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Combination Chemotherapy and Cetuximab in Treating Patients With Metastatic Esophageal Cancer or Gastroesophageal Junction Cancer

2 de setembro de 2021 atualizado por: Alliance for Clinical Trials in Oncology

Randomized Phase II Study of ECF-C, IC-C, or FOLFOX-C in Metastatic Esophageal and GE Junction Cancer

RATIONALE: Drugs used in chemotherapy work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Monoclonal antibodies, such as cetuximab, can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Giving more than one chemotherapy drug (combination chemotherapy) together with cetuximab may kill more tumor cells.

PURPOSE: This randomized phase II trial is studying three different combination chemotherapy regimens to compare how well they work when given together with cetuximab in treating patients with metastatic esophageal cancer or gastroesophageal junction cancer.

Visão geral do estudo

Descrição detalhada

OUTLINE: This is a randomized, multicenter study. Patients are stratified according to histology (squamous cell carcinoma vs adenocarcinoma) and Eastern Cooperative Oncology Group (ECOG) performance status (0 or 1 vs 2). Patients are randomized to 1 of 3 treatment arms. For more information please see the "Arms" section which includes a detailed description of the treatment regimens.

The primary objective of the study is evaluate the tumor response rate (RR) for each of the regimens in this trial and to select the most promising regimen based on RR for further testing in patients with metastatic esophageal or GE junction adenocarcinoma. The secondary objectives are:

  1. To evaluate overall survival (OS) for each of the regimens in this trial in patients with metastatic esophageal or GE junction adenocarcinoma.
  2. To evaluate progression-free survival (PFS) for each of the regimens in this trial in patients with metastatic esophageal or GE junction adenocarcinoma.
  3. To evaluate time to treatment failure (TTF) for each of the regimens in this trial in patients with metastatic esophageal or GE junction adenocarcinoma.
  4. To determine the type and severity of toxicities associated with each of these regimens in the multi-institutional phase II setting.
  5. Quantitative immunohistochemistry results will be correlated with objective response rate, overall survival and time to progression.
  6. To evaluate the cellular damage (apoptosis) as a result of oxaliplatin.
  7. To determine if germline EGFR variants correlate with skin rash in patients treated with cetuximab.
  8. To evaluate if a correlation exists between germline EGFR variants and tumor EFGR expression as measured by immunohistochemistry.

All subjects must be premedicated with diphenhydramine hydrochloride 50 mg IV (or a similar agent) prior to the first dose of cetuximab in an effort to minimize infusion and hypersensitivity reactions. Premedication is recommended prior to subsequent doses, but the dose of diphenhydramine (or similar agent) may be reduced at the investigator's discretion. More information is detailed in the protocol including a description of the premedication requirements. Patients were closely monitored for treatment-related adverse events. After completion of study treatment, patients are followed periodically for up to 2 years.

Tipo de estudo

Intervencional

Inscrição (Real)

245

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

    • Connecticut
      • Norwalk, Connecticut, Estados Unidos, 06856
        • Norwalk Hospital
    • Delaware
      • Lewes, Delaware, Estados Unidos, 19958
        • Tunnell Cancer Center at Beebe Medical Center
      • Newark, Delaware, Estados Unidos, 19713
        • CCOP - Christiana Care Health Services
    • District of Columbia
      • Washington, District of Columbia, Estados Unidos, 20007
        • Lombardi Comprehensive Cancer Center at Georgetown University Medical Center
    • Illinois
      • Aurora, Illinois, Estados Unidos, 60504
        • Rush-Copley Cancer Care Center
      • Bloomington, Illinois, Estados Unidos, 61701
        • St. Joseph Medical Center
      • Canton, Illinois, Estados Unidos, 61520
        • Graham Hospital
      • Carthage, Illinois, Estados Unidos, 62321
        • Memorial Hospital
      • Chicago, Illinois, Estados Unidos, 60637-1470
        • University of Chicago Cancer Research Center
      • Decatur, Illinois, Estados Unidos, 62526
        • Decatur Memorial Hospital Cancer Care Institute
      • Eureka, Illinois, Estados Unidos, 61530
        • Eureka Community Hospital
      • Evanston, Illinois, Estados Unidos, 60201-1781
        • Evanston Hospital
      • Galesburg, Illinois, Estados Unidos, 61401
        • Galesburg Cottage Hospital
      • Galesburg, Illinois, Estados Unidos, 61401
        • Galesburg Clinic, PC
      • Harvey, Illinois, Estados Unidos, 60426
        • Ingalls Cancer Care Center at Ingalls Memorial Hospital
      • Havana, Illinois, Estados Unidos, 62644
        • Mason District Hospital
      • Hopedale, Illinois, Estados Unidos, 61747
        • Hopedale Medical Complex
      • Joliet, Illinois, Estados Unidos, 60435
        • Joliet Oncology-Hematology Associates, Limited - West
      • Macomb, Illinois, Estados Unidos, 61455
        • Mcdonough District Hospital
      • Normal, Illinois, Estados Unidos, 61761
        • Bromenn Regional Medical Center
      • Normal, Illinois, Estados Unidos, 61761
        • Community Cancer Center
      • Ottawa, Illinois, Estados Unidos, 61350
        • Community Hospital of Ottawa
      • Ottawa, Illinois, Estados Unidos, 61350
        • Oncology Hematology Associates of Central Illinois, PC - Ottawa
      • Pekin, Illinois, Estados Unidos, 61554
        • Cancer Treatment Center at Pekin Hospital
      • Peoria, Illinois, Estados Unidos, 61636
        • Methodist Medical Center of Illinois
      • Peoria, Illinois, Estados Unidos, 61614
        • Proctor Hospital
      • Peoria, Illinois, Estados Unidos, 61637
        • OSF St. Francis Medical Center
      • Peoria, Illinois, Estados Unidos, 61615
        • CCOP - Illinois Oncology Research Association
      • Peoria, Illinois, Estados Unidos, 61615
        • Oncology Hematology Associates of Central Illinois, PC - Peoria
      • Peru, Illinois, Estados Unidos, 61354
        • Illinois Valley Community Hospital
      • Princeton, Illinois, Estados Unidos, 61356
        • Perry Memorial Hospital
      • Rockford, Illinois, Estados Unidos, 61104-2315
        • Swedish-American Regional Cancer Center
      • Spring Valley, Illinois, Estados Unidos, 61362
        • St. Margaret's Hospital
      • Springfield, Illinois, Estados Unidos, 62781-0001
        • Regional Cancer Center at Memorial Medical Center
      • Urbana, Illinois, Estados Unidos, 61801
        • Carle Cancer Center at Carle Foundation Hospital
      • Urbana, Illinois, Estados Unidos, 61801
        • CCOP - Carle Cancer Center
    • Indiana
      • Elkhart, Indiana, Estados Unidos, 46515
        • Elkhart General Hospital
      • Fort Wayne, Indiana, Estados Unidos, 46845
        • Fort Wayne Medical Oncology and Hematology
      • Indianapolis, Indiana, Estados Unidos, 46202-5289
        • Indiana University Melvin and Bren Simon Cancer Center
      • Indianapolis, Indiana, Estados Unidos, 46202
        • William N. Wishard Memorial Hospital
      • Kokomo, Indiana, Estados Unidos, 46904
        • Howard Community Hospital
      • La Porte, Indiana, Estados Unidos, 46350
        • Center for Cancer Therapy at LaPorte Hospital and Health Services
      • Michigan City, Indiana, Estados Unidos, 46360
        • Saint Anthony Memorial Health Centers
      • South Bend, Indiana, Estados Unidos, 46601
        • Memorial Hospital of South Bend
      • South Bend, Indiana, Estados Unidos, 46601
        • CCOP - Northern Indiana CR Consortium
      • South Bend, Indiana, Estados Unidos, 46617
        • Saint Joseph Regional Medical Center
      • South Bend, Indiana, Estados Unidos, 46617
        • South Bend Clinic
    • Iowa
      • Ames, Iowa, Estados Unidos, 50010
        • McFarland Clinic, PC
      • Bettendorf, Iowa, Estados Unidos, 52722
        • Hematology Oncology Associates of the Quad Cities
      • Cedar Rapids, Iowa, Estados Unidos, 52403
        • Cedar Rapids Oncology Associates
      • Cedar Rapids, Iowa, Estados Unidos, 52403
        • Mercy Regional Cancer Center at Mercy Medical Center
      • Des Moines, Iowa, Estados Unidos, 50309
        • CCOP - Iowa Oncology Research Association
      • Des Moines, Iowa, Estados Unidos, 50309
        • John Stoddard Cancer Center at Iowa Methodist Medical Center
      • Des Moines, Iowa, Estados Unidos, 50309
        • Medical Oncology and Hematology Associates at John Stoddard Cancer Center
      • Des Moines, Iowa, Estados Unidos, 50314
        • Medical Oncology and Hematology Associates at Mercy Cancer Center
      • Des Moines, Iowa, Estados Unidos, 50314
        • Mercy Cancer Center at Mercy Medical Center - Des Moines
      • Des Moines, Iowa, Estados Unidos, 50316
        • John Stoddard Cancer Center at Iowa Lutheran Hospital
      • Des Moines, Iowa, Estados Unidos, 50307
        • Mercy Capitol Hospital
      • Iowa City, Iowa, Estados Unidos, 52242-1002
        • Holden Comprehensive Cancer Center at University of Iowa
      • Mason City, Iowa, Estados Unidos, 50401
        • Mercy Cancer Center at Mercy Medical Center - North Iowa
      • Ottumwa, Iowa, Estados Unidos, 52501
        • McCreery Cancer Center at Ottumwa Regional
      • Sioux City, Iowa, Estados Unidos, 51101
        • Siouxland Hematology-Oncology Associates, LLP
      • Sioux City, Iowa, Estados Unidos, 51104
        • St. Luke's Regional Medical Center
      • Sioux City, Iowa, Estados Unidos, 51104
        • Mercy Medical Center - Sioux City
      • West Des Moines, Iowa, Estados Unidos, 50266
        • Medical Oncology and Hematology Associates - West Des Moines
    • Kansas
      • Anthony, Kansas, Estados Unidos, 67003
        • Hospital District Sixth of Harper County
      • Chanute, Kansas, Estados Unidos, 66720
        • Cancer Center of Kansas, PA - Chanute
      • Dodge City, Kansas, Estados Unidos, 67801
        • Cancer Center of Kansas, PA - Dodge City
      • El Dorado, Kansas, Estados Unidos, 67042
        • Cancer Center of Kansas, PA - El Dorado
      • Fort Scott, Kansas, Estados Unidos, 66701
        • Cancer Center of Kansas - Fort Scott
      • Independence, Kansas, Estados Unidos, 67301
        • Cancer Center of Kansas-Independence
      • Kingman, Kansas, Estados Unidos, 67068
        • Cancer Center of Kansas, PA - Kingman
      • Lawrence, Kansas, Estados Unidos, 66044
        • Lawrence Memorial Hospital
      • Liberal, Kansas, Estados Unidos, 67901
        • Southwest Medical Center
      • Newton, Kansas, Estados Unidos, 67114
        • Cancer Center of Kansas, PA - Newton
      • Overland Park, Kansas, Estados Unidos, 66209
        • Menorah Medical Center
      • Parsons, Kansas, Estados Unidos, 67357
        • Cancer Center of Kansas, PA - Parsons
      • Pratt, Kansas, Estados Unidos, 67124
        • Cancer Center of Kansas, PA - Pratt
      • Salina, Kansas, Estados Unidos, 67042
        • Cancer Center of Kansas, PA - Salina
      • Shawnee Mission, Kansas, Estados Unidos, 66204
        • Shawnee Mission Medical Center
      • Wellington, Kansas, Estados Unidos, 67152
        • Cancer Center of Kansas, PA - Wellington
      • Wichita, Kansas, Estados Unidos, 67208
        • Cancer Center of Kansas, PA - Medical Arts Tower
      • Wichita, Kansas, Estados Unidos, 67214
        • Cancer Center of Kansas, PA - Wichita
      • Wichita, Kansas, Estados Unidos, 67214
        • CCOP - Wichita
      • Wichita, Kansas, Estados Unidos, 67214
        • Via Christi Cancer Center at Via Christi Regional Medical Center
      • Wichita, Kansas, Estados Unidos, 67208
        • Associates in Womens Health, PA - North Review
      • Winfield, Kansas, Estados Unidos, 67156
        • Cancer Center of Kansas, PA - Winfield
    • Maine
      • Bangor, Maine, Estados Unidos, 04401
        • CancerCare of Maine at Eastern Maine Medical Center
    • Maryland
      • Baltimore, Maryland, Estados Unidos, 21237
        • Harry and Jeanette Weinberg Cancer Institute at Franklin Square Hospital Center
      • Easton, Maryland, Estados Unidos, 21601
        • Shore Regional Cancer Center at Memorial Hospital - Easton
      • Elkton, Maryland, Estados Unidos, 21921
        • Union Hospital of Cecil County
    • Massachusetts
      • Boston, Massachusetts, Estados Unidos, 02114
        • Massachusetts General Hospital
      • Boston, Massachusetts, Estados Unidos, 02115
        • Dana-Farber/Brigham and Women's Cancer Center
      • Boston, Massachusetts, Estados Unidos, 02115
        • Dana-Farber/Harvard Cancer Center at Dana-Farber Cancer Institute
      • Burlington, Massachusetts, Estados Unidos, 01805
        • Lahey Clinic Medical Center - Burlington
      • South Weymouth, Massachusetts, Estados Unidos, 02190
        • South Shore Hospital
      • Springfield, Massachusetts, Estados Unidos, 01199
        • Baystate Regional Cancer Program at D'Amour Center for Cancer Care
    • Michigan
      • Ann Arbor, Michigan, Estados Unidos, 48106-0995
        • Saint Joseph Mercy Cancer Center
      • Ann Arbor, Michigan, Estados Unidos, 48106
        • CCOP - Michigan Cancer Research Consortium
      • Dearborn, Michigan, Estados Unidos, 48123-2500
        • Oakwood Cancer Center at Oakwood Hospital and Medical Center
      • Escanaba, Michigan, Estados Unidos, 49431
        • Green Bay Oncology, Limited - Escanaba
      • Flint, Michigan, Estados Unidos, 48503
        • Hurley Medical Center
      • Flint, Michigan, Estados Unidos, 48503
        • Genesys Hurley Cancer Institute
      • Grosse Pointe Woods, Michigan, Estados Unidos, 48236
        • Van Elslander Cancer Center at St. John Hospital and Medical Center
      • Iron Mountain, Michigan, Estados Unidos, 49801
        • Dickinson County Healthcare System
      • Jackson, Michigan, Estados Unidos, 49201
        • Foote Memorial Hospital
      • Kalamazoo, Michigan, Estados Unidos, 49007
        • Bronson Methodist Hospital
      • Kalamazoo, Michigan, Estados Unidos, 49001
        • Borgess Medical Center
      • Kalamazoo, Michigan, Estados Unidos, 49007-3731
        • West Michigan Cancer Center
      • Lansing, Michigan, Estados Unidos, 48912-1811
        • Sparrow Regional Cancer Center
      • Livonia, Michigan, Estados Unidos, 48154
        • St. Mary Mercy Hospital
      • Pontiac, Michigan, Estados Unidos, 48341-2985
        • St. Joseph Mercy Oakland
      • Port Huron, Michigan, Estados Unidos, 48060
        • Mercy Regional Cancer Center at Mercy Hospital
      • Saginaw, Michigan, Estados Unidos, 48601
        • Seton Cancer Institute at Saint Mary's - Saginaw
      • Saint Joseph, Michigan, Estados Unidos, 49085
        • Lakeland Regional Cancer Care Center - St. Joseph
      • Saint Joseph, Michigan, Estados Unidos, 49085
        • Oncology Care Associates, PLLC
      • Warren, Michigan, Estados Unidos, 48093
        • St. John Macomb Hospital
    • Minnesota
      • Burnsville, Minnesota, Estados Unidos, 55337
        • Fairview Ridges Hospital
      • Coon Rapids, Minnesota, Estados Unidos, 55433
        • Mercy and Unity Cancer Center at Mercy Hospital
      • Duluth, Minnesota, Estados Unidos, 55805
        • CCOP - Duluth
      • Duluth, Minnesota, Estados Unidos, 55805
        • Miller - Dwan Medical Center
      • Duluth, Minnesota, Estados Unidos, 55805-1983
        • Essentia Health - Duluth Clinic
      • Edina, Minnesota, Estados Unidos, 55435
        • Fairview Southdale Hospital
      • Fridley, Minnesota, Estados Unidos, 55432
        • Mercy and Unity Cancer Center at Unity Hospital
      • Hutchinson, Minnesota, Estados Unidos, 55350
        • Hutchinson Area Health Care
      • Litchfield, Minnesota, Estados Unidos, 55355
        • Meeker County Memorial Hospital
      • Maplewood, Minnesota, Estados Unidos, 55109
        • HealthEast Cancer Care at St. John's Hospital
      • Maplewood, Minnesota, Estados Unidos, 55109
        • Minnesota Oncology - Maplewood
      • Minneapolis, Minnesota, Estados Unidos, 55417
        • Veterans Affairs Medical Center - Minneapolis
      • Minneapolis, Minnesota, Estados Unidos, 55407
        • Virginia Piper Cancer Institute at Abbott - Northwestern Hospital
      • Minneapolis, Minnesota, Estados Unidos, 55415
        • Hennepin County Medical Center - Minneapolis
      • Robbinsdale, Minnesota, Estados Unidos, 55422-2900
        • Humphrey Cancer Center at North Memorial Outpatient Center
      • Saint Louis Park, Minnesota, Estados Unidos, 55416
        • CCOP - Metro-Minnesota
      • Saint Louis Park, Minnesota, Estados Unidos, 55416
        • Park Nicollet Cancer Center
      • Saint Paul, Minnesota, Estados Unidos, 55102
        • United Hospital
      • Saint Paul, Minnesota, Estados Unidos, 55101
        • Regions Hospital Cancer Care Center
      • Shakopee, Minnesota, Estados Unidos, 55379
        • St. Francis Cancer Center at St. Francis Medical Center
      • Waconia, Minnesota, Estados Unidos, 55387
        • Ridgeview Medical Center
      • Woodbury, Minnesota, Estados Unidos, 55125
        • Minnesota Oncology - Woodbury
    • Missouri
      • Independence, Missouri, Estados Unidos, 64050
        • Independence Regional Health Center
      • Kansas City, Missouri, Estados Unidos, 64131
        • CCOP - Kansas City
      • Kansas City, Missouri, Estados Unidos, 64116
        • North Kansas City Hospital
      • Kansas City, Missouri, Estados Unidos, 64132
        • Research Medical Center
      • Kansas City, Missouri, Estados Unidos, 64108
        • Truman Medical Center - Hospital Hill
      • Kansas City, Missouri, Estados Unidos, 64111
        • Saint Luke's Cancer Institute at Saint Luke's Hospital
      • Kansas City, Missouri, Estados Unidos, 64114
        • St. Joseph Medical Center
      • Kansas City, Missouri, Estados Unidos, 64116
        • Parvin Radiation Oncology
      • Liberty, Missouri, Estados Unidos, 64068
        • Liberty Hospital
      • Saint Joseph, Missouri, Estados Unidos, 64506
        • Heartland Regional Medical Center
      • Saint Louis, Missouri, Estados Unidos, 63131
        • Missouri Baptist Cancer Center
      • Saint Louis, Missouri, Estados Unidos, 63141
        • Arch Medical Services, Incorporated at Center for Cancer Care and Research
    • Nebraska
      • Omaha, Nebraska, Estados Unidos, 68106
        • CCOP - Missouri Valley Cancer Consortium
      • Omaha, Nebraska, Estados Unidos, 68122
        • Immanuel Medical Center
      • Omaha, Nebraska, Estados Unidos, 68124
        • Alegant Health Cancer Center at Bergan Mercy Medical Center
      • Omaha, Nebraska, Estados Unidos, 68131-2197
        • Creighton University Medical Center
      • Omaha, Nebraska, Estados Unidos, 68114
        • Methodist Estabrook Cancer Center
    • Nevada
      • Las Vegas, Nevada, Estados Unidos, 89102
        • University Medical Center of Southern Nevada
      • Las Vegas, Nevada, Estados Unidos, 89106
        • CCOP - Nevada Cancer Research Foundation
    • New Hampshire
      • Lebanon, New Hampshire, Estados Unidos, 03756-0002
        • Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center
    • New Jersey
      • Marlton, New Jersey, Estados Unidos, 08053
        • Fox Chase Virtua Health Cancer Program at Virtua Memorial Hospital Marlton
      • Newark, New Jersey, Estados Unidos, 07112
        • Newark Beth Israel Medical Center
      • Sparta, New Jersey, Estados Unidos, 07871
        • Frederick R. and Betty M. Smith Cancer Treatment Center
      • Voorhees, New Jersey, Estados Unidos, 08043
        • Cancer Institute of New Jersey at Cooper - Voorhees
      • Voorhees, New Jersey, Estados Unidos, 08043
        • Fox Chase Virtua Health Cancer Program at Virtua West Jersey
    • New York
      • Bronx, New York, Estados Unidos, 10466
        • Our Lady of Mercy Medical Center Comprehensive Cancer Center
      • Buffalo, New York, Estados Unidos, 14215
        • Veterans Affairs Medical Center - Buffalo
      • East Syracuse, New York, Estados Unidos, 13057
        • CCOP - Hematology-Oncology Associates of Central New York
      • Glens Falls, New York, Estados Unidos, 12801
        • Charles R. Wood Cancer Center at Glens Falls Hospital
      • New York, New York, Estados Unidos, 10065
        • Memorial Sloan-Kettering Cancer Center
      • New York, New York, Estados Unidos, 10035
        • Ralph Lauren Center for Cancer Care and Prevention
    • North Carolina
      • Chapel Hill, North Carolina, Estados Unidos, 27599-7295
        • Lineberger Comprehensive Cancer Center at University of North Carolina - Chapel Hill
      • Charlotte, North Carolina, Estados Unidos, 28232-2861
        • Blumenthal Cancer Center at Carolinas Medical Center
      • Goldsboro, North Carolina, Estados Unidos, 27534
        • Wayne Memorial Hospital, Incorporated
      • Hendersonville, North Carolina, Estados Unidos, 28791
        • Pardee Memorial Hospital
      • Kinston, North Carolina, Estados Unidos, 28501
        • Kinston Medical Specialists
    • Ohio
      • Akron, Ohio, Estados Unidos, 44309-2090
        • Summa Center for Cancer Care at Akron City Hospital
      • Canton, Ohio, Estados Unidos, 44710-1799
        • Aultman Cancer Center at Aultman Hospital
      • Cleveland, Ohio, Estados Unidos, 44109
        • MetroHealth Cancer Care Center at MetroHealth Medical Center
      • Columbus, Ohio, Estados Unidos, 43210-1240
        • Arthur G. James Cancer Hospital and Richard J. Solove Research Institute at Ohio State University Comprehensive Cancer Center
      • Lima, Ohio, Estados Unidos, 45801
        • St. Rita's Medical Center
    • Pennsylvania
      • Allentown, Pennsylvania, Estados Unidos, 18105
        • Morgan Cancer Center at Lehigh Valley Hospital - Cedar Crest
      • Bethlehem, Pennsylvania, Estados Unidos, 18015
        • St. Luke's Cancer Network at St. Luke's Hospital
      • Danville, Pennsylvania, Estados Unidos, 17822-0001
        • Geisinger Cancer Institute at Geisinger Health
      • East Stroudsburg, Pennsylvania, Estados Unidos, 18301
        • Dale and Frances Hughes Cancer Center at Pocono Medical Center
      • Hazleton, Pennsylvania, Estados Unidos, 18201
        • Geisinger Hazleton Cancer Center
      • Hershey, Pennsylvania, Estados Unidos, 17033-0850
        • Penn State Hershey Cancer Institute at Milton S. Hershey Medical Center
      • Lewistown, Pennsylvania, Estados Unidos, 17044
        • Lewistown Hospital
      • Philadelphia, Pennsylvania, Estados Unidos, 19111-2497
        • Fox Chase Cancer Center - Philadelphia
      • Philadelphia, Pennsylvania, Estados Unidos, 19104-4283
        • Abramson Cancer Center of the University of Pennsylvania
      • Philadelphia, Pennsylvania, Estados Unidos, 19107-5541
        • Kimmel Cancer Center at Thomas Jefferson University - Philadelphia
      • Philadelphia, Pennsylvania, Estados Unidos, 19107
        • Joan Karnell Cancer Center at Pennsylvania Hospital
      • Philadelphia, Pennsylvania, Estados Unidos, 19114
        • Frankford Hospital Cancer Center - Torresdale Campus
      • Scranton, Pennsylvania, Estados Unidos, 18508
        • Hematology and Oncology Associates of Northeastern Pennsylvania
      • State College, Pennsylvania, Estados Unidos, 16803
        • Mount Nittany Medical Center
      • State College, Pennsylvania, Estados Unidos, 16801
        • Geisinger Medical Group - Scenery Park
      • Wilkes-Barre, Pennsylvania, Estados Unidos, 18711
        • Frank M. and Dorothea Henry Cancer Center at Geisinger Wyoming Valley Medical Center
      • Wilkes-Barre, Pennsylvania, Estados Unidos, 18765
        • Mercy Hospital at Wilkes-Barre
      • Williamsport, Pennsylvania, Estados Unidos, 17701
        • Susquehanna Cancer Center at Divine Providence Hospital
    • South Carolina
      • Florence, South Carolina, Estados Unidos, 29501
        • McLeod Regional Medical Center
    • South Dakota
      • Sioux Falls, South Dakota, Estados Unidos, 57105
        • Avera Cancer Institute
      • Sioux Falls, South Dakota, Estados Unidos, 57105
        • Medical X-Ray Center, PC
      • Sioux Falls, South Dakota, Estados Unidos, 57117-5039
        • Sanford Cancer Center at Sanford USD Medical Center
    • Tennessee
      • Kingsport, Tennessee, Estados Unidos, 37662
        • Christine LaGuardia Phillips Cancer Center at Wellmont Holston Valley Medical Center
    • Texas
      • Temple, Texas, Estados Unidos, 76508
        • CCOP - Scott and White Hospital
    • Vermont
      • Berlin, Vermont, Estados Unidos, 05602
        • Mountainview Medical
      • Burlington, Vermont, Estados Unidos, 05401
        • Fletcher Allen Health Care - University Health Center Campus
    • Virginia
      • Danville, Virginia, Estados Unidos, 24541
        • Danville Regional Medical Center
      • Norton, Virginia, Estados Unidos, 24273
        • Southwest Virginia Regional Cancer Center at Wellmonth Health
    • Wisconsin
      • Eau Claire, Wisconsin, Estados Unidos, 54701
        • Center for Cancer Treatment & Prevention at Sacred Heart Hospital
      • Eau Claire, Wisconsin, Estados Unidos, 54701
        • Marshfield Clinic Cancer Care at Regional Cancer Center
      • Green Bay, Wisconsin, Estados Unidos, 54307-3508
        • St. Vincent Hospital Regional Cancer Center
      • Green Bay, Wisconsin, Estados Unidos, 54301-3526
        • Green Bay Oncology, Limited at St. Vincent Hospital Regional Cancer Center
      • Green Bay, Wisconsin, Estados Unidos, 54303
        • Green Bay Oncology, Limited at St. Mary's Hospital
      • Green Bay, Wisconsin, Estados Unidos, 54303
        • St. Mary's Hospital Medical Center - Green Bay
      • Marinette, Wisconsin, Estados Unidos, 54143
        • Bay Area Cancer Care Center at Bay Area Medical Center
      • Marshfield, Wisconsin, Estados Unidos, 54449
        • Saint Joseph's Hospital
      • Milwaukee, Wisconsin, Estados Unidos, 53215
        • Medical Consultants, Limited
      • Minocqua, Wisconsin, Estados Unidos, 54548
        • Marshfield Clinic - Lakeland Center
      • Oconto Falls, Wisconsin, Estados Unidos, 54154
        • Green Bay Oncology, Limited - Oconto Falls
      • Rhinelander, Wisconsin, Estados Unidos, 54501
        • Ministry Medical Group at Saint Mary's Hospital
      • Rice Lake, Wisconsin, Estados Unidos, 54868
        • Marshfield Clinic - Indianhead Center
      • Stevens Point, Wisconsin, Estados Unidos, 54481
        • Saint Michael's Hospital Cancer Center
      • Sturgeon Bay, Wisconsin, Estados Unidos, 54235
        • Green Bay Oncology, Limited - Sturgeon Bay
      • Wausau, Wisconsin, Estados Unidos, 54401
        • Marshfield Clinic - Wausau Center
      • Wausau, Wisconsin, Estados Unidos, 54401
        • University of Wisconcin Cancer Center at Aspirus Wausau Hospital
      • Weston, Wisconsin, Estados Unidos, 54476
        • Marshfield Clinic - Weston Center
      • Wisconsin Rapids, Wisconsin, Estados Unidos, 54494
        • Marshfield Clinic - Wisconsin Rapids Center

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

  1. Metastatic disease of the esophagus or gastroesophageal junction

    1. Histologic, cytologic or radiologic documentation of metastatic squamous cell carcinoma or adenocarcinoma of the esophagus or gastroesophageal junction. Radiologic, endoscopic, histologic or cytologic evidence of locally recurrent or locally residual (post-resection) disease is also permitted.
    2. For the purposes of this study, undifferentiated adenocarcinomas and adenosquamous tumors will be considered as adenocarcinomas. In addition, tumors involving the gastroesophageal junction will be defined by the Siewert classification.
    3. Patients with gastroesophageal junction tumors who are eligible:

      • AEG Type I: Adenocarcinoma of the distal esophagus which usually arises from an area with specialized intestinal metaplasia of the esophagus (eg, Barrett's esophagus, and may infiltrate the esophagogastric junction from above).
      • AEG Type II: True carcinoma of the cardia arising from the cardiac epithelium or short segments with intestinal metaplasia at the esophagogastric junction.
    4. Patients with gastroesophageal junction tumors who are NOT eligible:

      • AEG Type III: Subcardial gastric carcinoma which infiltrates the esophagogastric junction and distal esophagus from below.
  2. Patients must have at least one paraffin block available (or at least 15 unstained slides for analysis of tumor EGFR status.

    1. Patients with a history of esophageal and GE junction carcinoma treated by surgical resection who develop radiological or clinical evidence of metastatic cancer do not require separate histological or cytological confirmation of metastatic disease unless an interval of greater than five years has elapsed between the primary surgery and the development of metastatic disease OR the primary cancer was stage I.
    2. Clinicians should consider biopsy of lesions to establish the diagnosis of metastatic esophageal or GE junction carcinoma if there is substantial clinical ambiguity regarding the nature or source of apparent metastases.
  3. Patients with Measurable Disease - Lesions that can be accurately measured in at least one dimension (longest diameter to be recorded) as ≥ 20 mm with conventional techniques or as ≥ 10 mm with spiral CT scan.
  4. Prior Treatment:

    1. No prior chemotherapy or radiotherapy. No prior therapy which specifically and directly targets the EGF(R) pathway.
    2. No prior allergic reaction to chimerized or murine monoclonal antibody therapy or documented presence of human anti-mouse antibodies (HAMA).
    3. Patients must have completed any major surgery ≥ 4 weeks or any minor surgery ≥ 2 weeks before registration. Patients must have fully recovered from the procedure. Insertion of a vascular access device is not considered major or minor surgery.
    4. No concurrent use of investigational agents is allowed while participating in this study.
  5. Patient Characteristics:

    1. ECOG Performance Status of 0-2
    2. ≥ 18 years of age
    3. Patients must be documented to have a stable weight (or less than one pound weight loss) for at least one week prior to registration.
    4. Non-pregnant and not breast-feeding. The effects of cetuximab, cisplatin, epirubicin, fluorouracil, leucovorin, irinotecan, and oxaliplatin on a developing human fetus are not well-known. Because the risk of toxicity in nursing infants secondary to cetuximab, cisplatin, epirubicin, fluorouracil, irinotecan, and oxaliplatin treatment of the mother is unknown but may be harmful, breastfeeding must be discontinued.
  6. No myocardial infarction < 6 months prior to registration or New York Heart Association classification III or IV.
  7. No ≥ grade 2 diarrhea within 7 days prior to registration.
  8. Patients may not concurrently have any of the following conditions:

    1. Known central nervous system metastases or carcinomatous meningitis
    2. Interstitial pneumonia or symptomatic interstitial fibrosis of the lung
    3. Seizure disorder or active neurological disease requiring anti-epileptic medication
    4. ≥ grade 2 peripheral neuropathy
  9. No evidence of Gilbert's Syndrome - Patients with Gilbert's Syndrome may have a greater risk of irinotecan toxicity due to the abnormal glucuronidation of SN-38, the active metabolite of irinotecan. Evidence of Gilbert's Syndrome would include documentation of elevation of indirect bilirubin at any time in the patient's medical history.
  10. Required Initial Laboratory Data:

    1. Granulocytes ≥ 1500/µl
    2. Platelet count ≥ 100,000/µl
    3. Creatinine ≤ 1.5 mg/dL
    4. AST (SGOT) ≤ 5.0 x Upper limits of normal
    5. Total bilirubin ≤ 1.5 mg/dL
    6. Albumin ≥ 2.5 grams/dL

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: Randomizado
  • Modelo Intervencional: Atribuição Paralela
  • Mascaramento: Nenhum (rótulo aberto)

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Experimental: Arm A (ECF + cetuximab)
Patients receive cetuximab 400 mg/m^2 IV over 120 minutes on day 1 of the first cycle, then 250 mg/m^2 IV over 60 minutes thereafter. Patients receive cetuximab IV on days 1, 8 and 15. Patients receive epirubicin 50 mg/m^2 IV after cetuximab on day 1 followed by cisplatin 60 mg/m^2 IV over 60 minutes. On days 1-21, patients receive 5-fluorouracil 200 mg/m^2/day continuous IV infusion. Treatment repeats every 21 days in the absence of disease progression and unacceptable toxicity.
dado IV
Outros nomes:
  • C225
epirubicin and 5-fluorouracil given IV
Outros nomes:
  • Ellence (epirubicin) and 5-fluorouracil (5-FU)
Experimental: Arm B (IC + cetuximab)
Patients receive cetuximab 400 mg/m^2 IV over 120 minutes on day 1 of the first cycle, then 250 mg/m^2 IV over 60 minutes thereafter. Patients receive cetuximab on days 1, 8 and 15. Patients receive cisplatin 30 mg/m^2 IV over 30 minutes on days 1 and 8 after cetuximab. Patients also receive irinotecan 65 mg/m^2 IV over 90 minutes on days 1 and 8 after receiving cisplatin.Treatment repeats every 21 days in the absence of disease progression and unacceptable toxicity.
dado IV
Outros nomes:
  • C225
cisplatin and irinotecan given IV
Outros nomes:
  • Platinol-AQ (cisplatin), CPT-11 (irinotecan)
Experimental: ARM C (FOLFOX + cetuximab)
Patients receive cetuximab 400 mg/m^2 IV over 120 minutes on day 1 of the first cycle, then 250 mg/m^2 IV over 60 minutes thereafter. Patients receive cetuximab on days 1 and 8. On Day 1, patients also receive oxaliplatin 85 mg/m^2 IV over 120 minutes and leucovorin 400 mg/m^2 IV over 120 minutes either concurrently with oxaliplatin via a separate infusion line or post oxaliplatin administration. Following leucovorin, patients will receive 5-fluorouracil 400 mg/m^2 IV bolus injection, then 5-fluorouracil 2400 mg/m^2 IV infusion over 46-48 hours. Treatment repeats every 14 days in the absence of disease progression or unacceptable toxicity.
dado IV
Outros nomes:
  • C225
oxaliplatin , leucovorin and 5-fluorouracil IV
Outros nomes:
  • Eloxatin (oxaliplatin), folinic acid (leucovorin), and 5-fluorouracil (5-FU)

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
Response Rate (Complete and Partial) in Patients With Measurable Esophageal or GE Junction Adenocarcinoma
Prazo: Up to 2 years post-treatment
Response was defined using Response Evaluation Criteria In Solid Tumors (RECIST) criteria: Complete Response (CR): disappearance of all target lesions; Partial Response (PR) 30% decrease in sum of longest diameter of target lesions; Progressive Disease (PD): 20% increase in sum of longest diameter of target lesions; Stable Disease (SD): small changes that do not meet above criteria. Overall tumor response is the total number of CR and PRs in participants with adenocarcinoma who have received at least one cycle of therapy.
Up to 2 years post-treatment

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
Tumor Response Rate (Complete and Partial) in Patients With Squamous Cell Carcinoma
Prazo: Up to 2 years post-treatment
Response was defined using Response Evaluation Criteria In Solid Tumors (RECIST) criteria: Complete Response (CR): disappearance of all target lesions; Partial Response (PR) 30% decrease in sum of longest diameter of target lesions; Progressive Disease (PD): 20% increase in sum of longest diameter of target lesions; Stable Disease (SD): small changes that do not meet above criteria. Overall tumor response is the total number of CR and PRs in participants with squamous cell carcinoma who have received at least one cycle of therapy.
Up to 2 years post-treatment
Overall Survival in Patients With Adenocarcinoma
Prazo: Up to 2 years post-treatment
Overall survival (OS) was defined as the time from study entry to death of any cause. The median OS with 95% CI was estimated using the Kaplan Meier method.
Up to 2 years post-treatment
Progression-free Survival in Patients With Adenocarcinoma
Prazo: Up to 2 years post-treatment
Progression free survival (PFS) was defined as the time from study entry to progression or death of any cause. The median PFS with 95% CI was estimated using the Kaplan Meier method.
Up to 2 years post-treatment
Time to Treatment Failure in Patients With Adenocarcinoma
Prazo: Up to 2 years post-treatment
Time to treatment failure (TTF) was measured from study entry until documented progression, death resulting from any cause, or end of protocol therapy because of unacceptable toxicity. The median TTF with 95% CI was estimated using the Kaplan Meier method.
Up to 2 years post-treatment

Colaboradores e Investigadores

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

Investigadores

  • Cadeira de estudo: Peter Enzinger, MD, Dana-Farber Cancer Institute

Publicações e links úteis

A pessoa responsável por inserir informações sobre o estudo fornece voluntariamente essas publicações. Estes podem ser sobre qualquer coisa relacionada ao estudo.

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 (Real)

15 de setembro de 2006

Conclusão Primária (Real)

1 de abril de 2011

Conclusão do estudo (Real)

15 de outubro de 2014

Datas de inscrição no estudo

Enviado pela primeira vez

26 de setembro de 2006

Enviado pela primeira vez que atendeu aos critérios de CQ

26 de setembro de 2006

Primeira postagem (Estimativa)

28 de setembro de 2006

Atualizações de registro de estudo

Última Atualização Postada (Real)

29 de setembro de 2021

Última atualização enviada que atendeu aos critérios de controle de qualidade

2 de setembro de 2021

Última verificação

1 de setembro de 2021

Mais Informações

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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