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Status unknownNCT03368131Updated Feb 19, 2020

Concurrent Neoadjuvant Chemoradiotherapy Plus Trastuzumab in the Treatment of Siewert II ,III of Human Epidermal Growth Factor Receptor-2(HER-2) Positive Gastroesophageal Junction Adenocarcinoma: A Randomized, Controlled Clinical Study

A Phase 2 interventional study of Trastuzumab and Capecitabine in Gastroesophageal Junction Adenocarcinoma, sponsored by Hebei Medical University. Status unknown at 1 site in China. Open to participants aged 18 Years to 60 Years. Per ClinicalTrials.gov, last updated 2020-02-19.

Sponsored by Hebei Medical University · Phase 2, Interventional, and Treatment

The sponsor has not verified this record recently (last verified Feb 2020), so the status shown — last known as Active, not recruiting — may be out of date.
Phase
Phase 2
Study type
Interventional
Enrollment
48
Allocation
Randomized
Ages
18 Years to 60 Years
Sex
All
01

Study summary

The purpose of this study is to assess the efficacy and safety of patients who receive concurrent neoadjuvant chemoradiotherapy for Siewert II ,III of locally advanced HER-2 Positive adenocarcinoma at gastroesophageal junction

02

Conditions studied

  • Gastroesophageal Junction Adenocarcinoma
03

Who can participate

Ages eligible
18 Years to 60 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Age:18 to 60 years old (man or female);
  • confirmed to Siewert II , III of locally advanced adenocarcinoma at gastroesophageal junction. The her-2 positive was detected by immunohistochemistry or Fluorescence in SituHybridization(FISH);
  • Patients with Stage for Ⅲ by Endorectal Ultrasonography( EUS), Computed Tomography(CT) (or Positron Emission Tomography(PET )-CT) and laparoscopic (According to the eighth edition of American Joint Committee on Cancer (AJCC) );
  • Patients are diagnosed as potentially resectable by multidisciplinary team, no surgical contraindications, and expected to be surgical resection;
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0-1;
  • Major organ function has to meet the following criteria:

HB≥80g/L; ANC≥1.5×109/L; PLT≥90×109/L; Alanine Transaminase (ALT) and Aspartate Transaminase(AST)≤2.5×ULN, but\<≤5×ULN if the transferase elevation is due to liver metastases; Total Bilirubin(TBIL)\<1.5×ULN; Serum creatinine ≤1.5×ULN;Serum albumin ≥ 30g / L

  • Life expectancy greater than or equal to 6 months;
  • Participants were willing to join in this study, and written informed consent, good adherence, cooperate with the follow-up.

Exclusion criteria

Exclusion Criteria:

  • Allergic to trastuzumab, capecitabine and oxaliplatin;
  • severe diseases such as liver and kidney,myocardial infarction, symptomatic congestive heart failure (CHF) (NYHA classes II-IV), unstable angina or serious cardiac arrhythmia,which affect the situation of chemotherapy or surgery
  • A variety of factors influencing oral drugs (such as unable to swallow, nausea, vomiting, chronic diarrhea and intestinal obstruction, etc);
  • Patients with tendency of gastrointestinal bleeding, including the following: a local active ulcerative lesions, and defecate occult blood (+ +); Has melena and hematemesis in two months;
  • Coagulant function abnormality (International Normalized Ratio(INR) > 1.5 ULN, Activated Partial Thromboplastin Time(APTT ) > 1.5 ULN), with bleeding tendency;
  • Pregnant or lactating women;
  • Patients with other malignant tumors within 5 years (except for curable skin basal cell carcinoma and cervical carcinoma in situ);
  • History of psychiatric drugs abuse and can't quit or patients with mental disorders;
  • Less than 4 weeks from the last clinical trial;
  • The researchers think inappropriate.
04

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
48 participants (actual)

Study arms

  • Experimental
    Trastuzumab XELOX and radiotherapy

    Trastuzumab is intravenously administered with the loading dose of 8 mg/kg followed by maintenance dose of 6mg/kg in day 1 of each cycle. XELOX:Capecitabine 825\~1000mg/m2 bid d1-14,Oxaliplatin 130 mg/m2 Ivgtt d1 q3w Radiotherapy:45 Gray (unit)Gy/25f (1.8Gy/f/d,5 f/w)

    Drug: Trastuzumab · Drug: Capecitabine · Drug: Oxaliplatin · Radiation: Radiotherapy

  • Active comparator
    XELOX and radiotherapy

    Capecitabine:825\~1000mg/m2 bid d1-14,Oxaliplatin 130 mg/m2 Ivgtt d1 q3w Radiotherapy:45Gy/25f (1.8Gy/f/d,5 f/w)

    Drug: Capecitabine · Drug: Oxaliplatin · Radiation: Radiotherapy

Interventions

  • DrugTrastuzumab

    intravenously administered with the loading dose of 8 mg/kg followed by maintenance dose of 6mg/kg in day 1 of each cycle

  • DrugCapecitabine

    825\~1000mg/m2 bid d1-14

  • DrugOxaliplatin

    130 mg/m2 Ivgtt d1 q3w

  • RadiationRadiotherapy

    45 Gray (unit) Gy/25f (1.8Gy/f/d,5 f/w)

05

What researchers measure

Primary outcomes

  1. The pathological complete response rate(pCR)

    The lesion disappeared completely by pathology

    Time frame: within 3 weeks after surgery

Secondary outcomes

  1. Overall survival (OS)

    Baseline to measured date of death from any cause

    Time frame: 3 years

  2. Disease-free survival(DFS)

    Baseline to measured date of recurrence or death from any cause

    Time frame: 3 years

  3. Disease Control Rate (DCR)

    Percentage of participants who achieved a best overall response of CR or PR or Stable Disease (SD).

    Time frame: 3 years

  4. Percentage of Participants With Objective Response According to Modified Response Evaluation Criteria In Solid Tumors(mRECIST) v1.1

    Objective response referred to participants with complete response (CR) or partial response (PR). CR: disappearance of all target lesions, non-target lesions, and normalization of tumor marker level. PR: greater than or equal to (\>=) 30% decrease in sum of the longest diameter (LD) of all target lesions taking as reference the screening sum LD. To be assigned a status of PR or CR, changes in tumor measurements had to be confirmed by repeat assessments that should have been performed no less than 4 weeks after the criteria for response were first met. Longer intervals as determined by the study protocol were also appropriate. Cumulative data (up to primary analysis cut-off date of 30-June-2015) are provided for both phase 2 and phase 3 within the results of this measure.

    Time frame: within 3 weeks after surgery

  5. Percentage of Participants With Clinically Significant Improvement in European Organisation for Research and Treatment of Cancer Quality of Life Core Module 30 (EORTC Quality of Life Questionnaire (QLQ)-C30) Score

    The EORTC QLQ-C30 is a validated, cancer-specific 30-item patient-reported measure, and contains 14 domains to assess the impact of cancer treatment on 5 aspects of participants functioning (physical, role, cognitive, emotional, and social), 9 aspects of disease/treatment-related symptoms (fatigue, nausea and vomiting, pain, dyspnea, insomnia, loss of appetite, constipation, diarrhea) and a global QoL/overall health status scale. Questions used 4 point scale (1 'Not at all' to 4 'Very much'; with the exception of the QoL/health status scale which uses a 7-point scale (1 'very poor' to 7 'Excellent'). Each scale is transformed on a scale of 0-100; a higher score equals (=) a better level of functioning or greater degree of symptoms. Change of greater than or equal to (\>=) 10-points has been found to be clinically significant. Cumulative data (up to primary analysis cut-off date of 30-June-2015) are provided for both phase 2 and phase 3 within the results of this measure.

    Time frame: Day 1 of each treatment cycle, at the study drug completion visit, and thereafter at follow-up

  6. Adverse events

    Toxicity according to the Common Terminology Criteria for Adverse Events (CTCAE) Version 4.0.The number of Participants with adverse events will be recorded at each treatment visit.

    Time frame: 3 years

06

Study locations

1 site
  • Fourth Affiliated Hospital of Hebei Medical University
    Shijiazhuang, Hebei 050011, China
07

Registry details

Key details

Study ID
NCT03368131
Lead sponsor
Hebei Medical University
Responsible party
Qun Zhao (Principal Investigator, Hebei Medical University) — Principal investigator
First posted
Dec 11, 2017
Start date
Dec 1, 2017
Primary completion
Dec 30, 2019
Completion
Dec 31, 2020 (estimated)
Last update
Feb 19, 2020

Study contacts

Qun Zhao
principal investigator · Hebei Medical University Fourth Hospital
Jun Wang
principal investigator · Hebei Medical University Fourth Hospital

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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