A Clinical Trial of Two Adjuvant Chemotherapy Regimens for Postoperative Gastric Cancer
Primary Purpose
Stomach Neoplasms
Status
Not yet recruiting
Phase
Phase 3
Locations
China
Study Type
Interventional
Intervention
docetaxel plus oxaliplatin and capecitabine
oxaliplatin plus capecitabine
Sponsored by
About this trial
This is an interventional treatment trial for Stomach Neoplasms
Eligibility Criteria
Inclusion Criteria:
- Have signed the informed consent and can comply with the visit and related procedures stipulated in the program
- Age ≥18 years old and ≤75 years old
- D2 radical resection was performed within 21-60 days before the beginning of the first cycle of chemotherapy in this clinical study
- Preoperative neoadjuvant chemotherapy was not performed and Gastric and gastroesophageal junction adenocarcinoma (including signed-ring cell carcinoma, mucinous adenocarcinoma, and hepatoid adenocarcinoma) at stage IIIB and IIIC were confirmed by postoperative pathological staging. Note: the presence of distant metastases should be confirmed by a CT or MRI scan.ECT should be performed if bone metastases are suspected.If peritoneal metastases are suspected, laparoscopy should be performed
- Postoperative ECOG score was 0 or 1
- Leukocyte ≥ 4×109/L, platelet ≥ 100×109/L without blood transfusion, neutrophil absolute value (ANC) ≥ 1.5×109/L without granulocyte stimulating factor treatment, and hemoglobin ≥ 90 g/L
- Bilirubin ≤ 1.5 times of the upper limit of normal value, glutamic oxalacetic transaminase and glutamic-pyruvic transaminase ≤ 2.5 times of the upper limit of normal value
- Serum creatinine ≤ 1.5 times the upper limit of normal value, or GFR>45 ml/min
- Serum albumin ≥ 25 g/L (2.5g /dL)
- INR or PT ≤ 1.5 times ULN
- Hepatitis b surface antigen positive patients need to be tested for hepatitis b DNA virus quantitative detection, only < the upper limit of the normal detection value can be included in the group, and should long-term use of anti-hepatitis b drugs
- Tumor specimens can be provided for consultation (if the patient's surgical specimen comes from another hospital), protein and gene testing
Exclusion Criteria:
- Postoperative wound healing is poor and chemotherapy is not appropriate to start
- Recurrent patients or suspected peritoneal metastases after radical surgery
- Known DPD enzyme deficiency
- Allergy to, or history of severe allergy to, or contraindication to any of the experimental drugs or its excipients
- Patients who are expected to require major surgery during the study period
- Congenital pulmonary fibrosis, drug-induced pneumonia, organized pneumonia, or CT-confirmed active pneumonia
- Tested positive for HIV
- Active hepatitis b or c
- Only liquid diet was allowed after the operation, with BMI <18kg/m2
- Uncontrolled pain
- A history of antitumor drug therapy other than radical surgery
- Severe infection in the active stage or with poor clinical control
- Use of hormones is contraindicated
- Severe cardiovascular disease, myocardial infection or cerebrovascular accident, arrhythmia, unstable angina pectoris within 3 months before the trial
- Uncontrollable increase in blood pressure or blood sugar
- A history of other malignancies within 5 years, except for carcinoma in situ of the cervix, non-melanoma skin cancer, or stage I uterine cancer
- Distant metastases are known
- Peripheral neuropathy ≥ NCI CTCAE grade 2
- Serum albumin < 2.5 g/dL
- Chronic enteritis
- Any other disease for which there is evidence of a need to limit the use of experimental drugs
- Participate in additional trials up to 30 days before the trial or plan to participate in additional trials while the trial is ongoing
- Receive other experimental drugs up to 28 days before the start of the trial
- Women who are pregnant or nursing, or who plan to become pregnant within five months of the end of treatment. Women of childbearing age should receive a blood/urine pregnancy test 7 days before the start of the trial
- Clinically significant active bleeding
- Patients who have trouble swallowing tablets
- Previous allogeneic bone marrow transplant or organ transplant
Sites / Locations
- Henan Cancer Hospital
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Active Comparator
Arm Label
experimental group
control group
Arm Description
docetaxel plus oxaliplatin and capecitabine
oxaliplatin plus capecitabine
Outcomes
Primary Outcome Measures
disease free survival
From the date of randomization until the date of the first recorded disease recurrence, metastasis or death from any cause, whichever came first.
Secondary Outcome Measures
overall survival
From the date of randomization until the date of the first recorded death from any cause. For subjects lost to follow-up prior to death, the last follow-up time is usually calculated as the time of death.
Adverse reaction
Adverse reaction will be assessed by NCI CT CAE v5.0.
Assessment of life quality
Quality of life will be assessed using The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Cancer (QLQ-C30) and the site-specific module for gastric cancer (QLQ-STO22) . These tables will be usde together to assessed the quality of life of the patients. The higher the score, the worse the quality of life.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT04351867
Brief Title
A Clinical Trial of Two Adjuvant Chemotherapy Regimens for Postoperative Gastric Cancer
Official Title
The Efficacy and Safety of Postoperative Chemotherapy With Docetaxel Plus Oxaliplatin and Capecitabine Versus Oxaliplatin Plus Capecitabine for Postoperative Pathological Stage IIIB/IIIC Gastric Adenocarcinoma: a Randomised, Phase 3 Trial
Study Type
Interventional
2. Study Status
Record Verification Date
July 2020
Overall Recruitment Status
Not yet recruiting
Study Start Date
September 2020 (Anticipated)
Primary Completion Date
June 2024 (Anticipated)
Study Completion Date
June 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
LiNing
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
This study was a prospective, randomized, controlled phase III clinical study to evaluate the efficacy and safety of docetaxel plus oxaliplatin and capecitabine versus oxaliplatin plus capecitabine in the treatment of gastric or gastroesophageal junction adenocarcinoma with postoperative pathological stage IIIB and IIIC.
Detailed Description
In 2019, CSCO guidelines grade I recommend gastric or gastroesophageal junction adenocarcinoma patients, after D2 R0 resection, whose postoperative pathological stage was III treated with XELOX as an adjuvant chemotherapy. However, some retrospective clinical studies in China suggest that the 3-year DFS rate of XELOX program as an adjuvant postoperative chemotherapy program is still low, and the risk of recurrence is higher for patients with postoperative pathological stage IIIB/IIIC.In recent years, the success of the JACCRO GC-07 trial has provided evidence for the value of Taxoids in postoperative adjuvant therapy of gastric cancer. In the FLOT4 trial, the FLOT improved the DFS rate by 3 years compared with the ECF/ECX. At present, there is no clinical study data to prove whether the combined three-drug regimen can further reduce the risk of postoperative recurrence and improve the treatment effect compared with oxaliplatin combined capecitabine two-drug regimen for patients with high postoperative recurrence risk (patients with postoperative pathological stage IIIB/IIIC). Therefore, the investigators carried out this trial.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Stomach Neoplasms
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
196 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
experimental group
Arm Type
Experimental
Arm Description
docetaxel plus oxaliplatin and capecitabine
Arm Title
control group
Arm Type
Active Comparator
Arm Description
oxaliplatin plus capecitabine
Intervention Type
Drug
Intervention Name(s)
docetaxel plus oxaliplatin and capecitabine
Other Intervention Name(s)
Three medicine combined
Intervention Description
docetaxel 50mg/㎡ ivgtt. d1+oxaliplatin 100mg/㎡ ivgtt. d1+capecitabine 1000mg/㎡ bid p.o. d1-d14 q21d
Intervention Type
Drug
Intervention Name(s)
oxaliplatin plus capecitabine
Other Intervention Name(s)
Two medicine combined
Intervention Description
oxaliplatin 130mg/㎡ ivgtt. d1+capecitabine 1000mg/㎡ bid p.o. d1-d14 q21d
Primary Outcome Measure Information:
Title
disease free survival
Description
From the date of randomization until the date of the first recorded disease recurrence, metastasis or death from any cause, whichever came first.
Time Frame
up to three years.
Secondary Outcome Measure Information:
Title
overall survival
Description
From the date of randomization until the date of the first recorded death from any cause. For subjects lost to follow-up prior to death, the last follow-up time is usually calculated as the time of death.
Time Frame
up to three years.
Title
Adverse reaction
Description
Adverse reaction will be assessed by NCI CT CAE v5.0.
Time Frame
up to three years.
Title
Assessment of life quality
Description
Quality of life will be assessed using The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Cancer (QLQ-C30) and the site-specific module for gastric cancer (QLQ-STO22) . These tables will be usde together to assessed the quality of life of the patients. The higher the score, the worse the quality of life.
Time Frame
up to three years.
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Have signed the informed consent and can comply with the visit and related procedures stipulated in the program
Age ≥18 years old and ≤75 years old
D2 radical resection was performed within 21-60 days before the beginning of the first cycle of chemotherapy in this clinical study
Preoperative neoadjuvant chemotherapy was not performed and Gastric and gastroesophageal junction adenocarcinoma (including signed-ring cell carcinoma, mucinous adenocarcinoma, and hepatoid adenocarcinoma) at stage IIIB and IIIC were confirmed by postoperative pathological staging. Note: the presence of distant metastases should be confirmed by a CT or MRI scan.ECT should be performed if bone metastases are suspected.If peritoneal metastases are suspected, laparoscopy should be performed
Postoperative ECOG score was 0 or 1
Leukocyte ≥ 4×109/L, platelet ≥ 100×109/L without blood transfusion, neutrophil absolute value (ANC) ≥ 1.5×109/L without granulocyte stimulating factor treatment, and hemoglobin ≥ 90 g/L
Bilirubin ≤ 1.5 times of the upper limit of normal value, glutamic oxalacetic transaminase and glutamic-pyruvic transaminase ≤ 2.5 times of the upper limit of normal value
Serum creatinine ≤ 1.5 times the upper limit of normal value, or GFR>45 ml/min
Serum albumin ≥ 25 g/L (2.5g /dL)
INR or PT ≤ 1.5 times ULN
Hepatitis b surface antigen positive patients need to be tested for hepatitis b DNA virus quantitative detection, only < the upper limit of the normal detection value can be included in the group, and should long-term use of anti-hepatitis b drugs
Tumor specimens can be provided for consultation (if the patient's surgical specimen comes from another hospital), protein and gene testing
Exclusion Criteria:
Postoperative wound healing is poor and chemotherapy is not appropriate to start
Recurrent patients or suspected peritoneal metastases after radical surgery
Known DPD enzyme deficiency
Allergy to, or history of severe allergy to, or contraindication to any of the experimental drugs or its excipients
Patients who are expected to require major surgery during the study period
Congenital pulmonary fibrosis, drug-induced pneumonia, organized pneumonia, or CT-confirmed active pneumonia
Tested positive for HIV
Active hepatitis b or c
Only liquid diet was allowed after the operation, with BMI <18kg/m2
Uncontrolled pain
A history of antitumor drug therapy other than radical surgery
Severe infection in the active stage or with poor clinical control
Use of hormones is contraindicated
Severe cardiovascular disease, myocardial infection or cerebrovascular accident, arrhythmia, unstable angina pectoris within 3 months before the trial
Uncontrollable increase in blood pressure or blood sugar
A history of other malignancies within 5 years, except for carcinoma in situ of the cervix, non-melanoma skin cancer, or stage I uterine cancer
Distant metastases are known
Peripheral neuropathy ≥ NCI CTCAE grade 2
Serum albumin < 2.5 g/dL
Chronic enteritis
Any other disease for which there is evidence of a need to limit the use of experimental drugs
Participate in additional trials up to 30 days before the trial or plan to participate in additional trials while the trial is ongoing
Receive other experimental drugs up to 28 days before the start of the trial
Women who are pregnant or nursing, or who plan to become pregnant within five months of the end of treatment. Women of childbearing age should receive a blood/urine pregnancy test 7 days before the start of the trial
Clinically significant active bleeding
Patients who have trouble swallowing tablets
Previous allogeneic bone marrow transplant or organ transplant
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Ning Li, PhD
Phone
0086-13526501903
Email
lining97@126.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ning Li, PhD
Organizational Affiliation
Henan Cancer Hospital
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Suxia Luo, PhD
Organizational Affiliation
Henan Cancer Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Henan Cancer Hospital
City
Zhengzhou
State/Province
Henan
ZIP/Postal Code
450008
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ning Li, PhD
Phone
0086-13526501903
Email
lining97@126.com
First Name & Middle Initial & Last Name & Degree
Ning LI, PhD
First Name & Middle Initial & Last Name & Degree
Suxia Luo, PhD
12. IPD Sharing Statement
Plan to Share IPD
Yes
IPD Sharing Plan Description
Raw data
IPD Sharing Time Frame
Within 1 year after completion of the main part
IPD Sharing Access Criteria
public management platform ResMan (www.medresman.org) was adopted to provide open access to the public
Learn more about this trial
A Clinical Trial of Two Adjuvant Chemotherapy Regimens for Postoperative Gastric Cancer
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