Gefitinib, Cisplatin, Irinotecan, and Radiation Therapy Before Surgery in Treating Patients With Esophageal Cancer or Gastroesophageal Junction Cancer That Can Be Removed By Surgery

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: NCT00290719
Recruitment Status : Terminated (low enrollment)
First Posted : February 13, 2006
Last Update Posted : May 9, 2014
National Cancer Institute (NCI)
Information provided by (Responsible Party):
University of California, San Francisco

Brief Summary:

RATIONALE: Gefitinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as cisplatin and irinotecan, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Radiation therapy uses high-energy x-rays to kill tumor cells. Giving gefitinib together with chemotherapy and radiation therapy before surgery may make the tumor smaller and reduce the amount of normal tissue that needs to be removed.

PURPOSE: This phase I/II trial is studying the side effects of gefitinib when given together with cisplatin, irinotecan, and radiation therapy before surgery and to see how well they work in treating patients with esophageal cancer or gastroesophageal junction cancer that can be removed by surgery.

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

Detailed Description:



  • Evaluate the pathologic response (complete and partial) in patients with resectable esophageal or gastroesophageal junction cancer treated with neoadjuvant gefitinib, cisplatin, irinotecan hydrochloride, and radiotherapy followed by surgical resection.


  • Assess the safety and toxicity of this regimen in these patients.
  • Evaluate objective tumor response in patients treated with this regimen.
  • Determine the rate of complete resection in patients treated with this regimen.
  • Determine surgical morbidity and mortality in patients treated with this regimen.

OUTLINE: This is an open-label study.

  • Induction phase: Patients receive oral gefitinib once daily on days 1-14. Patients with stable or responding disease proceed to neoadjuvant chemoradiotherapy.
  • Neoadjuvant chemoradiotherapy: Patients receive gefitinib as in the induction phase beginning in week 4 and continuing through the last day of radiotherapy. Patients also receive cisplatin IV over 1 hour and irinotecan hydrochloride IV over 30 minutes on days 22, 29, 43, and 50 and undergo radiotherapy once daily, 5 days a week, for 5 weeks (total of 25 doses).
  • Surgery: Within 4-8 weeks after completion of neoadjuvant chemoradiotherapy, patients with stable or responding disease undergo an esophagectomy and lymph node dissection. Patients with a progressive or unresectable disease are removed from the study.

After completion of study treatment, patients are followed periodically.

PROJECTED ACCRUAL: A total of 20 patients will be accrued for this study.

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 6 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase I/II Study to Evaluate Safety and Efficacy in Patients Who Have Resectable Esophageal Cancer and Are Treated With Neoadjuvant Cisplatin, Irinotecan (CPT-11) ZD1839 (IRESSA), and Radiotherapy Followed by Surgical Resection
Study Start Date : November 2005
Actual Primary Completion Date : April 2008
Actual Study Completion Date : June 2008

Resource links provided by the National Library of Medicine

Primary Outcome Measures :
  1. Pathological response (complete and partial) post-operatively

Secondary Outcome Measures :
  1. Safety and toxicity post-operatively
  2. Response rate 2 weeks into treatment, pre-operatively, and post-operatively
  3. Completeness of resection post-operatively
  4. Surgical morbidity and mortality post-operatively
  5. Compare the effects of gefitinib on biomarkers that effect EGF signaling and genomic composition of tumor samples before and after treatment

Information from the National Library of Medicine

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


  • Histologically confirmed adenocarcinoma (AC) or squamous cell carcinoma of the esophagus

    • AC of the gastroesophageal junction allowed
  • Tumor must be considered surgically resectable (T1-3, NX)

    • No early-stage cancer (T1, N0)
  • The following lymph node (LN) criteria are considered acceptable:

    • Regional thoracic LN metastases (N1)
    • LN metastases levels 15 to 20 measured as ≤ 1.5 cm by CT scan
    • Supraclavicular LN not palpable on clinical examination measured as ≤ 1.5 cm by CT scan
  • No distant metastases (M0)


  • Platelet count ≥ 100,000/mm^3
  • Absolute neutrophil count ≥ 1,500/mm^3
  • Hemoglobin ≥ 9.0 g/dL
  • Creatinine clearance ≥ 50 mL/min
  • Creatinine serum level ≤ CTC grade 2
  • Bilirubin ≤ 2 times upper limit of normal (ULN)
  • AST < 3 times ULN
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception during and for 3 months after completion of study treatment
  • No known severe hypersensitivity to gefitinib or any of its excipients
  • No evidence (except asymptomatic chronic stable radiographic changes) of clinically active interstitial lung disease
  • No pulmonary fibrosis, Gilbert's disease, uncontrolled diabetes mellitus, or unstable angina
  • No New York Heart Association class III or IV heart disease
  • No other concurrent malignancies or malignancies diagnosed within the past 5 years except basal cell carcinoma or carcinoma in situ of the cervix
  • No serious active or uncontrolled infection, systemic disease, psychiatric illness, or other medical condition that would preclude study participation
  • No evidence of any significant clinical disorder or laboratory finding that would preclude study participation


  • No prior chemotherapy or radiotherapy for esophageal cancer
  • No prior radiotherapy that would overlap the study treatment fields
  • Recovered from prior major surgery
  • No nonapproved or investigational drugs within the past 30 days
  • No concurrent phenytoin, carbamazepine, barbiturates, rifampin, phenobarbital, or Hypericum perforatum (St. John's wort)

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): NCT00290719

United States, California
UCSF Helen Diller Family Comprehensive Cancer Center
San Francisco, California, United States, 94115
Sponsors and Collaborators
University of California, San Francisco
National Cancer Institute (NCI)
Study Chair: Andrew Ko, MD University of California, San Francisco

Responsible Party: University of California, San Francisco Identifier: NCT00290719     History of Changes
Other Study ID Numbers: CDR0000456200
First Posted: February 13, 2006    Key Record Dates
Last Update Posted: May 9, 2014
Last Verified: May 2014

Keywords provided by University of California, San Francisco:
adenocarcinoma of the esophagus
squamous cell carcinoma of the esophagus
stage II esophageal cancer
stage III 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
Antineoplastic Agents, Phytogenic
Topoisomerase I Inhibitors
Topoisomerase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Protein Kinase Inhibitors