Inoperable Gastric Cancer
Conditions
Keywords
inoperable gastric cancer, palliative chemotherapy
Brief summary
Patients diagnosis with inoperable gastric cancers are treated with palliative chemotherapy. Palliative chemotherapy had proven to be better overall survivals and quality of life in unresectable advanced gastric cancer. NCCN guideline suggested two or three drug cytotoxic regimen as a first line therapy. But response rate of those regimens is about 50 percent. Disappointingly most of cases are about to experience progression of disease. Second line regimens of palliative chemotherapy are also have shown its efficacy and recommended within patients with better performance status. But There is still lack of evidences in gastric cancer patients second line chemotherapy. Several phase II trial those subjects are 2nd line palliative chemotherapy in gastric cancer had suggested that irinotecan, taxane, oxaliplatin, oral fluorouracil.Investigator assessed whether cisplatin in combination with paclitaxel would increase response rate in patient previously treated for advanced gastric cancer compared with FOFIRI regimen.
Interventions
DRUG5-fluorouracil, irinotecan and leucovorin
In FOLFIRI group, patients received irinotecan 180 mg/m2 and 5-fluorouracil 400mg/m2 intravenously bolus injection on days 1 and leucovorin 200mg/m2 for 2 hours and 5-fluorouracil 600mg/m2 for 22 hours intravenously infusion on day 2 of a 14-day cycle.
In DP group, patients received docetaxel 75 mg/m2 and cisplatin 75mg/m2 intravenously on days 1 of a 21-day cycle.
Sponsors
Yonsei University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Eligibility
Sex/Gender
ALL
Age
19 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
1. Older than 19 years old and younger than 75 years old 2. Pathologically confirmed gastric cancer 3. Inoperable stage at diagnosis 4. experienced diseases progression in first line palliative chemotherapy 5. ECOG performance status 0 or 1 6. Adequate renal function (serum creatinine \< 1.5 mg/dL or calculated creatinine clearance ≥ 60 ml/min) 7. Adequate liver function (total bilirubin \< 1.5 X the upper limits of normal (ULN), AST and ALT \<3 X UNL, and alkaline phosphatases \< 3 X ULN or \< 5 x ULN in case of liver involvement) 8. Adequate BM function (WBC ≥ 3,500/µl, absolute neutrophil cell count ≥ 1,500 /µl, platelet count ≥ 100,000/µl) 9. Subjects who given written informed consent after being given a full description of the study
Exclusion criteria
1. double primary cancer other than gastric cancer 2. history of palliative radiation therapy 3. Pregnant or on breast feeding 4. Neuropathy grade \> 3 5. Active infection 6. Symptomatic cardiopulmonary diseases 7. Active hepatitis of liver cirrhosis 8. Impaired renal function 9. Impaired psychologic bone marrow function 10. Psychologic disorder, Severe neurologic disorder. 11. hypersensitivity to chemotherapeutic agent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| response rate | up to 2 year | CT examination would be done at 7\ 8 weeks after initiation of 1st cycle chemotherapeutic agent, After 2 cycle of chemotherapy in DP group and 3cyle of chemotherapy in FOFIRI group. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| diseases control rate | up to 2 year | disease control, defined as the proportion of patients who had a best response of complete response, partial response, or stable |
| Overall survival | up to 2 year | overall survival, defined as time from randomisation to death |
| progression free survival | up to 2 year | progression-free survival, defined as time from randomisation to radiographic progression or death |
Outcome results
None listed