Evaluation for the Individualization of Therapy in Adenocarcinomas of the Gastroesophageal Junction

NCT ID: NCT02287129

Last Updated: 2023-11-28

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

75 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-12-05

Study Completion Date

2020-08-07

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Metabolic and Molecular Response evaluation for the individualization of therapy in adenocarcinomas of the gastroesophageal junction by evaluation of the R0 resection rate for patients with metabolically (ie, according to PET criteria) chemotherapy-resistant locally advanced AEG, who receive an intensified neoadjuvant chemoradiotherapy (INRCT). Additonal efforts will be done by investigation of molecular and metabolic biomarkers in relation to their predictive and prognostic value by correlating them with histopathologic responses and clinical outcome in an exploratory approach.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Adenocarcinomas of the esophagus and the esophagogastric junction (AEG) are clinically-topographically divided into subtypes I-III according to the Siewert classification and show an increased incidence. Neoadjuvant and/or perioperative chemotherapy or preoperative radiochemotherapy is well established in the management of AEG. However, a significant number of patients do not respond to preoperative chemotherapy, suffering from toxicity and facing a worse outcome due to lower R0 resection rates. Previous results from the MUNICON-1 and MUNICON-2 trials have shown that PET-based therapy individualization can be successfully integrated in neoadjuvant treatment algorithms.

Tumor-free resection edges (R0) constitute the greatest prognostic advantage in terms of overall survival. However, the R0 resection rates for patients who, according to early metabolic response evaluation, have not responded to the chemotherapy, have not been satisfactory, even after conversion to an - albeit moderate - radiochemotherapy in the MUNICON-2 trial. Thus, this patient population (so-called non responders) so far lack a beneficial neoadjuvant therapy modality.

Based on these results, the primary goal of MEMORI study is to evaluate the R0 resection rate for patients with metabolically (ie, according to PET criteria) chemotherapy-resistant locally advanced AEG, who receive an intensified neoadjuvant chemoradiotherapy (INRCT). Secondary it is planned to investigate molecular and metabolic biomarkers in relation to their predictive and prognostic value by correlating them with histopathologic responses and clinical outcome in an exploratory approach.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Adenocarcinoma of the Esophagogastric Junction

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Non-Responder

Oxaliplatin Epirubicin Capecitabine 5-FU Carboplatin Paclitaxel Radiation Biopsy

Group Type EXPERIMENTAL

Oxaliplatin

Intervention Type DRUG

130 mg/m2

Epirubicin

Intervention Type DRUG

50 mg/m2

Capecitabine

Intervention Type DRUG

625 mg/m2

5-FU

Intervention Type DRUG

200 mg/m2

Carboplatin

Intervention Type DRUG

2 mg/ml min

Paclitaxel

Intervention Type DRUG

50 mg/m2

radiation

Intervention Type RADIATION

total dosage 41,4 Gy

Biopsy

Intervention Type PROCEDURE

translational analysis

Responder

Oxaliplatin Epirubicin Capecitabine 5-FU Biopsy

Group Type ACTIVE_COMPARATOR

Oxaliplatin

Intervention Type DRUG

130 mg/m2

Epirubicin

Intervention Type DRUG

50 mg/m2

Capecitabine

Intervention Type DRUG

625 mg/m2

5-FU

Intervention Type DRUG

200 mg/m2

Biopsy

Intervention Type PROCEDURE

translational analysis

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Oxaliplatin

130 mg/m2

Intervention Type DRUG

Epirubicin

50 mg/m2

Intervention Type DRUG

Capecitabine

625 mg/m2

Intervention Type DRUG

5-FU

200 mg/m2

Intervention Type DRUG

Carboplatin

2 mg/ml min

Intervention Type DRUG

Paclitaxel

50 mg/m2

Intervention Type DRUG

radiation

total dosage 41,4 Gy

Intervention Type RADIATION

Biopsy

translational analysis

Intervention Type PROCEDURE

Other Intervention Names

Discover alternative or legacy names that may be used to describe the listed interventions across different sources.

Oxaliplan Epi Teva Xeloda 5-FU medac Carboplatin SUN Taxomedac intensitive neoadjuvant radiochemotherapy (INRCT) esophagogastroduodenoscopy

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Histologically confirmed AEG I-III
* Potentially R0 - resectable AEG and primary tumor category UT2 -4
* Functional operability : Exclusion of OP - limiting comorbidities
* Intense FDG tracer uptake of the tumor during Baseline PET/CT examination and thus suitability for monitoring and early response prediction by FDG - PET ( \[ 18F \] - FDG uptake in the tumor at baseline \> 1.35 x liver SUV + 2 x standard deviation of the liver SUV)
* Performance status (ECOG ) 0 or 1
* Age : ≥ 18
* creatinine clearance \> 60ml/min measured in a 24 h urine or calculated with the Cockgroft -Gault formula
* bilirubin ≤ 1.5 times upper limit of normal , serum transaminases (GOT

/ GPT ) ≤ 3 times ULN
* leukocytes ≥ 3.5 g / l, platelet ≥ 100 g / l
* Negative pregnancy test (determination of beta- HCG in urine or serum) in women of childbearing potential
* A signed consent form after implementation of medical education

Exclusion Criteria

* Existing distant metastases (M1b)
* Tumor infiltration into the tracheobronchial system
* Previous radiotherapy targeted at the thorax
* Lack of ability of the patient to adhere to the protocol rules
* Manifest heart failure despite optimal medication\> NYHA I
* existing angina pectoris at rest or undergoing stress without clarification via interventional cardiology and / or myocardial infarction within the last 6 months
* Existing pregnancy or lactation
* childbearing or fertility without using recognized safe methods of contraception
* Coexisting other malignant diseases with the exception of a non-melanomatuous, localized skin tumor or carcinoma in situ of the cervix
* absence of a signed consent form
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Technical University of Munich

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Jens Siveke, Prof. Dr.

Role: PRINCIPAL_INVESTIGATOR

II. Medizinische Klinik, Klinikum rechts der Isar (MRI) der TUM,Ismaninger Str. 22

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

2nd department of the Medical Clinic of the Technical University Munich

Munich, Bavaria, Germany

Site Status

Countries

Review the countries where the study has at least one active or historical site.

Germany

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

MEM-0000-SIV-0028-I

Identifier Type: -

Identifier Source: org_study_id