Metronomic Chemotherapy in Advanced Gastric Cancer

Huashan Hospital40 enrolled

Overview

phase II study of weekly metronomic chemotherapy using weekly Paclitaxel, Oxaliplatin, Leucovorin and 5-FU (POLF) in patients with advanced gastric cancer

About 80% of patients with advanced gastric cancer are diagnosed at an advanced stage with limited treatment options including systemic chemotherapy with or without radiation. Commonly used maximally tolerated dose (MTD) chemotherapy such as DCT, ECF, FOLFOX regimens induce responses in the range of 20 to 50% with median survival in the range of 10 to 12 months. Metronomic chemotherapy has been found to have more consistent anti-tumor effects through anti-angiogenic and immunomodulating effects. Preliminary clinical studies of weekly POLF have found very encouraging clinical activities and low overall toxicities in pancreatic cancer and gastric cancer. Here we conduct a formal clinical trial to determine the clinical efficacy and side effect profiles of this regimen in patients with advanced gastric cancer.

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Metastatic Gastric Cancer Locally Advanced Gastric Cancer

Interventions

Paclitaxel 60mg/m2, Oxaliplatin 50mg/m2, Leucovorin 20mg/m2, and 5-FU 425mg/m2 IV weeklyDRUG

metronomic chemotherapy

Eligibility

Sex: ALLMin age: 18 YearsMax age: 70 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. pathologically confirmed gastric cancer AJCC stage III or IV 2. measurable disease based on CT or endoscopy exam 3. non-surgical candidates or patients who declined surgery 4. non-radiation candidates or patients who declined radiation 5. patients who are able to sign informed consent 6. patients who are 2 weeks out and recovered from surgery 7. patients who have completed radiation to relieve obstructive symptoms 8. patient who previously received Oxaliplatin and 5-FU in other MTD regimens 9. adequate marrow function: neutrophil \>1000/ul, Hgb \>10g/dl, Plt\>50,000 Exclusion Criteria: 1. allergic to any of the drugs involved 2. concurrent malignancies 3. severe co-morbidities of heart, lungs, kidneys and bone marrow 4. severe psychological disorder 5. severe malnutrition 6. difficult to heal or unhealed wound 7. ECOG performance status equal or over 3 8. uncontrolled complications from the malignancy 9. uncontrolled CNS metastasis 10. peripheral neuropathy grade 3 or above 11. pregnancy or breast feeding

Locations (2)

Seattle Integrative Cancer Center

Seattle, Washington, United States

NOT_YET_RECRUITING

Huashan Hospital

Shanghai, Shanghai Municipality, China

RECRUITING

Outcomes

Primary Outcomes

response rate

based on Recist 1.1

Time frame: 3 months

Secondary Outcomes

adverse events

based on NCI-CTC v.2

Time frame: 2 years

progression free survival

median

Time frame: 2 years

overall survival

median

Time frame: 2 years

Central Contacts

Nick N Chen, M.D., Ph.D.

CONTACT

206-588-1722 nicknchenmd@gmail.com

Jie Liu, M.D.

CONTACT

021-5288236 jieliu@fudan.edu.cn

Data from ClinicalTrials.gov

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