Sunitinib in Patients With Advanced Gastric Cancer and Treated With FOLFIRI (SUN-CASE)
Primary Purpose
Adenocarcinoma
Status
Completed
Phase
Phase 2
Locations
Germany
Study Type
Interventional
Intervention
Sunitinib
Placebo
Sponsored by

About this trial
This is an interventional treatment trial for Adenocarcinoma focused on measuring adenocarcinoma of stomach, adenocarcinoma of lower oesophagus, sunitinib, FOLFIRI
Eligibility Criteria
Inclusion Criteria:
- Signed and dated informed consent before the start of specific protocol procedures
- Histological proven gastric adenocarcinoma including adenocarcinoma of the esophagogastric junction or lower esophagus
- Failure of any prior chemotherapy (docetaxel and/or platinum-based chemotherapy); but patient has not previously received FOLFIRI treatment
- Measurable metastatic disease according to the RECIST criteria patients aged 18 years and older
- karnofsky index 100 - 70 %
- Life expectancy > 12 weeks
- Adequate hematological, hepatic and renal functions
- At least 3 weeks from previous docetaxel- and/or platinum-based chemotherapy
- Recovery from hematological side effects (CTC grade <1) and non-hematological side effects (CTC grade=<1) of any prior therapy (except oxaliplatine induced neuropathy CTC grade =<2)
Exclusion Criteria:
- History of another primary malignancy >3 years, with the exception of non-melanoma skin cancer and in situ carcinoma of the uterine cervix
- Any prior palliative radiotherapy of the target lesions
- Concurrent treatment with any other medicinal anti-cancer therapy
- Prior treatment with a VEGF, VEGFR or RTK inhibitor, or prior enrolment on this study
- Known allergic/hypersensitivity reaction to any of the components of the treatment
- Treatment with potent CYP3A4 inhibitor within 7 days of Sunitinib/placebo dosing or with potent CYP3A4 inducer within 12 days of Sunitinib/placebo dosing
- Other serious illness or medical conditions within the last 12 months prior to study drug administration: Unstable cardiac disease despite treatment; myocardial infarction within 12 months prior to study entry; congestive heart failure NYHA grade 3 and 4; Hypertension that cannot be controlled by medication ; ongoing cardiac dysrhythmias of NCI CTCAE grade >2, atrial fibrillation of any grade, or QTc interval >450 msec for males or >470 msec for females; History of significant neurologic or psychiatric disorders including dementia or seizures; Active uncontrolled infection; History of clinically significant bleeding within the past 6 months, including hemoptysis or haematuria, or underlying coagulopathy; Active disseminated intravascular coagulation; Cerebrovascular accident including transient ischemic attack; Pulmonary embolus; Bowel obstruction or chronic diarrhoea, history or presence of inflammatory enteropathy or extensive intestinal resection; History of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within 6 months prior to study enrolment, unless affected area has been removed surgically
- Known deficit in DPD
- Hypercalcemia not controlled by bisphosphonates
- Contraindications to the use of atropine
- Pregnant or lactating women; female patients who are pregnant or lactating or men and women of reproductive potential not willing or not able to employ an effective method of birth control/contraception to prevent pregnancy during treatment and for 3 months after discontinuing study treatment
- Known drug abuse/alcohol abuse
- Current, recent, or planned participation in an experimental treatment drug study other than this protocol
- Major surgical procedure, open biopsy or significant traumatic injury within 4 weeks before starting treatment; anticipation of need for major surgical procedure (e.g. impending bowel obstruction) during the course of the study
- History of other medical or psychiatric condition, metabolic dysfunction, physical examination finding, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates the use of an investigational drug or that might affect the interpretation of the results of the study or render the patient at high risk from treatment complications
Sites / Locations
- Universitätsmedizin Mainz, 1. Med. Klinik
- Gesundheitszentrum St. Marien
- Helios Klinikum Berlin-Buch
- Universitätsmedizin Berlin Charite
- Evangelisches Krankenhaus Bielefeld
- Universitätsklinikum Essen
- Kliniken Essen-Mitte
- Krankenhaus Nordwest
- Martin-Luther-Universität Halle-Wittenberg
- MVZ für Innere Medizin in Hamburg-Eppendorf
- Universitätsklinikum des Saarlandes
- Klinikum Ludwigsburg Medizinische Klinik I
- Technische Universität München
- Universitätsklinikum Rostock Klinik für Innere Medizin
- Leopoldina-Krankenhaus der Stadt Schweinfurt gGmbH
- Klinikum Weiden
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
Sunitinib
Placebo
Arm Description
25 mg (2 capsules of 12.5 mg) for oral administration
2 capsules for oral administration
Outcomes
Primary Outcome Measures
The primary endpoint is the Progression-free survival (PFS) according to RECIST V1.1.
Secondary Outcome Measures
Objective response rate (CR + PR) according to RECIST
Safety and tolerability
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT01020630
Brief Title
Sunitinib in Patients With Advanced Gastric Cancer and Treated With FOLFIRI
Acronym
SUN-CASE
Official Title
A Randomized, Placebo-controlled Phase II Trial Investigating SUNITINIB Versus Placebo in Patients With Chemorefractory Advanced Adenocarcinoma of the Stomach or Lower Esophagus Treated With Chemotherapy FOLFIRI
Study Type
Interventional
2. Study Status
Record Verification Date
May 2014
Overall Recruitment Status
Completed
Study Start Date
November 2009 (undefined)
Primary Completion Date
November 2012 (Actual)
Study Completion Date
July 2013 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
PD Dr Markus Möhler
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This trial will be conducted to evaluate the efficacy, safety and tolerability of SUNITINIB as add-on therapy with a widely used second-line palliative FOLFIRI chemotherapy in patients with chemo-refractory advanced or metastatic adenocarcinoma of stomach or lower esophagus (mGC).
There is a clear scientific rationale for the use of Sunitinib to treat patients with mGC. Despite recent therapeutic advances, the median overall survival (OS) in patients with mG is still ≤ 12 months. Therefore, newer agents with novel mechanisms of action are desperately needed for treatment of these patients.
Detailed Description
In parallel to the efforts in front-line therapy, second-line protocols like irinotecan-based regimens have been established in clinical trials for those patients. As many patients are still in good performance status and present with low tumor burden after failure of first-line chemotherapy, they clearly benefit from second-line treatment.
Sunitinib inhibits the receptor tyrosine kinases (RTKs) involved in tumor proliferation and angiogenesis, specifically the VEGFR, PDGFR, KIT, FLT-3, and RET. The VEGF pathway has been shown to be a significant factor in metastatic gastric cancer.
The safety and efficacy of Sunitinib as single agent for the treatment of mGC has been determined and support the proposed clinical study with FOLFIRI in combination with Sunitinib in the treatment of patients with mGC.
Patients included in this trial suffer from advanced or metastatic adenocarcinoma of stomach or lower esophagus. They have failed to respond at least to one standard palliative first-line therapy (based on docetaxel and/or cisplatin plus 5-FU). Irinotecan/FA/5-FU can be determined as one established second-line treatment to be available for these patients.
Taken together, treatment of those patients with Sunitinib combined with standard chemotherapy FOLFIRI offers the chance to benefit from a new innovative therapy with acceptable side effects.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Adenocarcinoma
Keywords
adenocarcinoma of stomach, adenocarcinoma of lower oesophagus, sunitinib, FOLFIRI
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
91 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Sunitinib
Arm Type
Experimental
Arm Description
25 mg (2 capsules of 12.5 mg) for oral administration
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
2 capsules for oral administration
Intervention Type
Drug
Intervention Name(s)
Sunitinib
Other Intervention Name(s)
Sutent
Intervention Description
Sunitinib will be orally administered at 25 mg once daily (in the morning without regards to meals) for 4 consecutive weeks followed by a 2-week rest period to comprise a complete cycle of 6 weeks.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo will be orally administered once daily (in the morning without regards to meals) for 4 consecutive weeks followed by a 2-week rest period to comprise a complete cycle of 6 weeks.
Primary Outcome Measure Information:
Title
The primary endpoint is the Progression-free survival (PFS) according to RECIST V1.1.
Time Frame
Average time period: up to one year (participants are followed until progression or death)
Secondary Outcome Measure Information:
Title
Objective response rate (CR + PR) according to RECIST
Time Frame
Average time period: up to one year (participants are followed until progression or death)
Title
Safety and tolerability
Time Frame
one year
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Signed and dated informed consent before the start of specific protocol procedures
Histological proven gastric adenocarcinoma including adenocarcinoma of the esophagogastric junction or lower esophagus
Failure of any prior chemotherapy (docetaxel and/or platinum-based chemotherapy); but patient has not previously received FOLFIRI treatment
Measurable metastatic disease according to the RECIST criteria patients aged 18 years and older
karnofsky index 100 - 70 %
Life expectancy > 12 weeks
Adequate hematological, hepatic and renal functions
At least 3 weeks from previous docetaxel- and/or platinum-based chemotherapy
Recovery from hematological side effects (CTC grade <1) and non-hematological side effects (CTC grade=<1) of any prior therapy (except oxaliplatine induced neuropathy CTC grade =<2)
Exclusion Criteria:
History of another primary malignancy >3 years, with the exception of non-melanoma skin cancer and in situ carcinoma of the uterine cervix
Any prior palliative radiotherapy of the target lesions
Concurrent treatment with any other medicinal anti-cancer therapy
Prior treatment with a VEGF, VEGFR or RTK inhibitor, or prior enrolment on this study
Known allergic/hypersensitivity reaction to any of the components of the treatment
Treatment with potent CYP3A4 inhibitor within 7 days of Sunitinib/placebo dosing or with potent CYP3A4 inducer within 12 days of Sunitinib/placebo dosing
Other serious illness or medical conditions within the last 12 months prior to study drug administration: Unstable cardiac disease despite treatment; myocardial infarction within 12 months prior to study entry; congestive heart failure NYHA grade 3 and 4; Hypertension that cannot be controlled by medication ; ongoing cardiac dysrhythmias of NCI CTCAE grade >2, atrial fibrillation of any grade, or QTc interval >450 msec for males or >470 msec for females; History of significant neurologic or psychiatric disorders including dementia or seizures; Active uncontrolled infection; History of clinically significant bleeding within the past 6 months, including hemoptysis or haematuria, or underlying coagulopathy; Active disseminated intravascular coagulation; Cerebrovascular accident including transient ischemic attack; Pulmonary embolus; Bowel obstruction or chronic diarrhoea, history or presence of inflammatory enteropathy or extensive intestinal resection; History of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within 6 months prior to study enrolment, unless affected area has been removed surgically
Known deficit in DPD
Hypercalcemia not controlled by bisphosphonates
Contraindications to the use of atropine
Pregnant or lactating women; female patients who are pregnant or lactating or men and women of reproductive potential not willing or not able to employ an effective method of birth control/contraception to prevent pregnancy during treatment and for 3 months after discontinuing study treatment
Known drug abuse/alcohol abuse
Current, recent, or planned participation in an experimental treatment drug study other than this protocol
Major surgical procedure, open biopsy or significant traumatic injury within 4 weeks before starting treatment; anticipation of need for major surgical procedure (e.g. impending bowel obstruction) during the course of the study
History of other medical or psychiatric condition, metabolic dysfunction, physical examination finding, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates the use of an investigational drug or that might affect the interpretation of the results of the study or render the patient at high risk from treatment complications
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Markus Moehler, MD
Organizational Affiliation
Johannes Gutenberg University Mainz, 1. Med. Klinik
Official's Role
Principal Investigator
Facility Information:
Facility Name
Universitätsmedizin Mainz, 1. Med. Klinik
City
Mainz
State/Province
Rheinland-Pfalz
ZIP/Postal Code
55131
Country
Germany
Facility Name
Gesundheitszentrum St. Marien
City
Amberg
ZIP/Postal Code
92224
Country
Germany
Facility Name
Helios Klinikum Berlin-Buch
City
Berlin
ZIP/Postal Code
13125
Country
Germany
Facility Name
Universitätsmedizin Berlin Charite
City
Berlin
ZIP/Postal Code
13353
Country
Germany
Facility Name
Evangelisches Krankenhaus Bielefeld
City
Bielefeld
ZIP/Postal Code
33611
Country
Germany
Facility Name
Universitätsklinikum Essen
City
Essen
ZIP/Postal Code
45122
Country
Germany
Facility Name
Kliniken Essen-Mitte
City
Essen
ZIP/Postal Code
45136
Country
Germany
Facility Name
Krankenhaus Nordwest
City
Frankfurt
ZIP/Postal Code
60488
Country
Germany
Facility Name
Martin-Luther-Universität Halle-Wittenberg
City
Halle
ZIP/Postal Code
06120
Country
Germany
Facility Name
MVZ für Innere Medizin in Hamburg-Eppendorf
City
Hamburg
ZIP/Postal Code
20249
Country
Germany
Facility Name
Universitätsklinikum des Saarlandes
City
Homburg
ZIP/Postal Code
66421
Country
Germany
Facility Name
Klinikum Ludwigsburg Medizinische Klinik I
City
Ludwigsburg
ZIP/Postal Code
71640
Country
Germany
Facility Name
Technische Universität München
City
München
ZIP/Postal Code
81675
Country
Germany
Facility Name
Universitätsklinikum Rostock Klinik für Innere Medizin
City
Rostock
ZIP/Postal Code
18057
Country
Germany
Facility Name
Leopoldina-Krankenhaus der Stadt Schweinfurt gGmbH
City
Schweinfurt
ZIP/Postal Code
97422
Country
Germany
Facility Name
Klinikum Weiden
City
Weiden
ZIP/Postal Code
92637
Country
Germany
12. IPD Sharing Statement
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Sunitinib in Patients With Advanced Gastric Cancer and Treated With FOLFIRI
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