Trial Outcomes & Findings for Pralatrexate and Oxaliplatin in Treating Patients With Unresectable or Metastatic Esophageal, Stomach, or Gastroesophageal Junction Cancer (NCT NCT01178944)

NCT ID: NCT01178944

Last Updated: 2017-12-13

Results Overview

Overall response rate to combination pralatrexate and oxaliplatin as assessed by Response Evaluation Criteria in Solid Tumors version 1.1. Objective responses will be confirmed 4 weeks after first documentation of response. Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1) for target lesions and assessed by MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), \>=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

35 participants

Primary outcome timeframe

Up to 5 years

Results posted on

2017-12-13

Participant Flow

Participant milestones

Participant milestones
Measure
Treatment (Pralatrexate, Oxaliplatin)
Patients receive pralatrexate IV over 3-5 minutes and oxaliplatin IV over 2 hours on day 1. Courses repeat every 2 weeks in the absence of disease progression or unacceptable toxicity. Oxaliplatin will be discontinued after 12 courses. Laboratory Biomarker Analysis: Correlative studies Oxaliplatin: Given IV Pralatrexate: Given IV
Overall Study
STARTED
35
Overall Study
COMPLETED
35
Overall Study
NOT COMPLETED
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Pralatrexate and Oxaliplatin in Treating Patients With Unresectable or Metastatic Esophageal, Stomach, or Gastroesophageal Junction Cancer

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Treatment (Pralatrexate, Oxaliplatin)
n=35 Participants
Patients receive pralatrexate IV over 3-5 minutes and oxaliplatin IV over 2 hours on day 1. Courses repeat every 2 weeks in the absence of disease progression or unacceptable toxicity. Oxaliplatin will be discontinued after 12 courses. Laboratory Biomarker Analysis: Correlative studies Oxaliplatin: Given IV Pralatrexate: Given IV
Age, Continuous
64.7 years
STANDARD_DEVIATION 9.9 • n=5 Participants
Sex: Female, Male
Female
3 Participants
n=5 Participants
Sex: Female, Male
Male
32 Participants
n=5 Participants

PRIMARY outcome

Timeframe: Up to 5 years

Population: All Cohort -1 treated and eligible patients

Overall response rate to combination pralatrexate and oxaliplatin as assessed by Response Evaluation Criteria in Solid Tumors version 1.1. Objective responses will be confirmed 4 weeks after first documentation of response. Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1) for target lesions and assessed by MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), \>=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR.

Outcome measures

Outcome measures
Measure
Treatment (Pralatrexate, Oxaliplatin)
n=31 Participants
Patients receive pralatrexate IV over 3-5 minutes and oxaliplatin IV over 2 hours on day 1. Courses repeat every 2 weeks in the absence of disease progression or unacceptable toxicity. Oxaliplatin will be discontinued after 12 courses. Laboratory Biomarker Analysis: Correlative studies Oxaliplatin: Given IV Pralatrexate: Given IV
Overall Response Rate
26 percentage of participants
Interval 12.0 to 45.0

SECONDARY outcome

Timeframe: Up to 30 days after the last dose of study drug(s)

Population: All treated and eligible patients

Number of participants with an adverse event. Please refer to the adverse event reporting for more detail. Incidence of toxicity as assessed by National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0

Outcome measures

Outcome measures
Measure
Treatment (Pralatrexate, Oxaliplatin)
n=35 Participants
Patients receive pralatrexate IV over 3-5 minutes and oxaliplatin IV over 2 hours on day 1. Courses repeat every 2 weeks in the absence of disease progression or unacceptable toxicity. Oxaliplatin will be discontinued after 12 courses. Laboratory Biomarker Analysis: Correlative studies Oxaliplatin: Given IV Pralatrexate: Given IV
Number of Participants With an Adverse Event
35 participants

SECONDARY outcome

Timeframe: From the date of study enrollment to the time of death from any cause, assessed up to 5 years

Population: All treated and eligible patients.

Estimated using the Kaplan-Meier method and proportional hazards models.

Outcome measures

Outcome measures
Measure
Treatment (Pralatrexate, Oxaliplatin)
n=35 Participants
Patients receive pralatrexate IV over 3-5 minutes and oxaliplatin IV over 2 hours on day 1. Courses repeat every 2 weeks in the absence of disease progression or unacceptable toxicity. Oxaliplatin will be discontinued after 12 courses. Laboratory Biomarker Analysis: Correlative studies Oxaliplatin: Given IV Pralatrexate: Given IV
Overall Survival (OS)
7.2 months
Interval 6.4 to 10.8

SECONDARY outcome

Timeframe: From the date of study enrollment to the first observation of progressive disease, assessed up to 5 years

Population: All treated and eligible patients

Estimated using the Kaplan-Meier method and proportional hazards models.

Outcome measures

Outcome measures
Measure
Treatment (Pralatrexate, Oxaliplatin)
n=35 Participants
Patients receive pralatrexate IV over 3-5 minutes and oxaliplatin IV over 2 hours on day 1. Courses repeat every 2 weeks in the absence of disease progression or unacceptable toxicity. Oxaliplatin will be discontinued after 12 courses. Laboratory Biomarker Analysis: Correlative studies Oxaliplatin: Given IV Pralatrexate: Given IV
Time to Progression (TTP)
5.1 months
Interval 3.4 to 6.4

OTHER_PRE_SPECIFIED outcome

Timeframe: From the date of study enrollment up to 5 years

Population: All treated and eligible patients

Kaplan-Meier estimates of median survival time for each genotype

Outcome measures

Outcome measures
Measure
Treatment (Pralatrexate, Oxaliplatin)
n=35 Participants
Patients receive pralatrexate IV over 3-5 minutes and oxaliplatin IV over 2 hours on day 1. Courses repeat every 2 weeks in the absence of disease progression or unacceptable toxicity. Oxaliplatin will be discontinued after 12 courses. Laboratory Biomarker Analysis: Correlative studies Oxaliplatin: Given IV Pralatrexate: Given IV
Overall Survival (OS) for SNP ATIC/AICART - s10932606 Genotypes
C
10.22 months
Interval 6.74 to 12.39
Overall Survival (OS) for SNP ATIC/AICART - s10932606 Genotypes
T
18.71 months
Interval 2.33 to 31.38
Overall Survival (OS) for SNP ATIC/AICART - s10932606 Genotypes
TC
4.63 months
Interval 2.3 to 5.45

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline

Population: All treated participants that had enough tissue to perform microdissection to collect epithelial cells for subsequent microRNA profiling.

Mean microRNAs expression of mi-215-5p in tumor tissues of responders and non-responders using a microfabricated device called a gene chip.

Outcome measures

Outcome measures
Measure
Treatment (Pralatrexate, Oxaliplatin)
n=29 Participants
Patients receive pralatrexate IV over 3-5 minutes and oxaliplatin IV over 2 hours on day 1. Courses repeat every 2 weeks in the absence of disease progression or unacceptable toxicity. Oxaliplatin will be discontinued after 12 courses. Laboratory Biomarker Analysis: Correlative studies Oxaliplatin: Given IV Pralatrexate: Given IV
MicroRNA Expression - miR-215-5p
Responders: CR+PR
6.6 Arbitrary fluorescent intensity
Interval 5.7 to 7.1
MicroRNA Expression - miR-215-5p
Non responders: stable disease/progression
5.6 Arbitrary fluorescent intensity
Interval 5.3 to 5.9

Adverse Events

Treatment (Pralatrexate, Oxaliplatin)

Serious events: 10 serious events
Other events: 35 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Treatment (Pralatrexate, Oxaliplatin)
n=35 participants at risk
Patients receive pralatrexate IV over 3-5 minutes and oxaliplatin IV over 2 hours on day 1. Courses repeat every 2 weeks in the absence of disease progression or unacceptable toxicity. Oxaliplatin will be discontinued after 12 courses. Laboratory Biomarker Analysis: Correlative studies Oxaliplatin: Given IV Pralatrexate: Given IV
Cardiac disorders
Myocardial infarction
2.9%
1/35 • Number of events 2
Gastrointestinal disorders
Gastric haemorrhage
2.9%
1/35 • Number of events 2
Gastrointestinal disorders
Stomatitis
2.9%
1/35 • Number of events 2
General disorders
Disease progression
2.9%
1/35 • Number of events 2
General disorders
Pyrexia
2.9%
1/35 • Number of events 2
Infections and infestations
Infection
2.9%
1/35 • Number of events 4
Infections and infestations
Lung infection
2.9%
1/35 • Number of events 2
Infections and infestations
Urinary tract infection
2.9%
1/35 • Number of events 2
Investigations
Haemoglobin
2.9%
1/35 • Number of events 4
Metabolism and nutrition disorders
Dehydration
8.6%
3/35 • Number of events 6
Metabolism and nutrition disorders
Hypokalaemia
2.9%
1/35 • Number of events 2
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Neoplasm
2.9%
1/35 • Number of events 2
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Neoplasm malignant
2.9%
1/35 • Number of events 2
Nervous system disorders
Haemorrhage intracranial
2.9%
1/35 • Number of events 2
Respiratory, thoracic and mediastinal disorders
Aspiration
2.9%
1/35 • Number of events 2
Respiratory, thoracic and mediastinal disorders
Dyspnoea
2.9%
1/35 • Number of events 2
Respiratory, thoracic and mediastinal disorders
Pleural effusion
2.9%
1/35 • Number of events 2

Other adverse events

Other adverse events
Measure
Treatment (Pralatrexate, Oxaliplatin)
n=35 participants at risk
Patients receive pralatrexate IV over 3-5 minutes and oxaliplatin IV over 2 hours on day 1. Courses repeat every 2 weeks in the absence of disease progression or unacceptable toxicity. Oxaliplatin will be discontinued after 12 courses. Laboratory Biomarker Analysis: Correlative studies Oxaliplatin: Given IV Pralatrexate: Given IV
Blood and lymphatic system disorders
Anaemia
25.7%
9/35 • Number of events 37
Blood and lymphatic system disorders
Leukopenia
34.3%
12/35 • Number of events 65
Blood and lymphatic system disorders
Lymphopenia
34.3%
12/35 • Number of events 32
Blood and lymphatic system disorders
Neutropenia
34.3%
12/35 • Number of events 42
Blood and lymphatic system disorders
Thrombocytopenia
28.6%
10/35 • Number of events 50
Cardiac disorders
Tachycardia
8.6%
3/35 • Number of events 6
Eye disorders
Dry eye
2.9%
1/35 • Number of events 4
Eye disorders
Eye discharge
5.7%
2/35 • Number of events 4
Eye disorders
Eye pain
2.9%
1/35 • Number of events 2
Eye disorders
Lacrimation increased
2.9%
1/35 • Number of events 2
Eye disorders
Vision blurred
5.7%
2/35 • Number of events 6
Gastrointestinal disorders
Abdominal pain
20.0%
7/35 • Number of events 16
Gastrointestinal disorders
Abdominal pain lower
2.9%
1/35 • Number of events 1
Gastrointestinal disorders
Abdominal pain upper
8.6%
3/35 • Number of events 6
Gastrointestinal disorders
Ascites
2.9%
1/35 • Number of events 4
Gastrointestinal disorders
Constipation
37.1%
13/35 • Number of events 42
Gastrointestinal disorders
Diarrhoea
40.0%
14/35 • Number of events 71
Gastrointestinal disorders
Dry mouth
8.6%
3/35 • Number of events 6
Gastrointestinal disorders
Dyspepsia
2.9%
1/35 • Number of events 2
Gastrointestinal disorders
Dysphagia
17.1%
6/35 • Number of events 20
Gastrointestinal disorders
Faecal incontinence
2.9%
1/35 • Number of events 2
Gastrointestinal disorders
Flatulence
2.9%
1/35 • Number of events 2
Gastrointestinal disorders
Gastrooesophageal reflux disease
2.9%
1/35 • Number of events 2
Gastrointestinal disorders
Impaired gastric emptying
2.9%
1/35 • Number of events 2
Gastrointestinal disorders
Mouth haemorrhage
2.9%
1/35 • Number of events 2
Gastrointestinal disorders
Nausea
62.9%
22/35 • Number of events 96
Gastrointestinal disorders
Odynophagia
2.9%
1/35 • Number of events 2
Gastrointestinal disorders
Oesophageal stenosis
2.9%
1/35 • Number of events 2
Gastrointestinal disorders
Oesophagitis
2.9%
1/35 • Number of events 2
Gastrointestinal disorders
Stomatitis
85.7%
30/35 • Number of events 169
Gastrointestinal disorders
Vomiting
48.6%
17/35 • Number of events 55
General disorders
Asthenia
2.9%
1/35 • Number of events 2
General disorders
Chest pain
11.4%
4/35 • Number of events 8
General disorders
Chills
2.9%
1/35 • Number of events 2
General disorders
Early satiety
2.9%
1/35 • Number of events 2
General disorders
Fatigue
65.7%
23/35 • Number of events 103
General disorders
Gait disturbance
2.9%
1/35 • Number of events 2
General disorders
Infusion site extravasation
2.9%
1/35 • Number of events 2
General disorders
Localised oedema
2.9%
1/35 • Number of events 2
General disorders
Oedema
2.9%
1/35 • Number of events 2
General disorders
Oedema peripheral
22.9%
8/35 • Number of events 25
General disorders
Pain
2.9%
1/35 • Number of events 2
General disorders
Pyrexia
8.6%
3/35 • Number of events 6
General disorders
Temperature intolerance
8.6%
3/35 • Number of events 10
Hepatobiliary disorders
Hyperbilirubinaemia
5.7%
2/35 • Number of events 8
Immune system disorders
Hypersensitivity
8.6%
3/35 • Number of events 6
Infections and infestations
Abdominal wall infection
2.9%
1/35 • Number of events 2
Infections and infestations
Infection
2.9%
1/35 • Number of events 4
Infections and infestations
Nasopharyngitis
2.9%
1/35 • Number of events 2
Infections and infestations
Oral candidiasis
5.7%
2/35 • Number of events 4
Infections and infestations
Oral infection
2.9%
1/35 • Number of events 2
Infections and infestations
Pneumonia
2.9%
1/35 • Number of events 2
Infections and infestations
Skin infection
2.9%
1/35 • Number of events 4
Infections and infestations
Upper respiratory tract infection
2.9%
1/35 • Number of events 2
Injury, poisoning and procedural complications
Contusion
2.9%
1/35 • Number of events 2
Injury, poisoning and procedural complications
Feeding tube complication
2.9%
1/35 • Number of events 2
Injury, poisoning and procedural complications
Infusion related reaction
2.9%
1/35 • Number of events 2
Injury, poisoning and procedural complications
Road traffic accident
2.9%
1/35 • Number of events 2
Injury, poisoning and procedural complications
Thermal burn
2.9%
1/35 • Number of events 2
Injury, poisoning and procedural complications
Wound dehiscence
2.9%
1/35 • Number of events 2
Investigations
Alanine aminotransferase increased
5.7%
2/35 • Number of events 10
Investigations
Aspartate aminotransferase
14.3%
5/35 • Number of events 16
Investigations
Aspartate aminotransferase increased
34.3%
12/35 • Number of events 40
Investigations
Blood alkaline phosphatase
17.1%
6/35 • Number of events 15
Investigations
Blood alkaline phosphatase increased
25.7%
9/35 • Number of events 27
Investigations
Blood creatinine
11.4%
4/35 • Number of events 10
Investigations
Blood creatinine increased
5.7%
2/35 • Number of events 3
Investigations
Carbon dioxide increased
2.9%
1/35 • Number of events 2
Investigations
Haemoglobin
34.3%
12/35 • Number of events 75
Investigations
Haemoglobin decreased
25.7%
9/35 • Number of events 47
Investigations
Lymphocyte count decreased
25.7%
9/35 • Number of events 49
Investigations
Neutrophil count decreased
14.3%
5/35 • Number of events 13
Investigations
Platelet count decreased
14.3%
5/35 • Number of events 21
Investigations
Weight decreased
40.0%
14/35 • Number of events 42
Investigations
White blood cell count decreased
17.1%
6/35 • Number of events 18
Metabolism and nutrition disorders
Decreased appetite
25.7%
9/35 • Number of events 25
Metabolism and nutrition disorders
Dehydration
22.9%
8/35 • Number of events 16
Metabolism and nutrition disorders
Hypercalcaemia
5.7%
2/35 • Number of events 4
Metabolism and nutrition disorders
Hyperglycaemia
2.9%
1/35 • Number of events 2
Metabolism and nutrition disorders
Hyperkalaemia
20.0%
7/35 • Number of events 21
Metabolism and nutrition disorders
Hypernatraemia
11.4%
4/35 • Number of events 8
Metabolism and nutrition disorders
Hypoalbuminaemia
51.4%
18/35 • Number of events 69
Metabolism and nutrition disorders
Hypocalcaemia
8.6%
3/35 • Number of events 6
Metabolism and nutrition disorders
Hypoglycaemia
2.9%
1/35 • Number of events 2
Metabolism and nutrition disorders
Hypokalaemia
11.4%
4/35 • Number of events 8
Metabolism and nutrition disorders
Hypomagnesaemia
2.9%
1/35 • Number of events 2
Metabolism and nutrition disorders
Hyponatraemia
22.9%
8/35 • Number of events 27
Musculoskeletal and connective tissue disorders
Arthralgia
2.9%
1/35 • Number of events 6
Musculoskeletal and connective tissue disorders
Back pain
14.3%
5/35 • Number of events 10
Musculoskeletal and connective tissue disorders
Flank pain
2.9%
1/35 • Number of events 2
Musculoskeletal and connective tissue disorders
Joint effusion
2.9%
1/35 • Number of events 2
Musculoskeletal and connective tissue disorders
Muscular weakness
14.3%
5/35 • Number of events 9
Musculoskeletal and connective tissue disorders
Musculoskeletal pain
2.9%
1/35 • Number of events 2
Musculoskeletal and connective tissue disorders
Myalgia
2.9%
1/35 • Number of events 4
Musculoskeletal and connective tissue disorders
Neck pain
5.7%
2/35 • Number of events 6
Musculoskeletal and connective tissue disorders
Pain in extremity
11.4%
4/35 • Number of events 8
Musculoskeletal and connective tissue disorders
Pain in jaw
2.9%
1/35 • Number of events 2
Nervous system disorders
Dizziness
17.1%
6/35 • Number of events 16
Nervous system disorders
Dizziness postural
2.9%
1/35 • Number of events 2
Nervous system disorders
Dysaesthesia
5.7%
2/35 • Number of events 4
Nervous system disorders
Dysgeusia
31.4%
11/35 • Number of events 24
Nervous system disorders
Headache
17.1%
6/35 • Number of events 11
Nervous system disorders
Neuropathy peripheral
2.9%
1/35 • Number of events 2
Nervous system disorders
Paraesthesia
11.4%
4/35 • Number of events 22
Nervous system disorders
Peripheral sensory neuropathy
77.1%
27/35 • Number of events 106
Nervous system disorders
Peroneal nerve palsy
2.9%
1/35 • Number of events 4
Nervous system disorders
Sinus headache
2.9%
1/35 • Number of events 2
Psychiatric disorders
Anxiety
5.7%
2/35 • Number of events 6
Psychiatric disorders
Confusional state
2.9%
1/35 • Number of events 2
Psychiatric disorders
Delirium
2.9%
1/35 • Number of events 2
Psychiatric disorders
Hallucination
2.9%
1/35 • Number of events 2
Psychiatric disorders
Insomnia
2.9%
1/35 • Number of events 4
Psychiatric disorders
Restlessness
2.9%
1/35 • Number of events 2
Renal and urinary disorders
Chromaturia
2.9%
1/35 • Number of events 2
Renal and urinary disorders
Dysuria
2.9%
1/35 • Number of events 2
Renal and urinary disorders
Haematuria
2.9%
1/35 • Number of events 2
Renal and urinary disorders
Nephrolithiasis
2.9%
1/35 • Number of events 2
Renal and urinary disorders
Pollakiuria
5.7%
2/35 • Number of events 3
Renal and urinary disorders
Urinary incontinence
2.9%
1/35 • Number of events 2
Respiratory, thoracic and mediastinal disorders
Cough
11.4%
4/35 • Number of events 10
Respiratory, thoracic and mediastinal disorders
Dysphonia
14.3%
5/35 • Number of events 14
Respiratory, thoracic and mediastinal disorders
Dyspnoea
11.4%
4/35 • Number of events 8
Respiratory, thoracic and mediastinal disorders
Dyspnoea exertional
2.9%
1/35 • Number of events 2
Respiratory, thoracic and mediastinal disorders
Epistaxis
34.3%
12/35 • Number of events 24
Respiratory, thoracic and mediastinal disorders
Hiccups
8.6%
3/35 • Number of events 6
Respiratory, thoracic and mediastinal disorders
Hypoxia
2.9%
1/35 • Number of events 2
Respiratory, thoracic and mediastinal disorders
Nasal congestion
5.7%
2/35 • Number of events 4
Respiratory, thoracic and mediastinal disorders
Oropharyngeal pain
2.9%
1/35 • Number of events 2
Respiratory, thoracic and mediastinal disorders
Pleural effusion
2.9%
1/35 • Number of events 4
Respiratory, thoracic and mediastinal disorders
Wheezing
5.7%
2/35 • Number of events 4
Skin and subcutaneous tissue disorders
Alopecia
5.7%
2/35 • Number of events 4
Skin and subcutaneous tissue disorders
Decubitus ulcer
2.9%
1/35 • Number of events 2
Skin and subcutaneous tissue disorders
Dry skin
5.7%
2/35 • Number of events 6
Skin and subcutaneous tissue disorders
Hyperhidrosis
2.9%
1/35 • Number of events 2
Skin and subcutaneous tissue disorders
Night sweats
2.9%
1/35 • Number of events 2
Skin and subcutaneous tissue disorders
Rash
17.1%
6/35 • Number of events 12
Skin and subcutaneous tissue disorders
Rash papular
2.9%
1/35 • Number of events 2
Skin and subcutaneous tissue disorders
Skin hyperpigmentation
2.9%
1/35 • Number of events 2
Skin and subcutaneous tissue disorders
Skin ulcer
2.9%
1/35 • Number of events 2
Surgical and medical procedures
Medical diet
2.9%
1/35 • Number of events 2
Vascular disorders
Deep vein thrombosis
14.3%
5/35 • Number of events 10
Vascular disorders
Embolism
2.9%
1/35 • Number of events 2
Vascular disorders
Hot flush
2.9%
1/35 • Number of events 2
Vascular disorders
Hypertension
2.9%
1/35 • Number of events 2
Vascular disorders
Hypotension
14.3%
5/35 • Number of events 10
Vascular disorders
Orthostatic hypotension
2.9%
1/35 • Number of events 2
Vascular disorders
Superior vena cava syndrome
2.9%
1/35 • Number of events 2

Additional Information

Senior Administrator, Compliance - Clinical Research Services

Roswell Park Cancer Institute

Phone: 716-845-2300

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place