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S0425 Oxaliplatin, Capecitabine, and RT in Treating Patients W/Stomach Cancer That Can Be Removed By Surgery

12 de julho de 2012 atualizado por: Southwest Oncology Group

Neoadjuvant Chemoradiation Therapy With Oxaliplatin and Capecitabine for Patients With Surgically Resectable Gastric Cancer: A Pilot Phase II Trial With Molecular Correlates

RATIONALE: Drugs used in chemotherapy, such as oxaliplatin and capecitabine, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more tumor cells. Radiation therapy uses high-energy x-rays to kill tumor cells. Giving chemotherapy together with radiation therapy before surgery may make the tumor smaller and reduce the amount of normal tissue that needs to be removed.

PURPOSE: This phase II trial is studying how well giving oxaliplatin and capecitabine together with radiation therapy works in treating patients with stomach cancer that can be removed by surgery.

Visão geral do estudo

Status

Rescindido

Condições

Intervenção / Tratamento

Descrição detalhada

OBJECTIVES:

  • Determine the pathologic complete response rate in patients with primary gastric adenocarcinoma treated with neoadjuvant chemoradiotherapy comprising oxaliplatin, capecitabine, and radiotherapy. (This will not be completed as this study was closed early due to poor accrual.)
  • Assess the frequency and severity of toxicities associated with this regimen.
  • Explore, preliminarily, the association between DNA repair genes (ERCC-1, XRCC1, GST-P1, XPD, XPA, ribonucleotide reductase), target enzymes (thymidylate synthase [TS], dihydropyrimidine dehydrogenase, thymidine phosphorylase [TP]), and angiogenic factors (vascular endothelial growth factor [VEGF], epidermal growth factor [EGF], PD-ECGF, basic fibroblast growth factor, TSP-1 and -2, transforming growth factor [TGF]-β, and IL-8) and response to neoadjuvant therapy in patients with adenocarcinoma of the stomach. (This will not be completed as this study was closed early due to poor accrual.)
  • Explore, preliminarily, the association of haplotypes of candidate genes of TS, TP, ERCC-1, XPD, GST-P1, cyclooxygenase-2, EGF receptor, TGF-β, VEGF, and IL-8 with response and toxicity to neoadjuvant chemoradiation therapy in these patients. (This will not be completed as this study was closed early due to poor accrual.)
  • Explore, preliminarily, the feasibility of performing comparative genomic hybridization for analysis of DNA copy number changes in predicting response to neoadjuvant chemoradiation therapy. (This will not be completed as this study was closed early due to poor accrual.)

OUTLINE: This is a multicenter, pilot study.

  • Neoadjuvant chemotherapy: Patients receive oxaliplatin IV over 2 hours on days 1 and 22 and oral capecitabine twice daily on days 1-14 and 22-35 in the absence of disease progression or unacceptable toxicity.
  • Neoadjuvant chemoradiotherapy: Patients receive oral capecitabine twice daily on days 43-77 and undergo radiotherapy once daily on days 43-47, 50-54, 57-61, 64-68, and 71-75 in the absence of disease progression or unacceptable toxicity.
  • Surgery: Patients with stable or responding disease undergo surgery 4-6 weeks after completion of chemoradiotherapy.

Tumor tissue is obtained at surgery or endoscopic biopsy. Gene expression analysis and comparative genomic hybridization testing are conducted on the tissue. Blood is drawn prior to beginning study treatment and is analyzed for germline polymorphisms.

After completion of study treatment, patients are followed periodically for up to 3 years.

PROJECTED ACCRUAL: A total of 75 patients will be accrued for this study.

Tipo de estudo

Intervencional

Inscrição (Real)

7

Estágio

  • Fase 2

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Locais de estudo

  • Estados Unidos
    • Arkansas
      • Little Rock, Arkansas, Estados Unidos, 72205
        • Arkansas Cancer Research Center at University of Arkansas for Medical Sciences
    • California
      • Burbank, California, Estados Unidos, 91505
        • Providence Saint Joseph Medical Center - Burbank
      • Los Angeles, California, Estados Unidos, 90089-9181
        • USC/Norris Comprehensive Cancer Center and Hospital
      • Palm Springs, California, Estados Unidos, 92262
        • Desert Regional Medical Center Comprehensive Cancer Center
    • Colorado
      • Aurora, Colorado, Estados Unidos, 80045
        • University of Colorado Cancer Center at UC Health Sciences Center
      • Denver, Colorado, Estados Unidos, 80220
        • Veterans Affairs Medical Center - Denver
      • Edwards, Colorado, Estados Unidos, 81632
        • Shaw Regional Cancer Center
    • Georgia
      • Savannah, Georgia, Estados Unidos, 31403-3089
        • Curtis and Elizabeth Anderson Cancer Institute at Memorial Health University Medical Center
      • Savannah, Georgia, Estados Unidos, 31405
        • Nancy N. and J. C. Lewis Cancer and Research Pavilion at St. Joseph's/Candler
    • Indiana
      • Beech Grove, Indiana, Estados Unidos, 46107
        • St. Francis Hospital and Health Centers - Beech Grove Campus
      • Richmond, Indiana, Estados Unidos, 47374
        • Reid Hospital & Health Care Services
    • Kansas
      • Salina, Kansas, Estados Unidos, 67401
        • Tammy Walker Cancer Center at Salina Regional Health Center
    • Michigan
      • Battle Creek, Michigan, Estados Unidos, 49017
        • Battle Creek Health System Cancer Care Center
      • Big Rapids, Michigan, Estados Unidos, 49307
        • Mecosta County Medical Center
      • Grand Rapids, Michigan, Estados Unidos, 49503
        • Butterworth Hospital at Spectrum Health
      • Grand Rapids, Michigan, Estados Unidos, 49503
        • CCOP - Grand Rapids
      • Grand Rapids, Michigan, Estados Unidos, 49503
        • Lacks Cancer Center at Saint Mary's Health Care
      • Grand Rapids, Michigan, Estados Unidos, 49506
        • Metro Health Hospital
      • Holland, Michigan, Estados Unidos, 49423
        • Holland Community Hospital
      • Muskegon, Michigan, Estados Unidos, 49442
        • Hackley Hospital
      • Traverse City, Michigan, Estados Unidos, 49684
        • Munson Medical Center
    • Missouri
      • Springfield, Missouri, Estados Unidos, 65802
        • CCOP - Cancer Research for the Ozarks
      • Springfield, Missouri, Estados Unidos, 65804
        • St. John's Regional Health Center
      • Springfield, Missouri, Estados Unidos, 65807
        • Hulston Cancer Center at Cox Medical Center South
    • Montana
      • Billings, Montana, Estados Unidos, 59101
        • CCOP - Montana Cancer Consortium
      • Billings, Montana, Estados Unidos, 59101
        • Hematology-Oncology Centers of the Northern Rockies - Billings
      • Billings, Montana, Estados Unidos, 59101
        • Northern Rockies Radiation Oncology Center
      • Billings, Montana, Estados Unidos, 59101
        • St. Vincent Healthcare Cancer Care Services
      • Billings, Montana, Estados Unidos, 59107-7000
        • Billings Clinic - Downtown
      • Bozeman, Montana, Estados Unidos, 59715
        • Bozeman Deaconess Cancer Center
      • Butte, Montana, Estados Unidos, 59701
        • St. James Healthcare Cancer Care
      • Great Falls, Montana, Estados Unidos, 59405
        • Great Falls Clinic - Main Facility
      • Great Falls, Montana, Estados Unidos, 59405
      • Great Falls, Montana, Estados Unidos, 59405-5309
        • Big Sky Oncology
      • Great Falls, Montana, Estados Unidos, 59405
        • Sletten Cancer Institute at Benefis Healthcare
      • Helena, Montana, Estados Unidos, 59601
        • St. Peter's Hospital
      • Kalispell, Montana, Estados Unidos, 59901
        • Kalispell Regional Medical Center
      • Kalispell, Montana, Estados Unidos, 59901
        • Glacier Oncology, PLLC
      • Missoula, Montana, Estados Unidos, 59801
        • Community Medical Center
      • Missoula, Montana, Estados Unidos, 59804
        • Guardian Oncology and Center for Wellness
      • Missoula, Montana, Estados Unidos, 59807-7877
        • Montana Cancer Specialists at Montana Cancer Center
      • Missoula, Montana, Estados Unidos, 59807
        • Montana Cancer Center at St. Patrick Hospital and Health Sciences Center
    • New York
      • Rochester, New York, Estados Unidos, 14642
        • James P. Wilmot Cancer Center at University of Rochester Medical Center
      • Rochester, New York, Estados Unidos, 14623
        • Interlakes Oncology/Hematology PC
    • North Carolina
      • Goldsboro, North Carolina, Estados Unidos, 27534
        • Wayne Memorial Hospital, Incorporated
    • Ohio
      • Cincinnati, Ohio, Estados Unidos, 45267
        • Charles M. Barrett Cancer Center at University Hospital
      • Dayton, Ohio, Estados Unidos, 45428
        • Veterans Affairs Medical Center - Dayton
      • Dayton, Ohio, Estados Unidos, 45405
        • Grandview Hospital
      • Dayton, Ohio, Estados Unidos, 45406
        • Good Samaritan Hospital
      • Dayton, Ohio, Estados Unidos, 45409
        • David L. Rike Cancer Center at Miami Valley Hospital
      • Dayton, Ohio, Estados Unidos, 45415
        • Samaritan North Cancer Care Center
      • Dayton, Ohio, Estados Unidos, 45429
        • CCOP - Dayton
      • Findlay, Ohio, Estados Unidos, 45840
        • Blanchard Valley Medical Associates
      • Kettering, Ohio, Estados Unidos, 45429
        • Charles F. Kettering Memorial Hospital
      • Middletown, Ohio, Estados Unidos, 45044
        • Middletown Regional Hospital
      • Troy, Ohio, Estados Unidos, 45373-1300
        • UVMC Cancer Care Center at Upper Valley Medical Center
      • Xenia, Ohio, Estados Unidos, 45385
        • Ruth G. McMillan Cancer Center at Greene Memorial Hospital
    • South Carolina
      • Charleston, South Carolina, Estados Unidos, 29425
        • Hollings Cancer Center at Medical University of South Carolina
    • Texas
      • Dallas, Texas, Estados Unidos, 75230
        • Medical City Dallas Hospital
    • Virginia
      • Danville, Virginia, Estados Unidos, 24541
        • Danville Regional Medical Center
    • Washington
      • Bellingham, Washington, Estados Unidos, 98225
        • St. Joseph Cancer Center
      • Bremerton, Washington, Estados Unidos, 98310
        • Olympic Hematology and Oncology
      • Kennewick, Washington, Estados Unidos, 99336
        • Columbia Basin Hematology
      • Mt. Vernon, Washington, Estados Unidos, 98273
        • Skagit Valley Hospital Cancer Care Center
      • Seattle, Washington, Estados Unidos, 98104
        • Harborview Medical Center
      • Seattle, Washington, Estados Unidos, 98104
        • Fred Hutchinson Cancer Research Center
      • Seattle, Washington, Estados Unidos, 98104
        • Minor and James Medical, PLLC
      • Seattle, Washington, Estados Unidos, 98112
        • Group Health Central Hospital
      • Seattle, Washington, Estados Unidos, 98122-4307
        • Swedish Cancer Institute at Swedish Medical Center - First Hill Campus
      • Seattle, Washington, Estados Unidos, 98122
        • Polyclinic First Hill
      • Seattle, Washington, Estados Unidos, 98195-6043
        • University Cancer Center at University of Washington Medical Center
      • Spokane, Washington, Estados Unidos, 99202
        • Cancer Care Northwest - Spokane South
      • Wenatchee, Washington, Estados Unidos, 98801-2028
        • Wenatchee Valley Medical Center
      • Yakima, Washington, Estados Unidos, 98902
        • North Star Lodge Cancer Center at Yakima Valley Memorial Hospital
    • Wyoming
      • Sheridan, Wyoming, Estados Unidos, 82801
        • Welch Cancer Center at Sheridan Memorial Hospital

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

18 anos e mais velhos (Adulto, Adulto mais velho)

Aceita Voluntários Saudáveis

Não

Gêneros Elegíveis para o Estudo

Tudo

Descrição

DISEASE CHARACTERISTICS:

  • Histologically confirmed primary adenocarcinoma of the stomach, meeting the following criteria:

    • Newly diagnosed disease amenable to curative resection
    • Stage IB-III (T2-4)
  • Measurable or nonmeasurable disease

  • Enlarged lymph nodes outside of radiation fields must have preoperative biopsies

    • No positive lymph nodes outside of radiation fields
  • No distant metastasis
  • No gastroesophageal junction tumors

PATIENT CHARACTERISTICS:

  • Zubrod performance status 0-1
  • Absolute neutrophil count ≥ 1,500/mm³
  • WBC ≥ 3,000/mm³
  • Platelet count ≥ 100,000/mm³
  • Creatinine ≤ 1.5 times upper limit of normal
  • Albumin ≥ 3 g/dL
  • Bilirubin normal
  • No evidence of ischemic heart disease by EKG
  • No coronary artery disease requiring active medical treatment
  • No symptoms of angina
  • No history of myocardial infarction
  • No deep vein thrombosis within the past 12 months
  • No pre-existing peripheral neuropathy
  • No active pneumonia or inflammatory lung infiltrate
  • No prior malignancy except for adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer, or other cancer for which the patient has been disease free for ≥ 5 years
  • No clinically significant comorbid medical conditions that would prevent delivery of chemotherapy, radiotherapy, or the performance of surgery
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

  • At least 4 weeks since prior and no concurrent sorivudine or brivudine
  • No prior therapy for this malignancy, including chemotherapy, surgery, immunotherapy, or radiotherapy
  • No prior coronary angioplasty or stenting
  • No concurrent 2-dimensional or intensity-modulated radiotherapy

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Tratamento
  • Alocação: N / D
  • Modelo Intervencional: Atribuição de grupo único
  • Mascaramento: Nenhum (rótulo aberto)

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Experimental: Chemotherapy, Chemoradiation, Surgery

Chemotherapy: Oxaliplatin, 130 mg/m2, 2 hour IV infusion on Days 1 and 22; Capecitabine 850 mg/m2/dose, PO q 12 hours on Days 1-14 and 22-35 Chemoradiation: Capecitabine 650 mg/m2/dose, PO q 12 hours on days 43-77; Radiation therapy 180 cGy/day, 5 days/week beginning on Day 43.

Surgery: Distal subtotal gastrectomy, total gastrectomy, or proximal gastrectomy
Medicamento: capecitabine
850 mg/m2/dose PO q 12 hours Days 1-14 and 22-35. 650 mg/m2/dose PO q 12 hours Days 43-77.
Outros nomes:
  • Xeloda (NSC-712807)
Medicamento: oxaliplatin
130 mg/m2 by 2-hour infusion Days 1 and 22
Outros nomes:
  • Eloxatin (NSC-266046)
Procedimento: conventional surgery
Distal subtotal gastrectomy, total gastrectomy, or proximal gastrectomy
Outros nomes:
  • gastrectomia
Radiação: radiation therapy
Beginning Day 43, patients will be treated 5 days/week at 180 cGy/day times 25 fractions to a total dose of 4,500 cGy.
Outros nomes:
  • RT

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
Pathologic Complete Response
Prazo: 17-19 weeks
Pathologic complete response rates (pCR) of primary gastric adenocarcinoma when treated with oxaliplatin and capecitabine followed by capecitabine and radiation pre-operatively. On review of the resected gastric specimen and accompanying lymph nodes, pCR is no cancer recognized by the pathologist. Margins are free of tumor.
17-19 weeks

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
Number of Patients With Grade 3 Through 5 Adverse Events That Are Related to Study Drug
Prazo: Patients were assessed for adverse events after pre-operative chemotherapy, after pre-operative chemoradiation and within 14 days of surgery.
Adverse Events (AEs) are reported by the CTCAE (NCI Common Terminology Criteria for Adverse Events) Version 3.0. For each patient, worst grade of each event type is reported. Grade 3 = Severe, Grade 4 = Life-threatening, Grade 5= Fatal.
Patients were assessed for adverse events after pre-operative chemotherapy, after pre-operative chemoradiation and within 14 days of surgery.

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Patrocinador

Southwest Oncology Group

Colaboradores

National Cancer Institute (NCI)

Investigadores

  • Cadeira de estudo: Lawrence P. Leichman, MD, Desert Regional Medical Center Comprehensive Cancer Center
  • Cadeira de estudo: Syed A. Ahmad, MD, Barrett Cancer Center

Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo

1 de maio de 2006

Conclusão Primária (Real)

1 de abril de 2009

Datas de inscrição no estudo

Enviado pela primeira vez

8 de junho de 2006

Enviado pela primeira vez que atendeu aos critérios de CQ

8 de junho de 2006

Primeira postagem (Estimativa)

12 de junho de 2006

Atualizações de registro de estudo

Última Atualização Postada (Estimativa)

17 de agosto de 2012

Última atualização enviada que atendeu aos critérios de controle de qualidade

12 de julho de 2012

Última verificação

1 de julho de 2012

Mais Informações

Termos relacionados a este estudo

Palavras-chave

Termos MeSH relevantes adicionais

Outros números de identificação do estudo

  • CDR0000476577
  • U10CA032102 (Concessão/Contrato do NIH dos EUA)
  • S0425 (Outro identificador: SWOG)

Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .

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