Ignite Creation Date:
2024-05-06 @ 1:21 AM
Last Modification Date:
2024-10-26 @ 11:02 AM
Study NCT ID:
NCT01787539
Status:
UNKNOWN
Last Update Posted:
2013-02-08
First Post:
2013-02-06
Brief Title:
The Role of Postoperative Cycles in the Perioperative Chemotherapy for Gastric Cancer
Sponsor:
Medical University of Lublin
Organization:
Medical University of Lublin
Study Overview
Official Title:
The Role of Postoperative Chemotherapy Cycles in the Combined Modality Therapy of Gastric Cancer With Perioperative Chemotherapy and Surgery in Pathological Responders
Status:
UNKNOWN
Status Verified Date:
2013-02
Last Known Status:
RECRUITING
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
STOPEROPCHEM
Brief Summary:
Taking into account the substantial doubts concerning the potential benefit of postoperative part in the perioperative chemotherapy regimen we designed a study assessing value of this approach in gastric cancer To improve compliance with a protocol regimen of this aggressive combined therapy we replaced tested in the MAGIC trial ECF regimen with more effective and better tolerable EOX chemotherapy regimen The value of postoperative three-cycle EOX regimen will be tested in patients with locoregionally advanced gastric cancer with positive pathological response to preoperative three-cycle EOX chemotherapy regimen The patients will be randomized to the postoperative chemotherapy or to the follow-up arm
Detailed Description:
The MAGIC trial also considered the milestone study definitely proved that neoadjuvant chemotherapy improves the outcome of patients with locally advanced gastric cancer Resection was considered curative in 79 under combination therapy versus in 69 of only operated patients P 002 2-year survival rates were 50 and 41 and 5-year-survival rates were 36 and 23 P 0009 respectively The substantial weak point of the MAGIC trial remains the fact that only about 40 of the patients received the full dosage of scheduled postoperative chemotherapy mainly due to intolerance or toxicity reasons
The noninferiority in relation to survival of capecitabine to 5-FU in triplet regimens for the treatment of patients with advanced esophagogastric cancer was demonstrated in the large multicenter randomized phase III REAL-2 study including 1002 patients Capecitabine has overcome the doubts concerning the potential efficacy of oral drug administration in patients with gastric carcinoma especially in relation to those patients who have undergone partial or total gastrectomy The same study demonstrated the noninferiority of oxaliplatin versus cisplatin in advanced gastric cancer and confirmed the acceptable tolerability profile of this third-generation platinum analogue It was anticipated that the use of these newer agents as components of triplet regimens would reduce toxicity and thereby render an alternative to the standard ECF combination easier to handle as a consequence of replacing the cisplatin component with oxaliplatin replacing the infusional 5-fluorouracil component with oral capecitabine in EOX regimen Furthermore achieving a median overall survival time of 112 months the EOX regimen appeared to be more active than ECF median overall survival time 99 months with the higher 1-year survival rate 47 vs 38 respectively Compared with the ECF regimen EOX was associated with significantly lower rates of grade 3 or 4 neutropenia and grade 2 alopecia but significantly higher rates of grade 3 or 4 lethargy diarrhea and peripheral neuropathy Based on the results of the REAL study EOX is therefore tolerable and at least as active as ECF This modified regimen could therefore be considered to be a new standard treatment and may be an appropriate reference regimen for future studies in advanced gastric cancer
The noninferiority in relation to survival of capecitabine to 5-FU in triplet regimens for the treatment of patients with advanced esophagogastric cancer was demonstrated in the large multicenter randomized phase III REAL-2 study including 1002 patients Capecitabine has overcome the doubts concerning the potential efficacy of oral drug administration in patients with gastric carcinoma especially in relation to those patients who have undergone partial or total gastrectomy The same study demonstrated the noninferiority of oxaliplatin versus cisplatin in advanced gastric cancer and confirmed the acceptable tolerability profile of this third-generation platinum analogue It was anticipated that the use of these newer agents as components of triplet regimens would reduce toxicity and thereby render an alternative to the standard ECF combination easier to handle as a consequence of replacing the cisplatin component with oxaliplatin replacing the infusional 5-fluorouracil component with oral capecitabine in EOX regimen Furthermore achieving a median overall survival time of 112 months the EOX regimen appeared to be more active than ECF median overall survival time 99 months with the higher 1-year survival rate 47 vs 38 respectively Compared with the ECF regimen EOX was associated with significantly lower rates of grade 3 or 4 neutropenia and grade 2 alopecia but significantly higher rates of grade 3 or 4 lethargy diarrhea and peripheral neuropathy Based on the results of the REAL study EOX is therefore tolerable and at least as active as ECF This modified regimen could therefore be considered to be a new standard treatment and may be an appropriate reference regimen for future studies in advanced gastric cancer
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
None
Is a FDA Regulated Device?:
None
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None
Secondary IDs
| Secondary ID | Type | Domain | Link |
|---|---|---|---|
| GC-025428220112752012-MUL | OTHER | Medical University of Lublin | None |