Study of PEP02, Irinotecan or Docetaxel in Gastric or Gastroesophageal Junction Adenocarcinoma
Primary Purpose
Stomach Neoplasms, Esophageal Neoplasms
Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
PEP02
irinotecan
docetaxel
Sponsored by
About this trial
This is an interventional treatment trial for Stomach Neoplasms focused on measuring Gastric Cancer, Stomach Cancer, Gastroesophageal, Gastroesophageal Junction, Esophageal Cancer, phase II, PEP02, randomization, randomisation, adenocarcinoma, locally advanced, metastatic, simon's two
Eligibility Criteria
Inclusion Criteria:
- Histologically or cytologically confirmed locally advanced (unresectable) or metastatic adenocarcinoma of gastric or gastroesophageal junction
- Failed to only one systemic chemotherapy for locally advanced or metastatic disease, including patients whose diseases recur within 6 months after (neo)adjuvant chemotherapy. Chemotherapy administered with concurrent radiotherapy is NOT considered as systemic chemotherapy.
- Have at least one measurable lesion according to the RECIST criteria
- Aged above or equal to 18 years, at the time of acquisition of informed consent
- With ECOG performance status 0, 1, or 2
- Life expectancy equal to or more than 3 months
- With adequate organ and marrow function as defined below:
- With ability to understand and the willingness to sign a written Informed Consent Form
Exclusion Criteria:
- Had systemic chemotherapy within 3 weeks before the commencement of study treatment
- Had radiotherapy within 4 weeks before the commencement of study treatment
- With known brain metastasis
- With active multiple cancers or had treatment for other carcinomas within the last five years, except cured non-melanoma skin and treated in-situ cervical cancer
- With prior irinotecan or taxane (paclitaxel, docetaxel) treatment
- Have received irradiation affecting > 30% of the active bone marrow
- Had major surgery within 4 weeks of the start of study treatment (laparotomy, line placement is not considered major surgery)
- Have not recovered from prior treatments
- With preexisting peripheral neuropathy > grade 2
- With history of allergic reaction to liposome product or other drugs formulated with polysorbate
- With uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, active gastrointestinal bleeding, watery stools, central nervous system disorders or psychiatric illness/social situation that would limit compliance with study requirements or judged to be ineligible for the study by the investigator
- Have received any investigational agents within 3 weeks preceding the start of study treatment
- Pregnant or breastfeeding females (a pregnancy test must be performed on all female patients who are of child-bearing potential before entering the study, and the result must be negative)
- With intestinal obstruction
- Have received St. John's Wort, CYP3A4 inducing anticonvulsants (phenytoin, phenobarbital, and carbamazepine), rifampin and rifabutin within two weeks, or ketoconazole, itraconazole, troleandomycin, erythromycin, diltiazem and verapamil within one week before the administration of study medications
Sites / Locations
- Clinical Hospital Mostar
- Clinical Centre University of Sarajevo
- University Hospital Centre Rijeka
- University Hospital Centre Dubrava
- University Hospital Centre Zagreb
- Samsung Medical Center
- Asan Medical Center
- National Cancer Center
- Hospital Universitario Vall d'Hebron
- Hospital General Universitario de Elche
- Hospital Clínico San Carlos
- Hospital Universitario Marques de Valdecilla
- Chang Gung Memorial Hospital - Chiayi
- Chang Gung Memorial Hospital - LinKou
- National Cheng Kung University Hospital
- Taipei Veterans General Hospital
- Mackay Memorial Hospital
- Addenbrookes Hospital Oncology Center
- Guy's & St Thomas' NHS Foundation Trust
- Kent Oncology Centre, Maidstone Hospital
- Southampton University Hospital
- The Royal Marsden Hospital
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm Type
Experimental
Active Comparator
Active Comparator
Arm Label
1. PEP02
2. irinotecan
3. docetaxel
Arm Description
liposome irinotecan
Outcomes
Primary Outcome Measures
objective tumor response
Secondary Outcome Measures
progression-free survival, duration of tumor response, time to progression, time to treatment failure, disease control rate, 1-year survival rate,and overall survival; pharmacokinetics and pharmacogenetics of PEP02 and irinotecan
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT00813072
Brief Title
Study of PEP02, Irinotecan or Docetaxel in Gastric or Gastroesophageal Junction Adenocarcinoma
Official Title
A Randomized Phase II Study of PEP02, Irinotecan or Docetaxel as a Second Line Therapy in Patients With Locally Advanced or Metastatic Gastric or Gastroesophageal Junction Adenocarcinoma
Study Type
Interventional
2. Study Status
Record Verification Date
March 2012
Overall Recruitment Status
Completed
Study Start Date
November 2007 (undefined)
Primary Completion Date
July 2010 (Actual)
Study Completion Date
December 2010 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
PharmaEngine
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The purpose of this study is to assess objective tumor response in the single agent treatment of PEP02, irinotecan, or docetaxel for locally advanced or metastatic gastric or gastroesophageal junction adenocarcinoma
Detailed Description
Palliative chemotherapy has been shown to improve survival compared with best supportive care alone in patients with unresectable or recurrent gastric cancer. There is no standard second-line chemotherapy for advanced gastric cancer and no randomized-controlled trial data suggest a benefit of second-line chemotherapy compared with supportive care alone. Response rates of second-line therapy in phase II trials are similar to those seen for other cancers that are more commonly retreated. Combination therapy may achieve higher response rates than single agents, however, the survival outcome are the same. In addition, data suggest that patients may obtain symptomatic benefits from second-line therapy. In comparison to the toxicity profile of single agent with combination regimen, patients are more tolerable to single agent therapy than combination.
Based on the previous clinical experience in second line chemotherapy of advanced gastric cancer, the single agent of PEP02, irinotecan and docetaxel are selected as the regimens for this randomized phase II study. The efficacy and toxicity outcome of the three-arm design will be a valuable reference for future combination therapy or phase III study design.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Stomach Neoplasms, Esophageal Neoplasms
Keywords
Gastric Cancer, Stomach Cancer, Gastroesophageal, Gastroesophageal Junction, Esophageal Cancer, phase II, PEP02, randomization, randomisation, adenocarcinoma, locally advanced, metastatic, simon's two
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
135 (Actual)
8. Arms, Groups, and Interventions
Arm Title
1. PEP02
Arm Type
Experimental
Arm Description
liposome irinotecan
Arm Title
2. irinotecan
Arm Type
Active Comparator
Arm Title
3. docetaxel
Arm Type
Active Comparator
Intervention Type
Drug
Intervention Name(s)
PEP02
Other Intervention Name(s)
liposome irinotecan
Intervention Description
120 mg/m2, IV infusion for 90 minutes on day 1 of each 21 day as a treatment cycle.
Number of Cycles: until progression or unacceptable toxicity develops.
Intervention Type
Drug
Intervention Name(s)
irinotecan
Other Intervention Name(s)
Campto
Intervention Description
300 mg/m2, IV infusion on day 1 of each 21 day as a treatment cycle. Number of Cycles: until progression or unacceptable toxicity develops.
Intervention Type
Drug
Intervention Name(s)
docetaxel
Other Intervention Name(s)
Taxetere
Intervention Description
75 mg/m2, IV infusion for 60 minutes on day 1 of each 21 day as a treatment cycle.
Number of Cycles: until progression or unacceptable toxicity develops.
Primary Outcome Measure Information:
Title
objective tumor response
Secondary Outcome Measure Information:
Title
progression-free survival, duration of tumor response, time to progression, time to treatment failure, disease control rate, 1-year survival rate,and overall survival; pharmacokinetics and pharmacogenetics of PEP02 and irinotecan
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Histologically or cytologically confirmed locally advanced (unresectable) or metastatic adenocarcinoma of gastric or gastroesophageal junction
Failed to only one systemic chemotherapy for locally advanced or metastatic disease, including patients whose diseases recur within 6 months after (neo)adjuvant chemotherapy. Chemotherapy administered with concurrent radiotherapy is NOT considered as systemic chemotherapy.
Have at least one measurable lesion according to the RECIST criteria
Aged above or equal to 18 years, at the time of acquisition of informed consent
With ECOG performance status 0, 1, or 2
Life expectancy equal to or more than 3 months
With adequate organ and marrow function as defined below:
With ability to understand and the willingness to sign a written Informed Consent Form
Exclusion Criteria:
Had systemic chemotherapy within 3 weeks before the commencement of study treatment
Had radiotherapy within 4 weeks before the commencement of study treatment
With known brain metastasis
With active multiple cancers or had treatment for other carcinomas within the last five years, except cured non-melanoma skin and treated in-situ cervical cancer
With prior irinotecan or taxane (paclitaxel, docetaxel) treatment
Have received irradiation affecting > 30% of the active bone marrow
Had major surgery within 4 weeks of the start of study treatment (laparotomy, line placement is not considered major surgery)
Have not recovered from prior treatments
With preexisting peripheral neuropathy > grade 2
With history of allergic reaction to liposome product or other drugs formulated with polysorbate
With uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, active gastrointestinal bleeding, watery stools, central nervous system disorders or psychiatric illness/social situation that would limit compliance with study requirements or judged to be ineligible for the study by the investigator
Have received any investigational agents within 3 weeks preceding the start of study treatment
Pregnant or breastfeeding females (a pregnancy test must be performed on all female patients who are of child-bearing potential before entering the study, and the result must be negative)
With intestinal obstruction
Have received St. John's Wort, CYP3A4 inducing anticonvulsants (phenytoin, phenobarbital, and carbamazepine), rifampin and rifabutin within two weeks, or ketoconazole, itraconazole, troleandomycin, erythromycin, diltiazem and verapamil within one week before the administration of study medications
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
David Cunningham
Organizational Affiliation
The Royal Marsden Hospital, London & Surrey, UK
Official's Role
Principal Investigator
Facility Information:
Facility Name
Clinical Hospital Mostar
City
Mostar
ZIP/Postal Code
36 000
Country
Bosnia and Herzegovina
Facility Name
Clinical Centre University of Sarajevo
City
Sarajevo
ZIP/Postal Code
71 000
Country
Bosnia and Herzegovina
Facility Name
University Hospital Centre Rijeka
City
Rijeka
ZIP/Postal Code
51 000
Country
Croatia
Facility Name
University Hospital Centre Dubrava
City
Zagreb
ZIP/Postal Code
10 000
Country
Croatia
Facility Name
University Hospital Centre Zagreb
City
Zagreb
ZIP/Postal Code
10 000
Country
Croatia
Facility Name
Samsung Medical Center
City
Seoul
ZIP/Postal Code
135-710
Country
Korea, Republic of
Facility Name
Asan Medical Center
City
Seoul
ZIP/Postal Code
138-736
Country
Korea, Republic of
Facility Name
National Cancer Center
City
Seoul
ZIP/Postal Code
410-769
Country
Korea, Republic of
Facility Name
Hospital Universitario Vall d'Hebron
City
Barcelona
ZIP/Postal Code
08035
Country
Spain
Facility Name
Hospital General Universitario de Elche
City
Elche
ZIP/Postal Code
03203
Country
Spain
Facility Name
Hospital Clínico San Carlos
City
Madrid
ZIP/Postal Code
28040
Country
Spain
Facility Name
Hospital Universitario Marques de Valdecilla
City
Santander
ZIP/Postal Code
39008
Country
Spain
Facility Name
Chang Gung Memorial Hospital - Chiayi
City
Chiayi
Country
Taiwan
Facility Name
Chang Gung Memorial Hospital - LinKou
City
LinKou
Country
Taiwan
Facility Name
National Cheng Kung University Hospital
City
Tainan
ZIP/Postal Code
704
Country
Taiwan
Facility Name
Taipei Veterans General Hospital
City
Taipei
ZIP/Postal Code
112
Country
Taiwan
Facility Name
Mackay Memorial Hospital
City
Taipei
ZIP/Postal Code
25115
Country
Taiwan
Facility Name
Addenbrookes Hospital Oncology Center
City
Cambridge
ZIP/Postal Code
CB2 2QQ
Country
United Kingdom
Facility Name
Guy's & St Thomas' NHS Foundation Trust
City
London
ZIP/Postal Code
SE19RT
Country
United Kingdom
Facility Name
Kent Oncology Centre, Maidstone Hospital
City
Maidstone
ZIP/Postal Code
ME16 9QQ
Country
United Kingdom
Facility Name
Southampton University Hospital
City
Southampton
ZIP/Postal Code
SO16 6YD
Country
United Kingdom
Facility Name
The Royal Marsden Hospital
City
Surrey
ZIP/Postal Code
SM2 5PT
Country
United Kingdom
12. IPD Sharing Statement
Citations:
PubMed Identifier
23406728
Citation
Roy AC, Park SR, Cunningham D, Kang YK, Chao Y, Chen LT, Rees C, Lim HY, Tabernero J, Ramos FJ, Kujundzic M, Cardic MB, Yeh CG, de Gramont A. A randomized phase II study of PEP02 (MM-398), irinotecan or docetaxel as a second-line therapy in patients with locally advanced or metastatic gastric or gastro-oesophageal junction adenocarcinoma. Ann Oncol. 2013 Jun;24(6):1567-73. doi: 10.1093/annonc/mdt002. Epub 2013 Feb 13.
Results Reference
derived
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Study of PEP02, Irinotecan or Docetaxel in Gastric or Gastroesophageal Junction Adenocarcinoma
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