The primary objective of this study is to compare median overall survival of the test arm (docetaxel and S-1) to the control arm (S-1 only) in subjects with advanced or recurrent gastric cancer.
Seven-hundred and fifty thousand of new gastric cancer cases are diagnosed worldwide per year. Advanced gastric cancer (AGC) is considered nearly incurable with less than 10% of subjects alive 5 years after diagnosis. Therefore, new treatment regimens are needed for subjects with AGC. S-1, a new oral fluoropyrimidine which consists of the 5-FU prodrug tegafur (ftorafur, FT) and two enzyme inhibitors, CDHP (5-chloro-2,4-dihydroxypyridine) and OXO (potassium oxonate), in a molar ratio of 1(FT):0.4 (CDHP):1(OXO) is commercially available since late 90'in Japan. Phase II trials have demonstrated that S-1 is active, as a single agent, for the treatment of gastric (RR 44.6%), colorectal (RR 37.4%), head and neck, breast, non-small cell lung, and pancreatic cancers. In gastric cancer, phase III trials (JCOG 9912) comparing 5-FU alone and CPT-11/CDDP combination are currently underway and these results are awaited. Despite of JCOG 9912 study is ongoing, 80% of patients of AGC are already treated by S-1, because of high RR and convenience use for out-patient basis. P-II studies S-1/CDDP, S-1/CPT-11 and S-1/Docetaxel showed high RR(55-76%) and long MST(12-14M). Furthermore, P-III studies are already conducted S-1 vs. S-1/CDDP and S-1 vs. S-1/CPT-11 in Japan. The aim of this study is to compare S-1/Docetaxel vs. S-1 alone in the patients of AGC. This study is a prospective, multicenter, multinational, non-blinded, randomized phase III study. Patients: Inoperable or relapse gastric cancer. Informed consent must be obtained in writing before treatment. Subjects meeting all of the inclusion criteria and exclusion criteria will be considered for enrollment into study. Then patients will be randomly assigned into two groups S-1/Docetaxel(Treatment Arm A) or S-1 alone(Treatment Arm B).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
628
Docetaxel iv on day one and S-1 po days 1 to 14 every 3 weeks
S-1 po days 1-28 every 6 weeks
overall survival
Time frame: median
time-to-progression
Time frame: From onset of regression to progression
response rate
Time frame: response during observation
safety
Time frame: side effects during observation
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Aichi Cancer Center
Nagoya, Aichi-ken, Japan
Aichi Medical University Hospital
Okazaki, Aichi-ken, Japan
Akita University Hospital
Akita, Akita, Japan
Nakadoori General Hospital
Akita, Akita, Japan
Aomori Prefectural Central Hospital
Aomori, Aomori, Japan
Hirosahi University Graduate School of Medicine
Hirosaki, Aomori, Japan
Hirosaki Unuversity,School of Medicine
Hirosaki, Aomori, Japan
Misawa City Hospital
Misawa, Aomori, Japan
Department of frontier surgery Graduate school of medicine,Chiba University
Chiba, Chiba, Japan
Department of Organ kegulatory Surgery (First Department Surgery),Ehime University Graduate School of Medicine
Ehime, Ehime, Japan
...and 106 more locations