RATIONALE: Drugs used in chemotherapy, such as S-1 and irinotecan, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more tumor cells. Giving chemotherapy before surgery may shrink the tumor so that it can be completely removed. PURPOSE: This phase II trial is studying how well giving S-1 together with irinotecan works in treating patients who are undergoing surgery for locally advanced stomach cancer.
OBJECTIVES: Primary * Determine the efficacy of neoadjuvant S-1 and irinotecan in patients with locally advanced gastric cancer. Secondary * Determine the histological response in patients treated with this regimen. * Determine the overall survival of patients treated with this regimen. * Determine the progression-free survival of patients treated with this regimen. * Determine the toxicity of this regimen in these patients. * Determine postoperative morbidity in patients treated with this regimen. * Determine the rate of potentially curative surgery in patients treated with this regimen. OUTLINE: This is a multicenter study. Patients receive oral S-1 on days 1-21 and irinotecan IV over 90 minutes on days 1 and 15. Treatment repeats every 28 days for 2 courses in the absence of disease progression or unacceptable toxicity. Patients then undergo gastrectomy with lymphadenectomy. After surgery, patients resume treatment with S-1 alone as before for 1 year. PROJECTED ACCRUAL: A total of 70 patients will be accrued for this study.
Study Type
INTERVENTIONAL
Purpose
TREATMENT
Masking
NONE
Enrollment
70
Yamamoto Kumiai General Hospital
Noshiro, Akita, Japan
Fukushima Medical University Hospital
Fukushima, Fukushima, Japan
Asahikawa Kosei General Hospital
Asahikawa, Hokkaido, Japan
Kobe City General Hospital
Kobe, Hyōgo, Japan
Iwate Medical University Hospital
Morioka, Iwate, Japan
Tsuruoka Municipal Shonai Hospital
Tsuruoka, Yamagata, Japan
Yamagata Prefectural Central Hospital
Yamagata, Yamagata, Japan
Tumor shrinkage
Historical tumor shrinkage
Overall survival
Progression-free survival
Median survival
Safety
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