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出境医 / 临床实验 / S1+ Paclitaxel (IV&IP) + Bevacizumab (IP) Versus S1+Oxaliplatin as First-line Treatment in Gastric Cancer With Malignant Ascites

S1+ Paclitaxel (IV&IP) + Bevacizumab (IP) Versus S1+Oxaliplatin as First-line Treatment in Gastric Cancer With Malignant Ascites

Study Description
Brief Summary:
The purpose of this study is to compare the efficacy of S1 plus paclitaxel (intravenous injection & intraperitoneal injection) plus bevacizumab (intraperitoneal injection) vs. S1 plus oxaliplatin intravenous injection as first-line treatment in gastric or gastroesophageal junctional adenocarcinoma with malignant ascites.

Condition or disease Intervention/treatment Phase
Metastatic Gastric Adenocarcinoma Drug: S1 Drug: Paclitaxel Drug: Bevacizumab Drug: Oxaliplatin Phase 2

Detailed Description:
This is a prospective, open-label, multicenter clinical trial, to compare the efficacy of S1 plus paclitaxel (intravenous injection & intraperitoneal injection) plus bevacizumab (intraperitoneal injection) versus S1 plus oxaliplatin intravenous injection as first-line treatment in gastric or gastroesophageal junctional adenocarcinoma with malignant ascites. A total of 66 patients who are diagnosed with gastric or gastroesophageal junctional adenocarcinoma will be allocated to receive either S1 orally administration plus paclitaxel intravenous injection & intraperitoneal injection plus bevacizumab intraperitoneal injection, or to receive S1 orally administration plus oxaliplatin intravenous injection. The primary end point is ascites response rate at 6 weeks. The secondary end points include the median overall survival (OS), progression-free survival (PFS), time to treatment failure (TTF), objective response rate (ORR), puncture free survival, volume of drainage, the quality of life (QoL) and safety.
Study Design
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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 66 participants
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: S1 Plus Paclitaxel (IV&IP) Plus Bevacizumab (IP) Versus S1 Plus Oxaliplatin(IV) as First-line Treatment in Gastric or Gastroesophageal Junctional Adenocarcinoma With Malignant Ascites: An Open-label, Multicenter Phase II Study
Actual Study Start Date : November 1, 2017
Estimated Primary Completion Date : April 30, 2021
Estimated Study Completion Date : April 30, 2022
Arms and Interventions
Arm Intervention/treatment
Experimental: Experimental arm
S1+Paclitaxel (IV&IP)+Bevacizumab (IP)
Drug: S1
80-120 mg/day, PO, D1-14, every 21 days
Other Name: Tegafur Gimeracil Oteracil Potassium Capsule

Drug: Paclitaxel
20 mg/m2/day, IP, D1-3; 50 mg/m2, IV, D1; 70 mg/m2, IV, D8; every 21 days
Other Name: Paclitaxel Injection

Drug: Bevacizumab
200 mg, IP, D1, every 21 days
Other Name: Avastin ®

Active Comparator: Control arm
S1+Oxaliplatin (IV)
Drug: S1
80-120 mg/day, PO, D1-14, every 21 days
Other Name: Tegafur Gimeracil Oteracil Potassium Capsule

Drug: Oxaliplatin
130 mg/m2, IV, D1, every 21 days
Other Name: ELOXATIN®

Outcome Measures
Primary Outcome Measures :
  1. Ascites response rate at 6 weeks [ Time Frame: 6 weeks ]
    response of ascites at 6 weeks


Secondary Outcome Measures :
  1. PFS [ Time Frame: 12 months ]
    Progression-free survival,From 1st drug administration to the date of first progression or date of death (whichever occurs first)

  2. OS [ Time Frame: 2 years ]
    Overall survival, from enrollment until death from any cause

  3. ORR [ Time Frame: 12 months ]
    Objective response rate, the proportion of patients with reduction in tumor burden of a predefined amount

  4. TTF [ Time Frame: 12 months ]
    Time to treatment failure, from 1st drug administration to discontinuation of treatment for any reason, including disease progression, treatment toxicity, and death

  5. Puncture free survival [ Time Frame: 12 months ]
    Puncture free survival time, from the first puncture to secondary puncture

  6. Volume of drainage [ Time Frame: 12 months ]
    Volume of drainage

  7. Adverse events [ Time Frame: 12 months ]
    Adverse events


Eligibility Criteria
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Ages Eligible for Study:   18 Years to 70 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • 18 years ≥ Age≤ 70 years, male or female
  • Pathologically confirmed adenocarcinoma of the gastric or gastro-oesophageal junction with inoperable locally advanced or recurrent and/or metastatic disease; with medium amount of malignant ascites which can be catheterized.
  • Diagnostic criteria for malignant ascites (meet any of the following criteria): ascites cytology positive; or imaging or pathological confirmed peritoneal metastases.
  • No prior anti-tumor treatment to the metastatic disease; an interval of at least 6 months from the last adjuvant chemotherapy.
  • Eastern Cooperative Oncology Group (ECOG) performance status( PS) score 0-1.
  • Normal major organ function, and laboratory tests must meet the following criteria: hemoglobin (HGB) ≥ 90 g/L, neutrophil count ≥ 1.5×109/L, platelet count ≥ 100×109/L, total bilirubin (TBil) ≤ 1.5 upper normal limitation (UNL), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 2.5 UNL, serum creatinine (Cr) ≤ 1 UNL; creatinine clearance rate (CCr) ≥ 60 ml/min (calculated using the Cockcroft-Gault equation).
  • International Normalized Ratio (INR) ≤ 1.5 and partial prothrombin time (PPT) or activated partial thromboplastin time (APTT) ≤ 1.5 UNL within 7 days before enrollment.
  • Life expectancy of at least 12 weeks
  • Signed informed consent (ICF)
  • For women of child bearing potential, a negative serum or urine pregnancy test result should be obtained with 7 days before enrollment; Women of childbearing potential and men must agree to use adequate contraception before entering the program until at least 8 weeks after the last study drug administration.

Exclusion Criteria:

  • Known hypersensitivity or allergic to any of the study drugs, study drug classes, or excipients in the formulation.
  • Subject received chemotherapy to the metastatic disease (except adjuvant/neoadjuvant chemotherapy administered 24 weeks before enrollment)
  • Subject with other malignancies, except for non-melanoma skin cancer or in-situ cervical carcinoma under adequate treatment, or other treated malignancies without evidence of recurrent for 5 years.
  • Anti-tumor cytotoxic drug therapy within 14 days prior to enrollment(longer washout time interval might needed depends on drug characteristics)
  • Uncontrolled hypertension which cannot be reduced to normal range by antihypertensive agents [Systolic Blood Pressure(SBP) >140 mmHg, diastolic blood pressure (DBP) > 90 mmHg], coronary artery disease > grade 1, arrhythmia > grade 1 [including corrected QT(QTc) interval prolongation: QTc>450 ms for male,QTc>470 ms for female], grade 1 heart failure.
  • Proteinuria ≥ ++,or persistent proteinuria > 1.0 g/24 hours
  • Presence of any toxicity ≥ grade 1 according to NCI-CTCAE except for alopecia.
  • Arterial or venous thrombotic or embolic events such as cerebrovascular accident (including transient ischemic attacks, cerebral hemorrhage、cerebral infarction), deep vein thrombosis and pulmonary embolism within 12 months before enrollment.
  • Bowel obstruction within 6 weeks before enrollment.
  • Surgical treatment was performed within 6 weeks before enrollment. Subject should recover from any major surgery.
  • Serious uncontrolled systemic illness or medical condition or uncontrolled infections, including but not limited to: uncontrollable ventricular arrhythmias, history of documented myocardial infarction within 3 months, uncontrollable epileptic dementia, unstable spinal compression, superior vena cava syndrome, extensive bilateral interstitial pulmonary disease by high-resolution computed tomography (HRCT), or any neurological or mental abnormalities which affect compliance.
  • Human immunodeficiency virus (HIV) positive
  • Pregnancy or lactation women
  • Cannot be orally administered medication
  • Subject with a tendency for gastrointestinal hemorrhage. Including: Black stool or hematemesis within 2 months; For subjects positive in occult test with unresected primary lesion, if the principle investigator in each center considers with possibility of gastrointestinal hemorrhage, the subject could not be enrolled.
  • Subject with malignant pleural effusion need medical intervention.
  • A history or evidence of hereditary hemorrhagic constitution or coagulation disorder that increases the risk of bleeding
  • Subjects with central nerve system metastases
  • Have been enrolled in other clinical trial with investigational drug treatment within the 4 weeks of start of study treatment
  • For subject with bone metastases, palliative radiotherapy was given 4 weeks before enrollment (radiation field >5%).
  • Any other disease or condition that the investigator considers not suitable for participating in this clinical trial.
Contacts and Locations

Contacts
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Contact: Yunpeng Liu, M.D. 86-24-83282312 cmu_trial@163.com
Contact: Xiujuan Qu, M.D. 86-24-83282312 cmuquxiujuan@163.com

Locations
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China, Liaoning
The First Affiliated Hospital of China Medical University Recruiting
Shenyang, Liaoning, China, 110001
Contact: Yunpeng Liu, Ph.D         
Contact: Xiujuan Qu, M.D.         
Sponsors and Collaborators
China Medical University, China
Investigators
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Principal Investigator: Yunpeng Liu, M.D. China Medical University, China
Tracking Information
First Submitted Date  ICMJE May 28, 2019
First Posted Date  ICMJE June 18, 2019
Last Update Posted Date June 19, 2019
Actual Study Start Date  ICMJE November 1, 2017
Estimated Primary Completion Date April 30, 2021   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: June 17, 2019)
Ascites response rate at 6 weeks [ Time Frame: 6 weeks ]
response of ascites at 6 weeks
Original Primary Outcome Measures  ICMJE Same as current
Change History No Changes Posted
Current Secondary Outcome Measures  ICMJE
 (submitted: June 17, 2019)
  • PFS [ Time Frame: 12 months ]
    Progression-free survival,From 1st drug administration to the date of first progression or date of death (whichever occurs first)
  • OS [ Time Frame: 2 years ]
    Overall survival, from enrollment until death from any cause
  • ORR [ Time Frame: 12 months ]
    Objective response rate, the proportion of patients with reduction in tumor burden of a predefined amount
  • TTF [ Time Frame: 12 months ]
    Time to treatment failure, from 1st drug administration to discontinuation of treatment for any reason, including disease progression, treatment toxicity, and death
  • Puncture free survival [ Time Frame: 12 months ]
    Puncture free survival time, from the first puncture to secondary puncture
  • Volume of drainage [ Time Frame: 12 months ]
    Volume of drainage
  • Adverse events [ Time Frame: 12 months ]
    Adverse events
Original Secondary Outcome Measures  ICMJE Same as current
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title  ICMJE S1+ Paclitaxel (IV&IP) + Bevacizumab (IP) Versus S1+Oxaliplatin as First-line Treatment in Gastric Cancer With Malignant Ascites
Official Title  ICMJE S1 Plus Paclitaxel (IV&IP) Plus Bevacizumab (IP) Versus S1 Plus Oxaliplatin(IV) as First-line Treatment in Gastric or Gastroesophageal Junctional Adenocarcinoma With Malignant Ascites: An Open-label, Multicenter Phase II Study
Brief Summary The purpose of this study is to compare the efficacy of S1 plus paclitaxel (intravenous injection & intraperitoneal injection) plus bevacizumab (intraperitoneal injection) vs. S1 plus oxaliplatin intravenous injection as first-line treatment in gastric or gastroesophageal junctional adenocarcinoma with malignant ascites.
Detailed Description This is a prospective, open-label, multicenter clinical trial, to compare the efficacy of S1 plus paclitaxel (intravenous injection & intraperitoneal injection) plus bevacizumab (intraperitoneal injection) versus S1 plus oxaliplatin intravenous injection as first-line treatment in gastric or gastroesophageal junctional adenocarcinoma with malignant ascites. A total of 66 patients who are diagnosed with gastric or gastroesophageal junctional adenocarcinoma will be allocated to receive either S1 orally administration plus paclitaxel intravenous injection & intraperitoneal injection plus bevacizumab intraperitoneal injection, or to receive S1 orally administration plus oxaliplatin intravenous injection. The primary end point is ascites response rate at 6 weeks. The secondary end points include the median overall survival (OS), progression-free survival (PFS), time to treatment failure (TTF), objective response rate (ORR), puncture free survival, volume of drainage, the quality of life (QoL) and safety.
Study Type  ICMJE Interventional
Study Phase  ICMJE Phase 2
Study Design  ICMJE Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Condition  ICMJE Metastatic Gastric Adenocarcinoma
Intervention  ICMJE
  • Drug: S1
    80-120 mg/day, PO, D1-14, every 21 days
    Other Name: Tegafur Gimeracil Oteracil Potassium Capsule
  • Drug: Paclitaxel
    20 mg/m2/day, IP, D1-3; 50 mg/m2, IV, D1; 70 mg/m2, IV, D8; every 21 days
    Other Name: Paclitaxel Injection
  • Drug: Bevacizumab
    200 mg, IP, D1, every 21 days
    Other Name: Avastin ®
  • Drug: Oxaliplatin
    130 mg/m2, IV, D1, every 21 days
    Other Name: ELOXATIN®
Study Arms  ICMJE
  • Experimental: Experimental arm
    S1+Paclitaxel (IV&IP)+Bevacizumab (IP)
    Interventions:
    • Drug: S1
    • Drug: Paclitaxel
    • Drug: Bevacizumab
  • Active Comparator: Control arm
    S1+Oxaliplatin (IV)
    Interventions:
    • Drug: S1
    • Drug: Oxaliplatin
Publications * Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Recruiting
Estimated Enrollment  ICMJE
 (submitted: June 17, 2019)
66
Original Estimated Enrollment  ICMJE Same as current
Estimated Study Completion Date  ICMJE April 30, 2022
Estimated Primary Completion Date April 30, 2021   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria:

  • 18 years ≥ Age≤ 70 years, male or female
  • Pathologically confirmed adenocarcinoma of the gastric or gastro-oesophageal junction with inoperable locally advanced or recurrent and/or metastatic disease; with medium amount of malignant ascites which can be catheterized.
  • Diagnostic criteria for malignant ascites (meet any of the following criteria): ascites cytology positive; or imaging or pathological confirmed peritoneal metastases.
  • No prior anti-tumor treatment to the metastatic disease; an interval of at least 6 months from the last adjuvant chemotherapy.
  • Eastern Cooperative Oncology Group (ECOG) performance status( PS) score 0-1.
  • Normal major organ function, and laboratory tests must meet the following criteria: hemoglobin (HGB) ≥ 90 g/L, neutrophil count ≥ 1.5×109/L, platelet count ≥ 100×109/L, total bilirubin (TBil) ≤ 1.5 upper normal limitation (UNL), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 2.5 UNL, serum creatinine (Cr) ≤ 1 UNL; creatinine clearance rate (CCr) ≥ 60 ml/min (calculated using the Cockcroft-Gault equation).
  • International Normalized Ratio (INR) ≤ 1.5 and partial prothrombin time (PPT) or activated partial thromboplastin time (APTT) ≤ 1.5 UNL within 7 days before enrollment.
  • Life expectancy of at least 12 weeks
  • Signed informed consent (ICF)
  • For women of child bearing potential, a negative serum or urine pregnancy test result should be obtained with 7 days before enrollment; Women of childbearing potential and men must agree to use adequate contraception before entering the program until at least 8 weeks after the last study drug administration.

Exclusion Criteria:

  • Known hypersensitivity or allergic to any of the study drugs, study drug classes, or excipients in the formulation.
  • Subject received chemotherapy to the metastatic disease (except adjuvant/neoadjuvant chemotherapy administered 24 weeks before enrollment)
  • Subject with other malignancies, except for non-melanoma skin cancer or in-situ cervical carcinoma under adequate treatment, or other treated malignancies without evidence of recurrent for 5 years.
  • Anti-tumor cytotoxic drug therapy within 14 days prior to enrollment(longer washout time interval might needed depends on drug characteristics)
  • Uncontrolled hypertension which cannot be reduced to normal range by antihypertensive agents [Systolic Blood Pressure(SBP) >140 mmHg, diastolic blood pressure (DBP) > 90 mmHg], coronary artery disease > grade 1, arrhythmia > grade 1 [including corrected QT(QTc) interval prolongation: QTc>450 ms for male,QTc>470 ms for female], grade 1 heart failure.
  • Proteinuria ≥ ++,or persistent proteinuria > 1.0 g/24 hours
  • Presence of any toxicity ≥ grade 1 according to NCI-CTCAE except for alopecia.
  • Arterial or venous thrombotic or embolic events such as cerebrovascular accident (including transient ischemic attacks, cerebral hemorrhage、cerebral infarction), deep vein thrombosis and pulmonary embolism within 12 months before enrollment.
  • Bowel obstruction within 6 weeks before enrollment.
  • Surgical treatment was performed within 6 weeks before enrollment. Subject should recover from any major surgery.
  • Serious uncontrolled systemic illness or medical condition or uncontrolled infections, including but not limited to: uncontrollable ventricular arrhythmias, history of documented myocardial infarction within 3 months, uncontrollable epileptic dementia, unstable spinal compression, superior vena cava syndrome, extensive bilateral interstitial pulmonary disease by high-resolution computed tomography (HRCT), or any neurological or mental abnormalities which affect compliance.
  • Human immunodeficiency virus (HIV) positive
  • Pregnancy or lactation women
  • Cannot be orally administered medication
  • Subject with a tendency for gastrointestinal hemorrhage. Including: Black stool or hematemesis within 2 months; For subjects positive in occult test with unresected primary lesion, if the principle investigator in each center considers with possibility of gastrointestinal hemorrhage, the subject could not be enrolled.
  • Subject with malignant pleural effusion need medical intervention.
  • A history or evidence of hereditary hemorrhagic constitution or coagulation disorder that increases the risk of bleeding
  • Subjects with central nerve system metastases
  • Have been enrolled in other clinical trial with investigational drug treatment within the 4 weeks of start of study treatment
  • For subject with bone metastases, palliative radiotherapy was given 4 weeks before enrollment (radiation field >5%).
  • Any other disease or condition that the investigator considers not suitable for participating in this clinical trial.
Sex/Gender  ICMJE
Sexes Eligible for Study: All
Ages  ICMJE 18 Years to 70 Years   (Adult, Older Adult)
Accepts Healthy Volunteers  ICMJE No
Contacts  ICMJE
Contact: Yunpeng Liu, M.D. 86-24-83282312 cmu_trial@163.com
Contact: Xiujuan Qu, M.D. 86-24-83282312 cmuquxiujuan@163.com
Listed Location Countries  ICMJE China
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT03990103
Other Study ID Numbers  ICMJE CLOG1704
Has Data Monitoring Committee Yes
U.S. FDA-regulated Product
Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Product Manufactured in and Exported from the U.S.: No
IPD Sharing Statement  ICMJE
Plan to Share IPD: Undecided
Plan Description: not yet decided
Responsible Party Yunpeng Liu, China Medical University, China
Study Sponsor  ICMJE China Medical University, China
Collaborators  ICMJE Not Provided
Investigators  ICMJE
Principal Investigator: Yunpeng Liu, M.D. China Medical University, China
PRS Account China Medical University, China
Verification Date June 2019

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP

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