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Sunitinib in Patients With Advanced Gastric Cancer and Treated With FOLFIRI (SUN-CASE)

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: NCT01020630
Recruitment Status : Completed
First Posted : November 25, 2009
Last Update Posted : May 14, 2014
Information provided by (Responsible Party):
PD Dr Markus Möhler, Johannes Gutenberg University Mainz

Brief Summary:

This trial will be conducted to evaluate the efficacy, safety and tolerability of SUNITINIB as add-on therapy with a widely used second-line palliative FOLFIRI chemotherapy in patients with chemo-refractory advanced or metastatic adenocarcinoma of stomach or lower esophagus (mGC).

There is a clear scientific rationale for the use of Sunitinib to treat patients with mGC. Despite recent therapeutic advances, the median overall survival (OS) in patients with mG is still ≤ 12 months. Therefore, newer agents with novel mechanisms of action are desperately needed for treatment of these patients.

Condition or disease Intervention/treatment Phase
Adenocarcinoma Drug: Sunitinib Drug: Placebo Phase 2

Detailed Description:

In parallel to the efforts in front-line therapy, second-line protocols like irinotecan-based regimens have been established in clinical trials for those patients. As many patients are still in good performance status and present with low tumor burden after failure of first-line chemotherapy, they clearly benefit from second-line treatment.

Sunitinib inhibits the receptor tyrosine kinases (RTKs) involved in tumor proliferation and angiogenesis, specifically the VEGFR, PDGFR, KIT, FLT-3, and RET. The VEGF pathway has been shown to be a significant factor in metastatic gastric cancer.

The safety and efficacy of Sunitinib as single agent for the treatment of mGC has been determined and support the proposed clinical study with FOLFIRI in combination with Sunitinib in the treatment of patients with mGC.

Patients included in this trial suffer from advanced or metastatic adenocarcinoma of stomach or lower esophagus. They have failed to respond at least to one standard palliative first-line therapy (based on docetaxel and/or cisplatin plus 5-FU). Irinotecan/FA/5-FU can be determined as one established second-line treatment to be available for these patients.

Taken together, treatment of those patients with Sunitinib combined with standard chemotherapy FOLFIRI offers the chance to benefit from a new innovative therapy with acceptable side effects.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 91 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Randomized, Placebo-controlled Phase II Trial Investigating SUNITINIB Versus Placebo in Patients With Chemorefractory Advanced Adenocarcinoma of the Stomach or Lower Esophagus Treated With Chemotherapy FOLFIRI
Study Start Date : November 2009
Actual Primary Completion Date : November 2012
Actual Study Completion Date : July 2013

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
Experimental: Sunitinib
25 mg (2 capsules of 12.5 mg) for oral administration
Drug: Sunitinib
Sunitinib will be orally administered at 25 mg once daily (in the morning without regards to meals) for 4 consecutive weeks followed by a 2-week rest period to comprise a complete cycle of 6 weeks.
Other Name: Sutent

Placebo Comparator: Placebo
2 capsules for oral administration
Drug: Placebo
Placebo will be orally administered once daily (in the morning without regards to meals) for 4 consecutive weeks followed by a 2-week rest period to comprise a complete cycle of 6 weeks.

Primary Outcome Measures :
  1. The primary endpoint is the Progression-free survival (PFS) according to RECIST V1.1. [ Time Frame: Average time period: up to one year (participants are followed until progression or death) ]

Secondary Outcome Measures :
  1. Objective response rate (CR + PR) according to RECIST [ Time Frame: Average time period: up to one year (participants are followed until progression or death) ]
  2. Safety and tolerability [ Time Frame: one year ]

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.

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

Inclusion Criteria:

  • Signed and dated informed consent before the start of specific protocol procedures
  • Histological proven gastric adenocarcinoma including adenocarcinoma of the esophagogastric junction or lower esophagus
  • Failure of any prior chemotherapy (docetaxel and/or platinum-based chemotherapy); but patient has not previously received FOLFIRI treatment
  • Measurable metastatic disease according to the RECIST criteria patients aged 18 years and older
  • karnofsky index 100 - 70 %
  • Life expectancy > 12 weeks
  • Adequate hematological, hepatic and renal functions
  • At least 3 weeks from previous docetaxel- and/or platinum-based chemotherapy
  • Recovery from hematological side effects (CTC grade <1) and non-hematological side effects (CTC grade=<1) of any prior therapy (except oxaliplatine induced neuropathy CTC grade =<2)

Exclusion Criteria:

  • History of another primary malignancy >3 years, with the exception of non-melanoma skin cancer and in situ carcinoma of the uterine cervix
  • Any prior palliative radiotherapy of the target lesions
  • Concurrent treatment with any other medicinal anti-cancer therapy
  • Prior treatment with a VEGF, VEGFR or RTK inhibitor, or prior enrolment on this study
  • Known allergic/hypersensitivity reaction to any of the components of the treatment
  • Treatment with potent CYP3A4 inhibitor within 7 days of Sunitinib/placebo dosing or with potent CYP3A4 inducer within 12 days of Sunitinib/placebo dosing
  • Other serious illness or medical conditions within the last 12 months prior to study drug administration: Unstable cardiac disease despite treatment; myocardial infarction within 12 months prior to study entry; congestive heart failure NYHA grade 3 and 4; Hypertension that cannot be controlled by medication ; ongoing cardiac dysrhythmias of NCI CTCAE grade >2, atrial fibrillation of any grade, or QTc interval >450 msec for males or >470 msec for females; History of significant neurologic or psychiatric disorders including dementia or seizures; Active uncontrolled infection; History of clinically significant bleeding within the past 6 months, including hemoptysis or haematuria, or underlying coagulopathy; Active disseminated intravascular coagulation; Cerebrovascular accident including transient ischemic attack; Pulmonary embolus; Bowel obstruction or chronic diarrhoea, history or presence of inflammatory enteropathy or extensive intestinal resection; History of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within 6 months prior to study enrolment, unless affected area has been removed surgically
  • Known deficit in DPD
  • Hypercalcemia not controlled by bisphosphonates
  • Contraindications to the use of atropine
  • Pregnant or lactating women; female patients who are pregnant or lactating or men and women of reproductive potential not willing or not able to employ an effective method of birth control/contraception to prevent pregnancy during treatment and for 3 months after discontinuing study treatment
  • Known drug abuse/alcohol abuse
  • Current, recent, or planned participation in an experimental treatment drug study other than this protocol
  • Major surgical procedure, open biopsy or significant traumatic injury within 4 weeks before starting treatment; anticipation of need for major surgical procedure (e.g. impending bowel obstruction) during the course of the study
  • History of other medical or psychiatric condition, metabolic dysfunction, physical examination finding, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates the use of an investigational drug or that might affect the interpretation of the results of the study or render the patient at high risk from treatment complications

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): NCT01020630

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Universitätsmedizin Mainz, 1. Med. Klinik
Mainz, Rheinland-Pfalz, Germany, 55131
Gesundheitszentrum St. Marien
Amberg, Germany, 92224
Helios Klinikum Berlin-Buch
Berlin, Germany, 13125
Universitätsmedizin Berlin Charite
Berlin, Germany, 13353
Evangelisches Krankenhaus Bielefeld
Bielefeld, Germany, 33611
Universitätsklinikum Essen
Essen, Germany, 45122
Kliniken Essen-Mitte
Essen, Germany, 45136
Krankenhaus Nordwest
Frankfurt, Germany, 60488
Martin-Luther-Universität Halle-Wittenberg
Halle, Germany, 06120
MVZ für Innere Medizin in Hamburg-Eppendorf
Hamburg, Germany, 20249
Universitätsklinikum des Saarlandes
Homburg, Germany, 66421
Klinikum Ludwigsburg Medizinische Klinik I
Ludwigsburg, Germany, 71640
Technische Universität München
München, Germany, 81675
Universitätsklinikum Rostock Klinik für Innere Medizin
Rostock, Germany, 18057
Leopoldina-Krankenhaus der Stadt Schweinfurt gGmbH
Schweinfurt, Germany, 97422
Klinikum Weiden
Weiden, Germany, 92637
Sponsors and Collaborators
PD Dr Markus Möhler
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Principal Investigator: Markus Moehler, MD Johannes Gutenberg University Mainz, 1. Med. Klinik
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Responsible Party: PD Dr Markus Möhler, PD Dr., Johannes Gutenberg University Mainz Identifier: NCT01020630    
Other Study ID Numbers: 2009-02-SUN-Case
First Posted: November 25, 2009    Key Record Dates
Last Update Posted: May 14, 2014
Last Verified: May 2014
Keywords provided by PD Dr Markus Möhler, Johannes Gutenberg University Mainz:
adenocarcinoma of stomach
adenocarcinoma of lower oesophagus
Additional relevant MeSH terms:
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Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Antineoplastic Agents
Angiogenesis Inhibitors
Angiogenesis Modulating Agents
Growth Substances
Physiological Effects of Drugs
Growth Inhibitors
Protein Kinase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action