Panitumumab, Docetaxel, Cisplatin, Radiation Therapy, and Surgery in Treating Patients With Newly Diagnosed, Locally Advanced Esophageal Cancer or Cancer of the Gastroesophageal Junction
RATIONALE: Monoclonal antibodies, such as panitumumab, can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Drugs used in chemotherapy, such as cisplatin and docetaxel, work in different ways to kill tumor cells or stop them from growing. Radiation therapy uses high-energy x-rays to kill tumor cells. Giving combination chemotherapy together with panitumumab 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 II trial is studying how well giving panitumumab together with docetaxel, cisplatin, radiation therapy, and surgery works in treating patients with newly diagnosed, locally advanced esophageal cancer or cancer of the gastroesophageal junction.
Adenocarcinoma of the Gastroesophageal Junction
Procedure: neoadjuvant therapy
Procedure: therapeutic conventional surgery
Radiation: radiation therapy
|Study Design:||Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
|Official Title:||A Phase II Study of Neoadjuvant Therapy With Cisplatin, Docetaxel, Panitumumab Plus Radiation Therapy Followed by Surgery in Patients With Locally Advanced Adenocarcinoma of the Distal Esophagus|
- Number of Participants With Pathologic Complete Response Following Surgery [ Time Frame: Post surgery ] [ Designated as safety issue: No ]Pathologic complete response (pCR) was defined as no viable residual tumor cells. A cellular residual mucin pools should be noted but also considered a pathologic complete response.
- Number of Participants With Near-complete Response Rate (≤ 10% Residual Cancer in Primary Tumor Viable) [ Time Frame: Post surgery ] [ Designated as safety issue: No ]
- Percentage of Participants With 3-year Overall Survival [ Time Frame: 3 years ] [ Designated as safety issue: No ]Survival time was defined to be the length of time from start of study therapy to death due to any cause or until last follow-up (censored value).
- Percentage of Participants With 2-year Disease-free Survival [ Time Frame: 2 years ] [ Designated as safety issue: No ]Disease-free survival was defined as the time from start of study therapy to documentation of disease recurrence. Participants who died without documentation of recurrence were considered to have had tumor recurrence at the time of death unless there was documented evidence that no recurrence occured before death. Participants who failed to return for evaluation after beginning therapy were censored for recurrence on the last day of therapy. Participants who experienced major treatment violations were censored for recurrence on the date the treatment violation occured.
- Number of Participants With Frequent (>=15% Grade 3/4 Incidence) Adverse Events Regardless of Attribution [ Time Frame: Week 1, 3, 5, 7, 9, 4-6 weeks after therapy and within 30 days post surgery ] [ Designated as safety issue: Yes ]Adverse events were assessed by NCI CTCAE (Common Terminology Criteria for Adverse Events) v3.0. Grade 1= mild, grade 2= moderate, grade 3= severe, grade 4= life-threatening; and grade 5= death.
|Study Start Date:||January 2009|
|Primary Completion Date:||November 2011 (Final data collection date for primary outcome measure)|
Docetaxel + Cisplatin + Panitumumab + RT
Patients received docetaxel (40 mg/m^2), cisplatin (40 mg/m^2) and panitumumab (6 mg/kg) on weeks 1, 3, 5, 7, and 9 with radiotherapy (RT) (5040 cGy, 180 cGy/day x 28 days) beginning week 5. Resection was planned after completing chemotherapy (CRT).
|Biological: panitumumab Drug: cisplatin Drug: docetaxel Procedure: neoadjuvant therapy Procedure: therapeutic conventional surgery Radiation: radiation therapy|
- To determine the pathologic complete response rate in patients with newly diagnosed, locally advanced adenocarcinoma of the distal esophagus or gastroesophageal junction treated with neoadjuvant panitumumab and combination chemoradiotherapy followed by surgery.
- To determine the near-complete pathologic response rate in the primary tumor (≤ 10% residual viable cancer).
- To determine the overall survival and disease-free survival rates of these patients.
- To determine the safety profile of this regimen.
OUTLINE: Patients receive panitumumab IV over 1 hour, docetaxel IV over 1 hour, and cisplatin IV over 1-2 hours on day 1 in weeks 1, 3, 5, 7, and 9. Patients also undergo radiotherapy once daily 5 days a week beginning in week 5 and continuing for 5.5 weeks. Treatment continues in the absence of disease progression or unacceptable toxicity. Beginning 6-9 weeks after completion of chemoradiotherapy, patients with no evidence of metastatic disease undergo esophagectomy.
After completion of study treatment, patients are followed every 3 months for 2 years and then every 6 months for 1 year OR every 6 months for 3 years.
Please refer to this study by its ClinicalTrials.gov identifier: NCT00757172
|United States, Georgia|
|Curtis and Elizabeth Anderson Cancer Institute at Memorial Health University Medical Center|
|Savannah, Georgia, United States, 31403-3089|
|United States, Illinois|
|Robert H. Lurie Comprehensive Cancer Center at Northwestern University|
|Chicago, Illinois, United States, 60611-3013|
|University of Chicago Cancer Research Center|
|Chicago, Illinois, United States, 60637-1470|
|Evanston, Illinois, United States, 60201-1781|
|Simmons Cooper Cancer Institute|
|Springfield, Illinois, United States, 62794-9677|
|United States, Kentucky|
|Central Baptist Hospital|
|Lexington, Kentucky, United States, 40503-9985|
|United States, Michigan|
|William Beaumont Hospital - Royal Oak Campus|
|Royal Oak, Michigan, United States, 48073|
|United States, Minnesota|
|Mayo Clinic Cancer Center|
|Rochester, Minnesota, United States, 55905|
|United States, Missouri|
|Siteman Cancer Center at Barnes-Jewish Hospital - Saint Louis|
|Saint Louis, Missouri, United States, 63110|
|United States, New Hampshire|
|Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center|
|Lebanon, New Hampshire, United States, 03756-0002|
|United States, North Carolina|
|Blumenthal Cancer Center at Carolinas Medical Center|
|Charlotte, North Carolina, United States, 28232-2861|
|Wake Forest University Comprehensive Cancer Center|
|Winston-Salem, North Carolina, United States, 27157-1096|
|United States, Ohio|
|Good Samaritan Hospital|
|Dayton, Ohio, United States, 45406|
|Greenville, Ohio, United States, 45331|
|Charles F. Kettering Memorial Hospital|
|Kettering, Ohio, United States, 45429|
|United States, Oregon|
|Providence Cancer Center at Providence Portland Medical Center|
|Portland, Oregon, United States, 97213-2967|
|Legacy Emanuel Hospital and Health Center and Children's Hospital|
|Portland, Oregon, United States, 97227|
|United States, Pennsylvania|
|Geisinger Cancer Institute at Geisinger Health|
|Danville, Pennsylvania, United States, 17822-0001|
|Allegheny Cancer Center at Allegheny General Hospital|
|Pittsburgh, Pennsylvania, United States, 15212|
|UPMC Cancer Centers|
|Pittsburgh, Pennsylvania, United States, 15232|
|United States, South Carolina|
|Hollings Cancer Center at Medical University of South Carolina|
|Charleston, South Carolina, United States, 29425|
|Study Chair:||A. Craig Lockhart, MD||Washington University School of Medicine|