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Panitumumab, Paclitaxel, Carboplatin and 5FU in the Treatment of Potentially Resectable Gastroesophageal Adenocarcinoma

Primary Purpose

Gastroesophageal Adenocarcinoma, Adenocarcinoma of the Distal Esophagus, Adenocarcinomas of the Gastroesophageal Junction

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Panitumumab
Paclitaxel
Carboplatin
5FU
Sponsored by
Accelerated Community Oncology Research Network
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Gastroesophageal Adenocarcinoma

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Biopsy-proven adenocarcinoma of the distal esophagus, gastroesophageal junction, or proximal stomach (within 5cm of gastroesophageal junction)
  • No prior treatment for this disease
  • AJCC (American Joint Committee on Cancer) clinical stage II to IVA, potentially resectable disease
  • Measurable disease per RECIST 1.0 criteria
  • Medically fit for surgery; surgical consultation is encouraged prior to initiation of treatment
  • ECOG (Eastern Cooperative Oncology Group) performance status of 0 or 1
  • Male or female; aged equal to or greater than 18 years
  • Life expectancy of greater than 3 months
  • Good organ, metabolic, bone marrow, and pulmonary function as specified in the protocol
  • Functioning central venous access device prior to treatment initiation
  • Women of childbearing potential and men must agree to use adequate contraception prior to study entry and for at least 6 months following the last administration of panitumumab
  • Ability to understand and the willingness to sign a written IRB (Institutional Review Board) approved informed consent

Exclusion Criteria:

  • Prior treatment for this disease
  • History of another primary cancer except curatively treated in situ cervical cancer, curatively resected nonmelanoma skin cancer, or other primary solid tumor curatively treated with no active disease present and no treatment administered for at least 5 years prior to enrollment
  • History or known presence of central nervous system metastases
  • History of allergic reactions attributed to compounds similar chemical or biologic composition to panitumumab, paclitaxel, carboplatin, or 5FU
  • Prior anti-EGFr-antibody therapy or treatment with small molecule EGFr inhibitors
  • Systemic chemotherapy, hormonal therapy, immunotherapy, or experimental or approved proteins/antibodies within 30 days prior to enrollment
  • Chronic use of immunosuppressive agents with the exception of corticosteroids
  • Any investigational agent or therapy within 30 days prior to enrollment
  • Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
  • History of interstitial lung disease, e.g., pneumonitis or pulmonary fibrosis or any evidence of interstitial lung disease on baseline chest CT scan
  • History of any medical or psychiatric condition or laboratory abnormality that in the opinion of the investigator may increase the risks associated with study participation or investigational product(s) administration or may interfere with the interpretation of the results
  • Unwilling or unable to comply with study requirements
  • Female who tests positive for serum or urine pregnancy test or is breast feeding
  • Known positive test(s) for human immunodeficiency virus infection, hepatitis C virus, acute or chronic active hepatitis B infection
  • Major surgery within 28 days or minor surgery within 7 days prior to treatment. Placement of a central venous access device less than one day prior to treatment start
  • Male or female of childbearing potential (women who are post-menopausal less than 52 weeks, not surgically sterilized, or not abstinent) not consenting to use adequate contraception prior to study entry and for at least 6 months following the last administration of panitumumab
  • Arterial ischemic event (myocardial infarction, stroke) within 3 months prior to enrollment
  • Ongoing therapeutic anticoagulation

Sites / Locations

  • Clopton Clinic

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Treatment group

Arm Description

Panitumumab 9mg/kg on Days 1, 22, and 43 Paclitaxel 200mg/m2 on Days 1 and 22 Carboplatin AUC=6 on Days 1 and 22 5FU 225mg/m2/day on Days 1-15 and 22-36

Outcomes

Primary Outcome Measures

Response Rate
The primary endpoint is overall response rate (ORR) as determined per RECIST guidelines version 1.1 from baseline and restaging scans conducted between Days 36 to 43. Response is defined as the occurrence of either Complete Response (CR) or Partial Response (PR) as best response. CR is defined as the disappearance of all target lesions. Any pathological lymph nodes must have reduction in short axis to < 10 mm. A PR is defined as at least a 30% decrease in the sum of diameters of the target lesions taking as reference the baseline sum diameters.

Secondary Outcome Measures

Pathologic Response Rate
The patient will be scored as having had a pathologic complete response (pCR) if the routine histologic examination of the resected specimen shows no residual invasive cancer by standard hematoxylin and eosin (H&E) examination.
Resection Rate of Surgery
The patient will be scored as having an R0 resection, if no invasive cancer is detected involving the margins of the resection by routine microscopic hematoxylin and eosin (H&E)examination, and the operative report indicates complete resection with no residual disease. The patient will be scored as having an R1 resection, if invasive cancer is detected involving the margins of resection by routine microscopic hematoxylin and eosin (H&E) examination, and the operative report indicates complete resection with no residual disease. The patient will be scored as having an R2 resection, if the operative report indicates incomplete resection or gross residual disease.
Thirty-day Surgical Mortality
All subjects who have undergone surgical resection will be followed for a 30-day postoperative safety evaluation. Death from any cause within 30 days of the date of surgery will be considered a surgical mortality death.
Survival

Full Information

First Posted
August 13, 2010
Last Updated
November 29, 2012
Sponsor
Accelerated Community Oncology Research Network
Collaborators
Amgen
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1. Study Identification

Unique Protocol Identification Number
NCT01182610
Brief Title
Panitumumab, Paclitaxel, Carboplatin and 5FU in the Treatment of Potentially Resectable Gastroesophageal Adenocarcinoma
Official Title
A Phase II Study of Pre-operative Panitumumab, Paclitaxel, Carboplatin and Continuous Infusion 5FU in the Treatment of Potentially Resectable Gastroesophageal Adenocarcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
November 2012
Overall Recruitment Status
Terminated
Why Stopped
Safety concern in a similar trial enrolling the same patient population
Study Start Date
April 2011 (undefined)
Primary Completion Date
March 2012 (Actual)
Study Completion Date
March 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Accelerated Community Oncology Research Network
Collaborators
Amgen

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This is an open-label, Phase II, single-stage study evaluating the use of panitumumab, paclitaxel, carboplatin and 5FU as an induction regimen in subjects with gastroesophageal adenocarcinoma. The expectation is that this combination will both increase potential overall survival by incorporating novel biologic therapy in the neoadjuvant setting and decrease potential surgical mortality by eliminating pre-operative radiation therapy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Gastroesophageal Adenocarcinoma, Adenocarcinoma of the Distal Esophagus, Adenocarcinomas of the Gastroesophageal Junction, Adenocarcinoma of the Proximal Stomach

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
1 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Treatment group
Arm Type
Experimental
Arm Description
Panitumumab 9mg/kg on Days 1, 22, and 43 Paclitaxel 200mg/m2 on Days 1 and 22 Carboplatin AUC=6 on Days 1 and 22 5FU 225mg/m2/day on Days 1-15 and 22-36
Intervention Type
Drug
Intervention Name(s)
Panitumumab
Other Intervention Name(s)
Vectibix
Intervention Description
Panitumumab 9mg/kg on Days 1, 22, and 43
Intervention Type
Drug
Intervention Name(s)
Paclitaxel
Other Intervention Name(s)
Taxol
Intervention Description
Paclitaxel 200mg/m2 on Days 1 and 22
Intervention Type
Drug
Intervention Name(s)
Carboplatin
Other Intervention Name(s)
Paraplatin, CBDCA
Intervention Description
Carboplatin AUC=6 on Days 1 and 22
Intervention Type
Drug
Intervention Name(s)
5FU
Other Intervention Name(s)
5-fluorouracil
Intervention Description
5FU 225mg/m2/day on Days 1-15 and 22-36
Primary Outcome Measure Information:
Title
Response Rate
Description
The primary endpoint is overall response rate (ORR) as determined per RECIST guidelines version 1.1 from baseline and restaging scans conducted between Days 36 to 43. Response is defined as the occurrence of either Complete Response (CR) or Partial Response (PR) as best response. CR is defined as the disappearance of all target lesions. Any pathological lymph nodes must have reduction in short axis to < 10 mm. A PR is defined as at least a 30% decrease in the sum of diameters of the target lesions taking as reference the baseline sum diameters.
Time Frame
From the start of study treatment until restaging evaluation performed between days 36 to 43
Secondary Outcome Measure Information:
Title
Pathologic Response Rate
Description
The patient will be scored as having had a pathologic complete response (pCR) if the routine histologic examination of the resected specimen shows no residual invasive cancer by standard hematoxylin and eosin (H&E) examination.
Time Frame
At time of surgery (between days 50 to 64)
Title
Resection Rate of Surgery
Description
The patient will be scored as having an R0 resection, if no invasive cancer is detected involving the margins of the resection by routine microscopic hematoxylin and eosin (H&E)examination, and the operative report indicates complete resection with no residual disease. The patient will be scored as having an R1 resection, if invasive cancer is detected involving the margins of resection by routine microscopic hematoxylin and eosin (H&E) examination, and the operative report indicates complete resection with no residual disease. The patient will be scored as having an R2 resection, if the operative report indicates incomplete resection or gross residual disease.
Time Frame
At time of surgery (between days 50 to 64)
Title
Thirty-day Surgical Mortality
Description
All subjects who have undergone surgical resection will be followed for a 30-day postoperative safety evaluation. Death from any cause within 30 days of the date of surgery will be considered a surgical mortality death.
Time Frame
From date of surgery to 30 days after date of surgery
Title
Survival
Time Frame
2-year survival from first dose of panitumumab

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Biopsy-proven adenocarcinoma of the distal esophagus, gastroesophageal junction, or proximal stomach (within 5cm of gastroesophageal junction) No prior treatment for this disease AJCC (American Joint Committee on Cancer) clinical stage II to IVA, potentially resectable disease Measurable disease per RECIST 1.0 criteria Medically fit for surgery; surgical consultation is encouraged prior to initiation of treatment ECOG (Eastern Cooperative Oncology Group) performance status of 0 or 1 Male or female; aged equal to or greater than 18 years Life expectancy of greater than 3 months Good organ, metabolic, bone marrow, and pulmonary function as specified in the protocol Functioning central venous access device prior to treatment initiation Women of childbearing potential and men must agree to use adequate contraception prior to study entry and for at least 6 months following the last administration of panitumumab Ability to understand and the willingness to sign a written IRB (Institutional Review Board) approved informed consent Exclusion Criteria: Prior treatment for this disease History of another primary cancer except curatively treated in situ cervical cancer, curatively resected nonmelanoma skin cancer, or other primary solid tumor curatively treated with no active disease present and no treatment administered for at least 5 years prior to enrollment History or known presence of central nervous system metastases History of allergic reactions attributed to compounds similar chemical or biologic composition to panitumumab, paclitaxel, carboplatin, or 5FU Prior anti-EGFr-antibody therapy or treatment with small molecule EGFr inhibitors Systemic chemotherapy, hormonal therapy, immunotherapy, or experimental or approved proteins/antibodies within 30 days prior to enrollment Chronic use of immunosuppressive agents with the exception of corticosteroids Any investigational agent or therapy within 30 days prior to enrollment Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements History of interstitial lung disease, e.g., pneumonitis or pulmonary fibrosis or any evidence of interstitial lung disease on baseline chest CT scan History of any medical or psychiatric condition or laboratory abnormality that in the opinion of the investigator may increase the risks associated with study participation or investigational product(s) administration or may interfere with the interpretation of the results Unwilling or unable to comply with study requirements Female who tests positive for serum or urine pregnancy test or is breast feeding Known positive test(s) for human immunodeficiency virus infection, hepatitis C virus, acute or chronic active hepatitis B infection Major surgery within 28 days or minor surgery within 7 days prior to treatment. Placement of a central venous access device less than one day prior to treatment start Male or female of childbearing potential (women who are post-menopausal less than 52 weeks, not surgically sterilized, or not abstinent) not consenting to use adequate contraception prior to study entry and for at least 6 months following the last administration of panitumumab Arterial ischemic event (myocardial infarction, stroke) within 3 months prior to enrollment Ongoing therapeutic anticoagulation
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Robert Hermann, MD
Organizational Affiliation
Accelerated Community Oncology Research Network
Official's Role
Principal Investigator
Facility Information:
Facility Name
Clopton Clinic
City
Jonesboro
State/Province
Arkansas
ZIP/Postal Code
72401
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Panitumumab, Paclitaxel, Carboplatin and 5FU in the Treatment of Potentially Resectable Gastroesophageal Adenocarcinoma

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