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S-1 and Cisplatin in Treating Patients Who Are Undergoing Surgery for Stage III Stomach Cancer

This study has been completed.
Information provided by:
National Cancer Institute (NCI) Identifier:
First received: September 15, 2005
Last updated: June 25, 2013
Last verified: November 2008

RATIONALE: Drugs used in chemotherapy, such as S-1 and cisplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more tumor cells. Giving chemotherapy before surgery may shrink the tumor so that it can be removed. It is not yet known whether giving S-1 together with cisplatin before surgery is more effective than surgery followed by S-1 in treating stomach cancer.

PURPOSE: This randomized phase III trial is studying how well giving S-1 together with cisplatin before surgery works compared to surgery followed by S-1 in treating patients with stage III stomach cancer.

Condition Intervention Phase
Gastric Cancer Drug: cisplatin Drug: tegafur-gimeracil-oteracil potassium Procedure: adjuvant therapy Procedure: conventional surgery Procedure: neoadjuvant therapy Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Primary Purpose: Treatment
Official Title: Phase III Clinical Study of Preoperative S-1/CDDP Combination Chemotherapy in Patients With Potentially Resectable Stage III Advanced Gastric Cancer

Resource links provided by NLM:

Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Overall survival

Secondary Outcome Measures:
  • Progression-free survival (PFS)
  • Postoperative PFS
  • Surgical/pathological curative resection
  • Death related to treatment
  • Death related to operation
  • Postoperative complications
  • Adverse events

Estimated Enrollment: 100
Study Start Date: April 2004
Study Completion Date: November 2008
Primary Completion Date: September 2008 (Final data collection date for primary outcome measure)
Detailed Description:



  • Compare the overall survival of patients with potentially resectable stage III gastric cancer treated with neoadjuvant S-1 and cisplatin followed by gastrectomy and adjuvant S-1 vs no neoadjuvant chemotherapy before gastrectomy and adjuvant S-1.


  • Compare the progression-free survival of patients treated with these regimens.
  • Compare the curative resection rates in patients treated with these regimens.
  • Compare the safety of these regimens, in terms of postoperative complications, adverse events, and treatment- or surgery-related mortality rate, in these patients.

OUTLINE: This is a randomized, multicenter study. Patients are stratified according to disease stage (T3 vs T4) and ECOG performance status (0 vs 1). Patients are randomized to 1 of 2 treatment arms.

  • Arm I (control): Patients undergo gastrectomy with D2+ lymph node dissection. Patients then receive adjuvant oral S-1.
  • Arm II (neoadjuvant therapy): Patients receive neoadjuvant oral S-1 on days 1-21 and cisplatin IV over 2 hours on day 8. Treatment repeats every 35 days for 2 courses in the absence of disease progression. Patients then undergo surgery and receive adjuvant S-1 as in arm I.

PROJECTED ACCRUAL: A total of 100 patients (50 per treatment arm) will be accrued for this study.


Ages Eligible for Study:   20 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No


  • Histologically confirmed gastric adenocarcinoma, including type II or type III adenocarcinoma of the esophagogastric junction

    • Stage III disease

      • T3 or T4 and/or N2

        • No stage IV disease
    • Helical CT scan and laparoscopic staging required
  • Potentially resectable disease



  • 20 and over

Performance status

  • ECOG 0-1

Life expectancy

  • Not specified


  • WBC ≥ 4,000/mm³, but < 12,000/mm³
  • Granulocyte count ≥ 2,000/mm³
  • Platelet count ≥ 100,000/mm³
  • Hemoglobin ≥ 9.0 g/dL


  • AST and ALT ≤ 2.5 times upper limit of normal
  • Bilirubin ≤ 1.5 mg/dL


  • Creatinine clearance ≥ 50 mL/min


  • Arterial oxygen pressure (PaO_2) ≥ 70 mm Hg on room air


  • Able to take oral medications


Biologic therapy

  • Not specified


  • No prior chemotherapy for gastric cancer

Endocrine therapy

  • Not specified


  • No prior radiotherapy for gastric cancer


  • No prior surgery for gastric cancer


  • No other prior therapy for gastric cancer
  Contacts and Locations
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Please refer to this study by its identifier: NCT00182611

Yamato Municipal Hospital
Yamatotakada, Nara, Japan, 635-8501
Shimane Prefectural Central Hospital
Izumo-shi, Shimane, Japan, 693-0068
Fukui Red Cross Hospital
Fukui, Japan, 918-8501
Kyoto University Hospital
Kyoto, Japan, 606-8507
National Hospital Organization - Kyoto Medical Center
Kyoto, Japan, 612-0861
Kitano Hospital
Osaka, Japan, 530-8480
Sponsors and Collaborators
Kyoto University
Study Chair: Seiji Satoh Kyoto University
  More Information Identifier: NCT00182611     History of Changes
Other Study ID Numbers: KYUH-UHA-GC04-03
CDR0000426403 ( Registry Identifier: PDQ (Physician Data Query) )
Study First Received: September 15, 2005
Last Updated: June 25, 2013

Keywords provided by National Cancer Institute (NCI):
stage III gastric cancer
adenocarcinoma of the stomach

Additional relevant MeSH terms:
Stomach Neoplasms
Gastrointestinal Neoplasms
Digestive System Neoplasms
Neoplasms by Site
Digestive System Diseases
Gastrointestinal Diseases
Stomach Diseases
Antineoplastic Agents
Antimetabolites, Antineoplastic
Molecular Mechanisms of Pharmacological Action processed this record on August 23, 2017