Chemotherapy for Patients With Gastroesophageal Cancers Who Have Progressed After One Prior Chemo Regimen

This study has been terminated.
(As of 12/12/12 study closed to enrollment because study was determined to be ineffective.)
Sponsor:
Collaborators:
Roger Williams Medical Center
Rhode Island Hospital
The Miriam Hospital
Information provided by (Responsible Party):
howard safran, Brown University
ClinicalTrials.gov Identifier:
NCT01365130
First received: May 11, 2011
Last updated: December 13, 2012
Last verified: October 2012

May 11, 2011
December 13, 2012
June 2011
December 2012   (final data collection date for primary outcome measure)
To determine the response rate of Cabazitaxel in patients with metastatic gastroesophageal adenocarcinoma that have progressed after at least one line of therapy for metastatic disease [ Time Frame: every three cycles approx every 63 days ] [ Designated as safety issue: Yes ]
Same as current
Complete list of historical versions of study NCT01365130 on ClinicalTrials.gov Archive Site
To assess the toxicity associated with Cabazitaxel for patients with metastatic gastroesophageal adenocarcinomas that have progressed after at least one line of therapy for metastatic disease. [ Time Frame: at approx 6, 12 and 18 months ] [ Designated as safety issue: Yes ]
We will look at the number of patients who have Hematologic Toxicity as well as non-hematologic toxicity
Same as current
Not Provided
Not Provided
 
Chemotherapy for Patients With Gastroesophageal Cancers Who Have Progressed After One Prior Chemo Regimen
A Phase II Study Of Cabazitaxel For Metastatic Gastroesophageal Adenocarcinomas That Have Relapsed After At Least One Line Of Chemotherapy

The purpose of this study is to evaluate the effectiveness of Cabazitaxel, as well as safety and side effects for patients with advanced gastroesophageal cancer

Gastric cancer is the second most frequent cancer-related cause of death after lung cancer worldwide with approximately 900,000 cases per year. The incidence of gastric cancer is highest in East Asia, China and Japan. In the last two decades there has been a dramatic increase in North America and Europe of adenocarcinoma of the distal esophagus and GE junction which are indistinguishable from proximal gastric cancer.

Cabazitaxel (XRP6258) is a semi-synthetic novel taxoid. Like traditional taxane drugs, it binds to and stabilizes tubilin structures resulting in inhibition of cold-induced microtubule depolymerization and cell division with subsequent inhibition of tumor cell proliferation. This novel agent, however, has poor affinity for P-glycoprotein--the protein product of multidrug resistance gene ABCB1. P-glycoprotein is a membrane-associated drug efflux pump and is thought to be a potential cause of taxane resistance in tumors. Also unlike traditional taxanes, Cabazitaxel has exhibited penetration through the blood-brain barrier (BBB.) Preclinical studies have demonstrated that Cabazitaxel was cytotoxic for cell lines with acquired resistance to doxorubicin, vincristine, vinblastine, paclitaxel or docetaxel.

Taxanes have demonstrated statistically significant antitumor activity as both monotherapy and as part of combination triplet regimens in gastroesophageal carcinoma.Cabazitaxel has emerged as a novel investigational semi-synthetic taxoid that has established activity in cell lines refractory to traditional taxanes in preclinical studies and now in a phase III study in patients with metastatic prostate cancer. Cabazitaxel, with its low affinity for the P-glycoprotein drug efflux pump, may demonstrate superior response rates to docetaxel. Furthermore, as demonstrated in prostate cancer, cabazitaxel appears to have substantial activity in patients who have previously been treated with docetaxel.

Phase I and II trials have been conducted demonstrating safety and efficacy of Cabazitaxel (XRP6258) in metastatic breast and prostate cancer. Neutropenia was the primary dose-limiting toxicity with the recommended dose established at 20 and 25mg/m2. The latter dose was used in the TROPIC trial, the pivotal phase III trial demonstrating improved overall survival and median progression free survival in patients with hormone resistant prostate cancer refractory to docetaxel who had received Cabazitaxel plus prednisone versus those who received mitaxantrone plus prednisone. Cabazitaxel given at IV doses of 25mg/m2 has demonstrated both safety and anti-tumor efficacy in phase I, II and now phase III trials

The primary goal is to evaluate the activity of Cabazitaxel for the treatment of advanced gastroesophageal cancer that has progressed after at least one line of treatment for metastatic disease. Activity will be defined as a complete or partial response. The investigators will differentiate between a 10% level of activity and a 30% level of activity.

Interventional
Phase 2
Allocation: Non-Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
  • Esophageal
  • Gastrooesophageal Cancer
  • Gastric Cancer
Drug: jevtana
Cabazitaxel 25mg/m2, IV every 21 days until progression
Other Name: Cabazitaxel
Experimental: real drug
patients will receive Jevtana 25mg/m2, IV every 21 days until disease progression or unacceptable toxicity
Intervention: Drug: jevtana
Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Terminated
15
March 2013
December 2012   (final data collection date for primary outcome measure)

Inclusion Criteria:

  • Patients are required to have histologically or pathologically confirmed metastatic gastric or esophageal adenocarcinoma.
  • Patients must demonstrate relapse or progression after at least one prior line of chemotherapy for metastatic disease.
  • Patients must have measurable disease by CT scan or MRI
  • Absolute neutrophil count ≥ 1,500/uL, platelet ≥ 100,000/uL and Hgb > 8.0 g/dl.
  • Total bilirubin ≤ upper institutional limit of normal (ULN), and AST or ALT ≤ 3x ULN; if liver metastases then AST or ALT < 5x ULN
  • Peripheral neuropathy must be ≤ Grade 1
  • Creatinine < 2 x ULN
  • ECOG performance status 0 to 2
  • Minimum life expectancy of 12 weeks.
  • Age older than 18 years.
  • Voluntary, signed written informed consent.
  • Women of childbearing potential must have a negative pregnancy test Men and women of childbearing potential must be willing to consent to using effective contraception while on treatment and for at least 3 months thereafter.

Exclusion Criteria:

  • History of severe hypersensitivity reaction to Cabazitaxel or other drugs formulated with polysorbate 80.
  • Patients with known, untreated brain metastasis
  • Any uncontrolled severe, intercurrent illness.
  • Women who are breast-feeding.
  • Patients who have undergone major surgery, chemotherapy, or radiotherapy within the last 3 weeks.
  • Patients on concurrent anticancer therapy
Both
18 Years and older
No
Contact information is only displayed when the study is recruiting subjects
United States
 
NCT01365130
BrUOG 243
Yes
howard safran, Brown University
howard safran
  • Roger Williams Medical Center
  • Rhode Island Hospital
  • The Miriam Hospital
Principal Investigator: Howard safran, MD Brown University
Brown University
October 2012

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP