Oxaliplatin, Gefitinib, and Radiation Therapy in Treating Patients With Locally Advanced or Metastatic Esophageal Cancer
This study is currently recruiting patients.
Sponsored by: |
Roswell Park Cancer Institute |
Information provided by: |
National Cancer Institute (NCI) |
Purpose
RATIONALE: Drugs used in chemotherapy, such as oxaliplatin, work in different ways to stop tumor cells from dividing so they
stop growing or die. Radiation therapy uses high-energy x-rays to damage tumor cells. Gefitinib may stop the growth of tumor
cells by blocking the enzymes necessary for their growth. Combining oxaliplatin and gefitinib with radiation therapy may kill
more tumor cells.
PURPOSE: Phase I/II trial to study the effectiveness of combining oxaliplatin and gefitinib with radiation therapy in treating
patients who have locally advanced or metastatic esophageal cancer.
Condition
|
Treatment or Intervention |
Phase |
Adenocarcinoma of the Esophagus recurrent esophageal cancer stage II esophageal cancer stage III esophageal cancer stage IV esophageal cancer squamous cell carcinoma of the esophagus
|
Drug: gefitinib Drug: oxaliplatin Procedure: anti-cytokine therapy Procedure: antiangiogenesis therapy Procedure: biological response modifier therapy Procedure: chemosensitization/potentiation Procedure: chemotherapy Procedure: conventional surgery Procedure: enzyme inhibitor therapy Procedure: growth factor antagonist therapy Procedure: neoadjuvant therapy Procedure: protein tyrosine kinase inhibitor therapy Procedure: radiation therapy Procedure: radiosensitization Procedure: surgery
|
Phase I Phase II
|
MedlinePlus related topics: Cancer; Cancer Alternative Therapy; Esophageal Cancer
Study Type: Interventional
Study Design: Treatment
Official Title: Phase I/II Study of Oxaliplatin and Gefitinib in Combination With Radiotherapy in Patients With Locally Advanced or Metastatic
Adenocarcinoma or Squamous Cell Carcinoma of the Esophagus or Gastroesophageal Junction
Further Study Details:
OBJECTIVES: Primary
- Determine the maximum tolerated dose of oxaliplatin when administered with gefitinib and radiotherapy in patients with locally
advanced or metastatic adenocarcinoma or squamous cell carcinoma of the esophagus or gastroesophageal junction. (Phase I)
- Determine the response rate in patients treated with this regimen. (Phase II)
Secondary
- Determine time to tumor progression and median survival in patients treated with this regimen.
- Determine quality of life in patients treated with this regimen.
- Determine the safety of this regimen in these patients.
OUTLINE: This is a phase I, open-label, dose-escalation study of oxaliplatin followed by a phase II study.
- Patients receive oxaliplatin IV over 2 hours on days 1, 15, and 29. Beginning on day 1, patients undergo radiotherapy once
daily, 5 days a week, for 5.5 weeks. Patients also receive oral gefitinib once daily on days 1-365. Treatment continues in
the absence of disease progression or unacceptable toxicity Approximately 3-6 weeks after the completion of chemoradiotherapy,
patients are evaluated. Some patients undergo surgical resection* and possibly receive a second course of oxaliplatin (IV
over 2 hours on days 1, 15, and 29) 4-8 weeks after surgery. If surgery is not indicated, some patients may receive an additional
course of oxaliplatin.
Cohorts of 3-6 patients receive escalating doses of oxaliplatin until the maximum tolerated dose is determined. The MTD is
defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity.
- Patients receive oxaliplatin, gefitinib, and radiotherapy as in phase I at the MTD. Some patients then either undergo surgical
resection* and/or begin a second course of oxaliplatin as in phase I. NOTE: *Oral gefitinib is discontinued ≥ 7 days before
surgery and is restarted when the patient has recovered.
Quality of life is assessed at baseline, 5-6 weeks, and then every 2-3 months for 1 year.
Patients are followed every 2-3 months for 1 year.
PROJECTED ACCRUAL: Approximately 3-45 patients (3-12 for phase I and 12-33 for phase II) will be accrued for this study within
2 years.
Eligibility
Ages Eligible for Study:
18 Years and above,
Genders Eligible for Study:
Both
DISEASE CHARACTERISTICS:
- Histologically confirmed adenocarcinoma or squamous cell carcinoma of the esophagus or gastroesophageal (GE) junction
- Locally advanced or metastatic disease by clinical staging, including esophagastroduodenoscopy and esophageal ultrasound
- Stage T2, N0 disease and beyond
- Bulk of tumor must be in the esophagus of patients with GE junction tumor
- Bronchoscopy is required if primary esophageal tumor is < 26 cm from the incisors
- No brain metastases
PATIENT CHARACTERISTICS: Age
Performance status
Life expectancy
Hematopoietic
- WBC ≥ 3,000/mm^3
- Granulocyte count ≥ 1,500/mm^3
- Platelet count > 100,000/mm^3
Hepatic
- Bilirubin normal
- ALT and AST ≤ 2.5 times upper limit of normal (ULN)
- Alkaline phosphatase ≤ 2.5 times ULN
Renal
Cardiovascular
- No symptomatic congestive heart failure
- No unstable angina pectoris
- No cardiac arrhythmia
Pulmonary
- No clinically active interstitial lung disease
- Patients with chronic stable asymptomatic radiographic changes are eligible
Other
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective double-method (including barrier) contraception during and for 3 months after study participation
- No peripheral neuropathy ≥ grade II
- No severe hypersensitivity to gefitinib or any of its excipients
- No history of allergy to platinum-based compounds or antiemetics administered with protocol-directed chemotherapy
- No active or ongoing infection
- No other uncontrolled illness
- No other significant clinical disorder or laboratory finding that would preclude study participation
PRIOR CONCURRENT THERAPY: Biologic therapy
- No concurrent colony-stimulating factors during course 1 of study therapy
Chemotherapy
- More than 4 weeks since prior chemotherapy
Endocrine therapy
- Concurrent steroid therapy allowed
Radiotherapy
- More than 4 weeks since prior radiotherapy
Surgery
Other
- More than 30 days since prior non-approved or investigational drugs
- No concurrent administration of any of the following:
- Phenytoin
- Carbamazepine
- Rifampin
- Barbiturates
- Highly-active antiretroviral therapy (HAART)
- Hypericum perforatum (St. John's wort)
- No other concurrent investigational agents or therapy
Location
and Contact
Information
New York Roswell Park Cancer Institute, Buffalo,
New York,
14263-0001,
United States; Recruiting
Milind Javle, MD
716-845-8183
Study chairs or principal investigators
Milind Javle, MD, Principal Investigator, Roswell Park Cancer Institute
More Information
Clinical trial summary from the National Cancer Institute's PDQ® database
Study ID Numbers:
CDR0000389253; RPCI-PH-04603; ZENECA-IRUSIRES0303
Record last reviewed:
September 2004
Record first received:
October 6, 2004
ClinicalTrials.gov Identifier:
NCT00093652Health Authority: Unspecified
ClinicalTrials.gov processed this record on 2004-11-08