Neoadjuvant Study Using Trastuzumab or Trastuzumab With Pertuzumab in Gastric or Gastroesophageal Junction Adenocarcinoma

NCT ID: NCT02205047

Last Updated: 2025-07-31

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

172 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-07-15

Study Completion Date

2024-12-31

Brief Summary

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The purpose of this study is to find out whether either trastuzumab or the combination of trastuzumab and pertuzumab with standard chemotherapy shows more activity against gastro-oesophageal adenocarcinoma than standard chemotherapy given before and after surgery and it can be safely administered.

Detailed Description

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This is a randomized phase II trial with an internal control. The randomization will be a 1:2:2 randomization (control: experimental arm 1: experimental arm 2). Potentially eligible patients will be screened centrally for the HER-2 status. After confirmation of HER-2 positive disease, eligible patients will be centrally randomized through the EORTC randomization system. A minimization technique will be used for random treatment allocation between the three treatment arms. Stratification will be done by histological subtype (intestinal/non-intestinal); Korea versus Europe; stage II versus III; node positive versus node negative.

Conditions

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Malignant Neoplasm of Stomach Malignant Neoplasm of Cardio-esophageal Junction of Stomach Epidermal Growth Factor Receptor (EGFR) Protein Overexpression

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Standard chemotherapy

Cisplatin/capecitabine or cisplatin/5-fluorouracil

Group Type ACTIVE_COMPARATOR

Cisplatin

Intervention Type DRUG

5-fluorouracil or Capecitabine

Intervention Type DRUG

gastrectomy

Intervention Type PROCEDURE

D2 gastrectomy

Experimental arm 1

Cisplatin/capecitabine plus trastuzumab or cisplatin/5-fluorouracil plus trastuzumab

Group Type EXPERIMENTAL

Cisplatin

Intervention Type DRUG

5-fluorouracil or Capecitabine

Intervention Type DRUG

Trastuzumab

Intervention Type DRUG

gastrectomy

Intervention Type PROCEDURE

D2 gastrectomy

Experimental arm 2

cisplatin/capecitabine plus trastuzumab and pertuzumab or cisplatin/5-fluorouracil plus trastuzumab and pertuzumab

Group Type EXPERIMENTAL

Cisplatin

Intervention Type DRUG

5-fluorouracil or Capecitabine

Intervention Type DRUG

Trastuzumab

Intervention Type DRUG

Pertuzumab

Intervention Type DRUG

gastrectomy

Intervention Type PROCEDURE

D2 gastrectomy

Interventions

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Cisplatin

Intervention Type DRUG

5-fluorouracil or Capecitabine

Intervention Type DRUG

Trastuzumab

Intervention Type DRUG

Pertuzumab

Intervention Type DRUG

gastrectomy

D2 gastrectomy

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Histologically proven, gastric or gastroesophageal (GE)-junction adenocarcinoma (Siewert I-III)
* Patient medically fit for gastrectomy/oesophagogastrectomy as decided by the investigator
* Age ≥ 18 years
* WHO performance status 0 - 1
* HER-2 overexpression
* Amenable to gastrectomy/oesophagectomy
* The cardiac ejection fraction (LVEF), as determined by echocardiography, multiple gated acquisition scan (MUGA) or cardiac MRI should be at least 50 %
* Adequate organ function
* written informed consent
* For women who are not postmenopausal (\> 12 months of non-therapy induced amenorrhea) or surgically sterile (absence of ovaries and/or uterus): agreement to remain abstinent or use single or combined contraceptive methods that result in a failure rate of \< 1% per year during the treatment period and for at least 12 months after the last treatment dose
* For men: agreement to remain abstinent or use a condom plus an additional contraceptive method that together result in a failure rate of \< 1% per year during the treatment period and for at least 12 months after the last dose of study treatment. Abstinence is only acceptable if it is in line with the preferred and usual lifestyle of the patient. Periodic abstinence (e.g. calendar, ovulation, symptothermal, or postovulation methods) and withdrawal are not acceptable methods for contraception.

Exclusion Criteria

* Absence of distant metastases on CT scan of thorax and abdomen
* prior chemo- or antibody therapy
* history of significant cardiac disease
* current uncontrolled hypertension
* known hypersensitivity to the components of trastuzumab, pertuzumab, cisplatin, 5-follow-up or capecitabine
* known dihydropyrimidine dehydrogenase (DPD) deficiency
* ongoing or concomitant use of the antiviral drug sorivudine or its chemically related analogs, such as brivudine
* chronic treatment with high-dose intravenous corticosteroids
* previous malignancy within the last 5 years, with the exception of adequately treated cervical carcinoma in situ, localized non-melanoma skin cancer, or other curatively treated cancer without impact on the patient's overall prognosis according to the judgment of the investigator.
* psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule
* pregnant or breast feeding
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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European Organisation for Research and Treatment of Cancer - EORTC

NETWORK

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Anna Dorothea Wagner, MD

Role: STUDY_CHAIR

Centre hospitalier universitaire vaudois, Lausanne

Locations

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University Hospital Gent

Ghent, Flanders, Belgium

Site Status

North Estonia Medical Centre

Tallinn, , Estonia

Site Status

CHRU de Besancon - Hopital Jean Minjoz

Besançon, , France

Site Status

CHRU de Lille - Hopital Huriez

Lille, , France

Site Status

CHU de Bordeaux - Group Hospitalier Sud - Hopital Haut-Lévêque

Pessac, , France

Site Status

CHU de Reims - Hôpital Robert Debré

Reims, , France

Site Status

Institut Gustave Roussy

Villejuif, , France

Site Status

Charite - Universitaetsmedizin Berlin - Campus Virchow-Klinikum

Berlin, , Germany

Site Status

Universitaetsklinikum Carl Gustav Carus

Dresden, , Germany

Site Status

Kliniken Essen-Mitte - Evang. Huyssens-Stiftung

Essen, , Germany

Site Status

Universitaetsmedizin Goettingen - Georg-August Universitaet

Göttingen, , Germany

Site Status

Asklepios Kliniken GmbH - Asklepios Klinik Barmbek

Hamburg, , Germany

Site Status

SLK-Kliniken Heilbronn GmbH

Heilbronn, , Germany

Site Status

Onkologische Unter-Ems (Leer-Papenburg-Emden)

Leer, , Germany

Site Status

Universitaetsklinikum Leipzig

Leipzig, , Germany

Site Status

Johannes Gutenberg Universitaetskliniken - Mainz University Medical Center

Mainz, , Germany

Site Status

Ludwig-Maximilians-Universitaet München - Campus Grosshadern

München, , Germany

Site Status

Technische Universität München - Klinikum Rechts der Isar

München, , Germany

Site Status

Azienda Ospedaliera Papa Giovanni XXIII

Bergamo, , Italy

Site Status

Istituto Europeo di Oncologia

Milan, , Italy

Site Status

Azienda Ospedaliera Ordine Mauriziano di Torino

Torino, , Italy

Site Status

The Netherlands Cancer Institute-Antoni Van Leeuwenhoekziekenhuis

Amsterdam, , Netherlands

Site Status

Academisch Medisch Centrum - UMC Universiteit van Amsterdam - site: VUMC

Amsterdam, , Netherlands

Site Status

Oslo University Hospital - Radiumhospitalet

Oslo, , Norway

Site Status

Instituto Portugues de Oncologia de Lisboa Francisco Gentil

Lisbon, , Portugal

Site Status

Instituto Portugues De Oncologia - Centro Do Porto

Porto, , Portugal

Site Status

National Cancer Centre Singapore

Singapore, , Singapore

Site Status

Asan Medical Center

Seoul, , South Korea

Site Status

Gangnam Severance Hospital

Seoul, , South Korea

Site Status

Hallym University Sacred Heart Hospital

Seoul, , South Korea

Site Status

Asan Medical Center

Seoul, , South Korea

Site Status

Gangnam Severance Hospital

Seoul, , South Korea

Site Status

Hallym University Sacred Heart Hospital

Seoul, , South Korea

Site Status

Severance Hospital YUCM

Seoul, , South Korea

Site Status

Severance Hospital, Yonsei University Health System (YUCM)

Seoul, , South Korea

Site Status

The Catholic University of Korea-St. Vincent's Hospital

Suwon-Si Gyeonggi-do, , South Korea

Site Status

Institut Catala d'Oncologia - ICO L'Hospitalet

L'Hospitalet de Llobregat, Barcelona, Spain

Site Status

ICO Badalona (Institut Catala d'Oncologia) - Hospital Germans Trias i Pujol

Badalona, , Spain

Site Status

Hospital Universitari Vall d'Hebron - Institut Oncologia

Barcelona, , Spain

Site Status

ICO Girona - Hospital Dr Josep Trueta (Institut Catala d'Oncologia)

Girona, , Spain

Site Status

Hospital Universitario Ramon y Cajal

Madrid, , Spain

Site Status

Hospital Clinico Universitario De Valencia

Valencia, , Spain

Site Status

Hôpitaux Universitaires de Genève - HUG

Geneva, , Switzerland

Site Status

Centre Hospitalier Universitaire Vaudois

Lausanne, , Switzerland

Site Status

University Hospitals Birmingham NHS - UHB-Queen Elisabeth MC

Birmingham, , United Kingdom

Site Status

University College London Hospitals (UCLH) - NHS Foundation Trust

London, , United Kingdom

Site Status

The Christie NHS Foundation Trust

Manchester, , United Kingdom

Site Status

Royal Marsden Hospital - site: Sutton, Surrey

Sutton, , United Kingdom

Site Status

Countries

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Belgium Estonia France Germany Italy Netherlands Norway Portugal Singapore South Korea Spain Switzerland United Kingdom

References

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Wagner AD, Grabsch HI, Mauer M, Marreaud S, Caballero C, Thuss-Patience P, Mueller L, Elme A, Moehler MH, Martens U, Kang YK, Rha SY, Cats A, Tokunaga M, Lordick F. EORTC-1203-GITCG - the "INNOVATION"-trial: Effect of chemotherapy alone versus chemotherapy plus trastuzumab, versus chemotherapy plus trastuzumab plus pertuzumab, in the perioperative treatment of HER2 positive, gastric and gastroesophageal junction adenocarcinoma on pathologic response rate: a randomized phase II-intergroup trial of the EORTC-Gastrointestinal Tract Cancer Group, Korean Cancer Study Group and Dutch Upper GI-Cancer group. BMC Cancer. 2019 May 24;19(1):494. doi: 10.1186/s12885-019-5675-4.

Reference Type DERIVED
PMID: 31126258 (View on PubMed)

Integration of Trastuzumab, with or without Pertuzumab, into Perioperative Chemotherapy of HER2- Positive Stomach Cancer: The INNOVATION Trial (EORTC-1203-GITCG). Oncol Res Treat. 2016;39(3):153-4; discussion 155. doi: 10.1159/000444702. No abstract available.

Reference Type DERIVED
PMID: 27486629 (View on PubMed)

Other Identifiers

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2014-000722-38

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

MO28922

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

EORTC-1203-GITCG

Identifier Type: -

Identifier Source: org_study_id

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