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A Randomized, Double Blind Study Evaluating Paclitaxel With and Without RAD001 in Patients With Gastric Carcinoma After Prior Chemotherapy (AIO-STO-0111)

Primary Purpose

Advanced Gastric Cancer, Esophagogastric Junction Cancer

Status
Completed
Phase
Phase 3
Locations
Germany
Study Type
Interventional
Intervention
Paclitaxel
RAD001
Sponsored by
Krankenhaus Nordwest
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Advanced Gastric Cancer focused on measuring RAD001, Paclitaxel, gastric cancer, advanced gastric or esophagogastric junction cancer

Eligibility Criteria

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

Inclusion Criteria:

  • Male or female patients ≥ 18 years old
  • Histologically or cytologically confirmed and documented gastric adenocarcinoma. Adenocarcinomata of the gastro-esophageal junction will be allowed, if they have advanced disease (inoperable, recurrent or metastatic disease).
  • Documented progressive disease during/after one, two or three prior treatments containing 5FU and/or its precursors or derivatives in the palliative setting
  • At least one measurable or evaluable lesion by RECIST as determined by Computed Tomography (CT) Scan or Magnetic Resonance Imaging (MRI)
  • ECOG performance status of 0, 1 or 2
  • The following laboratory parameters:

    • Absolute neutrophil count ≥ 1.5 x 109/L
    • Platelets ≥ 100 x 109/L
    • Hemoglobin (Hgb) ≥ 9 g/dL
    • Serum creatinine ≤ 2 x Upper Limit of Normal (ULN)
    • Adequate liver function:
    • Total serum calcium (corrected for serum albumin) or ionized calcium ≥ LLN
  • Women of childbearing potential must have a negative serum pregnancy test within 7 days of the first administration of study treatments and must be willing to use adequate methods of contraception during the study and for 3 months after last study drug administration.
  • Written informed consent

Exclusion Criteria:

  • Current treatment with any anti cancer therapy or treatment with anti cancer therapy ≤ 2 weeks prior to study treatment start unless rapidly progressing disease is measured
  • Known hypersensitivity to RAD001 (everolimus) or to its excipients, or to other rapamycins (e.g. sirolimus, temsirolimus)
  • Known prior history of hypersensitivity to paclitaxel.
  • Paclitaxel refractory disease, which is defined as a disease progression under or within 12 weeks of last taxan treatment
  • Chronic treatment with steroids (except for oral, topical or local injection) or another immunosuppressive agent
  • Major surgery ≤ 2 weeks prior to starting study treatment or patients who have not recovered from such therapy
  • Lack of resolution of all acute toxic effects (excluding alopecia) of prior chemotherapy, prior radiotherapy, or surgical procedure to National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) grade <= 1. Note: Neuropathy due to prior chemotherapy is allowed.
  • Unstable CNS disease

    • Requiring increasing doses of steroids to maintain stable neurological status
    • Deteriorating / changing neurological status
  • Known history of HIV seropositivity (HIV testing is not mandatory) or Hepatitis B or C.
  • Active, bleeding diathesis or on oral anti-vitamin K medication (except low dose warfarin, as long as the INR is <= 2.0)
  • Any other severe and/or uncontrolled medical conditions

Sites / Locations

  • Krankenhaus Nordwest

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Experimental

Arm Label

paclitaxel + placebo

paclitaxel + RAD001

Arm Description

Paclitaxel 80 mg/m2 on day 1, day 8 and day 15 of every 28-day cycle. + Placebo (2 tablets / day) d1-d28

Paclitaxel 80 mg/m2 on day 1, day 8 and day 15 of every 28-day cycle. + RAD001 10mg (2 x5 mg tablets / day) d1-d28

Outcomes

Primary Outcome Measures

overall survival

Secondary Outcome Measures

best overall response
progression-free survival
number of participants with adverse events as a measure of safety and tolerability
disease control rate
responders + stable disease ≥12 weeks

Full Information

First Posted
November 23, 2010
Last Updated
January 27, 2020
Sponsor
Krankenhaus Nordwest
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1. Study Identification

Unique Protocol Identification Number
NCT01248403
Brief Title
A Randomized, Double Blind Study Evaluating Paclitaxel With and Without RAD001 in Patients With Gastric Carcinoma After Prior Chemotherapy
Acronym
AIO-STO-0111
Official Title
A Randomized, Double-blind, Multi-center Phase III Study Evaluating Paclitaxel With and Without RAD001 in Patients With Gastric Carcinoma Who Have Progressed After Therapy With a Fluoropyrimidine-containing Regimen
Study Type
Interventional

2. Study Status

Record Verification Date
January 2020
Overall Recruitment Status
Completed
Study Start Date
October 2011 (Actual)
Primary Completion Date
July 2017 (Actual)
Study Completion Date
October 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Krankenhaus Nordwest

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Adult patients with gastric carcinoma which has progressed after initial treatment with a fluoropyrimidines-containing regimen will be treated with paclitaxel plus RAD001 or plus placebo. The hypothesis is that patients with RAD001 have significantly prolonged overall survival compared to patients who are treated with paclitaxel alone.
Detailed Description
This is a randomized, double-blind, phase III two-arm multi-center study aiming at estimating the relative efficacy of the combination of RAD001 and paclitaxel versus that of paclitaxel alone as second-, third- or fourth-line treatment in terms of hazard ratio of overall survival in patients with gastric cancer who have relapsed after one treatment regimen containing a fluoropyrimidine (e.g., 5-FU, S-1, capecitabine and other 5-FU prodrugs or derivatives). Patients will be randomized in a 1:1 ratio for a total of 240 patients per treatment arm. Randomization will be stratified according to performance status (0-1 versus 2), prior taxan use (yes vs. no) and treatment line (2nd versus 3rd/4th line). Study treatment will be continued until progression or intolerable toxicity. Patients will be seen at baseline/screening, and weekly for paclitaxel administration and safety assessment until disease progression or discontinuation of trial therapy for other reasons. Radiological tumor assessment will be performed every second cycle (every 8 weeks) or earlier if clinically indicated. Post-study follow-up will be completed every 8 weeks for survival.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Advanced Gastric Cancer, Esophagogastric Junction Cancer
Keywords
RAD001, Paclitaxel, gastric cancer, advanced gastric or esophagogastric junction cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
300 (Actual)

8. Arms, Groups, and Interventions

Arm Title
paclitaxel + placebo
Arm Type
Active Comparator
Arm Description
Paclitaxel 80 mg/m2 on day 1, day 8 and day 15 of every 28-day cycle. + Placebo (2 tablets / day) d1-d28
Arm Title
paclitaxel + RAD001
Arm Type
Experimental
Arm Description
Paclitaxel 80 mg/m2 on day 1, day 8 and day 15 of every 28-day cycle. + RAD001 10mg (2 x5 mg tablets / day) d1-d28
Intervention Type
Drug
Intervention Name(s)
Paclitaxel
Intervention Description
Paclitaxel 80 mg/m2 on day 1, day 8 and day 15 of every 28-day cycle.
Intervention Type
Drug
Intervention Name(s)
RAD001
Other Intervention Name(s)
Everolimus, Certican
Intervention Description
RAD001 10mg (2 x5 mg tablets / day) d1-d28
Primary Outcome Measure Information:
Title
overall survival
Time Frame
6 months follow-up
Secondary Outcome Measure Information:
Title
best overall response
Time Frame
staging every 8 weeks
Title
progression-free survival
Time Frame
staging every 8 weeks
Title
number of participants with adverse events as a measure of safety and tolerability
Time Frame
every week until end of treatment
Title
disease control rate
Description
responders + stable disease ≥12 weeks
Time Frame
every 8 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female patients ≥ 18 years old Histologically or cytologically confirmed and documented gastric adenocarcinoma. Adenocarcinomata of the gastro-esophageal junction will be allowed, if they have advanced disease (inoperable, recurrent or metastatic disease). Documented progressive disease during/after one, two or three prior treatments containing 5FU and/or its precursors or derivatives in the palliative setting At least one measurable or evaluable lesion by RECIST as determined by Computed Tomography (CT) Scan or Magnetic Resonance Imaging (MRI) ECOG performance status of 0, 1 or 2 The following laboratory parameters: Absolute neutrophil count ≥ 1.5 x 109/L Platelets ≥ 100 x 109/L Hemoglobin (Hgb) ≥ 9 g/dL Serum creatinine ≤ 2 x Upper Limit of Normal (ULN) Adequate liver function: Total serum calcium (corrected for serum albumin) or ionized calcium ≥ LLN Women of childbearing potential must have a negative serum pregnancy test within 7 days of the first administration of study treatments and must be willing to use adequate methods of contraception during the study and for 3 months after last study drug administration. Written informed consent Exclusion Criteria: Current treatment with any anti cancer therapy or treatment with anti cancer therapy ≤ 2 weeks prior to study treatment start unless rapidly progressing disease is measured Known hypersensitivity to RAD001 (everolimus) or to its excipients, or to other rapamycins (e.g. sirolimus, temsirolimus) Known prior history of hypersensitivity to paclitaxel. Paclitaxel refractory disease, which is defined as a disease progression under or within 12 weeks of last taxan treatment Chronic treatment with steroids (except for oral, topical or local injection) or another immunosuppressive agent Major surgery ≤ 2 weeks prior to starting study treatment or patients who have not recovered from such therapy Lack of resolution of all acute toxic effects (excluding alopecia) of prior chemotherapy, prior radiotherapy, or surgical procedure to National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) grade <= 1. Note: Neuropathy due to prior chemotherapy is allowed. Unstable CNS disease Requiring increasing doses of steroids to maintain stable neurological status Deteriorating / changing neurological status Known history of HIV seropositivity (HIV testing is not mandatory) or Hepatitis B or C. Active, bleeding diathesis or on oral anti-vitamin K medication (except low dose warfarin, as long as the INR is <= 2.0) Any other severe and/or uncontrolled medical conditions
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Salah-Eddin Al-Batran, MD
Organizational Affiliation
Institute of Clinical Cancer Research (IKF), UCT - University Cancer Center, Frankfurt, Germany
Official's Role
Principal Investigator
Facility Information:
Facility Name
Krankenhaus Nordwest
City
Frankfurt/Main
ZIP/Postal Code
60488
Country
Germany

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
No IPD will be shared.
Citations:
PubMed Identifier
32339253
Citation
Lorenzen S, Knorrenschild JR, Pauligk C, Hegewisch-Becker S, Seraphin J, Thuss-Patience P, Kopp HG, Dechow T, Vogel A, Luley KB, Pink D, Stahl M, Kullmann F, Hebart H, Siveke J, Egger M, Homann N, Probst S, Goetze TO, Al-Batran SE. Phase III randomized, double-blind study of paclitaxel with and without everolimus in patients with advanced gastric or esophagogastric junction carcinoma who have progressed after therapy with a fluoropyrimidine/platinum-containing regimen (RADPAC). Int J Cancer. 2020 Nov 1;147(9):2493-2502. doi: 10.1002/ijc.33025. Epub 2020 May 7.
Results Reference
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A Randomized, Double Blind Study Evaluating Paclitaxel With and Without RAD001 in Patients With Gastric Carcinoma After Prior Chemotherapy

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