A Phase II Study of Conversion Surgery After IP Paclitaxel With XELOX Chemotherapy in AGC With Peritoneal Dissemination

NCT ID: NCT04797923

Last Updated: 2021-03-15

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

UNKNOWN

Clinical Phase

PHASE2

Total Enrollment

43 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-12-01

Study Completion Date

2021-12-30

Brief Summary

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

Advanced gastric cancer combined with peritoneal seeind has dismal prognosis with poor response to systemic chemotherapy and with rapid aggravation of symptoms such as abdominal pain, ileus, and poor nutritional intake. Intraperitoneal (IP) chemotherapy through IP port or catheter has lower complication than HIPEC (hyperthermic intraperitoneal chemotherapy) and can deliver higher dose of chemotherapy with less systemic toxicity. IP chemotherapy combined with systemic chemotehrapy showed benefit in several clinical trials, despite lack of statistical significance in phase 3 clinical trial. Proper dose/combination of chemotherapeutic agents and indication of IP chemotherapy should be investigated through prospective, large-scale clinical trials.

Conversion surgery after cytotoxic chemotherapy showed improved survival in retrospective studies. Our hypothesis is that IP chemotherapy combined with systemic chemotherpay (capecitabine + oxaliplatin) would improve success rate of conversion surgery with R0 resection. In the present study, the treatment regimen consists of intraperitoneal paclitaxel combined with oxaliplatin and capecitabine (XELOX), and will be performed following surgery.

Detailed Description

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

Conditions

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

Advanced Gastric Cancer Peritoneal Carcinomatosis

Study Design

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

Allocation Method

NA

Intervention Model

SINGLE_GROUP

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.

Intraperitoneal paclitaxel with systemic chemotherapy

Group Type EXPERIMENTAL

1. Treatment: IP chemotherapy + Systemic chemotherapy

Intervention Type DRUG

1\. Treatment: IP chemotherapy + Systemic chemotherapy Day1 + Day 8: IP Paclitaxel 40 mg/m2 every 3 weeks Day1: IV Oxaliplatin 100 mg/m2 every 3 weeks Day 1\~14: Capecitabine 1000 mg/m2 PO, BID every 3 weeks

2. Response evaluation after 4 cycles of IP + systemic chemotherapy

Intervention Type PROCEDURE

2\. Response evaluation after 4 cycles of IP + systemic chemotherapy

* Conversion surgery will be done following diagnostic laparoscopy after 4 cycles of IP + systemic chemotherapy. Additional 4 cycles of IP + systemic chemotherapy wille be done following surgery.
* If surgery is impossible after 4th cycle, four additional cycles of treatment will be done, and convertibility will be evaluated.
* IP chemotherapy should not exceed total of 8 cycles.

Interventions

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

1. Treatment: IP chemotherapy + Systemic chemotherapy

1\. Treatment: IP chemotherapy + Systemic chemotherapy Day1 + Day 8: IP Paclitaxel 40 mg/m2 every 3 weeks Day1: IV Oxaliplatin 100 mg/m2 every 3 weeks Day 1\~14: Capecitabine 1000 mg/m2 PO, BID every 3 weeks

Intervention Type DRUG

2. Response evaluation after 4 cycles of IP + systemic chemotherapy

2\. Response evaluation after 4 cycles of IP + systemic chemotherapy

* Conversion surgery will be done following diagnostic laparoscopy after 4 cycles of IP + systemic chemotherapy. Additional 4 cycles of IP + systemic chemotherapy wille be done following surgery.
* If surgery is impossible after 4th cycle, four additional cycles of treatment will be done, and convertibility will be evaluated.
* IP chemotherapy should not exceed total of 8 cycles.

Intervention Type PROCEDURE

Eligibility Criteria

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

Inclusion Criteria

1. Histologically or cytologically confirmed advanced gastric cancer adenocarcinoma
2. Peritoneal metastasis histopathologically confirmed by laparoscopy or laparotomy and PCI \<12 (including patients with no gross peritoneal lesion and cytology positive)
3. No prior surgery for curative aim and previous chemotherapy for recurrent/metastatic gastric cancer
4. Patient who is willing and able to provide written informed consent/assent for the trial
5. Age between 19 and 75 years
6. Measurable lesion according to RECIST 1.1 criteria
7. ECOG performance status 0-1
8. Have adequate organ function

* ANC ≥ 2,000/uL,
* hemoglobin ≥ 9.0g/dL
* platelet ≥ 100,000/uL
* total Bilirubin: ≤ 1.5 × upper normal limit
* Creatinine ≤ 1.5 × upper normal limit or Creatinine clearance ≥ 60ml/min
* AST/ALT ≤ 3.0 x upper normal limit
* Albumin ≥ 2.5 g/dL
* PT or INR, aPTT ≤ 1.5 × upper normal limit
9. Should agree to use an adequate method of contraception

Exclusion Criteria

1. Previous systemic chemotherapy for metastatic/recurrent advanced gastric cancer
2. Patient who has distant metastasis or para-aortic lymph node metastasis or retroperitoneal metastasis except peritoneal metastasis. (But the patient who has ovarian metastasis with resectable status can be enrolled.)
3. Primary tumor cannot be resected because of direct invasion to other important organ. (But, if the invaded organ can be resected together, such as spleen, gallbladder, distal pancreas, and liver, the patient can be enrolled)
4. BMI ≤ 18.5 kg/m2
5. HER2 positive patient (IHC 3+, 2+ with in situ hybridization +)
6. Remnant gastric cancer
7. Intolerable to oral intake of chemotherapeutic agent or have malabsorption syndrome
8. Known additional malignancy that is progressing or requires active treatment in recent 3 years (excluding skin basal cell carcinoma, skin squamous cell carcinoma, thyroid cancer, or in situ cervix cancer that has undergone potentially curative therapy)
9. Symtomatic CNS metastasis and/or leptomeningeal seeding
10. Autoimmune disease in recent 2 years requiring systemic therapy
11. Clinically significant heart disease
12. Peripheral neuropathy ≥ Grade 2
13. Pregnant or breastfeeding, or expecting to conceive or father children within the projected duration of the trial, starting with the pre-screening or screening visit through 120 days after the last dose of trial treatment
14. History of HIV, HBV, or HCV
Minimum Eligible Age

19 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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

Gangnam Severance Hospital

OTHER

Sponsor Role lead

Responsible Party

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

Seung Ho Choi

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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

Gangnam Severacne Hospital

Seoul, Gangnnam, South Korea

Site Status RECRUITING

Countries

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

South Korea

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Seung Ho Choi, M.D., Ph.D.

Role: CONTACT

82-2-2019-3374

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Seung Ho Choi

Role: primary

82-2-2019-3374

Other Identifiers

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

3-2020-0237

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.