Gastric Adenocarcinoma Clinical Trial
Official title:
ITACA-S2(Intergroup Trial in Adjuvant Chemotherapy for Adenocarcinoma of the Stomach:Comparison of the Efficacy of a Peri-operative Versus a Post-operative Chemotherapy Treatment in Patients With Operable Gastric Cancer and Assessment of the Benefit of a Post-operative Chemo-radiotherapy.
The study addresses two primary questions, according to its factorial design:
- to compare the efficacy in terms of overall survival (OS) of a peri-operative vs. a
post-operative chemotherapy (CHT) treatment, irrespectively of the presence of a
post-surgical chemo-radiotherapy (CHT-RTX) (Timing Study);
- to compare the efficacy in terms of relapse free survival (l-RFS) of a post-surgical
CHT-RTX treatment vs. no other treatment, irrespectively of the timing of CHT (RTX
Study).
The study has a 2x2 factorial design, thus consisting of two independent, following specific
eligibility criteria and with different randomization scheme studies, the Timing Study and
the RTX Study.
Both studies are Italian, multicentre, open-label, randomized, superiority, phase III trials
conducted in patients with histologically confirmed, localized gastric adenocarcinoma, which
is considered operable.
In the Timing Study patients fulfilling the eligibility criteria will be randomized with a
1:1 ratio to receive:
- peri-operative CHT (Arm A) or
- post-operative CHT (Arm B) Once randomized in the Timing Study, patients may also be
randomized in the RTX
Study to receive in addition to CHT a post-operative CHT-RTX treatment or no other
treatment. This is possible since the randomization will be done in two steps: the first for
the Timing Study for all the participating centres (peri-operative CHT vs. post-operative
CHT) and the second one for the RTX Study, only for those centres with the radiotherapist
willing and able to participate (post- surgical CHT-RTX vs. no other treatment). Thus the
following four arms will be generated:
- peri-operative CHT (Arm A)
- post-operative CHT (Arm B)
- peri-operative CHT + post-operative CHT-RTX (Arm C)
- post-operative CHT + post-operative CHT-RTX (Arm D) The study will be conducted in more
than one hundred experimental centres. Follow-up F(-up) procedures and timing of the
visits will be consistent with current clinical practice.
Based on case-mix of sample 1000-1180 patients are needed in the Timing study and 420-520 in
the RTX study.
n/a
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Factorial Assignment, Masking: Open Label, Primary Purpose: Treatment
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