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S-1 for 9 Months Versus 1 Year for Stage II Gastric Cancer (SMAC)

Compare S-1 for 9 Months to 1 Year as Adjuvant Chemotherapy in Stage II Gastric Cancer (SMAC)

Status
Recruiting
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT03941561
Enrollment
1006
Registered
2019-05-08
Start date
2019-01-01
Completion date
2027-05-01
Last updated
2019-05-31

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Gastric Cancer

Keywords

Gastric Cancer, S-1

Brief summary

The study aims to compare the efficacy and safety of S-1 for 9 months versus S-1 for 1 year as adjuvant chemotherapy after D2 resection in patients with gastric cancer. Hypothesis: For gastric patients after D2 resection, S-1 for 9 months shows non-inferiority to S-1 for 1 year in disease-free survival(DFS), overall survival (OS) and safety.

Detailed description

It has been identified that S-1 is an effective adjuvant treatment for East Asian patients who have undergone a D2 dissection for locally advanced gastric cancer(GC) in the Japanese Adjuvant Chemotherapy Trial of TS-1(S-1) for Gastric Cancer (ACTS-GC) trail, And S-1 has become one of the standard therapies to these patients. But it is still unknown whether it would improve equally or even more to overall survival(OS) and disease-free survival(DFS) than S-1 for 1 year compared with S-1 for 9 months. As a result, An further clinical trial is still needed, This trial is designed to investigate the efficacy and safety of S-1 for 9 months versus S-1 for 1 year as adjuvant chemotherapy after D2 resection in patients with gastric cancer. In this study, patients histologically confirmed stage II and who received D2 resection were randomly assigned to receive S-1 for 9 months or S-1 for 1 year. Patients aged from 18 to 75 years and adequate organ function are randomized 1:1 to S-1 for 9 months and S-1 for 1 year. Both are the 3-week recycle of S-1 (80-120mg per day) for 2 weeks, followed by 1 week of rest. The primary endpoint is 3-year DFS, and the secondary endpoint is 5-year OS and safety. Final study analysis will be conducted at the end of the 5th year after the last patient's enrollment. In summary, we hold the hypothesis that S-1 for 9 months is equally effective, safer, and easier to carry out. If possible, there will be a new adjuvant chemotherapy strategy for gastric cancer patients after D2 resection. To ensure the quality of the study, two interim analyses will be planned at the half and the completion of the study respectively. The DATA and Safety Monitoring Committee will independently review the interim analysis and stop the study ahead of schedule if necessary. Furthermore, to improve the study progress and quality, the in-house interim monitoring will be performed.

Interventions

DRUGS-1 for 9 months

S-1 for 9 months after D2 resection

S-1 for 1 year after D2 resection

Sponsors

Fudan University
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No

Inclusion criteria

1. The lower age limit of research subjects 18 years old and upper age limit of 75 years old. 2. Be proven to be primary adenocarcinoma of gastric cancer and staged II by pathological evidence 3. R0 surgery with lymphadenectomy 4. Without any other malignancies 5. ECOG (ECOG score standard) performance status of 0 or 1 and expected to survive more than 6 months 6. No contraindications to chemotherapy, including normal peripheral blood routine, liver, and kidney function and electrocardiogram (WBC≥4.0 x 109 /L, NEU≥1.5 x 109 /L, PLT≥100 x 109 /L and HGB≥90g/L).

Exclusion criteria

1. Female in pregnancy or lactation, or refuse to receive Contraception measures during chemotherapy. 2. Patients with stage I, III and IV. 3. Unavailable for R0 resection and D2 lymph node dissection. 4. Suffering from other uncontrolled diseases, such as other tumors, acute and Chronic infection. 5. With severe heart disease, including congestive heart failure, uncontrolled arrhythmias, unstable angina, myocardial infarction, severe heart valve disease, and resistant hypertension. 6. Any Known or suspected history of drug allergy test. 7. The researchers believe the patient is not able to complete the entire course of the experiment. 8. Patients (within 4 weeks) are receiving any other anti-cancer drugs therapy, biological therapy, radiation therapy, or Immunosuppressive therapy. 9. Patients conform to any of the following: post-organ transplant, necessary for long-term immunosuppressive or suffering with autoimmune diseases.

Design outcomes

Primary

MeasureTime frameDescription
DFS3-yearDisease-free survival

Secondary

MeasureTime frameDescription
OS5-yearOverall survival

Other

MeasureTime frameDescription
Side effects1-yearComplications such as Nausea, vomiting, myelosuppression, and Liver or kidney function disorder

Countries

China

Contacts

Primary ContactDazhi Xu, PHD, MD
xudzh@sysucc.org.cn(+86) 020-87343737

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026