Gastric Cancer
Conditions
Keywords
upper gastrointestinal endoscopy, suspected gastric cancer
Brief summary
Patients with early gastric cancer, who require therapeutic upper gastrointestinal endoscopy, such as endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD), will receive intragastric spraying of NPO-11 or placebo. The superiority of NPO-11 to placebo as anti-peristaltic agent will be verified in a randomized, double-blind, parallel-assignment design based on the proportion of patients with suppressed gastric peristalsis during the procedures. The degree of gastric peristalsis is assessed by an independent committee. The safety of NPO-11 will be evaluated based on adverse events and adverse drug reactions (ADRs) observed between administration and seven days after administration in comparison with the placebo group.
Interventions
DRUGMenthol
20 mL NPO-11 in a prefilled plastic syringe
DRUGPlacebo
The placebo is included same additives as active comparator.
Sponsors
Nihon Pharmaceutical Co., Ltd
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
20 Years to No maximum
Healthy volunteers
No
Inclusion criteria
inpatients or outpatients of either sex who require therapeutic upper gastrointestinal endoscopy (EMR or ESD) and meet the criteria (1)-(4) below will be enrolled in the study. Patients have to provide written informed consent for voluntary participation in the study. The criteria (2) and (3) will be confirmed by the endoscopic observation just before starting the intended treatment. 1. Patients with an early gastric cancer located in the lower third of the stomach, who require therapeutic upper gastrointestinal endoscopy (EMR or ESD) (except for those with an intended treatment by using a scope of \<9 mm in diameter) 2. Differentiated -type intramucosal gastric cancer or the suspected lesion, ≤ 2 cm in size, no ulcer finding 3. Patients with a single intended lesion for the treatment 4. Patients who are older than 20 years at the time of consent
Exclusion criteria
Patients who meet any of the following criteria will be excluded from the study beforehand. The criteria (3) to (5) will be confirmed by the endoscopic observation just before starting the intended treatment. 1. Patients with a history of surgery to the upper gastrointestinal tract 2. Patients who require emergency endoscopy 3. Patients with severe gastric stenosis or deformation which makes observation of gastric peristalsis difficult 4. Patients who require emergency endoscopic treatment except for the intended lesion 5. Patients with a lesion extended to the pyloric ring 6. Patients with an ongoing cancer treatment (chemotherapy or radiotherapy) 7. Patients with pacemaker 8. Patients with known bleeding tendency or Patients with difficulty of antithrombogenic agents withdrawal 9. Patients with a history of shock or hypersensitivity to l-menthol or peppermint oil 10. Patients with contraindications to glucagon 11. Patients with contraindications to benzodiazepines, pethidine hydrochloride, and epinephrine 12. Pregnant or lactating women, women of childbearing potential, or women who plan to become pregnant during the study 13. Patients who have received other investigational drugs within four months before consent or who are participating in other clinical studies 14. Patients otherwise ineligible for participation in the study in the investigator's opinion
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The proportion of patients had no or mild peristalsis during the therapeutic procedures | 60 minutes | No or mild gastric peristalsis is defined as when patients have no or suppressed gastric peristalsis during the therapeutic procedure. The degree of gastric peristalsis in the time periods is assessed by an independent committee. |
Secondary
| Measure | Time frame |
|---|---|
| Duration of peristalsis-suppressing effect | 60 minutes |
| Difficulty level of the therapeutic procedure | 60 minutes |
| One-piece resection rate with tumor-free margin | 60 minutes |
| Adverse events and adverse drug reactions | 7 days |
Countries
Japan
Outcome results
None listed