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Clinical Trial to Compare Apatinib Plus Irinotecan Versus Single Irinotecan as Second-line Treatment in AGC or EGJA

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT03030937
Recruitment Status : Unknown
Verified January 2017 by Fujian Cancer Hospital.
Recruitment status was:  Not yet recruiting
First Posted : January 25, 2017
Last Update Posted : January 25, 2017
Sponsor:
Information provided by (Responsible Party):
Fujian Cancer Hospital

Brief Summary:
The purpose of this study is to determine whether apatinib plus irinotecan can improve progression free survival compared with single irinotecan in patients with advanced gastric cancer or adenocarcinoma of esophagogastric junction who failed one lines of chemotherapy.

Condition or disease Intervention/treatment Phase
Advanced Gastric Cancer Adenocarcinoma of Esophagogastric Junction Drug: Apatinib Drug: Irinotecan Phase 2

Detailed Description:
Gastric cancer is the leading cause of cancer death in China. Most patients are unresectable or metastatic disease at the time of diagnosis,so the prognosis is poor.Systemic therapy was required for the patients with advanced stage. Platinum combined with fluoropyrimidines always were considered as first line treatment. After failure of initial therapy, single agent of irinotecan was used as second line treatment,but limited survival benefit.Apatinib, a novel targeted inhibitor of VEGF receptor 2 (VEGFR2).The purpose of this study is to determine whether apatinib plus irinotecan can improve progression free survival compared with single irinotecan in patients with advanced gastric cancer or adenocarcinoma of esophagogastric junction who failed one lines of chemotherapy.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 74 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Randomized, Parallel Control, Exploratory Trial to Compare Apatinib Plus Irinotecan Versus Single Irinotecan as Second-line Treatment in Subjects With Advanced Gastric Cancer or Adenocarcinoma of Esophagogastric Junction
Estimated Study Start Date : February 1, 2017
Estimated Primary Completion Date : July 31, 2018
Estimated Study Completion Date : December 30, 2018

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Stomach Cancer

Arm Intervention/treatment
Experimental: Irinotecan plus apatinib

Irinotecan:160mg/m2, ivgtt,given on the eighth day; Apatinib:initial dose:250mg,oral,once a day, after meal ( try to take the medicine at the same time of the dauntoy ).

Repeat the therapeutic schedule every 2 weeks till progressive disease or intolerable toxicities.

Drug: Apatinib
Apatinib, a novel targeted inhibitor of VEGF receptor 2 (VEGFR2).

Drug: Irinotecan
Irinotecan was used as second line treatment with AGC.

Active Comparator: Irinotecan
Irinotecan:180mg/m2, ivgtt,given on the eighth day. Repeat the therapeutic schedule every 2 weeks till progressive disease or intolerable toxicities.
Drug: Irinotecan
Irinotecan was used as second line treatment with AGC.




Primary Outcome Measures :
  1. Progression-Free Survival (PFS) [ Time Frame: 18 months ]
  2. Adverse Event(AE) [ Time Frame: 18 months ]
    NCI CTC 4.03


Secondary Outcome Measures :
  1. Objective Response Rate (ORR) [ Time Frame: 18 months ]
  2. Disease Control Rate (DCR) [ Time Frame: 18 months ]
  3. Overall Survival(OS) [ Time Frame: 18 months ]
  4. Quality of Life (QoL) [ Time Frame: 18 months ]
    Use the validated European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 [EORTC QLQ-C30].



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 70 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Age:18~70years;
  2. Subjects with Histologically or cytologically confirmed advanced gastric cancer or adenocarcinoma of esophagogastric junction ;
  3. Subjects must have received no more than one lines treatment before participating,and have received no irinotecan or antiangiogenic(including apatinib)treatment previously; Note:(1) Time of first-line treatment for subjects with advanced tumour must more than 1 cycles;(2) Adjuvant / neoadjuvant therapy was allowed; adjuvant / neoadjuvant therapy will be considered as a first-line treatment if disease recurrence during treatment or after less than 24 weeks.
  4. subjects with at least one measurable lesion as defined by RECIST (version 1.1);Lesions previously treated with radiotherapy or locoregional therapy must show radiographic evidence of disease progression to be deemed a target lesion.
  5. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1;
  6. Survival expectation≥ 3 months;
  7. The interval of subjects had received cytotoxic drugs, radiotherapy or surgery must more than 4 weeks(besides nitroso or mitomycin must more than 6 weeks), and the wound has healed before participating;
  8. No serious concomitant diseases(including heart,lung,liver jaundice or gastrointestinal obstruction and so on );
  9. Adequate organ functions defined as indicated below: (1)Adequate bone marrow function, defined as: (no blood transfusion within 14 days)

    1. Hemoglobin (Hb)≥80g/L,
    2. White blood count (WBC)≥3.5×109/L
    3. Absolute neutrophil count (ANC)≥1.5×109/L,
    4. Platelet count (PLT)≥75×109/L; (2)Adequate liver function, defined as:
    1. Bilirubin ≤1.5×the upper limit of normal (ULN)
    2. Alanine aminotransferase (ALT), or Aspartate aminotransferase (AST) ≤3.0×(ULN), Glutamyl transpeptidase(GGT)≤2.5×(ULN), (When liver metastases, ALT or AST and GPT <5.0×(ULN)).
    3. serum creatinine ≤1.0×(ULN), or creatinine clearance > 50 mL/min( calculated per the Cockcroft and Gault formula)
  10. Females of childbearing potential must be a pregnancy test in 7 days before participating ( including serum or urine), and the results were negative, Females of childbearing potential must agree to use a highly effective method of contraception throughout the entire study period and for 8 weeks after study drug discontinuation. Male subjects must have had a successful vasectomy or they and their female partners must meet the criteria above (i.e.not of childbearing potential or practicing highly effective contraception throughout the study period and for 8 weeks after study drug discontinuation).
  11. Subjects provided written informed consent before participating,Willing and able to comply with all aspects of the protocol

Exclusion Criteria:

  1. Females are lactating or pregnant at Screening or Baseline
  2. Subjects with other active malignancy (except for definitively treated melanoma in-situ, basal or squamous cell carcinoma of the skin, or carcinoma in-situ of the cervix)
  3. Subjects with symptomatic brain metastases;
  4. Subjects with uncontrolled blood pressure with medication (140/90 mmHg),
  5. Subjects with coronary heart disease (CHD) above grade I, arrhythmia (including Prolongation of QTc interval : Male subjects > 450 ms, Females> 470 ms) or cardiac dysfunction;.
  6. Subjects with gastrointestinal bleeding tendency,including the following: current of local active ulcerative lesions with fstool OB (+ +); history of melena or hematemesis within past 2 months ; current of fstool OB (+) with gastric primary tumor without surgical , investigator considerd ulcerative stomach cancer is associated with risks of gastrointestinal bleeding.
  7. Subjects with bleeding tendency ,defined as abnormal coagulation (INR>1.5×(ULN),APTT>1.5 ×(ULN));
  8. Subjects with previous history of cardiovascular and cerebrovascular diseases ,those receiving thrombolytics or anticoagulants were excluded
  9. Subjects with urine protein positive (defined as urine protein detection 2+ or above, or urine protein ≥ 1 g/24 hours );
  10. Subjects with a variety of factors that affect oral medications (such as inability to swallow, persistent nausea and vomiting, chronic diarrhea and intestinal obstruction, and so on.);
  11. Subject with any other condition that in the opinion of the investigator would preclude his/her participation in a clinical study.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03030937


Contacts
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Contact: Jianwei Yang 008613805097959 swzcq62@163.com
Contact: Sha Huang 008613763820570 huangsha0210@163.com

Locations
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China, Fujian
Jianwei Yang
Fuzhou, Fujian, China, 350000
Sponsors and Collaborators
Fujian Cancer Hospital
Investigators
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Principal Investigator: Jianwei Yang Fujian Cancer Hospital
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Responsible Party: Fujian Cancer Hospital
ClinicalTrials.gov Identifier: NCT03030937    
Other Study ID Numbers: Arise-FJ-G201
First Posted: January 25, 2017    Key Record Dates
Last Update Posted: January 25, 2017
Last Verified: January 2017
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Undecided

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
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Adenocarcinoma
Stomach Neoplasms
Carcinoma
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Neoplasms
Gastrointestinal Neoplasms
Digestive System Neoplasms
Neoplasms by Site
Digestive System Diseases
Gastrointestinal Diseases
Stomach Diseases
Irinotecan
Apatinib
Topoisomerase I Inhibitors
Topoisomerase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Protein Kinase Inhibitors