Multicentric Randomised Trial for Resectable Gastric Cancer

NCT ID: NCT02931890

Last Updated: 2024-05-02

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

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE2

Total Enrollment

207 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-12-21

Study Completion Date

2029-03-31

Brief Summary

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The CRITICS-II trial aims to identify the optimal preoperative regimen in resectable gastric cancer by comparing three investigational treatment arms: chemotherapy vs. chemotherapy and subsequent chemoradiotherapy vs. chemoradiotherapy. The rationale behind this trial design is based on the following concepts:

* Preoperative treatment is associated with better patient compliance than postoperative regimens
* Preoperative treatment increases the likelihood of disease downsizing/downstaging and radical R0 resections
* Preoperative paclitaxel/carboplatin-based concurrent chemoradiotherapy and DOC chemotherapy are effective, feasible and safe regimens

Detailed Description

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Conditions

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Gastric Cancer

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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neo-adjuvant chemotherapy followed by surgery

4 courses of 3 weekly DOC followed by surgery

Group Type ACTIVE_COMPARATOR

Docetaxel

Intervention Type DRUG

3 weekly course of docetaxel i.v in arm 1 and 2

Oxaliplatin

Intervention Type DRUG

3 weekly course oxaliplatin as a 2 hr i.v. in arm 1 and 2

Capecitabine

Intervention Type DRUG

oral capecitabine in arm 1 and 2

gastrectomy

Intervention Type PROCEDURE

resection of gastric cancer after pre-operative chemotherapy for all arms

neo-adjuvant chemo and subsequent CRT followed by surgery

2 courses of 3 weekly DOC and subsequent CRT followed by surgery

Group Type ACTIVE_COMPARATOR

Docetaxel

Intervention Type DRUG

3 weekly course of docetaxel i.v in arm 1 and 2

Oxaliplatin

Intervention Type DRUG

3 weekly course oxaliplatin as a 2 hr i.v. in arm 1 and 2

Capecitabine

Intervention Type DRUG

oral capecitabine in arm 1 and 2

gastrectomy

Intervention Type PROCEDURE

resection of gastric cancer after pre-operative chemotherapy for all arms

radiotherapy of gastric cancer

Intervention Type RADIATION

5 weeks of radiation, 5 times a week with a total of 45 Gy (in arm 2 and 3)

Paclitaxel

Intervention Type DRUG

5 weeks of paclitaxel i.v once a week (in arm 2 and 3)

Carboplatin

Intervention Type DRUG

5 weeks of carboplatin i.v once a week (in arm 2 and 3)

neo-adjuvant chemoradiotherapy followed by surgery

chemoradiotherapy followed by surgery

Group Type ACTIVE_COMPARATOR

gastrectomy

Intervention Type PROCEDURE

resection of gastric cancer after pre-operative chemotherapy for all arms

radiotherapy of gastric cancer

Intervention Type RADIATION

5 weeks of radiation, 5 times a week with a total of 45 Gy (in arm 2 and 3)

Paclitaxel

Intervention Type DRUG

5 weeks of paclitaxel i.v once a week (in arm 2 and 3)

Carboplatin

Intervention Type DRUG

5 weeks of carboplatin i.v once a week (in arm 2 and 3)

Interventions

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Docetaxel

3 weekly course of docetaxel i.v in arm 1 and 2

Intervention Type DRUG

Oxaliplatin

3 weekly course oxaliplatin as a 2 hr i.v. in arm 1 and 2

Intervention Type DRUG

Capecitabine

oral capecitabine in arm 1 and 2

Intervention Type DRUG

gastrectomy

resection of gastric cancer after pre-operative chemotherapy for all arms

Intervention Type PROCEDURE

radiotherapy of gastric cancer

5 weeks of radiation, 5 times a week with a total of 45 Gy (in arm 2 and 3)

Intervention Type RADIATION

Paclitaxel

5 weeks of paclitaxel i.v once a week (in arm 2 and 3)

Intervention Type DRUG

Carboplatin

5 weeks of carboplatin i.v once a week (in arm 2 and 3)

Intervention Type DRUG

Other Intervention Names

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Taxotere Eloxatin Xeloda

Eligibility Criteria

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Inclusion Criteria

* TNM 8th ed stage IB-IIIC gastric cancer (histologically proven); tumour bulk has to be in the stomach but may involve gastro-oesophageal junction
* WHO \< 2
* Age ≥ 18 yrs
* Resectable adenocarcinoma of the stomach or gastro-oesophageal junction
* No prior abdominal radiotherapy
* Haematology: Hb ≥5.0 mmol/l; leukocytes≥3.0x109/l, neutrophils ≥1.5x109/l, thrombocytes ≥100x109/l
* Renal function: serum creatinine ≤1.25x ULN, creatinine clearance ≥ 50 ml/min (calculated by Cockcroft and Gault formula) Liver function: total bilirubin ≤1.5x ULN, alkaline phosphatase and ASAT/ALAT ≤ 3x ULN
* At staging laparoscopy (mandatory) obtained biopsies of suspected peritoneal lesions and/or substantial free peritoneal fluid if any should be pathologically proven tumor negative
* Written informed consent
* Expected adequacy of follow-up
* Caloric intake≥1500 kcal/day, verified by a dietician before registration.
* if caloric intake is \< 1500 kcal/day or if bodyweight has decreased \> 10% over the last 6 months or \> 5% over the last month, dietary intervention such as oral nutritional support or enteral tube feeding is mandatory

Exclusion Criteria

* T1N0 disease (assessed by endoscopic ultrasound)
* Distant metastases
* Inoperable patients; due to technical surgery-related factors or general condition
* Previous malignancy, except adequately treated non-melanoma skin cancer or in-situ cancer of the cervix uteri; in case of a previous other malignancy with a disease-free period≥5 years, inclusion can be accepted after consultation of the principal investigator
* Solitary functioning kidney that will be within the radiation field
* Major surgery within 4 weeks prior to study treatment start, or lack of complete recovery from the effects of major surgery
* Uncontrolled (bacterial) infections
* Significant concomitant diseases preventing the safe administration of study drugs or likely to interfere with study assessments
* Uncontrolled angina pectoris, cardiac failure or clinically significant arrhythmias
* Continuous use of immunosuppressive agents equivalent to \>10 mg daily prednison
* Concurrent use of the antiviral agent sorivudine or chemically related analogues, such as brivudine
* Neurotoxicity \> CTC grade 1
* Pregnancy or breast feeding
* Patients (M/F) with reproductive potential not implementing adequate contraceptive measures
* Gastric or gastro-esophageal stent within radiation field
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The Netherlands Cancer Institute

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Marcel Verheij, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

The Netherlands Cancer Institute

Locations

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Zuyderland Medisch Centrum

Sittard-Geleen, Limburg, Netherlands

Site Status

Viecuri Medisch Centrum

Venlo, Limburg, Netherlands

Site Status

Elkerliek

Deurne, North Brabant, Netherlands

Site Status

Catharina Ziekenhuis

Eindhoven, North Brabant, Netherlands

Site Status

Maxima Medisch Centrum

Eindhoven, North Brabant, Netherlands

Site Status

St. Anna Zorggroep

Geldrop, North Brabant, Netherlands

Site Status

Elkerliek

Helmond, North Brabant, Netherlands

Site Status

Instituut Verbeeten

Tilburg, North Brabant, Netherlands

Site Status

Bernhoven

Uden, North Brabant, Netherlands

Site Status

Maxima Medisch Centrum

Veldhoven, North Brabant, Netherlands

Site Status

Spaarne Gasthuis

Hoofddorp, North Holland, Netherlands

Site Status

Ziekenhuisgroep Twente

Almelo, Overijssel, Netherlands

Site Status

Deventer Ziekenhuis

Deventer, Overijssel, Netherlands

Site Status

Medisch Spectrum Twente

Enschede, Overijssel, Netherlands

Site Status

Medisch Centrum Leeuwarden

Leeuwarden, Provincie Friesland, Netherlands

Site Status

Radiotherapeutisch Instituut Friesland

Leeuwarden, Provincie Friesland, Netherlands

Site Status

Reinier de Graaf Gasthuis

Delft, South Holland, Netherlands

Site Status

Leids Universitair Medisch Centrum

Leiden, South Holland, Netherlands

Site Status

Jeroen Bosch Ziekenhuis

's-Hertogenbosch, , Netherlands

Site Status

Netherlands Cancer Instituut

Amsterdam, , Netherlands

Site Status

Academisch Medisch Centrum

Amsterdam, , Netherlands

Site Status

Rijnstate

Arnhem, , Netherlands

Site Status

Ziekenhuis Gelderse Vallei

Ede, , Netherlands

Site Status

Universitair Medisch Centrum Groningen

Groningen, , Netherlands

Site Status

Ziekenhuis St Antonius

Nieuwegein, , Netherlands

Site Status

HAGA ziekenhuis

The Hague, , Netherlands

Site Status

Elisabeth Tweesteden Ziekenhuis

Tilburg, , Netherlands

Site Status

Universitair Medisch Centrum Utrecht

Utrecht, , Netherlands

Site Status

Countries

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Netherlands

References

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Slagter AE, Jansen EPM, van Laarhoven HWM, van Sandick JW, van Grieken NCT, Sikorska K, Cats A, Muller-Timmermans P, Hulshof MCCM, Boot H, Los M, Beerepoot LV, Peters FPJ, Hospers GAP, van Etten B, Hartgrink HH, van Berge Henegouwen MI, Nieuwenhuijzen GAP, van Hillegersberg R, van der Peet DL, Grabsch HI, Verheij M. CRITICS-II: a multicentre randomised phase II trial of neo-adjuvant chemotherapy followed by surgery versus neo-adjuvant chemotherapy and subsequent chemoradiotherapy followed by surgery versus neo-adjuvant chemoradiotherapy followed by surgery in resectable gastric cancer. BMC Cancer. 2018 Sep 10;18(1):877. doi: 10.1186/s12885-018-4770-2.

Reference Type DERIVED
PMID: 30200910 (View on PubMed)

Other Identifiers

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NL 55436.031.015

Identifier Type: REGISTRY

Identifier Source: secondary_id

2015-004627-31

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

M15CRI

Identifier Type: -

Identifier Source: org_study_id

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