Gastric Carcinoma
Conditions
Keywords
Gastric cancer, First-line therapy, Tesetaxel, Taxane, Capecitabine, Oral fluoropyrimidine, Cisplatin, Platinum
Brief summary
Cisplatin, an intravenously administered platinum agent, in combination with an intravenously administered taxane and capecitabine has been shown to improve time to disease progression and overall survival in previously untreated patients with gastric cancer. This study is being performed to evaluate an orally administered taxane (tesetaxel) in combination with cisplatin and capecitabine in previously untreated patients with gastric cancer.
Interventions
Phase 1: Tesetaxel orally on Day 1 of each cycle at dose of 18, 21, 24, or 27 mg/m2. If no dose-limiting toxicity, at least 3 subjects will be treated at each dose level until the maximum tolerated dose or the maximum dose of 27 mg/m2 is reached. At each tesetaxel dose level, capecitabine orally at a dose of 2000 mg/m2/day (administered in 2 equally divided doses) on Day 1-Day 14 and cisplatin intravenously at a dose of 60 mg/m2 on Day 1. Phase 2: Tesetaxel orally on Day 1 of each cycle at dose determined in Phase 1. Capecitabine orally at a dose of 2000 mg/m2/day (administered in 2 equally divided doses) on Day 1-Day 14 and cisplatin intravenously at a dose of 60 mg/m2 on Day 1.
Sponsors
Study design
Eligibility
Inclusion criteria
Primary Inclusion Criteria: * At least 20 years of age * Histologically or cytologically confirmed gastric carcinoma, including gastric or gastroesophageal-junction adenocarcinoma. * Measurable disease (revised RECIST) based on computed tomography, or nonmeasurable disease * Previously untreated, unresectable advanced (M0) or unresectable metastatic (M1) disease except for prior adjuvant (or neo-adjuvant) chemotherapy. * ECOG performance status 0 or 1 * At least 4 weeks and recovery from effects of prior major surgery * Adequate bone marrow, hepatic, and renal function Primary
Exclusion criteria
* Operable gastric or gastroesophageal-junction cancer * Known brain metastasis * Second cancer * Previous adjuvant or neo-adjuvant chemotherapy with capecitabine and cisplatin in combination. (Previous adjuvant or neo-adjuvant monotherapy with capecitabine or S-1 or therapy with S-1 and cisplatin in combination or 5-FU and cisplatin in combination is allowed.) * Uncontrolled diarrhea * Nausea or vomiting for at least 3 consecutive days within the 14 days prior to registration despite the administration of standard antiemetic therapy * Symptomatic peripheral neuropathy ≥ Grade 2 * Malabsorption syndrome or other disease that significantly affects gastrointestinal function * Other uncontrolled systemic illness
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Progression-free survival rate (in Phase 2 portion of study) | 6 months from the date of first dose of study medication |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Response rate, as defined in revised RECIST (in Phase 2 portion of study) | Up to 12 months following the date of first dose of study medication | — |
| Duration of response (in Phase 2 portion of study) | Up to 12 months following the date of first dose of study medication | — |
| Rate of responses at least 3 months in duration (in Phase 2 portion of study) | Up to 12 months following the date of first dose of study medication | — |
| Disease control rate, which is defined as the percentage of patients with a response of any duration or stable disease at least 6 weeks in duration (in Phase 2 portion of study) | Up to 12 months following the date of first dose of study medication | — |
| Recommended dose of tesetaxel for Phase 2 (in Phase 1 portion of study) | Up to 21 days after first dose of study medication | The dose of tesetaxel in mg/m2 will be determined for Phase 2 based on the occurrence of dose-limiting toxicities in Phase 1. |
| Progression-free survival (in Phase 2 portion of study) | Up to 12 months following the date of first dose of study medication | — |
| Overall survival (in Phase 2 portion of study) | Up to 12 months following the date of first dose of study medication | — |
| Percentage of patients with adverse events (in Phase 1 and Phase 2 portions) | Up to 30 days after the last dose of study medication | — |
| Durable response rate, which is defined as the percentage of patients with a response at least 6 months in duration (in Phase 2 portion of study) | Up to 12 months following the date of first dose of study medication | — |
Countries
South Korea