Randomized Controlled Study of Postoperative Adjuvant Therapy for Gastric Cancer Using TS-1 or TS-1+PSK
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Purpose
A randomized controlled study is conducted on patients with resected gastric cancer assigned to postoperative adjuvant therapy of TS-1 alone or PSK combined with TS-1, with the objective to examine or validate the outcome, QOL and prognostic factors (host and tumor factors), and explore the factors enhancing the antitumor effect of TS-1.
| Condition | Intervention | Phase |
|---|---|---|
|
Gastric Cancer |
Drug: Tegafur-gimeracil-oteracil potassium (TS-1) Drug: Krestin (PSK) |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Randomized Multicenter Controlled Phase III Study of Postoperative Adjuvant Therapy for Stage II/IIIA Gastric Cancer Using TS-1 Alone or TS-1+PSK Combined Therapy |
- Time of recurrence (calculation of 3-year disease-free survival and overall survival rates) [ Time Frame: Five years after surgery ] [ Designated as safety issue: No ]
- Relations of survival rate with compliance, postoperative complication, QOL, adverse events, recurrence status, and expression of immune or tumor markers [ Time Frame: Five years after surgery ] [ Designated as safety issue: Yes ]
| Estimated Enrollment: | 280 |
| Study Start Date: | March 2005 |
| Estimated Study Completion Date: | February 2016 |
| Estimated Primary Completion Date: | February 2016 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: 1
TS-1 Group: The group treated with TS-1 mono-therapy
|
Drug: Tegafur-gimeracil-oteracil potassium (TS-1)
From 4-8 weeks after surgery to 27-31 weeks after surgery, 80 mg/m2, PO from day 1 to day 14 of each 21 day cycle. Number of Cycles: 8 From 28-32 weeks after surgery to 53-57 weeks after surgery, 80 mg/m2, PO from day 1 to day 14 of each 28 day cycle. Number of Cycles: 7
Other Name: TS-1
|
|
Experimental: 2
TS-1+PSK Group: The group treated with combination therapy using TS-1 and PSK
|
Drug: Tegafur-gimeracil-oteracil potassium (TS-1)
From 4-8 weeks after surgery to 27-31 weeks after surgery, 80 mg/m2, PO from day 1 to day 14 of each 21 day cycle. Number of Cycles: 8 From 28-32 weeks after surgery to 53-57 weeks after surgery, 80 mg/m2, PO from day 1 to day 14 of each 28 day cycle. Number of Cycles: 7
Other Name: TS-1
Drug: Krestin (PSK)
From 4-8 weeks after surgery to 53-57 weeks after surgery, 3 g/day, PO every day
Other Name: PSK
|
Detailed Description:
The 5-year survival after gastric cancer surgery remains poor as the cancer advances to stages II, IIIA, IIIB and IV. Tegafur-gimeracil-oteracil potassium (TS-1) is used as the first line treatment for advanced and recurrent gastric cancer. But TS-1 is accompanied by an adverse drug reaction of bone marrow suppression that is not readily seen in conventional oral fluoropyrimidines. Among randomized controlled trials on postoperative adjuvant chemotherapy for gastric cancer, the beneficial results of survival rates using Krestin (PSK) in combination with chemotherapy have been reported. With the objective to enhance the antitumor effect of TS-1 and to improve the QOL of patients, we have planned to validate the clinical significance of combined PSK and TS-1 therapy as postoperative adjuvant therapy for gastric cancer, using in principle the TS-1 regimen of 2-week dosing 1-week off for 6 months followed by 2-week dosing 2-week off for 6 months.
Eligibility| Ages Eligible for Study: | 20 Years to 80 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Patients with microscopic stage II or IIIA resectable gastric cancer
- Patients who have not received preoperative cancer therapy (radiotherapy, chemotherapy or immunotherapy)
- Patients with serum immunosuppressive acidic protein (IAP) measured within 2 weeks before surgery
- Patients with no metachronous or synchronous multiple cancer
- Patients without severe impairment of renal, hepatic and bone marrow functions
- Patients who are judged to be capable of tolerating surgery
- Patients with preoperative performance status 0 to 2
- Patients with no serious concurrent complications (such as bone marrow suppression, diarrhea and infection)
- Patients who are judged to be capable of tolerating this treatment, and who have given written informed consent to participate in this study
Exclusion Criteria:
- Patients with fresh hemorrhage from the gastrointestinal tract
- Patients with retention of body fluid necessitating treatment
- Patients with infection, intestinal palsy or intestinal occlusion
- Patients who are pregnant or hope to become pregnant during the study period
- Patients with diabetes treated by continuous use of insulin or showing poor glycemic control
- Patients with a history of ischemic heart disease
- Patients with concurrent psychiatric disease or psychotic symptoms, and judged to have difficulties participating in the study
- Patients receiving continuous administration of steroids
- Patients who have experienced serious drug allergy in the past
- Others, patients judged by the investigator or subinvestigator to be inappropriate as subject
Contacts and Locations| Japan | |
| University of Fukui Hospital | |
| Eiheiji, Fukui, Japan, 910-1193 | |
| National Hospital Organization Fukui Hospital | |
| Tsuruga, Fukui, Japan, 914-0195 | |
| Shakaihoken Kobe Central Hospital | |
| Kobe, Hyogo, Japan, 651-1145 | |
| Public Central Hospital of Matto Ishikawa | |
| Hakusan, Ishikawa, Japan, 924-8588 | |
| Kanazawa Redcross Hospital | |
| Kanazawa, Ishikawa, Japan, 921-8162 | |
| Ishikawa Prefectural Central Hospital | |
| Kanazawa, Ishikawa, Japan, 920-8530 | |
| Kanazawa University Hospital | |
| Kanazawa, Ishikawa, Japan, 920-0934 | |
| Kanazawa Medical University Hospital | |
| Uchinada, Ishikawa, Japan, 920-0293 | |
| Fukuchiyama City Hospital | |
| Fukuchiyama, Kyoto, Japan, 620-8505 | |
| Kyoto Ohashi General Hospital | |
| Fushimi, Kyoto, Japan, 612-8364 | |
| Houyu hospital | |
| Joyo, Kyoto, Japan, 610-0121 | |
| National Hospital Organization Maizuru Medical Center | |
| Maizuru, Kyoto, Japan, 625-8502 | |
| Saiseikai Kyoto Hospital | |
| Nagaokakyo, Kyoto, Japan, 617-0814 | |
| Nantan General Hospital | |
| Nantan, Kyoto, Japan, 629-0197 | |
| Rokujizo Hospital | |
| Uji, Kyoto, Japan, 611-0001 | |
| Second Okamoto General Hospital | |
| Uji, Kyoto, Japan, 611-0025 | |
| Kyoto Prefectural Yosanoumi Hospital | |
| Yosano, Kyoto, Japan, 629-2261 | |
| Marutamachi Hospital | |
| Nishinokyokurumazaka-cho, Nakagyou-ku Kyoto, Japan, 604-8405 | |
| Osaka City University Hospital | |
| Asahi-machi, Osaka Abeno-ku, Japan, 545-8586 | |
| Sumitomo Hospital | |
| Nakanoshima, Osaka Kita-ku, Japan, 530-0005 | |
| Matsushita Memorial Hospital | |
| Moriguchi, Osaka, Japan, 570-8540 | |
| Midorigaoka Hospital | |
| Takatsuki, Osaka, Japan, 569-1121 | |
| Shiga University of Medical Science Hospital | |
| Otsu, Shiga, Japan, 520-2192 | |
| Saiseikai Shigaken Hospital | |
| Ritto, Shiga, Japan, 520-3040 | |
| Shimane University Hospital | |
| Izumo, Shimane, Japan, 693-8501 | |
| Kouseiren Takaoka Hoapital | |
| Takaoka, Toyama, Japan, 933-8555 | |
| Saiseikai Takaoka Hospital | |
| Takaoka, Toyama, Japan, 933-8525 | |
| Toyama Rosai Hospital | |
| Uozu, Toyama, Japan, 937-0042 | |
| Yatsuo General Hospital | |
| Yatsuo, Toyama, Japan, 939-2376 | |
| Kitade Hospital | |
| Gobou, Wakayama, Japan, 644-0011 | |
| Fukui General Hospital | |
| Fukui, Japan, 910-8561 | |
| Fukui Cardio Vascular Center | |
| Fukui, Japan, 910-0833 | |
| Fukui Saiseikai Hospital | |
| Fukui, Japan, 918-8503 | |
| Gifu Prefectural General Medical Center | |
| Gifu, Japan, 500-8717 | |
| Gifu Municipal Hospital | |
| Gifu, Japan, 500-8513 | |
| Gifu University Hospital | |
| Gifu, Japan, 501-1194 | |
| University Hospital, Kyoto Prefectural University of Medicine | |
| Kyoto, Japan, 602-8566 | |
| Kyoto First Red Cross Hospital | |
| Kyoto, Japan, 605-0981 | |
| Nishijin Hospital | |
| Kyoto, Japan, 602-8800 | |
| Nara City Hospital | |
| Nara, Japan, 630-8305 | |
| Osaka Railway hospital | |
| Osaka, Japan, 545-0053 | |
| Toyama Prefectural Central Hospital | |
| Toyama, Japan, 930-8550 | |
| Study Chair: | Koichi Miwa, MD, PhD | Hokuriku-Kinki Immunochemotherapy Study Group |
More Information
Publications:
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | Takashi Fujimura, Assistant Professor of Gastroenterologic Surgery, Kanazawa University Hospital, Hokuriku-Kinki Immunochemotherapy Study Group |
| ClinicalTrials.gov Identifier: | NCT00216034 History of Changes |
| Other Study ID Numbers: | HKIT-GC |
| Study First Received: | September 18, 2005 |
| Last Updated: | March 20, 2012 |
| Health Authority: | Japan: Ministry of Health, Labor and Welfare |
Keywords provided by Hokuriku-Kinki Immunochemotherapy Study Group:
|
Gastric Cancer TS-1 PSK Disease-free survival Overall survival |
Additional relevant MeSH terms:
|
Stomach Neoplasms Gastrointestinal Neoplasms Digestive System Neoplasms Neoplasms by Site Neoplasms Digestive System Diseases Gastrointestinal Diseases Stomach Diseases Tegafur S 1 (combination) Krestin Antimetabolites, Antineoplastic Antimetabolites |
Molecular Mechanisms of Pharmacological Action Pharmacologic Actions Antineoplastic Agents Therapeutic Uses Antibiotics, Antineoplastic Antiviral Agents Anti-Infective Agents Adjuvants, Immunologic Immunologic Factors Physiological Effects of Drugs Interferon Inducers Radiation-Protective Agents Protective Agents |
ClinicalTrials.gov processed this record on May 22, 2013