Adenocarcinoma
Conditions
Keywords
Adenocarcinoma of the gastro-esophageal, Her2, Dose finding, Taxotere (Docetaxel), Eloxatin (Oxaliplatin), Xeloda (Capecitabine), Herceptin (Trastuzumab)
Brief summary
The primary aim of this dose-finding study is to determine the maximum tolerated dose of taxotere, eloxatin and capecitabine (TEX) in combination with herceptin given every third week as first-line treatment in patients with HER2-positive advanced gastro-esophageal cancer. Secondary end points are to evaluate progression-free survival and overall survival.
Detailed description
Primary aim: To define the maximum tolerated dose of the combination of taxotere, eloxatin and capecitabine (TEX) in combination with herceptin given every third week as first- line treatment in patients with HER2-positive advanced gastro-esophageal cancer. Secondary aims: Estimating response-rate, progression free survival and overall survival Methods: This dose-finding study is planned to include 15 patients with HER2 positive gastro-esophageal cancer, adenocarcinoma. Patients will be included in cohorts of three at progressively higher dose levels. Chemotherapy will be repeated day 1 every third week to a maximum of eight cycles. Treatment with trastuzumab will continue until disease progression. Dose-limiting toxicity (DLT) will be evaluated after the first cycle. In case of DLT among one of the three patients during the first course of treatment additional three patients will be added at the respective dose level. Dose escalation is continued if 0/3 or 1/6 patients experience DLT. Patients will be evaluated with a ct- scan at baseline and after every three cycles to exclude progression and evaluate response. Response is assessed by investigators according to RECIST version 1.1. Blood counts regarding tumour biology will be collected at baseline before 2nd, 4th and 7th cycle and 4 weeks after ended treatment. After completion of treatment patients will be followed every third month until progression or death.
Interventions
DRUGDocetaxel
42, 51 or 60 mg/m² day 1 every 3. week
DRUGOxaliplatin
100 mg/m² day 1 every 3. week
DRUGCapecitabine
1250 mg/² continuously
DRUGTrastuzumab
Trastuzumab 8 mg/kg day 1, cycle 1. Following cycles 6 mg/kg every 3. week
Sponsors
Aalborg University Hospital
Aarhus University Hospital
Rigshospitalet, Denmark
Odense University Hospital
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
1. Patients with histologically proven ECV-adenocarcinoma, non-resectable or metastatic disease 2. HER2-positive tumor tissue (IHC 3 + or FISH positive) 3. LVEF \> 50 % (MUGA scan or echocardiography) 4. Age ≥ 18 years 5. No prior chemotherapy 6. WHO performance status 0-1 7. Life expectancy of at least 3 months 8. Neutrophils ≥ 1.5 x 109/L and platelets ≥ 100 x 109/L 9. Bilirubin ≤ 1.5 x UNL (Upper Normal Limit) and ASAT and/or ALAT ≤ 3 x UNL. In case of liver metastases no UNL for ASAT and ALAT 10. Creatinine clearance ≥ 50 ml/min. Calculated with the Cockroft-Gault formula 11. No neuropathy 12. Planned treatment start within 8 days after inclusion
Exclusion criteria
1. Patients who cannot complete treatment or evaluation 2. Any condition or treatment which after the opinion of the investigator may expose the patients to a risc or influence the purpose of the study 3. Known hypersensitivity towards any of the study drugs 4. Other malignant disease within the last 5 days, except for non-melanoma skin cancer 5. Other serious disease (e.g. cardiac disease, AMI within 1 year or infection) 6. Pregnant women or nursing women 7. Physical or mental conditions which may prevent absorption of oral treatment
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| To determine maximum tolerable dose (MTD) for the combination regime TEX | 2 years | The investigators have planned to examine 3 dose levels including 3 patients at each level with escalating doses of docetaxel from 42 mg/m² to 60 mg/m² and fixed doses of oxaliplatin (100 mg/m²), capecitabine 625 mg/m² x 2 and trastuzumab 6 mg/kg. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Progression free survival | 3 years | Time from inclusion to disease progression or death of any cause. |
| Survival | 4 years | Time from inclusion to death of any cause. |
| Response rate | 3 years | According to RECIST version 1.1. |
Countries
Denmark
Outcome results
None listed