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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT02995850
Other study ID # 4-2016-0252
Secondary ID
Status Completed
Phase Phase 1/Phase 2
First received
Last updated
Start date February 22, 2017
Est. completion date May 5, 2022

Study information

Verified date August 2023
Source Yonsei University
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

This is an open-label, non-randomized, single-center, phase Ib/II study, evaluating efficacy and feasibility of cytoreductive surgery(CRS), extensive peritoneal lavage, hyperthermic intraperitoneal chemotherapy(HIPEC) and post-operative intraperitoneal chemotherapy combination in gastric cancer with peritoneal metastasis


Description:

Peritoneal metastases in gastric cancer are considered to indicate terminal disease due to poor prognosis because systemic chemotherapy is unlikely to accumulate in peritoneal nodules in cytotoxic concentrations. Cytoreductive surgery (CRS) along with hyperthermic intraperitoneal chemotherapy (HIPEC) has been suggested to improve survival in select patients with limited peritoneal spread, resulting in a median overall survival (OS) of 8 to 14 months. It remains unclear, however, which regimen is best and who have benefits from CRS and HIPEC. Herein, we has conducting prospective phase Ib/II trial of CRC and HIPEC with intraperitoneal paclitaxel and cisplatin, and oral S-1 in gastric cancer with peritoneal metastasis.


Recruitment information / eligibility

Status Completed
Enrollment 25
Est. completion date May 5, 2022
Est. primary completion date April 19, 2022
Accepts healthy volunteers No
Gender All
Age group 19 Years and older
Eligibility Inclusion Criteria: 1. Patient age of 19 years or older and age of 75 years or younger. 2. Histologically proven gastric or esophagogastric junction adenocarcinoma with peritoneal metastasis under diagnostic laparoscopy. 3. Primary tumor measured as resectable in preoperative images. 4. Performance status based on ECOG : 0~1 5. No prior treatment (chemotherapy, radiotherapy, etc.) 6. Adequate hepatic, renal, and hematologic function - ANC=1,500/uL, - hemoglobin=9.0g/dL - platelet=100,000/uL - total Bilirubin: = 1.5 × upper normal limit - Creatinine<1.5mg/dL - AST/ALT, ALP = 2.5 x upper normal limit 7. Patients who can understand this study and sign the consent form. Exclusion Criteria: 1. Patient who has distant metastasis or para-aortic lymph node metastasis or retroperitoneal metastasis except peritoneal metastasis. (But the patient who has ovarian metastasis with resectable status can be enrolled.) 2. Primary tumor cannot be resected because of direct invasion to other important organ. (But, if the invaded organ can be resected together, such as spleen, gallbladder, distal pancreas, and liver, the patient can be enrolled) 3. HER2 positive patient 4. Patient with active viral infection (for example, HIV, HBV, HCV, except stable status of HBV infection) 5. Pregnant patient, or patient in breast-feeding, or who is planning pregnancy. 6. Patients in exclusion criteria of TS-1, cisplatin, paclitaxel - Patients with a history of severe hypersensitivity to these drugs - Patients with severe bone marrow depression - patients who has severe hepatic, renal disorder - patients who has hereditary problem or galactose intolerance, lapp lactase deficiency, or glucose-galactose malabsorption 7. Patients who has important medical problem or infection - Cerebrovascular accident(CVA) within 1 year - Heart attack within 6 months, uncontrolled hypertension, unstable angina, uncontrolled congestive heart failure(CHF), severe arrhythmia - Major operation or injury within 28 days - Severe and not recovered wound, ulcer, fracture - Uncontrolled bleeding disease - Recent active gastric infection 8. Patient with another primary cancer within last 5 years 9. Patient on medication which can interact with the drugs used in this study (fluoropyrimidine-group antineoplastic agents, flucytosine, phenytoin, etc) 10. Patients with other systemic chemotherapy or radiotherapy 11. Patients with psychiatric or neurologic disorder so that he or she cannot understand and sign the consent form.

Study Design


Intervention

Drug:
CRS+HIPEC
Ib Dose-escalation of intraperitoneal paclitaxel will follow a modified 3 + 3 dose escalation procedure. II ? CRS If PCI <12, CRS will be performed by gastrectomy with D2-lymphadenectomy and resection of any involved adjacent structures. If PCI=12, instead of CRS, 3 times of IP paclitaxel +cisplatin and oral S-1 chemotherapy every 3 weeks, and then PCI <12, CRS will be done. ? Extensiveintraperitoneal lavage Peritoneal lavage after CRS will be done with 10 L before HIPEC. ? HIPEC Following surgery HIPEC will be performed using CDDP (60 mg/m2) and PTX (P2RD mg/m2). IP chemotherapy will be performed. ? Post-operative intraperitoneal chemotherapy Postoperative chemotherapy will be done 8 cycles of IP paclitaxel+ cisplatin and oral S-1 after 4 weeks.

Locations

Country Name City State
Korea, Republic of Department of Surgery, Yonsei University College of Medicine Seoul

Sponsors (1)

Lead Sponsor Collaborator
Yonsei University

Country where clinical trial is conducted

Korea, Republic of, 

Outcome

Type Measure Description Time frame Safety issue
Primary Ib: Maximum tolerate dose Ib: To determine the MTD of orally administered S-1 + intraperitoneal paclitaxel +cisplatin in gastric cancer with peritoneal metastasis. 3 months
Primary II: Safety II:To assess the safety and tolerability of CRS +HIPEC (Clavien-Dindo classification of surgical complication & NCI-common terminology criteria for adverse events(CTC-AE) for chemotherapy] 3 months
Secondary OS (overall survival) the length of time from the patient signing the consent form until the patient is still alive 12 months
Secondary PFS (Progression-free survival) the length of time from the patient signing the consent form until the patient shows disease progression 12 months
Secondary RR (response rate) the proportion of complete response to partial response These will be estimated by the Kaplan-Meire method. 12 months