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Gefitinib in Treating Patients With Recurrent or Metastatic Esophageal or Gastroesophageal Junction Cancer

This study has been completed.
National Cancer Institute (NCI)
Information provided by (Responsible Party):
David Adelstein, MD, Case Comprehensive Cancer Center Identifier:
First received: December 20, 2005
Last updated: December 4, 2015
Last verified: December 2015

RATIONALE: Gefitinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth.

PURPOSE: This phase II trial is studying how well gefitinib works in treating patients with recurrent or metastatic esophageal or gastroesophageal junction cancer.

Condition Intervention Phase
Esophageal Cancer
Drug: ZD1839
Phase 2

Study Type: Interventional
Study Design: Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Phase II Trial of ZD1839 (IRESSA®) for Patients With Recurrent or Metastatic Cancer of the Esophagus or Gastroesophageal Junction

Resource links provided by NLM:

Further study details as provided by Case Comprehensive Cancer Center:

Primary Outcome Measures:
  • The Number of Patients With Complete or Partial Response Rate of Single Agent ZD1839 in a Patient Population With Recurrent or Metastatic Cancer of the Esophagus or Gastroesophageal Junction, Using the RECIST 1.0 Criteria. [ Time Frame: at 8 weeks after initiation of treatment ]
    The overall response is the number of patients with the best response recorded in measurable disease (target lesions) from start to disease progression.Complete response is the number of patients with the disappearance of all target lesions. Partial response is the number of patients with larger than or equal to 30% decrease in sum of the longest diameters from baseline. Progressive disease is larger than or equal to 20% increase in sum of the longest diameters over the smallest sum observed or appearance of new lesions. Stable disease is neither PR nor PD criteria met.

Enrollment: 58
Study Start Date: October 2005
Study Completion Date: August 2011
Primary Completion Date: January 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: ZD1839 Drug: ZD1839
ZD1839 treatment will be taken once a day PO, every day about the same time
Other Names:
  • Gefitinib

Detailed Description:



  • Explore the activity of single agent gefitinib, in terms of response rate, in a patient population with recurrent or metastatic esophageal or gastroesophageal junction cancer.


  • Assess the toxicity of this drug in these patients.

OUTLINE: Patients are stratified according to prior treatment (yes vs no).

Patients receive oral gefitinib once daily for at least 8 weeks in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed periodically for survival.

PROJECTED ACCRUAL: A total of 76 patients will be accrued for this study.


Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No


  • Pathologically confirmed squamous cell carcinoma, adenocarcinoma, or large-cell undifferentiated carcinoma of the esophagus or gastroesophageal junction

    • Patients must have disease that is either metastatic (i.e., M1b by the definitions of the American Joint Committee on Cancer 1997 staging system) or recurrent after definitive therapy, and must be considered incurable by conventional treatments
    • Patients with small cell, or mixed small cell/non-small-cell histology are ineligible
    • Patients with lymphoma or sarcoma are also ineligible
  • Disease must be measurable in at least one dimension by physical exam, x-ray, CT scan or MRI, ultrasound, or endoscopy

    • Measurable disease can be a previously irradiated lesion if disease growth has been documented in the lesion since completion of radiation therapy
    • An elevation in carcinoembryonic antigen (CEA) is not sufficient to use by itself in response assessment


  • ECOG Performance Status 0-1
  • WBC ≥ 3,000/mm^3
  • Platelet count ≥ 100,000/mm^3
  • Creatinine ≤ 2.0 mg/dL
  • Alkaline phosphatase and AST < twice normal
  • Bilirubin < twice normal
  • Calcium normal
  • No known severe hypersensitivity to study drug or any of its excipients
  • No clinical evidence of any other uncontrolled malignancy except adequately treated basal or squamous cell skin cancer or in situ cervical cancer
  • Pregnant or nursing women are ineligible
  • Fertile patients must use effective contraception
  • No evidence of severe or uncontrolled systemic disease (e.g., unstable or uncompensated respiratory, cardiac, hepatic, or renal disease)
  • No evidence of clinically active interstitial lung disease

    • Patients with chronic stable radiographic changes who are asymptomatic need not be excluded


  • Patients may not have received more than one previous systemic treatment regimen

    • Systemic treatment may have been given as part of definitive (adjuvant, neoadjuvant, concurrent, or sequential) management or for metastatic or recurrent disease
    • Previously untreated patients are also eligible
  • No previous treatment with study drug or any other epidermal growth factor receptor (EGFR) antagonists
  • More than 30 days since prior treatment with a non-approved or investigational drug
  • At least 4 weeks must have elapsed since any surgery, radiation therapy, or chemotherapy administration
  • Recovered from previous oncologic or other major surgery
  • No concurrent barbiturates (e.g., phenytoin), carbamazepine, rifampicin, phenobarbital or Hypericum perforatum (St. John's wort)
  • No concurrent surgery, radiation therapy, hormonal therapy, or other chemotherapy
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Please refer to this study by its identifier: NCT00268346

United States, Ohio
Cleveland Clinic Taussig Cancer Institute, Case Comprehensive Cancer Center
Cleveland, Ohio, United States, 44195
Sponsors and Collaborators
Case Comprehensive Cancer Center
National Cancer Institute (NCI)
Study Chair: David J. Adelstein, MD Cleveland Clinic Taussig Cancer Institute, Case Comprehensive Cancer Center
  More Information

Responsible Party: David Adelstein, MD, Principal Investigator, Case Comprehensive Cancer Center Identifier: NCT00268346     History of Changes
Other Study ID Numbers: CCF5538
P30CA043703 ( US NIH Grant/Contract Award Number )
CCF-5538 ( Other Identifier: Cleveland Clinic IRB )
Study First Received: December 20, 2005
Results First Received: October 27, 2011
Last Updated: December 4, 2015

Keywords provided by Case Comprehensive Cancer Center:
adenocarcinoma of the esophagus
recurrent esophageal cancer
squamous cell carcinoma of the esophagus
stage IV esophageal cancer

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 processed this record on May 23, 2017