Esophageal Cancer Clinical Trial
Official title:
A Randomized Phase II Trial of Sunitinib Plus Capecitabine Versus Capecitabine Alone (With the Potential for Crossover) for Elderly and/or Poor Performance Status Patients With Metastatic Adenocarcinoma of the Esophagus or Gastroesophageal Junction
RATIONALE: Drugs used in chemotherapy, such as capecitabine, work in different ways to stop
the growth of tumor cells, either by killing the cells or by stopping them from dividing.
Sunitinib malate may stop the growth of tumor cells by blocking some of the enzymes needed
for cell growth and by blocking blood flow to the tumor. It is not yet known whether
capecitabine is more effective when given alone or together with sunitinib malate in treating
patients with metastatic esophageal cancer or gastroesophageal junction cancer.
PURPOSE: This randomized phase II trial is studying how well capecitabine works compared with
capecitabine given together with sunitinib malate as first-line therapy in treating patients
with metastatic cancer of the esophagus or gastroesophageal junction.
OBJECTIVES:
Primary
- Compare the progression-free survival of elderly (age ≥ 65 years) and/or poor
performance status patients with metastatic adenocarcinoma of the esophagus or
gastroesophageal junction treated with capecitabine with verus without sunitinib malate.
- Report other indicators of efficacy with these regimens, including the confirmed
response rate, overall survival, time to tumor progression, duration of response, and
time to treatment failure.
- Compare the adverse event profiles of these regimens in these patients.
Secondary
- Explore whether certain key proteins associated with anti-VEGF therapy are able to
predict tumor response.
- Bank paraffin-embedded tissue blocks or slides, and blood products for future studies.
OUTLINE: This is a multicenter study. Patients are stratified according to gender (male vs
female), ECOG performance status (0 vs 1 vs 2), and age (≥ 65 years vs < 65 years). Patients
are randomized to 1 of 2 treatment arms.
- Arm I: Patients receive oral capecitabine twice daily on days 1-14. Patients
experiencing disease progression may crossover to arm II at the physician's discretion.
- Arm II: Patients receive oral capecitabine as in arm 1 and oral sunitinib malate once
daily on days 1-21.
In both arms, courses repeat every 21 days in the absence of disease progression or
unacceptable toxicity.
Tumor tissue samples are collected at baseline for evaluation of protein markers as possible
predictors of tumor response to this regimen. Samples are analyzed by IHC for expression
levels of markers
After completion of study therapy, patients are followed periodically for 3 years.
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