Prediction of Benefit From Adjuvant Chemotherapy for pT1N1 Gastric Cancer

NCT ID: NCT03485105

Last Updated: 2018-04-09

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

UNKNOWN

Total Enrollment

1000 participants

Study Classification

OBSERVATIONAL

Study Start Date

2017-11-01

Study Completion Date

2019-11-01

Brief Summary

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To conduct a retrospective study to prove a hypothesis of "adjuvant chemotherapy provides survival benefit for patients of CTX-benefit group in gastric cancer of pT1N1, especially in high-risk group". This study is a pilot study and the result will be used as a reference for the upcoming prospective randomized controlled trial for same issue including estimating sample size. Two high-volume hospitals (Yonsei University Severance Hospital and Samsung Hospital) will participant this pilot study.

FFPE sample blocks and clinical information pertaining to the patients who satisfied with selection criteria will be collected from two institutions. The primary end point of this study is disease-free survival (DFS) that is defined as the time from surgery to death or gastric cancer recurrence whichever occurred first; and overall survival (OS) that is defined as time from surgery to death by any causes. Clinical information such as age, sex, histology, Lauren classification, depth of invasion, number of retrieved and metastatic lymph nodes, sizes of tumor, location of tumor, gross type, lympho-vascular invasion, received chemotherapy or not will be centralized.

One or 2 of 3mm core of tumor will be punched from FFPE and it will be delivered through Eppendorf tube to laboratory (Novomics Co. Ltd., Seoul, Korea). RNA will be extracted from the tissue and the pattern of RNA expression will be evaluated and each sample will be categorized into three risk group (high, intermediate, low risk group) and two predictive group (CTX-benefit and no-benefit group) by GMP-grade nProfiler 1TM Stomach Cancer Assay Kit (Novomics Co. Ltd., Seoul, Korea). Both clinical information and classification will be delivered to independent statisticians who are responsible to conduct statistical analyses.

Detailed Description

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Conditions

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Gastric Cancer

Study Design

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Observational Model Type

COHORT

Study Time Perspective

RETROSPECTIVE

Study Groups

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CTX-benefit group

CTX-benefit group: based on the result of nProfiler Stomach cancer assay kit which was decided by expression level of mRNA, this group will be beneficial from adjuvant chemotherapy

No interventions assigned to this group

no-benefit group

no-benefit group: based on the result of nProfiler Stomach cancer assay kit which was decided by expression level of mRNA, this group will not be beneficial from adjuvant chemotherapy

No interventions assigned to this group

high-risk group

high-risk group: based on the result of nProfiler Stomach cancer assay kit which was decided by expression level of mRNA, the prognosis of this group will be worse compared to others regardless of the response to adjuvant chemotherapy

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

1. Pathologically confirmed gastric adenocarcinoma
2. Patients who received R0 resection with curative intent surgery
3. pT1 (mucosa/submucosa) N1(one or two metastatic lymph nodes) M0
4. patients received surgery with lymph node dissection of D1 + or more
5. number of retrieved lymph nodes \>15
6. Formalin-Fixed Paraffin-Embedded cancer tissues are available
7. Adults over 19 years

Exclusion Criteria

1. Patients received pre-operative chemotherapy or radiotherapy
2. Cancer in remnant stomach (history of gastrectomy)
3. in hospital mortality or died within 30 days after surgery
4. FFPE is not available
Minimum Eligible Age

20 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Yonsei University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Division of Upper Gastrointestinal Surgery, Department of Surgery, Yonsei University College of Medicine

Seoul, , South Korea

Site Status

Countries

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South Korea

References

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Cheong JH, Yang HK, Kim H, Kim WH, Kim YW, Kook MC, Park YK, Kim HH, Lee HS, Lee KH, Gu MJ, Kim HY, Lee J, Choi SH, Hong S, Kim JW, Choi YY, Hyung WJ, Jang E, Kim H, Huh YM, Noh SH. Predictive test for chemotherapy response in resectable gastric cancer: a multi-cohort, retrospective analysis. Lancet Oncol. 2018 May;19(5):629-638. doi: 10.1016/S1470-2045(18)30108-6. Epub 2018 Mar 19.

Reference Type BACKGROUND
PMID: 29567071 (View on PubMed)

Nakajima T, Nashimoto A, Kitamura M, Kito T, Iwanaga T, Okabayashi K, Goto M. Adjuvant mitomycin and fluorouracil followed by oral uracil plus tegafur in serosa-negative gastric cancer: a randomised trial. Gastric Cancer Surgical Study Group. Lancet. 1999 Jul 24;354(9175):273-7. doi: 10.1016/s0140-6736(99)01048-x.

Reference Type BACKGROUND
PMID: 10440302 (View on PubMed)

Shin HB, An JY, Lee SH, Choi YY, Kim JW, Sohn SS, Noh SH. Is adjuvant chemotherapy necessary in pT1N1 gastric cancer? BMC Cancer. 2017 Apr 22;17(1):287. doi: 10.1186/s12885-017-3265-x.

Reference Type BACKGROUND
PMID: 28431518 (View on PubMed)

Noh SH, Park SR, Yang HK, Chung HC, Chung IJ, Kim SW, Kim HH, Choi JH, Kim HK, Yu W, Lee JI, Shin DB, Ji J, Chen JS, Lim Y, Ha S, Bang YJ; CLASSIC trial investigators. Adjuvant capecitabine plus oxaliplatin for gastric cancer after D2 gastrectomy (CLASSIC): 5-year follow-up of an open-label, randomised phase 3 trial. Lancet Oncol. 2014 Nov;15(12):1389-96. doi: 10.1016/S1470-2045(14)70473-5. Epub 2014 Oct 15.

Reference Type BACKGROUND
PMID: 25439693 (View on PubMed)

Sasako M, Sakuramoto S, Katai H, Kinoshita T, Furukawa H, Yamaguchi T, Nashimoto A, Fujii M, Nakajima T, Ohashi Y. Five-year outcomes of a randomized phase III trial comparing adjuvant chemotherapy with S-1 versus surgery alone in stage II or III gastric cancer. J Clin Oncol. 2011 Nov 20;29(33):4387-93. doi: 10.1200/JCO.2011.36.5908. Epub 2011 Oct 17.

Reference Type BACKGROUND
PMID: 22010012 (View on PubMed)

Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer. 2011 Jun;14(2):101-12. doi: 10.1007/s10120-011-0041-5. No abstract available.

Reference Type BACKGROUND
PMID: 21573743 (View on PubMed)

Other Identifiers

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4-2017-0914

Identifier Type: -

Identifier Source: org_study_id

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