Celecoxib/Oxaliplatin/Capecitabine for Gastric/GE Junction Carcinoma
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Purpose
Gastric cancer is the second most common neoplasm in the world. Early diagnosis and surgical resection improve the survival and the chance of cure. Unfortunately, majority of cases are diagnosed at advanced stage, with only 20% of the patients presenting with localized disease. The five-year survival for gastric cancer of all stages remains at a dismal 8%. Chemotherapy has been used for advanced gastric cancer but with unsatisfactory results. Therefore, new approaches are needed for these patients. Among the newer chemotherapy regimens for advanced gastric cancer include a combination of oral 5FU-based compound called Capecitabine(Xeloda) and Oxaliplatin. A few phase II studies suggest that the combination regimen is active with overall response rates ranging 30-40%. Several preclinical and clinical studies have shown that the expression of cyclooxygenase enzyme II(COX-2) is upregulated in many pre-neoplastic and neoplastic lesions. Furthermore, there appears to be an association with the overexpression of Cox-2 and the invasiveness of cancer and prognosis. Finally, preclinical and clinical studies suggest selective Cox-2 inhibitors can induce apoptosis in gastric cancer cells and retard tumor progression. Therefore, there is a strong rationale for the combination of a selective Cox-2 inhibitor, Celecoxib, with Capecitabine and Oxaliplatin in a therapeutic phase II trial for patients with advanced or recurrent gastric cancer.
| Condition | Intervention | Phase |
|---|---|---|
|
Gastric Carcinoma Gastroesophageal Junction Carcinoma |
Drug: Oxaliplatin Drug: Capecitabine Drug: Celecoxib |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Endpoint Classification: Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | A Phase II Study of Celecoxib/Oxaliplatin/Capecitabine Combination Chemotherapy for Unresectable,Recurrent, or Metastatic Gastric/Gastroesophageal Junction Carcinoma |
Eligibility| Ages Eligible for Study: | 18 Years to 80 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Patient must have histologically proven, pathologically verified and surgically incurable(unresectable, recurrent, or metastatic) gastric/gastroesophageal junction carcinoma. Gastric lymphoma and Gastrointestinal stromal tumor(GIST) are ineligible for this study. At least 6 unstained paraffin-embedded pathologic specimen slides will be required for the COX-2 expression assays.
- Patient must have bidimensionally measurable disease as defined in Section 10.1a. All measurable lesions must be assessed (by physical examination, CT scan, radionuclide scan or plain X-ray) within 30 days prior to registration. The patient's disease status must be completely assessed and reported.
- All patients must undergo a CT of abdomen and chest within 30 days prior to registration.
- Patients with brain metastases are NOT eligible for this study. It is not mandatory to obtain brain CT or MRI on all patients. However, patients who exhibit neurological symptoms or have pulmonary metastases on radiographic studies must obtain brain CT w/ IV contrast or MRI prior to registration to ascertain the presence of brain metastasis.
- Patients must NOT have received capecitabine or oxaliplatin. Prior use of cisplatin, carboplatin, 5-FU are permitted. Prior systemic therapy must have been completed at least 30 days before registration.
- Patients may have received prior radiation therapy. Radiation therapy must have been completed at least 30 days before registration.
- Patients may have received prior surgery. Prior surgery must have been completed at least 30 days before registration.
- Patients must have a Zubrod Performance Status of 0-2.
- Pregnant or nursing women are not eligible to participate in this trial because the safe use of these drugs in pregnancy have not been established. Urine pregnancy test must be done prior to the study.
- Patient must NOT have known allergic reaction to sulfonamides
- Patient must NOT have known allergic or other adverse reaction to celecoxib
- Patient must NOT have persistent peripheral neuropathy
- Patient must NOT have known hypersensitivity reactions to 5-FU or platinum
- Patient must NOT have active gastric/duodenal bleeding
- Patient must NOT have had a sensitivity reaction to aspirin or other NSAIDS [experiencing asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs]
Contacts and Locations| United States, California | |
| Chao Family Comprehensive Cancer Center | |
| Orange, California, United States, 92868 | |
| Principal Investigator: | Randall Holcombe, MD | Chao Family Comprehensive Cancer Center |
More Information
No publications provided
| ClinicalTrials.gov Identifier: | NCT00256321 History of Changes |
| Other Study ID Numbers: | UCI 03-34 |
| Study First Received: | November 18, 2005 |
| Last Updated: | February 27, 2008 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by University of California, Irvine:
|
Gastric Carcinoma Gastroesophageal junction Carcinoma |
Additional relevant MeSH terms:
|
Carcinoma Stomach Neoplasms Neoplasms, Glandular and Epithelial Neoplasms by Histologic Type Neoplasms Gastrointestinal Neoplasms Digestive System Neoplasms Neoplasms by Site Digestive System Diseases Gastrointestinal Diseases Stomach Diseases Oxaliplatin Capecitabine Fluorouracil Celecoxib |
Antineoplastic Agents Therapeutic Uses Pharmacologic Actions Cyclooxygenase 2 Inhibitors Cyclooxygenase Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action Anti-Inflammatory Agents, Non-Steroidal Analgesics, Non-Narcotic Analgesics Sensory System Agents Peripheral Nervous System Agents Physiological Effects of Drugs Anti-Inflammatory Agents Central Nervous System Agents |
ClinicalTrials.gov processed this record on May 21, 2013