Imatinib, Capecitabine, and Cisplatin in Treating Patients With Unresectable or Metastatic Stomach Cancer

This is an interventional treatment trial for Gastric Cancer focused on measuring stage III gastric cancer, stage IV gastric cancer Read More

DISEASE CHARACTERISTICS:

• Histologically confirmed gastric cancer

  • Unresectable and/or metastatic disease
• Incurable with any conventional multimodality approach by interdisciplinary assessment of the local tumor board
• Immunohistochemical documentation of c-kit (CD117) and PDGF-R overexpression by tumor if obtainable (preferably on a tumor sample taken within 6 weeks of study entry)
• At least one evaluable site of disease according to RECIST criteria
• No known brain metastasis or CNS disorder that might alter study compliance or may worsen during or following therapy

PATIENT CHARACTERISTICS:

• ECOG performance status 0-2
• WBC ≥ 3,000/μL
• ANC ≥ 2,000/μL
• Platelet count ≥ 100,000/μL
• Hemoglobin ≥ 9.0 g/dL
• Total bilirubin < 2 times upper limit of normal (ULN)
• SGOT and SGPT < 2.5 times ULN (5 times ULN if hepatic metastases present)
• Glomerular filtration rate ≥ 60 mL/min
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective barrier contraception during and for up to 3 months after completion of study treatment
• No known or documented hypersensitivity against fluoropyrimidines, tyrosine kinase inhibitors, cisplatin, other platinums, or their respective derivatives
• No gastrointestinal disorder that might affect the gastrointestinal absorption of capecitabine or imatinib mesylate or ability to swallow for the oral administration of capecitabine or imatinib mesylate
• At least 5 years since prior primary malignancy except if the other primary malignancy is not currently clinically significant nor requiring active intervention, or if other primary malignancy is a basal cell skin cancer or carcinoma in situ of the cervix
• No other concurrent malignant disease
• No NYHA class III-IV cardiac disease (i.e., congestive heart failure or myocardial infarction within the past 6 months)
• No severe and/or uncontrolled medical disease (i.e., uncontrolled diabetes, chronic renal disease, or active uncontrolled infection)
• No known neuropathy, impaired hearing, history of seizures, and/or psychiatric disorder that might alter study compliance or may worsen during or following therapy
• No documented dihydropyrimidine dehydrogenase deficiency
• No known chronic liver disease (i.e., chronic active hepatitis or cirrhosis)
• No known diagnosis of HIV infection or other serious uncontrolled infections
• No significant history of non-compliance to medical regimens or inability to grant reliable informed consent

PRIOR CONCURRENT THERAPY:

• No chemotherapy or investigational agents within the past 4 weeks (6 weeks for nitrosoureas or mitomycin C) unless the disease is rapidly progressing
• No prior radiotherapy to ≥ 25% of the bone marrow
• No major surgery within the past 2 weeks

• No concurrent warfarin or acetaminophen

  • Therapeutic anticoagulation using heparin or low-molecular weight heparin allowed
• No concurrent sorivudine or related substances
• No other concurrent anticancer agents, including chemotherapy and biologic agents
• No other concurrent investigational drugs