This trial will be conducted to evaluate the efficacy, safety and tolerability of SUNITINIB as add-on therapy with a widely used second-line palliative FOLFIRI chemotherapy in patients with chemo-refractory advanced or metastatic adenocarcinoma of stomach or lower esophagus (mGC). There is a clear scientific rationale for the use of Sunitinib to treat patients with mGC. Despite recent therapeutic advances, the median overall survival (OS) in patients with mG is still ≤ 12 months. Therefore, newer agents with novel mechanisms of action are desperately needed for treatment of these patients.
In parallel to the efforts in front-line therapy, second-line protocols like irinotecan-based regimens have been established in clinical trials for those patients. As many patients are still in good performance status and present with low tumor burden after failure of first-line chemotherapy, they clearly benefit from second-line treatment. Sunitinib inhibits the receptor tyrosine kinases (RTKs) involved in tumor proliferation and angiogenesis, specifically the VEGFR, PDGFR, KIT, FLT-3, and RET. The VEGF pathway has been shown to be a significant factor in metastatic gastric cancer. The safety and efficacy of Sunitinib as single agent for the treatment of mGC has been determined and support the proposed clinical study with FOLFIRI in combination with Sunitinib in the treatment of patients with mGC. Patients included in this trial suffer from advanced or metastatic adenocarcinoma of stomach or lower esophagus. They have failed to respond at least to one standard palliative first-line therapy (based on docetaxel and/or cisplatin plus 5-FU). Irinotecan/FA/5-FU can be determined as one established second-line treatment to be available for these patients. Taken together, treatment of those patients with Sunitinib combined with standard chemotherapy FOLFIRI offers the chance to benefit from a new innovative therapy with acceptable side effects.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Sunitinib will be orally administered at 25 mg once daily (in the morning without regards to meals) for 4 consecutive weeks followed by a 2-week rest period to comprise a complete cycle of 6 weeks.
Placebo will be orally administered once daily (in the morning without regards to meals) for 4 consecutive weeks followed by a 2-week rest period to comprise a complete cycle of 6 weeks.
Krankenhaus Nordwest
Frankfurt, Germany, Germany
Universitätsmedizin Mainz, 1. Med. Klinik
Mainz, Rhineland-Palatinate, Germany
The primary endpoint is the Progression-free survival (PFS) according to RECIST V1.1.
Time frame: Average time period: up to one year (participants are followed until progression or death)
Objective response rate (CR + PR) according to RECIST
Time frame: Average time period: up to one year (participants are followed until progression or death)
Safety and tolerability
Time frame: one year
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Enrollment
91
Gesundheitszentrum St. Marien
Amberg, Germany
Helios Klinikum Berlin-Buch
Berlin, Germany
Universitätsmedizin Berlin Charite
Berlin, Germany
Evangelisches Krankenhaus Bielefeld
Bielefeld, Germany
Universitätsklinikum Essen
Essen, Germany
Kliniken Essen-Mitte
Essen, Germany
Martin-Luther-Universität Halle-Wittenberg
Halle, Germany
MVZ für Innere Medizin in Hamburg-Eppendorf
Hamburg, Germany
...and 6 more locations