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Phase III of Gemcitabine Vs TS-1 Vs Gemcitabine Plus TS-1 in Pancreatic Cancer (GEST)

Primary Purpose

Pancreatic Cancer

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Gemcitabine plus TS-1
TS-1
Gemcitabine
Sponsored by
Taiho Pharmaceutical Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pancreatic Cancer focused on measuring Pancreatic Cancer

Eligibility Criteria

20 Years - 79 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Pancreatic carcinoma histologically determined to be adenocarcinoma or adenosquamous carcinoma.
  • Advanced unresectable pancreatic (including pancreatic cancer with local progression and recurrent pancreatic cancer).Presence/absence of measurable lesions is not considered. Patients with measurable lesions must undergo diagnostic imaging tests within 28 days before registration.
  • Patients with no previous treatment (radiotherapy,chemotherapy etc) for pancreatic cancer, except resection. Intra-operative radiotherapy during resection of pancreatic cancer will be permitted, although registration must occur at least 4 weeks after the radiotherapy. Patients that have undergone preoperative/postoperative adjuvant chemotherapy may be enrolled if relapse is diagnosed beyond week 24 after the final administration (on day 169 when the day following the final day is set as day 1).
  • Age: 20 years to 79 years.
  • ECOG Performance Status (PS) of 0 or 1.
  • Sufficient function of major organs as defined below. (The following criteria are satisfied in laboratory tests conducted within 14 days before registration. Laboratory tests conducted 2 weeks before registration (on the same weekday) will be included.) White blood cell count≥ 3500/mm3 Neutrophil count≥ 2000/mm3 Hemoglobin≥9.0 g/dL Platelet count≥100000/mm3 Total bilirubin≤ 2.0 mg/dL* *≤ 3.0 mg/dL in patients treated by biliary drainage for obstructive jaundice. AST and ALT≤ 150 U/L Serum creatinine≤1.2 mg/dL Creatinine clearance≥50mL/min.** **Measured values will be used if available. Otherwise, values calculated by the Cockcroft-Gault method will be used.Formula for estimation:body weight (kg) x [140 - age (years) / 72 x serum creatinine (mg/dL)] *Estimated value will be multiplied by 0.85 for females.
  • Able to take capsules orally.
  • No clinically abnormal ECG findings within 28 days (4 weeks)before registration.
  • Voluntarily signed the written consent form.

Exclusion Criteria:

  • Pulmonary fibrosis or interstitial pneumonia (to be confirmed by chest X-ray within 28 days before enrollment).
  • Watery diarrhoea.
  • Active infections (e.g. patients with pyrexia of 38°C or greater), excluding viral hepatitis.
  • Serious complications (e.g. heart failure, renal failure,hepatic failure, haemorrhagic peptic ulcer, intestinal paralysis, intestinal obstruction or poorly controlled diabetes).
  • Moderate or severe (requiring drainage) ascites or pleural effusion requiring treatment.
  • Metastasis in the CNS.
  • Active double cancer (synchronous double cancer or asynchronous double cancer with disease-free duration of 3 years or less). Carcinoma in situ and lesions of intramucosal carcinoma will not be included in active double cancer and will be permitted for registration.
  • Patients under treatment with flucytosine, phenytoin or warfarin potassium.
  • Pregnant females, possibly pregnant females, females wishing to become pregnant and nursing mothers. Males that are currently attempting to produce a pregnancy.
  • Severe mental disorder.
  • Judged ineligible by physicians for participation in the study from a safety viewpoint.

Sites / Locations

  • National Cancer Center Hospital
  • Chung-Ho Memorial Hospital, Kaohsiung Medical University
  • Chang Gung Memorial Hospital, Kaohsiung
  • Changhua Christian Hospital
  • National Cheng Kung University Hospital
  • China Medical University Hospital
  • Taipei Veterans General Hospital
  • Chi Mei Medical Center Liou Ying Campus
  • Chang Gung Memorial Hospital, Lonkou
  • National Taiwan University Hospital
  • Chi Mei Medical Center
  • Mackay Memorial Hospital, Taipei

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Active Comparator

Arm Label

1

2

3

Arm Description

Gemcitabine plus TS-1

TS-1

Gemcitabine

Outcomes

Primary Outcome Measures

Over all survival(OS)

Secondary Outcome Measures

progression-free survival (PFS), response rate (RECIST, if measurable), incidence rate of adverse events, incidence rate of adverse drug reactions, QOL (EQ-5D)

Full Information

First Posted
July 6, 2007
Last Updated
November 1, 2012
Sponsor
Taiho Pharmaceutical Co., Ltd.
Collaborators
TTY Biopharm
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1. Study Identification

Unique Protocol Identification Number
NCT00498225
Brief Title
Phase III of Gemcitabine Vs TS-1 Vs Gemcitabine Plus TS-1 in Pancreatic Cancer
Acronym
GEST
Official Title
Randomized Phase III Study of Gemcitabine Versus TS-1 Versus Gemcitabine Plus TS-1 in Unresectable Advanced Pancreatic Cancer (With Local Progression or Metastasis)
Study Type
Interventional

2. Study Status

Record Verification Date
November 2012
Overall Recruitment Status
Completed
Study Start Date
July 2007 (undefined)
Primary Completion Date
July 2011 (Actual)
Study Completion Date
June 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Taiho Pharmaceutical Co., Ltd.
Collaborators
TTY Biopharm

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
In patients with unresectable advanced pancreatic cancer, non-inferiority of TS-1 monotherapy and superiority of GEM + TS-1 combination therapy to gemcitabine (GEM) will be verified using survival time.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pancreatic Cancer
Keywords
Pancreatic Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
834 (Actual)

8. Arms, Groups, and Interventions

Arm Title
1
Arm Type
Experimental
Arm Description
Gemcitabine plus TS-1
Arm Title
2
Arm Type
Experimental
Arm Description
TS-1
Arm Title
3
Arm Type
Active Comparator
Arm Description
Gemcitabine
Intervention Type
Drug
Intervention Name(s)
Gemcitabine plus TS-1
Intervention Description
Gemcitabine plus TS-1:Gemcitabine was administered i.v. by 1000 mg/m2 at day 1, 8 followed by 2 week rest as 1 course. TS-1 was co-administered orally at 40 mg/m2 twice daily for 14 days with a rest period of 1 week as one course.
Intervention Type
Drug
Intervention Name(s)
TS-1
Intervention Description
TS-1 was administered orally at 40 mg/m2 twice daily for 28 days with a rest period of 2week as one course.
Intervention Type
Drug
Intervention Name(s)
Gemcitabine
Intervention Description
Gemcitabine was administered i.v. by 1000 mg/m2 at day 1, 8, 15 followed by 2 week rest as 1 course.
Primary Outcome Measure Information:
Title
Over all survival(OS)
Time Frame
every course for first three courses, then every other course
Secondary Outcome Measure Information:
Title
progression-free survival (PFS), response rate (RECIST, if measurable), incidence rate of adverse events, incidence rate of adverse drug reactions, QOL (EQ-5D)
Time Frame
adverse events will be collected during treatment

10. Eligibility

Sex
All
Minimum Age & Unit of Time
20 Years
Maximum Age & Unit of Time
79 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Pancreatic carcinoma histologically determined to be adenocarcinoma or adenosquamous carcinoma. Advanced unresectable pancreatic (including pancreatic cancer with local progression and recurrent pancreatic cancer).Presence/absence of measurable lesions is not considered. Patients with measurable lesions must undergo diagnostic imaging tests within 28 days before registration. Patients with no previous treatment (radiotherapy,chemotherapy etc) for pancreatic cancer, except resection. Intra-operative radiotherapy during resection of pancreatic cancer will be permitted, although registration must occur at least 4 weeks after the radiotherapy. Patients that have undergone preoperative/postoperative adjuvant chemotherapy may be enrolled if relapse is diagnosed beyond week 24 after the final administration (on day 169 when the day following the final day is set as day 1). Age: 20 years to 79 years. ECOG Performance Status (PS) of 0 or 1. Sufficient function of major organs as defined below. (The following criteria are satisfied in laboratory tests conducted within 14 days before registration. Laboratory tests conducted 2 weeks before registration (on the same weekday) will be included.) White blood cell count≥ 3500/mm3 Neutrophil count≥ 2000/mm3 Hemoglobin≥9.0 g/dL Platelet count≥100000/mm3 Total bilirubin≤ 2.0 mg/dL* *≤ 3.0 mg/dL in patients treated by biliary drainage for obstructive jaundice. AST and ALT≤ 150 U/L Serum creatinine≤1.2 mg/dL Creatinine clearance≥50mL/min.** **Measured values will be used if available. Otherwise, values calculated by the Cockcroft-Gault method will be used.Formula for estimation:body weight (kg) x [140 - age (years) / 72 x serum creatinine (mg/dL)] *Estimated value will be multiplied by 0.85 for females. Able to take capsules orally. No clinically abnormal ECG findings within 28 days (4 weeks)before registration. Voluntarily signed the written consent form. Exclusion Criteria: Pulmonary fibrosis or interstitial pneumonia (to be confirmed by chest X-ray within 28 days before enrollment). Watery diarrhoea. Active infections (e.g. patients with pyrexia of 38°C or greater), excluding viral hepatitis. Serious complications (e.g. heart failure, renal failure,hepatic failure, haemorrhagic peptic ulcer, intestinal paralysis, intestinal obstruction or poorly controlled diabetes). Moderate or severe (requiring drainage) ascites or pleural effusion requiring treatment. Metastasis in the CNS. Active double cancer (synchronous double cancer or asynchronous double cancer with disease-free duration of 3 years or less). Carcinoma in situ and lesions of intramucosal carcinoma will not be included in active double cancer and will be permitted for registration. Patients under treatment with flucytosine, phenytoin or warfarin potassium. Pregnant females, possibly pregnant females, females wishing to become pregnant and nursing mothers. Males that are currently attempting to produce a pregnancy. Severe mental disorder. Judged ineligible by physicians for participation in the study from a safety viewpoint.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Takuji Okusaka, MD
Organizational Affiliation
National Cancer Center Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
National Cancer Center Hospital
City
Tokyo
ZIP/Postal Code
104-0045
Country
Japan
Facility Name
Chung-Ho Memorial Hospital, Kaohsiung Medical University
City
No.100, Tzyou 1st Rd., Kaohsiung
ZIP/Postal Code
807
Country
Taiwan
Facility Name
Chang Gung Memorial Hospital, Kaohsiung
City
No.123, Ta-Pei Rd., Niao-Sung Hsiang, Kaohsiung Hsien
ZIP/Postal Code
833
Country
Taiwan
Facility Name
Changhua Christian Hospital
City
No.135, Nanxiao St., Changhua
ZIP/Postal Code
500
Country
Taiwan
Facility Name
National Cheng Kung University Hospital
City
No.138, Sheng Li Road,Tainan
ZIP/Postal Code
704
Country
Taiwan
Facility Name
China Medical University Hospital
City
No.2, Yuh-Der Rd.,Taichung
ZIP/Postal Code
404
Country
Taiwan
Facility Name
Taipei Veterans General Hospital
City
No.201, Sec. 2, Shih-Pai road, Taipei
ZIP/Postal Code
112
Country
Taiwan
Facility Name
Chi Mei Medical Center Liou Ying Campus
City
No.201, Taikang Village, Liou Ying Township, Tainan
ZIP/Postal Code
736
Country
Taiwan
Facility Name
Chang Gung Memorial Hospital, Lonkou
City
No.5, Fu-Hsing St. Kuei Shan Hsiang, Taoyuan Hsien
ZIP/Postal Code
333
Country
Taiwan
Facility Name
National Taiwan University Hospital
City
No.7, Chung San South Road, Taipei
ZIP/Postal Code
100
Country
Taiwan
Facility Name
Chi Mei Medical Center
City
No.901, Chung Hwa Rd., Yong Kang city, Tainan
ZIP/Postal Code
710
Country
Taiwan
Facility Name
Mackay Memorial Hospital, Taipei
City
No.92, Sec. 2, Zhongshan N. Rd., Taipei
ZIP/Postal Code
104
Country
Taiwan

12. IPD Sharing Statement

Citations:
PubMed Identifier
9196156
Citation
Burris HA 3rd, Moore MJ, Andersen J, Green MR, Rothenberg ML, Modiano MR, Cripps MC, Portenoy RK, Storniolo AM, Tarassoff P, Nelson R, Dorr FA, Stephens CD, Von Hoff DD. Improvements in survival and clinical benefit with gemcitabine as first-line therapy for patients with advanced pancreas cancer: a randomized trial. J Clin Oncol. 1997 Jun;15(6):2403-13. doi: 10.1200/JCO.1997.15.6.2403.
Results Reference
background
PubMed Identifier
16006754
Citation
Ueno H, Okusaka T, Ikeda M, Takezako Y, Morizane C. An early phase II study of S-1 in patients with metastatic pancreatic cancer. Oncology. 2005;68(2-3):171-8. doi: 10.1159/000086771. Epub 2005 Jul 4.
Results Reference
background
PubMed Identifier
16319514
Citation
Ueno H, Okusaka T, Ikeda M, Ishiguro Y, Morizane C, Matsubara J, Furuse J, Ishii H, Nagase M, Nakachi K. A phase I study of combination chemotherapy with gemcitabine and oral S-1 for advanced pancreatic cancer. Oncology. 2005;69(5):421-7. doi: 10.1159/000089997. Epub 2005 Nov 25.
Results Reference
background
PubMed Identifier
28210843
Citation
Okusaka T, Miyakawa H, Fujii H, Nakamori S, Satoh T, Hamamoto Y, Ito T, Maguchi H, Matsumoto S, Ueno H, Ioka T, Boku N, Egawa S, Hatori T, Furuse J, Mizumoto K, Ohkawa S, Yamaguchi T, Yamao K, Funakoshi A, Chen JS, Cheng AL, Sato A, Ohashi Y, Tanaka M; GEST group. Updated results from GEST study: a randomized, three-arm phase III study for advanced pancreatic cancer. J Cancer Res Clin Oncol. 2017 Jun;143(6):1053-1059. doi: 10.1007/s00432-017-2349-y. Epub 2017 Feb 16.
Results Reference
derived
PubMed Identifier
23547081
Citation
Ueno H, Ioka T, Ikeda M, Ohkawa S, Yanagimoto H, Boku N, Fukutomi A, Sugimori K, Baba H, Yamao K, Shimamura T, Sho M, Kitano M, Cheng AL, Mizumoto K, Chen JS, Furuse J, Funakoshi A, Hatori T, Yamaguchi T, Egawa S, Sato A, Ohashi Y, Okusaka T, Tanaka M. Randomized phase III study of gemcitabine plus S-1, S-1 alone, or gemcitabine alone in patients with locally advanced and metastatic pancreatic cancer in Japan and Taiwan: GEST study. J Clin Oncol. 2013 May 1;31(13):1640-8. doi: 10.1200/JCO.2012.43.3680. Epub 2013 Apr 1.
Results Reference
derived

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Phase III of Gemcitabine Vs TS-1 Vs Gemcitabine Plus TS-1 in Pancreatic Cancer

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