
      • Detroit, Michigan, 미국, 48202
        • 모병
        • Henry Ford Hospital
        • 연락하다:
        • 수석 연구원:
          • Rupen Shah
      • Grand Rapids, Michigan, 미국, 49503
        • 모병
        • Corewell Health Grand Rapids Hospitals - Butterworth Hospital
        • 연락하다:
        • 수석 연구원:
          • Kathleen Y. Butler
      • Kalamazoo, Michigan, 미국, 49007
        • 모병
        • West Michigan Cancer Center
        • 연락하다:
        • 수석 연구원:
          • Kathleen Y. Butler
    • Minnesota
      • Rochester, Minnesota, 미국, 55905
        • 모병
        • Mayo Clinic in Rochester
        • 연락하다:
          • Site Public Contact
          • 전화번호: 855-776-0015
        • 수석 연구원:
          • Travis E. Grotz
    • Missouri
      • City of Saint Peters, Missouri, 미국, 63376
        • 모병
        • Siteman Cancer Center at Saint Peters Hospital
        • 연락하다:
        • 수석 연구원:
          • Ramon Jin
      • Creve Coeur, Missouri, 미국, 63141
        • 모병
        • Siteman Cancer Center at West County Hospital
        • 연락하다:
        • 수석 연구원:
          • Ramon Jin
      • St Louis, Missouri, 미국, 63110
        • 모병
        • Washington University School of Medicine
        • 연락하다:
        • 수석 연구원:
          • Ramon Jin
      • St Louis, Missouri, 미국, 63129
        • 모병
        • Siteman Cancer Center-South County
        • 연락하다:
        • 수석 연구원:
          • Ramon Jin
      • St Louis, Missouri, 미국, 63136
        • 모병
        • Siteman Cancer Center at Christian Hospital
        • 연락하다:
        • 수석 연구원:
          • Ramon Jin
    • New Jersey
      • Basking Ridge, New Jersey, 미국, 07920
        • 모병
        • Memorial Sloan Kettering Basking Ridge
        • 연락하다:
          • Site Public Contact
          • 전화번호: 212-639-7592
        • 수석 연구원:
          • George Z. Li
      • Middletown, New Jersey, 미국, 07748
        • 모병
        • Memorial Sloan Kettering Monmouth
        • 연락하다:
          • Site Public Contact
          • 전화번호: 212-639-7592
        • 수석 연구원:
          • George Z. Li
      • Montvale, New Jersey, 미국, 07645
        • 모병
        • Memorial Sloan Kettering Bergen
        • 연락하다:
          • Site Public Contact
          • 전화번호: 212-639-7592
        • 수석 연구원:
          • George Z. Li
      • New Brunswick, New Jersey, 미국, 08903
        • 모병
        • Rutgers Cancer Institute of New Jersey
        • 연락하다:
          • Site Public Contact
          • 전화번호: 732-235-7356
        • 수석 연구원:
          • Haejin In
    • New Mexico
      • Albuquerque, New Mexico, 미국, 87106
        • 모병
        • University of New Mexico Cancer Center
        • 수석 연구원:
          • Alissa Greenbaum
        • 연락하다:
    • New York
      • Commack, New York, 미국, 11725
        • 모병
        • Memorial Sloan Kettering Commack
        • 연락하다:
          • Site Public Contact
          • 전화번호: 212-639-7592
        • 수석 연구원:
          • George Z. Li
      • East White Plains, New York, 미국, 10604
        • 모병
        • Memorial Sloan Kettering Westchester
        • 연락하다:
          • Site Public Contact
          • 전화번호: 212-639-7592
        • 수석 연구원:
          • George Z. Li
      • Mineola, New York, 미국, 11501
        • 모병
        • NYU Langone Hospital - Long Island
        • 연락하다:
        • 수석 연구원:
          • Zachary J. Brown
      • New York, New York, 미국, 10065
        • 모병
        • Memorial Sloan Kettering Cancer Center
        • 연락하다:
          • Site Public Contact
          • 전화번호: 212-639-7592
        • 수석 연구원:
          • George Z. Li
      • New York, New York, 미국, 10016
        • 모병
        • Laura and Isaac Perlmutter Cancer Center at NYU Langone
        • 연락하다:
        • 수석 연구원:
          • Zachary J. Brown
      • Uniondale, New York, 미국, 11553
        • 모병
        • Memorial Sloan Kettering Nassau
        • 연락하다:
          • Site Public Contact
          • 전화번호: 212-639-7592
        • 수석 연구원:
          • George Z. Li
    • North Carolina
      • Chapel Hill, North Carolina, 미국, 27599
        • 모병
        • UNC Lineberger Comprehensive Cancer Center
        • 연락하다:
        • 수석 연구원:
          • Ashwin Somasundaram
      • Hillsborough, North Carolina, 미국, 27278
        • 모병
        • University of North Carolina-Hillsborough Campus
        • 연락하다:
        • 수석 연구원:
          • Ashwin Somasundaram
      • Winston-Salem, North Carolina, 미국, 27157
        • 모병
        • Wake Forest University Health Sciences
        • 수석 연구원:
          • Edward A. Levine
        • 연락하다:
          • Site Public Contact
          • 전화번호: 336-713-6771
    • North Dakota
      • Fargo, North Dakota, 미국, 58122
    • Ohio
      • Columbus, Ohio, 미국, 43210
        • 모병
        • Ohio State University Comprehensive Cancer Center
        • 연락하다:
        • 수석 연구원:
          • Pamela W. Lu
    • Oregon
      • Portland, Oregon, 미국, 97239
        • 모병
        • Oregon Health and Science University
        • 연락하다:
          • Site Public Contact
          • 전화번호: 503-494-1080
          • 이메일: trials@ohsu.edu
        • 수석 연구원:
          • Divya Sood
    • Pennsylvania
      • Philadelphia, Pennsylvania, 미국, 19107
        • 모병
        • Thomas Jefferson University Hospital
        • 연락하다:
        • 수석 연구원:
          • Nader Hanna
      • Pittsburgh, Pennsylvania, 미국, 15237
        • 모병
        • UPMC-Passavant Hospital
        • 연락하다:
          • Site Public Contact
          • 전화번호: 412-367-6454
        • 수석 연구원:
          • Mohammad Haroon A. Choudry
      • Pittsburgh, Pennsylvania, 미국, 15232
        • 모병
        • UPMC Hillman Cancer Center
        • 연락하다:
          • Site Public Contact
          • 전화번호: 412-647-8073
        • 수석 연구원:
          • Mohammad Haroon A. Choudry
    • Rhode Island
      • Westerly, Rhode Island, 미국, 02891
        • 모병
        • Smilow Cancer Hospital Care Center - Westerly
        • 연락하다:
        • 수석 연구원:
          • Raghav Sundar
    • Tennessee
      • Nashville, Tennessee, 미국, 37232
        • 모병
        • Vanderbilt University/Ingram Cancer Center
        • 연락하다:
          • Site Public Contact
          • 전화번호: 800-811-8480
        • 수석 연구원:
          • Deepa Magge
    • Texas
      • Dallas, Texas, 미국, 75390
        • 모병
        • UT Southwestern/Simmons Cancer Center-Dallas
        • 연락하다:
        • 수석 연구원:
          • Alex C. Kim
      • Dallas, Texas, 미국, 75235
      • Dallas, Texas, 미국, 75237
        • 모병
        • UT Southwestern Simmons Cancer Center - RedBird
        • 수석 연구원:
          • Alex C. Kim
        • 연락하다:
      • Fort Worth, Texas, 미국, 76104
        • 모병
        • UT Southwestern/Simmons Cancer Center-Fort Worth
        • 연락하다:
        • 수석 연구원:
          • Alex C. Kim
      • Richardson, Texas, 미국, 75080
        • 모병
        • UT Southwestern Clinical Center at Richardson/Plano
        • 연락하다:
        • 수석 연구원:
          • Alex C. Kim
    • Utah
      • Salt Lake City, Utah, 미국, 84112
        • 모병
        • Huntsman Cancer Institute/University of Utah
        • 연락하다:
        • 수석 연구원:
          • Erin P. Ward
    • Wisconsin
      • Madison, Wisconsin, 미국, 53792
        • 모병
        • University of Wisconsin Carbone Cancer Center - University Hospital
        • 수석 연구원:
          • Nataliya V. Uboha
        • 연락하다:
      • Madison, Wisconsin, 미국, 53718
        • 모병
        • University of Wisconsin Carbone Cancer Center - Eastpark Medical Center
        • 수석 연구원:
          • Nataliya V. Uboha
        • 연락하다:
      • Marshfield, Wisconsin, 미국, 54449
      • Menomonee Falls, Wisconsin, 미국, 53051
        • 모병
        • Froedtert Menomonee Falls Hospital
        • 연락하다:
          • Site Public Contact
          • 전화번호: 262-257-5100
        • 수석 연구원:
          • Ugwuji N. Maduekwe
      • Milwaukee, Wisconsin, 미국, 53226
        • 모병
        • Medical College of Wisconsin
        • 연락하다:
          • Site Public Contact
          • 전화번호: 414-805-3666
        • 수석 연구원:
          • Ugwuji N. Maduekwe
      • New Berlin, Wisconsin, 미국, 53151
        • 모병
        • Froedtert and MCW Moorland Reserve Health Center
        • 연락하다:
          • Site Public Contact
          • 전화번호: 414-805-0505
        • 수석 연구원:
          • Ugwuji N. Maduekwe
      • Oak Creek, Wisconsin, 미국, 53154
        • 모병
        • Drexel Town Square Health Center
        • 연락하다:
          • Site Public Contact
          • 전화번호: 414-805-0505
        • 수석 연구원:
          • Ugwuji N. Maduekwe
      • West Bend, Wisconsin, 미국, 53095
        • 모병
        • Froedtert West Bend Hospital/Kraemer Cancer Center
        • 연락하다:
          • Site Public Contact
          • 전화번호: 414-805-0505
        • 수석 연구원:
          • Ugwuji N. Maduekwe
      • Weston, Wisconsin, 미국, 54476

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

공부할 수 있는 나이

18년 이상 (성인, 고령자)

건강한 자원 봉사자를 받아들입니다

아니

연구 대상 성별

모두

설명

STEP 0 REGISTRATION:

  • Patient must be at least 18 years of age

  • Patient must have an Eastern Cooperative Oncology Group (ECOG) performance status of 0-1

  • Patient must have histologically or cytologically confirmed microsatellite stable (MSS) or mismatch repair (MMR) protein expression proficient primary gastric or gastroesophageal adenocarcinoma (Siewert 3) with synchronous cytology positive disease (cyt+) OR peritoneal carcinomatosis detected by imaging, laparoscopy or laparotomy. Patients with microsatellite instability-high (MSI-H/dMMR) mismatch repair deficient disease are not eligible

  • Patient must have received a minimum of 3 months and a maximum of 6 months of first line systemic treatment

  • Patient must be registered to Step 0 within 4 weeks of the last dose of first line systemic therapy. Patient must not have any ongoing significant adverse events that would prohibit them from undergoing a diagnostic laparoscopy procedure followed by further systemic and intraperitoneal therapy

  • Patient must have no evidence of small or large bowel obstruction other than gastric outlet obstruction due to primary malignancy

  • Patient must have no evidence of solid organ metastases except for ovarian metastases. Baseline imaging must be done within 30 days prior to Step 0 registration

  • Patient must have no evidence of clinically significant radiologic peritoneal disease progression during first line systemic therapy

  • Patient must have no evidence of extensive retroperitoneal lymph node metastases not amenable to resection during gastrectomy

  • Patient must have no history of prior surgery that would preclude safe diagnostic laparoscopy and port placement

  • Patient must have no evidence of massive ascites on imaging or history of two therapeutic paracentesis with drainage of more than 1.0 liter of ascites each time in 30 days prior to Step 0 registration

  • Patients with known history or current symptoms of cardiac disease, or history of treatment with cardiotoxic agents, should have a clinical risk assessment of cardiac function using the New York Heart Association Functional Classification. To be eligible for this trial, patients should be class II or better

  • Patient must not have any uncontrolled intercurrent illness or any other significant condition(s) that would make this protocol unreasonably hazardous

  • Patient must not have any known contraindications or drug allergies to the protocol treatment agents: paclitaxel, 5-fluorouracil, or leucovorin

  • Leukocytes ≥ 2,000/uL (≤ 30 days prior to Step 0 registration)

  • Absolute neutrophil count (ANC) ≥ 1,500/uL (≤ 30 days prior to Step 0 registration)

  • Platelets ≥ 75,000/uL (≤ 30 days prior to Step 0 registration)

  • Total bilirubin ≤ 1.5 institutional upper limit of normal (ULN). If patient has Gilbert's syndrome, total bilirubin must be < 2.0 mg/dL (≤ 30 days prior to Step 0 registration)

  • Aspartate aminotransferase (AST)(serum glutamic oxaloacetic transaminase [SGOT]) and alanine aminotransferase (ALT)(serum glutamic pyruvic transaminase [SGPT]) ≤ 3.0 x institutional ULN (≤ 30 days prior to Step 0 registration)

  • Creatinine clearance ≥ 30 mL/min (estimated using Cockcroft and Gault formula or measured) (≤ 30 days prior to Step 0 registration)

  • Hemoglobin ≥ 8 g/dL (≤ 30 days prior to Step 0 registration)

  • Serum albumin ≥ 2.5 g/dL (≤ 30 days prior to Step 0 registration)

  • Human immunodeficiency virus (HIV)-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months of Step 0 registration are eligible for this trial

  • For patients with evidence of chronic hepatitis B virus (HBV) infection, the HBV viral load must be undetectable on suppressive therapy, if indicated

  • Patients with a history of hepatitis C virus (HCV) infection must have been treated and cured. For patients with HCV infection who are currently on treatment, they are eligible if they have an undetectable HCV viral load

  • Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial

  • Patient must not be pregnant or breast-feeding due to the potential harm to an unborn fetus and possible risk for adverse events in nursing infants with the treatment regimens being used

    • All patients of childbearing potential must have a blood test or urine study within 14 days prior to Step 0 registration to rule out pregnancy
    • A patient of childbearing potential is defined as anyone, regardless of sexual orientation or whether they have undergone tubal ligation, who meets the following criteria: 1) has achieved menarche at some point, 2) has not undergone a hysterectomy or bilateral oophorectomy; or 3) has not been naturally postmenopausal (amenorrhea following cancer therapy does not rule out childbearing potential) for at least 24 consecutive months (i.e., has had menses at any time in the preceding 24 consecutive months)

  • Patient must not expect to conceive or father children by using accepted and effective method(s) of contraception (or by abstaining from sexual intercourse) for the duration of their participation in the study. Arm A patients must adhere to the contraceptive requirements outlined in the product specific package inserts while on protocol treatment. Arm B patients must continue contraceptive measures for at least 3 months after the last dose of protocol treatment. In addition, both Arm A and Arm B patients who continue with targeted agents must adhere to the contraceptive requirements outlined in the product specific package inserts while on protocol treatment

  • Patient must have the ability to understand and the willingness to sign a written informed consent document. Patients with impaired decision-making capacity (IDMC) who have a legally authorized representative (LAR) or caregiver and/or family member available will also be considered eligible

STEP 1 RANDOMIZATION:

  • Patient must have undergone a diagnostic laparoscopy with peritoneal lavage performed and aspiration for cytology obtained
  • The extent of peritoneal disease burden must have been assessed during the diagnostic laparoscopy with the Peritoneal Cancer Index (PCI) available
  • Patient must not have extensive intraabdominal adhesions that preclude safe placement of the intraperitoneal port

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

  • 주 목적: 치료
  • 할당: 무작위
  • 중재 모델: 병렬 할당
  • 마스킹: 없음(오픈 라벨)

무기와 개입

참가자 그룹 / 팔
개입 / 치료
활성 비교기: Step 1, Arm A (standard systemic therapy)

Patients on Arm A will start systemic therapy with physician's choice of any standard-of-care systemic regimen for gastric/GEJ adenocarcinoma. Patients on Arm A will start systemic therapy as early as the day after Step 1 randomization and must start within 30 calendar days (including holidays) after Step 1 randomization. After 12 weeks (+/- 2 weeks) of standard of care treatment, patients will undergo a restaging assessment as outlined in Section 5.2 (restaging will occur at this timepoint, regardless of if the patient completed all 4 cycles or not). Patients who are found to have stable disease or a response may continue assigned standard of care treatment and will undergo restaging every 12 weeks (+/- 2 weeks) as outlined in Section 5.2. Treatment will continue until progression (radiographic progression or clinical progression as defined in Section 6), intolerance (unacceptable toxicity), or cytoreduction.
의약품: Standard of Care Chemotherapy

The most common regimens are FOLFOX, CAPOX, FLOT, CF, and CX. Other local institutional standard of care regimens as well as targeted agents for gastric/GEJ adenocarcinoma are allowed.

다른 이름들:
  • 치료의 표준
  • 표준 요법
  • 모범 사례
절차: Biospecimen Collection

Plasma is to be submitted at baseline and every three months for the first year or until progression, whichever comes first. For patients who have progression, their last plasma sample should be at time of progression.

다른 이름들:
  • 생물학적 샘플 수집
  • 생체 표본 수집
  • 표본 수집
절차: Computed Tomography

Restaging imaging with CT and/or diffusion weighted MRI with contrast will be obtained after completion of 12 weeks (+/- 2 weeks) of assigned treatment (restaging will occur at this timepoint, regardless of if the patient completed all 4 cycles or not). At this point, patients with stable disease or a response will continue assigned treatment. In the absence of radiological or clinical progression, if clinically indicated by treatment team, patients may undergo diagnostic laparoscopy to assess surgical candidacy at which time a PCI assessment and biopsies of peritoneal nodules, peritoneal lavage could be performed. Cytoreduction can be offered to patients with a PCI < 7 and if complete cytoreduction is feasible based on treating surgeon's discretion. If deemed a candidate for surgical cytoreduction, surgery should be performed within 6 weeks of the last study treatment in both arms.

다른 이름들:
  • CT
  • 고양이
  • 고양이 스캔
  • 컴퓨터 축 단층 촬영
  • 전산화 단층 촬영
  • CT 스캔
  • 단층 촬영
  • 컴퓨터 축 단층 촬영(시술)
  • 컴퓨터 단층촬영(CT) 스캔
절차: Diagnostic Laparoscopy

After induction of general anesthesia, administration of preoperative antibiotics and placement of appropriate laparoscopic ports, peritoneal lavage will be performed by instillation of 200 ml of normal saline in the left upper quadrant and allowed to dwell for 5 minutes after which it will be aspirated for cytology. Extent of peritoneal disease burden will be ascertained as per the Peritoneal Cancer Index (PCI) scoring system as outlined in Appendix V.

절차: Magnetic Resonance Imaging

Restaging imaging with CT and/or diffusion weighted MRI with contrast will be obtained after completion of 12 weeks (+/- 2 weeks) of assigned treatment (restaging will occur at this timepoint, regardless of if the patient completed all 4 cycles or not). At this point, patients with stable disease or a response will continue assigned treatment. In the absence of radiological or clinical progression, if clinically indicated by treatment team, patients may undergo diagnostic laparoscopy to assess surgical candidacy at which time a PCI assessment and biopsies of peritoneal nodules, peritoneal lavage could be performed. Cytoreduction can be offered to patients with a PCI < 7 and if complete cytoreduction is feasible based on treating surgeon's discretion. If deemed a candidate for surgical cytoreduction, surgery should be performed within 6 weeks of the last study treatment in both arms.

다른 이름들:
  • MRI
  • 자기 공명
  • 자기공명영상 스캔
  • 의료영상, 자기공명 / 핵자기공명
  • 씨
  • MR 이미징
  • MRI 검사
  • NMR 이미징
  • NMRI
  • 핵자기공명영상
  • 자기공명영상(MRI)
  • SMRI
  • 자기공명영상(시술)
  • 구조적 MRI
실험적: Step 1, Arm B (Systemic Therapy + Intraperitoneal Paclitaxel)

Patients on Arm B will start systemic therapy + intraperitoneal paclitaxel as early as the day after Step 1 randomization and must start within 30 calendar days (including holidays) after Step 1 randomization.

Therapy will be administered on Days 1 and 8 of a 21-day cycle for 4 cycles. After 12 weeks (+/- 2 weeks) of study treatment, patients will undergo restaging assessments as outlined in Section 5.2 (restaging will occur at this timepoint, regardless of if the patient completed all 4 cycles or not). Patients who are found to have stable disease or a response may continue assigned protocol treatment and will undergo restaging every 12 weeks (+/- 2 weeks) as outlined in Section 5.2. Treatment will continue until progression (radiographic progression or clinical progression as defined in Section 6), intolerance (unacceptable toxicity), or cytoreduction.
의약품: Standard of Care Chemotherapy

The most common regimens are FOLFOX, CAPOX, FLOT, CF, and CX. Other local institutional standard of care regimens as well as targeted agents for gastric/GEJ adenocarcinoma are allowed.

다른 이름들:
  • 치료의 표준
  • 표준 요법
  • 모범 사례
절차: Biospecimen Collection

Plasma is to be submitted at baseline and every three months for the first year or until progression, whichever comes first. For patients who have progression, their last plasma sample should be at time of progression.

다른 이름들:
  • 생물학적 샘플 수집
  • 생체 표본 수집
  • 표본 수집
절차: Computed Tomography

Restaging imaging with CT and/or diffusion weighted MRI with contrast will be obtained after completion of 12 weeks (+/- 2 weeks) of assigned treatment (restaging will occur at this timepoint, regardless of if the patient completed all 4 cycles or not). At this point, patients with stable disease or a response will continue assigned treatment. In the absence of radiological or clinical progression, if clinically indicated by treatment team, patients may undergo diagnostic laparoscopy to assess surgical candidacy at which time a PCI assessment and biopsies of peritoneal nodules, peritoneal lavage could be performed. Cytoreduction can be offered to patients with a PCI < 7 and if complete cytoreduction is feasible based on treating surgeon's discretion. If deemed a candidate for surgical cytoreduction, surgery should be performed within 6 weeks of the last study treatment in both arms.

다른 이름들:
  • CT
  • 고양이
  • 고양이 스캔
  • 컴퓨터 축 단층 촬영
  • 전산화 단층 촬영
  • CT 스캔
  • 단층 촬영
  • 컴퓨터 축 단층 촬영(시술)
  • 컴퓨터 단층촬영(CT) 스캔
절차: Diagnostic Laparoscopy

After induction of general anesthesia, administration of preoperative antibiotics and placement of appropriate laparoscopic ports, peritoneal lavage will be performed by instillation of 200 ml of normal saline in the left upper quadrant and allowed to dwell for 5 minutes after which it will be aspirated for cytology. Extent of peritoneal disease burden will be ascertained as per the Peritoneal Cancer Index (PCI) scoring system as outlined in Appendix V.

절차: Magnetic Resonance Imaging

Restaging imaging with CT and/or diffusion weighted MRI with contrast will be obtained after completion of 12 weeks (+/- 2 weeks) of assigned treatment (restaging will occur at this timepoint, regardless of if the patient completed all 4 cycles or not). At this point, patients with stable disease or a response will continue assigned treatment. In the absence of radiological or clinical progression, if clinically indicated by treatment team, patients may undergo diagnostic laparoscopy to assess surgical candidacy at which time a PCI assessment and biopsies of peritoneal nodules, peritoneal lavage could be performed. Cytoreduction can be offered to patients with a PCI < 7 and if complete cytoreduction is feasible based on treating surgeon's discretion. If deemed a candidate for surgical cytoreduction, surgery should be performed within 6 weeks of the last study treatment in both arms.

다른 이름들:
  • MRI
  • 자기 공명
  • 자기공명영상 스캔
  • 의료영상, 자기공명 / 핵자기공명
  • 씨
  • MR 이미징
  • MRI 검사
  • NMR 이미징
  • NMRI
  • 핵자기공명영상
  • 자기공명영상(MRI)
  • SMRI
  • 자기공명영상(시술)
  • 구조적 MRI
절차: Intraperitoneal Port Placement

Patients assigned to Arm B will undergo placement of indwelling tunneled intraperitoneal port with Teflon cuff following Step 1 randomization and during the diagnostic laparoscopy procedure.

의약품: Intraperitoneal Paclitaxel

Patients on Arm B will start systemic therapy + intraperitoneal paclitaxel as early as the day after Step 1 randomization and must start within 30 calendar days (including holidays) after Step 1 randomization as per the schedule shown in the table below.

Therapy will be administered on Days 1 and 8 of a 21-day cycle for 4 cycles.

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
Progression free survival (Phase II)
기간: From randomization to progression or death without documentation of progression, assessed up to 5 years.

For the Phase II portion, full information is expected to occur 12 months after accrual or 38 months after study activation. This power calculation is based on a stratified log rank test and accounts for a planned interim analysis at 50% information time. At 50% information time, futility test using Wieand rule would be conducted. If the study results show promising results for the investigational arm and reject the null hypothesis at interim efficacy analysis, the study will proceed to investigate Phase III portion without having a pause in accrual before starting Phase III. Otherwise, if the study is not futile at 50% information time (HR>1), then the study will proceed and wait for the data to reach 100% information, meaning that the study will wait until the data is mature for Phase II analysis (projected to wait 12 months after end of the accrual to collect 58 PFS events).
From randomization to progression or death without documentation of progression, assessed up to 5 years.
Overall survival (Phase III)
기간: From randomization to the date of death, of any cause, assessed up to 5 years

For the Phase III portion, a futility interim analysis is planned at 50% information time, projected to occur 4.3 years after study activation. However, because of the potential one year pause before starting Phase III portion, the futility interim analysis may occur early. Similar to the Phase II portion, the interim analysis for futility would use the Wieand rule to make sure the investigational arm is not doing worse than the control arm. For efficacy, interim analysis would start at 30% information time and be conducted every 6 months subsequently accordingly with the DSMC monitoring schedule. Approximately 1.5 additional years after completion of accrual, the OS analysis will reach 100% information time with 105 OS events.
From randomization to the date of death, of any cause, assessed up to 5 years

2차 결과 측정

결과 측정
측정값 설명
기간
Incidence of adverse events
기간: Up to 30 days after the last day of protocol treatment

Safety and tolerability will be assessed by counting treatment-related grade 3 or higher toxicity events of the patients.
Up to 30 days after the last day of protocol treatment

공동 작업자 및 조사자

여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

스폰서

ECOG-ACRIN Cancer Research Group

협력자

National Cancer Institute (NCI)

수사관

  • 수석 연구원: Maheswari Senthil, ECOG-ACRIN Cancer Research Group

연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작 (실제)

2025년 10월 24일

기본 완료 (추정된)

2030년 5월 30일

연구 완료 (추정된)

2031년 5월 30일

연구 등록 날짜

최초 제출

2025년 5월 23일

QC 기준을 충족하는 최초 제출

2025년 5월 23일

처음 게시됨 (실제)

2025년 6월 3일

연구 기록 업데이트

마지막 업데이트 게시됨 (실제)

2026년 11월 13일

QC 기준을 충족하는 마지막 업데이트 제출

2026년 11월 11일

마지막으로 확인됨

2026년 11월 1일

추가 정보

이 연구와 관련된 용어

키워드

추가 관련 MeSH 약관

기타 연구 ID 번호

  • EA2234
  • U10CA180820 (미국 NIH 보조금/계약)
  • EA2234 (기타 식별자: CTEP)
  • NCI-2025-01831 (레지스트리 식별자: CTRP (Clinical Trial Reporting Program))
  • EA2234 (기타 식별자: ECOG-ACRIN Cancer Research Group)

개별 참가자 데이터(IPD) 계획

개별 참가자 데이터(IPD)를 공유할 계획입니까?

미정

약물 및 장치 정보, 연구 문서

미국 FDA 규제 의약품 연구

아니

미국 FDA 규제 기기 제품 연구

아니

미국에서 제조되어 미국에서 수출되는 제품

아니

이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .

구독하다