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Reversal of Preneoplastic Metaplasia in the Stomach With MEK Inhibitor

Primary Purpose

Gastric Cancer, Metaplasia, Stage I Gastric Cancer

Status
Active
Phase
Phase 1
Locations
Japan
Study Type
Interventional
Intervention
Trametinib treatment
Endoscopy
Sponsored by
Vanderbilt-Ingram Cancer Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Gastric Cancer

Eligibility Criteria

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

Inclusion Criteria:

Primary registration

  • Person having intact stomach after treatment of early gastric cancer or gastric adenoma
  • Person whose treated gastric cancer histological type is intestinal type.
  • Person whose treated gastric cancer or gastric adenoma was curatively resected.
  • Person who does not have symptoms of gastric cancer recurrence.
  • Person who can declare agreement for enrollment by understanding the study and signing the informed consent document after hearing the explanation.
  • Person who can visit the hospital in accordance with the schedule.

Secondary registration

  • Person who has gastric atrophy at endoscopy.
  • Person who does not have symptoms of gastric cancer recurrence by endoscopy.
  • Person who has intestinal metaplasia in stomach, histologically confirmed in biopsy specimens taken under endoscopy within 8 weeks prior to taking MEK inhibitor, Trametinib.

Exclusion Criteria:

  • Person whose treated gastric cancer was diffuse or signet ring cancer.
  • Person whose treated gastric cancer or gastric adenoma was not curatively resected.
  • Person who has the history of other malignant disease.
  • Person who had a significant improvement in metaplasia after eradication therapy for Helicobacter pylori within one year.
  • Person who had plan of eradication Helicobacter pylori in 1 year 9 months
  • Person who has history of previous Trametinib or other MEK inhibitor use.
  • Person who has history of hypersensitivity to excipients.
  • Person who entered clinical trial and took investigational new drug within 12 weeks.
  • Presence of active infection other than chronic gastritis.
  • Cardiac conditions as follows:

    • Uncontrolled hypertension (BP>=150/95 mm Hg despite medical therapy)
    • Acute myocardial infection within 6 months prior to starting treatment
    • Uncontrolled Angina (Canadian Cardiovascular Society grade II-IV even after medication)
    • Symptomatic heart failure NYHA Class II-IV
    • <45% in the past
    • Severe valvular disease
    • <55% at present
    • Atrial fibrilation in ECG with BPM=>100 Laboratory values as listed below (SI units) Absolute Neutrophil Count <1.5x10A9/L (1500 per mm3) Platelets <100x10A9/L (100,000 per mm3) Hemoglobin<=9.0 g /dL Serum creatinine >1.5 X upper limit of normal (ULN) Serum bilirubin >1.5 x ULN AST or ALT > 2.5 x ULN

Ophthalmological conditions as follows:

Current or past history of retinal pigment epithelial detachment (RPED)/central serous retinopathy (CSR) or retinal vein occlusion Intraocular pressure (IOP) > 21 mmHg or uncontrolled glaucoma (irrespective of IOP)

Male or female patients of reproductive potential and, as judged by the investigator, are not employing an effective method of birth control and pregnant female.

Breast feeding female Have refractory nausea and vomiting , chronic gastrointestinal diseases (e.g . inflammatory bowel disease), or significant bowel resection that would adversely affect the absorption / bioavailability of the orally administered study medication.

Person who has history of hyperrefractory for Trametinib methyl sulfoxide Person who has pneumonia under chest X-ray. Have evidence of any other significant clinical disorder or laboratory finding that, as judgedby the investigator, makes it undesirable for the patient to participate in the study.

Sites / Locations

  • Nagasaki University Hospital
  • Nihon University School of Medicine
  • University of Tokyo Medical Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Trametinib treatment

Arm Description

Outcomes

Primary Outcome Measures

Effectiveness of Trametinib in reversing metaplasia: changes in cell lineages
The ability of Trametinib treatment to decrease the presence of metaplastic cell lineages in biopsies of the lining of the stomach, while also allowing the return of normal cell lineages (i.e. acid-secreting parietal cells). Cell lineages will be identified by immunostaining of tissue sections from biopsies.
Safety of Trametinib treatment: adverse events
Assessment of side effects induced during or after treatment with Trametinib.

Secondary Outcome Measures

Full Information

First Posted
June 24, 2020
Last Updated
September 19, 2023
Sponsor
Vanderbilt-Ingram Cancer Center
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1. Study Identification

Unique Protocol Identification Number
NCT04454476
Brief Title
Reversal of Preneoplastic Metaplasia in the Stomach With MEK Inhibitor
Official Title
Reversal of Preneoplastic Metaplasia in the Stomach With MEK Inhibitor Treatment
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
November 9, 2022 (Actual)
Primary Completion Date
May 2024 (Anticipated)
Study Completion Date
May 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Vanderbilt-Ingram Cancer Center

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a study of the safety and effectiveness of Trametinib treatment in patients who have received successful endoscopic submucosal resection of a Stage I gastric cancer.
Detailed Description
Objectives: To evaluate the efficacy of Trametinib in reversing metaplasia in participants with Stage 1 gastric cancer To evaluate the safety of Trametinibin in Stage I gastric cancer patients

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Gastric Cancer, Metaplasia, Stage I Gastric Cancer, Initial-onset Gastric Cancer

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Trametinib treatment
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Trametinib treatment
Intervention Description
1 mg taken by mouth once a day for 14 days
Intervention Type
Procedure
Intervention Name(s)
Endoscopy
Intervention Description
A tiny camera on the end of a long, flexible tube will be used to examine the stomach and take biopsies.
Primary Outcome Measure Information:
Title
Effectiveness of Trametinib in reversing metaplasia: changes in cell lineages
Description
The ability of Trametinib treatment to decrease the presence of metaplastic cell lineages in biopsies of the lining of the stomach, while also allowing the return of normal cell lineages (i.e. acid-secreting parietal cells). Cell lineages will be identified by immunostaining of tissue sections from biopsies.
Time Frame
About 12 months
Title
Safety of Trametinib treatment: adverse events
Description
Assessment of side effects induced during or after treatment with Trametinib.
Time Frame
About 12 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
20 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Primary registration Person having intact stomach after treatment of early gastric cancer or gastric adenoma Person whose treated gastric cancer histological type is intestinal type. Person whose treated gastric cancer or gastric adenoma was curatively resected. Person who does not have symptoms of gastric cancer recurrence. Person who can declare agreement for enrollment by understanding the study and signing the informed consent document after hearing the explanation. Person who can visit the hospital in accordance with the schedule. Secondary registration Person who has gastric atrophy at endoscopy. Person who does not have symptoms of gastric cancer recurrence by endoscopy. Person who has intestinal metaplasia in stomach, histologically confirmed in biopsy specimens taken under endoscopy within 8 weeks prior to taking MEK inhibitor, Trametinib. Exclusion Criteria: Person whose treated gastric cancer was diffuse or signet ring cancer. Person whose treated gastric cancer or gastric adenoma was not curatively resected. Person who has the history of other malignant disease. Person who had a significant improvement in metaplasia after eradication therapy for Helicobacter pylori within one year. Person who had plan of eradication Helicobacter pylori in 1 year 9 months Person who has history of previous Trametinib or other MEK inhibitor use. Person who has history of hypersensitivity to excipients. Person who entered clinical trial and took investigational new drug within 12 weeks. Presence of active infection other than chronic gastritis. Cardiac conditions as follows: Uncontrolled hypertension (BP>=150/95 mm Hg despite medical therapy) Acute myocardial infection within 6 months prior to starting treatment Uncontrolled Angina (Canadian Cardiovascular Society grade II-IV even after medication) Symptomatic heart failure NYHA Class II-IV <45% in the past Severe valvular disease <55% at present Atrial fibrilation in ECG with BPM=>100 Laboratory values as listed below (SI units) Absolute Neutrophil Count <1.5x10A9/L (1500 per mm3) Platelets <100x10A9/L (100,000 per mm3) Hemoglobin<=9.0 g /dL Serum creatinine >1.5 X upper limit of normal (ULN) Serum bilirubin >1.5 x ULN AST or ALT > 2.5 x ULN Ophthalmological conditions as follows: Current or past history of retinal pigment epithelial detachment (RPED)/central serous retinopathy (CSR) or retinal vein occlusion Intraocular pressure (IOP) > 21 mmHg or uncontrolled glaucoma (irrespective of IOP) Male or female patients of reproductive potential and, as judged by the investigator, are not employing an effective method of birth control and pregnant female. Breast feeding female Have refractory nausea and vomiting , chronic gastrointestinal diseases (e.g . inflammatory bowel disease), or significant bowel resection that would adversely affect the absorption / bioavailability of the orally administered study medication. Person who has history of hyperrefractory for Trametinib methyl sulfoxide Person who has pneumonia under chest X-ray. Have evidence of any other significant clinical disorder or laboratory finding that, as judgedby the investigator, makes it undesirable for the patient to participate in the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
James Goldenring, MD
Organizational Affiliation
Vanderbilt Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Nagasaki University Hospital
City
Nagasaki
Country
Japan
Facility Name
Nihon University School of Medicine
City
Tokyo
Country
Japan
Facility Name
University of Tokyo Medical Center
City
Tokyo
Country
Japan

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Reversal of Preneoplastic Metaplasia in the Stomach With MEK Inhibitor

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