CAPOX, Bevacizumab and Trastuzumab for Patients With HER2-Positive Metastatic Esophagogastric Cancer
Verified July 2013 by Dana-Farber Cancer Institute
Brigham and Women's Hospital
Massachusetts General Hospital
Information provided by (Responsible Party):
Peter C. Enzinger, MD, Dana-Farber Cancer Institute
First received: August 27, 2010
Last updated: July 16, 2013
Last verified: July 2013
The purpose of this study is to determine the safety and effectiveness of a combination of chemotherapy, capecitabine and oxaliplatin, plus the antibodies bevacizumab and trastuzumab. Trastuzumab (also called Herceptin) is an antibody that attacks HER2 protein in tumor cells. Bevacizumab (also called Avastin) works by slowing or stopping the growth of cells in cancer tumors by decreasing the blood supply of the tumors. If blood supply is decreased, oxygen and nutrients that are needed for tumor growth are decreased. The chemotherapy used in this trial is called CAPOX, which is an abbreviation of capecitabine and oxaliplatin.
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
||Phase II Trial of CAPOX, Bevacizumab and Trastuzumab for Patients With HER2-Positive Metastatic Esophagogastric Cancer
Primary Outcome Measures:
Secondary Outcome Measures:
| Estimated Enrollment:
| Study Start Date:
| Estimated Study Completion Date:
| Estimated Primary Completion Date:
||December 2014 (Final data collection date for primary outcome measure)
Given intravenously on day 1 of each cycle beginning cycle 2
Other Name: Avastin
Given intravenously on day 1 of each treatment cycle
Other Name: Herceptin
Given intravenously on day one of each cycle beginning cycle 2
Taken orally on days 1-14 of each cycle beginning cycle 2
Other Name: xeloda
- We recommend that the participants have a vascular access device, more commonly known as a PORT, inserted prior to starting chemotherapy. A port is a small device that is inserted under the skin (usually near the collar bone) by a minor surgical procedure and is then connected to one of the large veins inside the chest. The port will be used to give the intravenous medications.
- During the first cycle, the participant will receive trastuzumab intravenously on Day 1. Cycle 2 will then start one week later. On this day, bevacizumab will be given intravenously first followed by trastuzumab and then oxaliplatin. The participant will then start taking capecitabine tablets orally twice a day for 14 days. Each treatment cycle is 21 days long.
- Participants will have the following tests and procedures at specific time points during study treatment; physical exam, blood tests, CT scan, MUGA scan or echocardiogram, and urine test.
|Ages Eligible for Study:
||18 Years and older
|Genders Eligible for Study:
|Accepts Healthy Volunteers:
- Confirmed HER2-positive esophageal, GE junction or gastric adenocarcinoma that is metastatic or unresectable.
- All patients must have available tumor sample (either paraffin block or 15 freshly cut, unstained slides) prior to study entry.
Part II: Patient must have primary esophagogastric tumor in place or other tumor that is accessible for mandatory biopsy.
- Measurable disease, defined in RECIST 1.1
- 18 years of age or older
- Life expectancy of greater than 12 weeks
- ECOG performance status of 0 or 1
- Organ and marrow function as outlined in the protocol
- Women of child-bearing potential and men must agree to use adequate contraception during study participation and for 30 days from the date of the last study drug administration.
- Part II only: Participant agrees to undergo mandatory pre and post loading dose of trastuzumab biopsy for correlative science.
- Prior therapy with any of the following; capecitabine, oxaliplatin, bevacizumab or trastuzumab is not allowed. May have received and completed adjuvant therapy at least 6 months prior to study entry or one prior therapy for metastatic disease as long as it did not include any of the above agents.
- Chemotherapy or radiotherapy to greater then 25% of bone marrow within 4 weeks prior to entering the study.
- Palliative radiation therapy to isolated bone metastasis within 2 weeks of initiating therapy.
- Major surgery, open biopsy, significant traumatic injury within 4 weeks prior to study entry,.
- Minor surgery, including placement of vascular access device within 7 days prior to the first dose of bevacizumab.
- Residual toxicity from prior chemotherapy and/or radiation therapy of Grade 2 or greater.
- Participants may not be receiving any concurrent investigational agents
- Active brain or other CNS metastasis by history or clinical examination.
- History of allergic reactions attributed to compounds of similar chemical or biologic composition to capecitabine, bevacizumab or trastuzumab. No known allergy or hypersensitivity to Chinese hamster ovary, or any of the study agents. No known DPD deficiency.
- Warfarin is prohibited; anticoagulation using low molecular weight heparin is allowed.
- Uncontrolled, intercurrent illness
- Patients with a history of other malignancy are not eligible except for the following circumstances: disease-free for at least 3 years and are deemed to be at low risk for recurrence of that malignancy; cervical cancer in situ, basal cell or squamous cell carcinoma of the skin that was treated with curative intent within the past 5 years.
- Known HIV seropositivity, hepatitis C, acute or chronic hepatitis B or other serious active infection
- LVEF less than 50% as determined by MUGA scan or echocardiogram within 28 days prior to initiation of therapy
- Inadequately controlled hypertension
- History of prior hypertensive crisis or hypertensive encephalopathy
- History of any arterial thrombosis, CVA, TIA, MI or unstable angina in past 6 months.
- Evidence of bleeding diathesis or coagulopathy
- Serious, unhealed wounds, bone fractures or skin ulcers
- Pregnant or breast feeding
- Greater than grade 1 peripheral neuropathy at baseline
- Lack of physical integrity of the upper gastrointestinal tract or malabsorption syndrome.
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study.
To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below.
For general information, see Learn About Clinical Studies.
Please refer to this study by its ClinicalTrials.gov identifier: NCT01191697
|Dana-Farber Cancer Institute
|Boston, Massachusetts, United States, 02115 |
|Principal Investigator: Peter Enzinger, MD |
|Massachusetts General Hospital
|Boston, Massachusetts, United States, 02114 |
|Principal Investigator: Eunice Kwak, MD |
Dana-Farber Cancer Institute
Brigham and Women's Hospital
Massachusetts General Hospital
||Peter Enzinger, MD
||Dana-Farber Cancer Institute
No publications provided
||Peter C. Enzinger, MD, Principal Investigator, Dana-Farber Cancer Institute
History of Changes
|Other Study ID Numbers:
|Study First Received:
||August 27, 2010
||July 16, 2013
||United States: Institutional Review Board
Keywords provided by Dana-Farber Cancer Institute:
Additional relevant MeSH terms:
ClinicalTrials.gov processed this record on July 24, 2014
Digestive System Neoplasms
Neoplasms by Site
Head and Neck Neoplasms
Digestive System Diseases
Molecular Mechanisms of Pharmacological Action
Angiogenesis Modulating Agents
Physiological Effects of Drugs