S1+ Paclitaxel (IV&IP) + Bevacizumab (IP) Versus S1+Oxaliplatin as First-line Treatment in Gastric Cancer With Malignant Ascites

NCT ID: NCT03990103

Last Updated: 2019-06-19

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

Clinical Phase

PHASE2

Total Enrollment

66 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-11-01

Study Completion Date

2022-04-30

Brief Summary

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The purpose of this study is to compare the efficacy of S1 plus paclitaxel (intravenous injection \& intraperitoneal injection) plus bevacizumab (intraperitoneal injection) vs. S1 plus oxaliplatin intravenous injection as first-line treatment in gastric or gastroesophageal junctional adenocarcinoma with malignant ascites.

Detailed Description

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This is a prospective, open-label, multicenter clinical trial, to compare the efficacy of S1 plus paclitaxel (intravenous injection \& intraperitoneal injection) plus bevacizumab (intraperitoneal injection) versus S1 plus oxaliplatin intravenous injection as first-line treatment in gastric or gastroesophageal junctional adenocarcinoma with malignant ascites. A total of 66 patients who are diagnosed with gastric or gastroesophageal junctional adenocarcinoma will be allocated to receive either S1 orally administration plus paclitaxel intravenous injection \& intraperitoneal injection plus bevacizumab intraperitoneal injection, or to receive S1 orally administration plus oxaliplatin intravenous injection. The primary end point is ascites response rate at 6 weeks. The secondary end points include the median overall survival (OS), progression-free survival (PFS), time to treatment failure (TTF), objective response rate (ORR), puncture free survival, volume of drainage, the quality of life (QoL) and safety.

Conditions

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Metastatic Gastric Adenocarcinoma

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Experimental arm

S1+Paclitaxel (IV\&IP)+Bevacizumab (IP)

Group Type EXPERIMENTAL

S1

Intervention Type DRUG

80-120 mg/day, PO, D1-14, every 21 days

Paclitaxel

Intervention Type DRUG

20 mg/m2/day, IP, D1-3; 50 mg/m2, IV, D1; 70 mg/m2, IV, D8; every 21 days

Bevacizumab

Intervention Type DRUG

200 mg, IP, D1, every 21 days

Control arm

S1+Oxaliplatin (IV)

Group Type ACTIVE_COMPARATOR

S1

Intervention Type DRUG

80-120 mg/day, PO, D1-14, every 21 days

Oxaliplatin

Intervention Type DRUG

130 mg/m2, IV, D1, every 21 days

Interventions

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S1

80-120 mg/day, PO, D1-14, every 21 days

Intervention Type DRUG

Paclitaxel

20 mg/m2/day, IP, D1-3; 50 mg/m2, IV, D1; 70 mg/m2, IV, D8; every 21 days

Intervention Type DRUG

Bevacizumab

200 mg, IP, D1, every 21 days

Intervention Type DRUG

Oxaliplatin

130 mg/m2, IV, D1, every 21 days

Intervention Type DRUG

Other Intervention Names

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Tegafur Gimeracil Oteracil Potassium Capsule Paclitaxel Injection Avastin ® ELOXATIN®

Eligibility Criteria

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Inclusion Criteria

* 18 years ≥ Age≤ 70 years, male or female
* Pathologically confirmed adenocarcinoma of the gastric or gastro-oesophageal junction with inoperable locally advanced or recurrent and/or metastatic disease; with medium amount of malignant ascites which can be catheterized.
* Diagnostic criteria for malignant ascites (meet any of the following criteria): ascites cytology positive; or imaging or pathological confirmed peritoneal metastases.
* No prior anti-tumor treatment to the metastatic disease; an interval of at least 6 months from the last adjuvant chemotherapy.
* Eastern Cooperative Oncology Group (ECOG) performance status( PS) score 0-1.
* Normal major organ function, and laboratory tests must meet the following criteria: hemoglobin (HGB) ≥ 90 g/L, neutrophil count ≥ 1.5×109/L, platelet count ≥ 100×109/L, total bilirubin (TBil) ≤ 1.5 upper normal limitation (UNL), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 2.5 UNL, serum creatinine (Cr) ≤ 1 UNL; creatinine clearance rate (CCr) ≥ 60 ml/min (calculated using the Cockcroft-Gault equation).
* International Normalized Ratio (INR) ≤ 1.5 and partial prothrombin time (PPT) or activated partial thromboplastin time (APTT) ≤ 1.5 UNL within 7 days before enrollment.
* Life expectancy of at least 12 weeks
* Signed informed consent (ICF)
* For women of child bearing potential, a negative serum or urine pregnancy test result should be obtained with 7 days before enrollment; Women of childbearing potential and men must agree to use adequate contraception before entering the program until at least 8 weeks after the last study drug administration.

Exclusion Criteria

* Known hypersensitivity or allergic to any of the study drugs, study drug classes, or excipients in the formulation.
* Subject received chemotherapy to the metastatic disease (except adjuvant/neoadjuvant chemotherapy administered 24 weeks before enrollment)
* Subject with other malignancies, except for non-melanoma skin cancer or in-situ cervical carcinoma under adequate treatment, or other treated malignancies without evidence of recurrent for 5 years.
* Anti-tumor cytotoxic drug therapy within 14 days prior to enrollment(longer washout time interval might needed depends on drug characteristics)
* Uncontrolled hypertension which cannot be reduced to normal range by antihypertensive agents \[Systolic Blood Pressure(SBP) \>140 mmHg, diastolic blood pressure (DBP) \> 90 mmHg\], coronary artery disease \> grade 1, arrhythmia \> grade 1 \[including corrected QT(QTc) interval prolongation: QTc\>450 ms for male,QTc\>470 ms for female\], grade 1 heart failure.
* Proteinuria ≥ ++,or persistent proteinuria \> 1.0 g/24 hours
* Presence of any toxicity ≥ grade 1 according to NCI-CTCAE except for alopecia.
* Arterial or venous thrombotic or embolic events such as cerebrovascular accident (including transient ischemic attacks, cerebral hemorrhage、cerebral infarction), deep vein thrombosis and pulmonary embolism within 12 months before enrollment.
* Bowel obstruction within 6 weeks before enrollment.
* Surgical treatment was performed within 6 weeks before enrollment. Subject should recover from any major surgery.
* Serious uncontrolled systemic illness or medical condition or uncontrolled infections, including but not limited to: uncontrollable ventricular arrhythmias, history of documented myocardial infarction within 3 months, uncontrollable epileptic dementia, unstable spinal compression, superior vena cava syndrome, extensive bilateral interstitial pulmonary disease by high-resolution computed tomography (HRCT), or any neurological or mental abnormalities which affect compliance.
* Human immunodeficiency virus (HIV) positive
* Pregnancy or lactation women
* Cannot be orally administered medication
* Subject with a tendency for gastrointestinal hemorrhage. Including: Black stool or hematemesis within 2 months; For subjects positive in occult test with unresected primary lesion, if the principle investigator in each center considers with possibility of gastrointestinal hemorrhage, the subject could not be enrolled.
* Subject with malignant pleural effusion need medical intervention.
* A history or evidence of hereditary hemorrhagic constitution or coagulation disorder that increases the risk of bleeding
* Subjects with central nerve system metastases
* Have been enrolled in other clinical trial with investigational drug treatment within the 4 weeks of start of study treatment
* For subject with bone metastases, palliative radiotherapy was given 4 weeks before enrollment (radiation field \>5%).
* Any other disease or condition that the investigator considers not suitable for participating in this clinical trial.
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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China Medical University, China

OTHER

Sponsor Role lead

Responsible Party

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Yunpeng Liu

Director

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Yunpeng Liu, M.D.

Role: PRINCIPAL_INVESTIGATOR

China Medical University, China

Locations

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The First Affiliated Hospital of China Medical University

Shenyang, Liaoning, China

Site Status RECRUITING

Countries

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China

Central Contacts

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Yunpeng Liu, M.D.

Role: CONTACT

86-24-83282312

Xiujuan Qu, M.D.

Role: CONTACT

86-24-83282312

Facility Contacts

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Yunpeng Liu, Ph.D

Role: primary

Xiujuan Qu, M.D.

Role: backup

Other Identifiers

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CLOG1704

Identifier Type: -

Identifier Source: org_study_id

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