Oxaliplatin, Gefitinib, and Radiation Therapy in Treating Patients With Locally Advanced or Metastatic Esophageal Cancer

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00093652
Recruitment Status : Terminated
First Posted : October 8, 2004
Last Update Posted : October 6, 2015
Information provided by:
Roswell Park Cancer Institute

Brief Summary:

RATIONALE: Drugs used in chemotherapy, such as oxaliplatin, work in different ways to stop tumor cells from dividing so they stop growing or die. Gefitinib may stop the growth of tumor cells by blocking the enzymes necessary for their growth. Radiation therapy uses high-energy x-rays to damage tumor cells. Combining oxaliplatin and gefitinib with radiation therapy may kill more tumor cells.

PURPOSE: This phase I/II trial is studying the side effects and best dose of oxaliplatin when given together with gefitinib and radiation therapy and to see how well they work in treating patients with locally advanced or metastatic esophageal cancer.

Condition or disease Intervention/treatment Phase
Esophageal Cancer Drug: gefitinib Drug: oxaliplatin Procedure: conventional surgery Procedure: neoadjuvant therapy Radiation: radiation therapy Phase 1 Phase 2

Detailed Description:



  • Determine the maximum tolerated dose of oxaliplatin when administered with gefitinib and radiotherapy in patients with locally advanced or metastatic adenocarcinoma or squamous cell carcinoma of the esophagus or gastroesophageal junction. (Phase I)
  • Determine the response rate in patients treated with this regimen. (Phase II)


  • Determine time to tumor progression and median survival in patients treated with this regimen.
  • Determine quality of life in patients treated with this regimen.
  • Determine the safety of this regimen in these patients.

OUTLINE: This is a phase I, open-label, dose-escalation study of oxaliplatin followed by a phase II study.

  • Phase I: Patients receive oxaliplatin IV over 2 hours on days 1, 15, and 29. Beginning on day 1, patients undergo radiotherapy once daily, 5 days a week, for 5.5 weeks. Patients also receive oral gefitinib once daily on days 1-365. Treatment continues in the absence of disease progression or unacceptable toxicity Approximately 3-6 weeks after the completion of chemoradiotherapy, patients are evaluated. Some patients undergo surgical resection* and possibly receive a second course of oxaliplatin (IV over 2 hours on days 1, 15, and 29) 4-8 weeks after surgery. If surgery is not indicated, some patients may receive an additional course of oxaliplatin.

Cohorts of 3-6 patients receive escalating doses of oxaliplatin until the maximum tolerated dose is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity.

  • Phase II: Patients receive oxaliplatin, gefitinib, and radiotherapy as in phase I at the MTD. Some patients then either undergo surgical resection* and/or begin a second course of oxaliplatin as in phase I.

NOTE: *Oral gefitinib is discontinued ≥ 7 days before surgery and is restarted when the patient has recovered.

Quality of life is assessed at baseline, 5-6 weeks, and then every 2-3 months for 1 year.

Patients are followed every 2-3 months for 1 year.

PROJECTED ACCRUAL: Approximately 15-45 patients (3-12 for phase I and 12-33 for phase II) will be accrued for this study within 2 years.

Study Type : Interventional  (Clinical Trial)
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: ZD1839 (IRESSA®) With Oxaliplatin and Radiotherapy for Esophageal Carcinoma. A Phase I/II Study With Biologic Correlates
Study Start Date : May 2003
Actual Primary Completion Date : May 2006

Resource links provided by the National Library of Medicine

Primary Outcome Measures :
  1. Maximum tolerated dose (phase I)
  2. Response (phase II)

Secondary Outcome Measures :
  1. Survival
  2. Quality of life
  3. Safety and toxicity
  4. Immunohistochemistry

Information from the National Library of Medicine

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, Learn About Clinical Studies.

Ages Eligible for Study:   18 Years to 120 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No


  • Histologically confirmed adenocarcinoma or squamous cell carcinoma of the esophagus or gastroesophageal (GE) junction

    • Locally advanced or metastatic disease by clinical staging, including esophagogastroduodenoscopy and esophageal ultrasound

      • Stage T2, N0 disease and beyond
    • Bulk of tumor must be in the esophagus of patients with GE junction tumor

      • Bronchoscopy is required if primary esophageal tumor is < 26 cm from the incisors
  • No brain metastases



  • Over 18

Performance status

  • ECOG 0-1

Life expectancy

  • At least 4 months


  • WBC ≥ 3,000/mm^3
  • Granulocyte count ≥ 1,500/mm^3
  • Platelet count > 100,000/mm^3


  • Bilirubin normal
  • ALT and AST ≤ 2.5 times upper limit of normal (ULN)
  • Alkaline phosphatase ≤ 2.5 times ULN


  • Not specified


  • No symptomatic congestive heart failure
  • No unstable angina pectoris
  • No cardiac arrhythmia


  • No clinically active interstitial lung disease

    • Patients with chronic stable asymptomatic radiographic changes are eligible


  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective double-method (including barrier) contraception during and for 3 months after study participation
  • No peripheral neuropathy ≥ grade II
  • No severe hypersensitivity to gefitinib or any of its excipients
  • No history of allergy to platinum-based compounds or antiemetics administered with protocol-directed chemotherapy
  • No active or ongoing infection
  • No other uncontrolled illness
  • No other significant clinical disorder or laboratory finding that would preclude study participation


Biologic therapy

  • No concurrent colony-stimulating factors during course 1 of study therapy


  • More than 4 weeks since prior chemotherapy

Endocrine therapy

  • Concurrent steroid therapy allowed


  • More than 4 weeks since prior radiotherapy


  • Not specified


  • More than 30 days since prior non-approved or investigational drugs
  • No concurrent administration of any of the following:

    • Phenytoin
    • Carbamazepine
    • Rifampin
    • Barbiturates
    • Highly-active antiretroviral therapy (HAART)
    • Hypericum perforatum (St. John's wort)
  • No other concurrent investigational agents or therapy

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00093652

United States, New York
Roswell Park Cancer Institute
Buffalo, New York, United States, 14263-0001
Sponsors and Collaborators
Roswell Park Cancer Institute
Principal Investigator: Milind Javle, MD Roswell Park Cancer Institute

Publications of Results: Identifier: NCT00093652     History of Changes
Other Study ID Numbers: I 04603
First Posted: October 8, 2004    Key Record Dates
Last Update Posted: October 6, 2015
Last Verified: October 2015

Keywords provided by Roswell Park Cancer Institute:
adenocarcinoma of the esophagus
recurrent esophageal cancer
stage II esophageal cancer
stage III esophageal cancer
stage IV esophageal cancer
squamous cell carcinoma of the esophagus

Additional relevant MeSH terms:
Esophageal Neoplasms
Gastrointestinal Neoplasms
Digestive System Neoplasms
Neoplasms by Site
Head and Neck Neoplasms
Digestive System Diseases
Esophageal Diseases
Gastrointestinal Diseases
Antineoplastic Agents
Protein Kinase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action