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Phase II Trial of XP Versus XG in Advanced Esophageal Squamous Cell Carcinoma

This study has been completed.
Information provided by (Responsible Party):
Jeeyun Lee, Samsung Medical Center Identifier:
First received: November 10, 2011
Last updated: December 28, 2015
Last verified: December 2015

Until today, the 5-FU/cisplatin combination is the reference regimen with 30-45% response rates, which is most commonly used to treat patients with metastatic, recurrent or locally advanced, unresectable squamous cell carcinoma of the esophagus. Because the classical dose schedule of this two-drug combination is cisplatin 100 mg/m2 day 1 and 5-FU 1000 mg/m2/day continuous infusion for 96-120 hr, prolonged administration time and mucosal toxicity are inconvenient to the patients with the aim of palliation. Capecitabine, which is oral prodrug of 5-FU and mimic continuously-infused 5-FU, is being investigated in phase I, II and III trials for the treatment of gastric, gastroesophageal, and esophageal cancers, primarily in the first-line metastatic setting but also in the adjuvant setting. In the investigators experience, capecitabine plus cisplatin combination (XP) as a first-line treatment for 45 patients with advanced or recurrent esophageal squamous cell carcinoma demonstrated a promising anti-tumor activity with 57% of response rate and showed tolerable toxicity with convenience.

Paclitaxel has been also investigated as monotherapy and in combination with cisplatin in patients with advanced esophageal cancer. A Dutch phase II study demonstrated that paclitaxel combination with carboplatin had shown an encouraging confirmed response rate of 59% with 51 patients with resectable esophageal cancer in neoadjuvant setting. Another Dutch phase II study showed 43% of response rate including 4% of CR with 8 months of response duration when paclitaxel plus cisplatin administration was given for patients with metastatic esophageal cancer. Although recently first-line palliative chemotherapy regimen in esophageal cancer has been investigated, many trials have failed to show superiority to 5-FU/cisplatin combination. Since the investigators considered that XP or XG (genexol) is more effective and convenient chemotherapy regimen than 5-FU/cisplatin, this randomized phase II study was planned to compare XP with XG in terms of efficacy and tolerability.

Condition Intervention Phase
Advanced or Recurrent Esophageal Squamous Cell Carcinoma Drug: Capecitabine/Cisplatin(XP) Drug: Capecitabine/Paditaxel(XG) Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Randomized Phase II Trial of Capecitabine Plus Cisplatin (XP) Versus Capecitabine Plus Genexol (XG) as a First-line Treatment for Advanced or Recurrent Esophageal Squamous Cell Carcinoma

Resource links provided by NLM:

Further study details as provided by Jeeyun Lee, Samsung Medical Center:

Primary Outcome Measures:
  • response rate [ Time Frame: 12 months ]

Secondary Outcome Measures:
  • progression free survival [ Time Frame: 12 months ]
  • quality of life [ Time Frame: 12 months ]
  • Number of Adverse Event [ Time Frame: 12 months ]
  • overall survival [ Time Frame: 12 months ]
  • predictive marker [ Time Frame: 12 months ]

Enrollment: 64
Study Start Date: September 2008
Study Completion Date: May 2014
Primary Completion Date: September 2013 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: Capecitabine/Cisplatin(XP)
Capecitabine AND Cisplatin
Drug: Capecitabine/Cisplatin(XP)
Capecitabine/Cisplatin(XP) D1-D14 Capecitabine 2000mg/m2 D#2 PO D1 Cisplatin 75mg/m2 iv q 3 weeks
Active Comparator: Capecitabine/Paditaxel(XG)
Capecitabine + Paditaxel(genexol)
Drug: Capecitabine/Paditaxel(XG)
Capecitabine/Paditaxel(XG) D1-D14 Capecitabine 2000mg/m2 D#2 PO D1,D8 Paditaxel(genexol) 80mg/m2 iv q 3 weeks


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

Inclusion Criteria

  • Histologically confirmed metastatic, or recurrent esophageal squamous cell carcinoma
  • Age > 18 years
  • ECOG performance status 0 - 2
  • At least one measurable lesion(s) by RECIST criteria
  • Life expectancy ≥ 3 months
  • No prior palliative chemotherapy
  • Patients may have received prior adjuvant chemotherapy with 5-FU with cisplatin as long as it has been 6months since completion of regimen.
  • Adequate bone marrow function (≥ ANC 1,500/ul, ≥ platelet 100,000/ul, ≥ Hb 9.0 g/dl)
  • Adequate renal function (≤ serum creatinine 1.5 mg/dl or CCr ≥ 50 ml/min)
  • Adequate liver function (≤ serum bilirubin 1.5 mg/dl, ≤ AST/ALT x 3 UNL)
  • Written informed consent

Exclusion Criteria:

  • Other tumor type than squamous cell carcinoma
  • CNS metastasis
  • Contraindication to any drug contained in the chemotherapy regimen
  • Previous adjuvant treatment with 5-FU, cisplstin, capecitabine or paclitaxel finished less than 1 year6 months
  • Evidence of serious gastrointestinal bleeding
  • History of another malignancy within the last five years except cured
  • basal cell carcinoma of skin and cured carcinoma in-situ of uterine cervix
  • Clinically significant cardiac disease
  • Serious pulmonary conditions/illness
  • Serious metabolic disease such as severe non-compensated diabetes mellitus
  • History of significant neurologic or psychiatric disorders
  • Serious uncontrolled intercurrent infections, or other serious uncontrolled concomitant disease
  • Positive serology for the HIV
  • Pregnancy, breast feeding patient
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Please refer to this study by its identifier: NCT01474642

Korea, Republic of
Samsung Medical Center
Seoul, Korea, Republic of
Sponsors and Collaborators
Samsung Medical Center
Principal Investigator: Jeeyun Lee, M.D., Ph.D. Samsung Medical Center, Seoul, Korea
  More Information

Responsible Party: Jeeyun Lee, Professor of Medicine, Sungkyunkwan University School of Medicine, Department of Hematology and Oncology, Samsung Medical Center Identifier: NCT01474642     History of Changes
Other Study ID Numbers: 2011-09-10
Study First Received: November 10, 2011
Last Updated: December 28, 2015

Keywords provided by Jeeyun Lee, Samsung Medical Center:
Advanced or recurrent esophageal squamous cell carcinoma
Randomizes phase II trial

Additional relevant MeSH terms:
Carcinoma, Squamous Cell
Esophageal Neoplasms
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Neoplasms, Squamous Cell
Gastrointestinal Neoplasms
Digestive System Neoplasms
Neoplasms by Site
Head and Neck Neoplasms
Digestive System Diseases
Esophageal Diseases
Gastrointestinal Diseases
Antineoplastic Agents
Antimetabolites, Antineoplastic
Molecular Mechanisms of Pharmacological Action processed this record on August 22, 2017