Adenocarcinoma of the Gastroesophageal JunctionPhase 2NCT00938470
Docetaxel, Oxaliplatin, Capecitabine, Fluorouracil, and Radiation Therapy in Treating Patients With Locally Advanced Cancer of the Esophagus or Gastroesophageal Junction
A Phase 2 study testing capecitabine, docetaxel and fluorouracil in people with Adenocarcinoma of the Gastroesophageal Junction and Esophageal Cancer, run by Alliance for Clinical Trials in Oncology at 187 sites in United States.
Trial summary
This randomized phase II trial studies how well docetaxel, oxaliplatin, capecitabine, fluorouracil, and radiation therapy works compared with fluorouracil when given together with oxaliplatin and radiation therapy in treating patients with cancer of the esophagus or gastroesophageal junction that has spread from where… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Adenocarcinoma of the Gastroesophageal Junction, Esophageal Cancer, Gastric Cancer
- What is being tested?
- capecitabine, docetaxel and fluorouracil
- Type of treatment
- Injection or infusion, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 73 participants
- Where
- 187 sitesUnited States
- Study dates
- Jan 2010to Mar 2018
- Phase
- Phase 2
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Histological confirmation of adenocarcinoma of the esophagus, gastroesophageal (GE) junction, or gastric cardia
- Tumor must be considered surgically resectable; Note: patients with T4N0M0 tumors that are potentially resectable are also eligible
- Nodal involvement: patients with involvement of celiac nodes, (stations 15-20) are eligible if the primary lesion is mid-thoracic, distal esophagus or GE junction; patients with supraclavicular node involvement are eligible with upper thoracic esophagus primary lesions
- Capable of swallowing pills
- Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0, 1, or 2
- Absolute neutrophil count (ANC) >= 1500
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- Peripheral platelet count >= 100,000
- Hemoglobin >= 9.0 g/dL
- Total bilirubin =< 1.5 x upper normal limit (UNL)
- Serum glutamic oxaloacetic transaminase (SGOT) (alanine aminotransferase [AST]) =< 3 x UNL
- Creatinine =< 1.5 x UNL
- Negative pregnancy test done =< 7 days prior to registration, for women of childbearing potential only
- Provide informed written consent
- Willingness to return to NCCTG enrolling institution for follow-up
- Patient willing to provide mandatory tissue and blood samples for research purposes
- Patient willing to allow use of FDG PET/CT scans for mandatory research purposes
Who cannot join
- Evidence of distant metastases
- Palpable supraclavicular nodes, biopsy-proven involvement of supraclavicular nodes, or radiographically involved supraclavicular nodes (> 1.5 cm in greatest dimension) for lesions in mid-thoracic, distal thoracic or GE junction
- T1N0M0 or T2N0M0 tumor stage
- Any of the following
- Pregnant women
- Nursing women
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- Men or women of childbearing potential who are unwilling to employ adequate contraception
- Co-morbid systemic illnesses or other severe concurrent disease which, in the judgment of the investigator, would make the patient inappropriate for entry into this study or interfere significantly with the proper assessment of safety and toxicity of the prescribed regimens
- Immunocompromised patients (other than that related to the use of corticosteroids) including patients known to be human immunodeficiency virus (HIV) positive
- Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
- Uncontrolled diabetes (i.e., will interfere with the performance of the FDG PET/CT scans)
- Receiving current treatment or prior treatment for this malignancy
- Other active malignancy 5 years prior to registration, except non-melanotic skin cancer or carcinoma-in-situ of the cervix; if there is a history of prior malignancy, patient must not be receiving other specific treatment (other than hormonal therapy) for cancer
- Prior radiation to > 30% of the marrow cavity
Trial locations and contacts
187 sites in 1 country.
187 sites in 1 country
United States187 sites
University of New Mexico Cancer Center
Albuquerque, New Mexico, 87131-5636
AnMed Cancer Center
Anderson, South Carolina, 29621
Saint Joseph Mercy Cancer Center
Ann Arbor, Michigan, 48106-0995
CCOP - Michigan Cancer Research Consortium
Ann Arbor, Michigan, 48106
Battle Creek Health System Cancer Care Center
Battle Creek, Michigan, 49017
St. Francis Hospital and Health Centers - Beech Grove Campus
Beech Grove, Indiana, 46107
Study site
Bettendorf, Iowa, 52722
CCOP - Montana Cancer Consortium
Billings, Montana, 59101
Hematology-Oncology Centers of the Northern Rockies - Billings
Billings, Montana, 59102
Billings Clinic - Downtown
Billings, Montana, 59107-7000
Illinois CancerCare - Bloomington
Bloomington, Illinois, 61701
St. Joseph Medical Center
Bloomington, Illinois, 61701
Saint Alphonsus Cancer Care Center at Saint Alphonsus Regional Medical Center
Boise, Idaho, 83706
Central Care Cancer Center at Carrie J. Babb Cancer Center
Bolivar, Missouri, 65613
Bozeman Deaconess Cancer Center
Bozeman, Montana, 59715
Fairview Ridges Hospital
Burnsville, Minnesota, 55337
St. James Healthcare Cancer Care
Butte, Montana, 59701
Graham Hospital
Canton, Illinois, 61520
Illinois CancerCare - Canton
Canton, Illinois, 61520
Illinois CancerCare - Carthage
Carthage, Illinois, 62321
Cancer Center of Kansas, PA - Chanute
Chanute, Kansas, 66720
Adena Regional Medical Center
Chillicothe, Ohio, 45601
Medical Oncology and Hematology Associates - West Des Moines
Clive, Iowa, 50325
Mercy Cancer Center - West Lakes
Clive, Iowa, 50325
Riverside Methodist Hospital Cancer Care
Columbus, Ohio, 43214-3998
CCOP - Columbus
Columbus, Ohio, 43215
Grant Medical Center Cancer Care
Columbus, Ohio, 43215
Mount Carmel Health - West Hospital
Columbus, Ohio, 43222
Doctors Hospital at Ohio Health
Columbus, Ohio, 43228
Mercy and Unity Cancer Center at Mercy Hospital
Coon Rapids, Minnesota, 55433
Geisinger Cancer Institute at Geisinger Health
Danville, Pennsylvania, 17822-0001
Grandview Hospital
Dayton, Ohio, 45405
Good Samaritan Hospital
Dayton, Ohio, 45406
David L. Rike Cancer Center at Miami Valley Hospital
Dayton, Ohio, 45409
Samaritan North Cancer Care Center
Dayton, Ohio, 45415
CCOP - Dayton
Dayton, Ohio, 45420
Oakwood Cancer Center at Oakwood Hospital and Medical Center
Dearborn, Michigan, 48123-2500
Grady Memorial Hospital
Delaware, Ohio, 43015
CCOP - Iowa Oncology Research Association
Des Moines, Iowa, 50309
John Stoddard Cancer Center at Iowa Methodist Medical Center
Des Moines, Iowa, 50309
Medical Oncology and Hematology Associates at John Stoddard Cancer Center
Des Moines, Iowa, 50309
Medical Oncology and Hematology Associates at Mercy Cancer Center
Des Moines, Iowa, 50314
Mercy Cancer Center at Mercy Medical Center - Des Moines
Des Moines, Iowa, 50314
John Stoddard Cancer Center at Iowa Lutheran Hospital
Des Moines, Iowa, 50316
Cancer Center of Kansas, PA - Dodge City
Dodge City, Kansas, 67801
Duluth Clinic Cancer Center - Duluth
Duluth, Minnesota, 55805-1983
CCOP - Duluth
Duluth, Minnesota, 55805
Miller - Dwan Medical Center
Duluth, Minnesota, 55805
Midelfort Clinic - Luther
Eau Claire, Wisconsin, 54703-1510
Luther Midlelfort Hospital
Eau Claire, Wisconsin, 54703
Fairview Southdale Hospital
Edina, Minnesota, 55435
Cancer Center of Kansas, PA - El Dorado
El Dorado, Kansas, 67042
Green Bay Oncology, Limited - Escanaba
Escanaba, Michigan, 49431
Eureka Community Hospital
Eureka, Illinois, 61530
Illinois CancerCare - Eureka
Eureka, Illinois, 61530
Dakota Cancer Institute at Dakota Clinic - South University
Fargo, North Dakota, 58103
Blanchard Valley Medical Associates
Findlay, Ohio, 45840
Genesys Hurley Cancer Institute
Flint, Michigan, 48503
Hurley Medical Center
Flint, Michigan, 48503
Poudre Valley Hospital
Fort Collins, Colorado, 80524
Front Range Cancer Specialists
Fort Collins, Colorado, 80528
Cancer Center of Kansas - Fort Scott
Fort Scott, Kansas, 66701
Middletown Regional Hospital
Franklin, Ohio, 45005-1066
Mercy and Unity Cancer Center at Unity Hospital
Fridley, Minnesota, 55432
Galesburg Clinic, PC
Galesburg, Illinois, 61401
Illinois CancerCare - Galesburg
Galesburg, Illinois, 61401
Altru Cancer Center at Altru Hospital
Grand Forks, North Dakota, 58201
Butterworth Hospital at Spectrum Health
Grand Rapids, Michigan, 49503
CCOP - Grand Rapids
Grand Rapids, Michigan, 49503
Lacks Cancer Center at Saint Mary's Health Care
Grand Rapids, Michigan, 49503
Great Falls Clinic - Main Facility
Great Falls, Montana, 59405
Sletten Cancer Institute at Benefis Healthcare
Great Falls, Montana, 59405
Green Bay Oncology, Limited at St. Vincent Hospital Regional Cancer Center
Green Bay, Wisconsin, 54301-3526
Green Bay Oncology, Limited at St. Mary's Hospital
Green Bay, Wisconsin, 54303
St. Mary's Hospital Medical Center - Green Bay
Green Bay, Wisconsin, 54303
St. Vincent Hospital Regional Cancer Center
Green Bay, Wisconsin, 54307-3508
Wayne Hospital
Greenville, Ohio, 45331
Bon Secours St. Francis Health System
Greenville, South Carolina, 29601
Van Elslander Cancer Center at St. John Hospital and Medical Center
Grosse Pointe Woods, Michigan, 48236
Saint Francis/Mount Sinai Regional Cancer Center at Saint Francis Hospital and Medical Center
Hartford, Connecticut, 06105
Illinois CancerCare - Havana
Havana, Illinois, 62644
Mason District Hospital
Havana, Illinois, 62644
Northern Montana Hospital
Havre, Montana, 59501
Geisinger Hazleton Cancer Center
Hazleton, Pennsylvania, 18201
St. Peter's Hospital
Helena, Montana, 59601
Hutchinson Area Health Care
Hutchinson, Minnesota, 55350
Cancer Center of Kansas-Independence
Independence, Kansas, 67301
Dickinson County Healthcare System
Iron Mountain, Michigan, 49801
Foote Memorial Hospital
Jackson, Michigan, 49201
Mayo Clinic - Jacksonville
Jacksonville, Florida, 32224
Glacier Oncology, PLLC
Kalispell, Montana, 59901
Kalispell Medical Oncology at KRMC
Kalispell, Montana, 59901
Kalispell Regional Medical Center
Kalispell, Montana, 59901
Charles F. Kettering Memorial Hospital
Kettering, Ohio, 45429
Illinois CancerCare - Kewanee Clinic
Kewanee, Illinois, 61443
Cancer Center of Kansas, PA - Kingman
Kingman, Kansas, 67068
Fairfield Medical Center
Lancaster, Ohio, 43130
Sparrow Regional Cancer Center
Lansing, Michigan, 48912-1811
Lawrence Memorial Hospital
Lawrence, Kansas, 66044
Cancer Center of Kansas, PA - Liberal
Liberal, Kansas, 67901
St. Mary Mercy Hospital
Livonia, Michigan, 48154
Illinois CancerCare - Macomb
Macomb, Illinois, 61455
McDonough District Hospital
Macomb, Illinois, 61455
Holy Family Memorial Medical Center Cancer Care Center
Manitowoc, Wisconsin, 54221-1450
HealthEast Cancer Care at St. John's Hospital
Maplewood, Minnesota, 55109
Minnesota Oncology - Maplewood
Maplewood, Minnesota, 55109
Strecker Cancer Center at Marietta Memorial Hospital
Marietta, Ohio, 45750
Bay Area Cancer Care Center at Bay Area Medical Center
Marinette, Wisconsin, 54143
Virginia Piper Cancer Institute at Abbott - Northwestern Hospital
Minneapolis, Minnesota, 55407
Hennepin County Medical Center - Minneapolis
Minneapolis, Minnesota, 55415
Montana Cancer Specialists at Montana Cancer Center
Missoula, Montana, 59807-7877
Montana Cancer Center at St. Patrick Hospital and Health Sciences Center
Missoula, Montana, 59807
Trinity Cancer Center at Trinity Medical Center - 7th Street Campus
Moline, Illinois, 61265
Study site
Moline, Illinois, 61265
Illinois CancerCare - Monmouth
Monmouth, Illinois, 61462
OSF Holy Family Medical Center
Monmouth, Illinois, 61462
Knox Community Hospital
Mount Vernon, Ohio, 43050
Mercy General Health Partners
Muskegon, Michigan, 49443
Licking Memorial Cancer Care Program at Licking Memorial Hospital
Newark, Ohio, 43055
Cancer Center of Kansas, PA - Newton
Newton, Kansas, 67114
BroMenn Regional Medical Center
Normal, Illinois, 61761
Community Cancer Center
Normal, Illinois, 61761
Illinois CancerCare - Community Cancer Center
Normal, Illinois, 61761
Green Bay Oncology, Limited - Oconto Falls
Oconto Falls, Wisconsin, 54154
Community Hospital of Ottawa
Ottawa, Illinois, 61350
Oncology Hematology Associates of Central Illinois, PC - Ottawa
Ottawa, Illinois, 61350
Cancer Center of Kansas, PA - Parsons
Parsons, Kansas, 67357
Cancer Treatment Center at Pekin Hospital
Pekin, Illinois, 61554
CCOP - Illinois Oncology Research Association
Peoria, Illinois, 61615
Oncology Hematology Associates of Central Illinois, PC - Peoria
Peoria, Illinois, 61615
Methodist Medical Center of Illinois
Peoria, Illinois, 61636
OSF St. Francis Medical Center
Peoria, Illinois, 61637
Illinois CancerCare - Peru
Peru, Illinois, 61354
Illinois Valley Community Hospital
Peru, Illinois, 61354
St. Joseph Mercy Oakland
Pontiac, Michigan, 48341-2985
Mercy Regional Cancer Center at Mercy Hospital
Port Huron, Michigan, 48060
Cancer Center of Kansas, PA - Pratt
Pratt, Kansas, 67124
Illinois CancerCare - Princeton
Princeton, Illinois, 61356
Perry Memorial Hospital
Princeton, Illinois, 61356
Spectrum Health Reed City Hospital
Reed City, Michigan, 49677
Reid Hospital & Health Care Services
Richmond, Indiana, 47374
Humphrey Cancer Center at North Memorial Outpatient Center
Robbinsdale, Minnesota, 55422-2900
Mayo Clinic Cancer Center
Rochester, Minnesota, 55905
Rutherford Hospital
Rutherfordton, North Carolina, 28139
Seton Cancer Institute at Saint Mary's - Saginaw
Saginaw, Michigan, 48601
CCOP - Metro-Minnesota
Saint Louis Park, Minnesota, 55416
Park Nicollet Cancer Center
Saint Louis Park, Minnesota, 55416
Regions Hospital Cancer Care Center
Saint Paul, Minnesota, 55101
United Hospital
Saint Paul, Minnesota, 55102
Cancer Center of Kansas, PA - Salina
Salina, Kansas, 67401
Mayo Clinic Scottsdale
Scottsdale, Arizona, 85259-5499
St. Francis Cancer Center at St. Francis Medical Center
Shakopee, Minnesota, 55379
St. Nicholas Hospital
Sheboygan, Wisconsin, 53081
Welch Cancer Center at Sheridan Memorial Hospital
Sheridan, Wyoming, 82801
Siouxland Hematology-Oncology Associates, LLP
Sioux City, Iowa, 51101
Mercy Medical Center - Sioux City
Sioux City, Iowa, 51102
St. Luke's Regional Medical Center
Sioux City, Iowa, 51104
Avera Cancer Institute
Sioux Falls, South Dakota, 57105
CCOP - Upstate Carolina
Spartanburg, South Carolina, 29303
Gibbs Regional Cancer Center at Spartanburg Regional Medical Center
Spartanburg, South Carolina, 29303
CCOP - Cancer Research for the Ozarks
Springfield, Missouri, 65802
St. John's Regional Health Center
Springfield, Missouri, 65804
Hulston Cancer Center at Cox Medical Center South
Springfield, Missouri, 65807
Community Hospital of Springfield and Clark County
Springfield, Ohio, 45505
Geisinger Medical Group - Scenery Park
State College, Pennsylvania, 16801
Lakeview Hospital
Stillwater, Minnesota, 55082
Door County Cancer Center at Door County Memorial Hospital
Sturgeon Bay, Wisconsin, 54235-1495
Green Bay Oncology, Limited - Sturgeon Bay
Sturgeon Bay, Wisconsin, 54235
Munson Medical Center
Traverse City, Michigan, 49684
UVMC Cancer Care Center at Upper Valley Medical Center
Troy, Ohio, 45373-1300
Ridgeview Medical Center
Waconia, Minnesota, 55387
St. John Macomb Hospital
Warren, Michigan, 48093
Cancer Center of Kansas, PA - Wellington
Wellington, Kansas, 67152
Methodist West Hospital
West Des Moines, Iowa, 50266-7700
Mount Carmel St. Ann's Cancer Center
Westerville, Ohio, 43081
Associates in Womens Health, PA - North Review
Wichita, Kansas, 67208
Cancer Center of Kansas, PA - Medical Arts Tower
Wichita, Kansas, 67208
Cancer Center of Kansas, PA - Wichita
Wichita, Kansas, 67214
CCOP - Wichita
Wichita, Kansas, 67214
Via Christi Cancer Center at Via Christi Regional Medical Center
Wichita, Kansas, 67214
Wesley Medical Center
Wichita, Kansas, 67214
Frank M. and Dorothea Henry Cancer Center at Geisinger Wyoming Valley Medical Center
Wilkes-Barre, Pennsylvania, 18711
Willmar Cancer Center at Rice Memorial Hospital
Willmar, Minnesota, 56201
Cancer Center of Kansas, PA - Winfield
Winfield, Kansas, 67156
Minnesota Oncology - Woodbury
Woodbury, Minnesota, 55125
Ruth G. McMillan Cancer Center at Greene Memorial Hospital
Xenia, Ohio, 45385
Genesis - Good Samaritan Hospital
Zanesville, Ohio, 43701
About this study
Official title: Randomized Phase II Trial of Extended Neoadjuvant Therapy for Locally Advanced Adenocarcinoma of the Esophagus, Gastroesophageal Junction, and Gastric Cardia
This randomized phase II trial studies how well docetaxel, oxaliplatin, capecitabine, fluorouracil, and radiation therapy works compared with fluorouracil when given together with oxaliplatin and radiation therapy in treating patients with cancer of the esophagus or gastroesophageal junction that has spread from where it started to nearby tissue or lymph nodes. Drugs used in chemotherapy, such as docetaxel, oxaliplatin, capecitabine, and fluorouracil, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from dividing. Radiation therapy uses high-energy x-rays to kill tumor cells. Giving more than one drug (combination chemotherapy) together with radiation therapy before surgery may make the tumor smaller and reduce the amount of normal tissue that needs to be removed.
Read the detailed description
PRIMARY OBJECTIVES:
- To assess and compare the pathologic complete response (PCR) rate of patients in Arm A receiving the sequence docetaxel, oxaliplatin, and capecitabine (DOC) followed by 5-fluorouracil (5-FU), oxaliplatin, and radiation therapy (RT) with patients in Arm B receiving only 5-FU, oxaliplatin and RT in patients with potentially resectable adenocarcinoma (ACA) of the esophagus, gastroesophageal junction (GEJ), or gastric cardia.
SECONDARY OBJECTIVES:
- To assess the adverse event (AE) profile and safety of the proposed treatment in this population.
II. To assess and compare the overall survival (OS) between treatment arms. III. To assess and compare the disease-free survival between treatment arms. IV. To assess and compare the clinical tumor response rate of the proposed regiments when administered before surgery between treatment arms.
OUTLINE: Patients are randomized to 1 of 2 treatment arms.
ARM I: Patients receive docetaxel intravenously (IV) over 1 hour and oxaliplatin IV over 2 hours on day 1. Patients also receive capecitabine orally (PO) twice daily (BID) on days 1-14. Treatment repeats every 21 days for 2 courses in the absence of disease progression or unacceptable toxicity. After completion of the second course, patients receive fluorouracil* IV continuously on days 1-5 and oxaliplatin IV over 2 hours on days 1, 15, and 29. Patients also undergo radiotherapy** 5 days a week for 5.5 weeks in the absence of disease progression or unacceptable toxicity. Approximately 4-12 weeks after completion of radiotherapy, patients undergo surgery.
ARM II: Patients receive fluorouracil IV continuously on days 1-5 and oxaliplatin IV over 2 hours on days 1, 15, and 29. Patients also undergo radiotherapy and then surgery as in Arm I.
- NOTE: * Fluorouracil continuous IV infusion begins within 24 hours of radiotherapy and ends within 24 hours of radiotherapy completion.
- NOTE: ** Radiotherapy should begin within 2-6 weeks after completion of 2 courses of docetaxel, oxaliplatin, and capecitabine.
After completion of study treatment, patients are followed up every 3 months for 2 years.
- Being tested
- capecitabine, docetaxel, fluorouracil, oxaliplatin, radiation therapy
- Keywords
- adenocarcinoma of the esophagus, adenocarcinoma of the gastroesophageal junction, stage IIIA gastric cancer, stage IIIB gastric cancer, stage IIIC gastric cancer, stage IIIA esophageal cancer, stage IIIB esophageal cancer, stage IIIC esophageal cancer
- Medical subject headings
- Esophageal Neoplasms, Stomach Neoplasms, Adenocarcinoma Of Esophagus
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
capecitabineDrug
Given PO
docetaxelDrug
Given IV
fluorouracilDrug
Given IV
oxaliplatinDrug
Given IV
radiation therapyRadiation
Undergo radiation therapy
therapeutic conventional surgeryProcedure or surgery
Undergo surgery
| Study group | Role | What they receive |
|---|---|---|
| Arm I (combination chemotherapy, radiation therapy, surgery) | Experimental | Patients receive docetaxel IV over 1 hour and oxaliplatin IV over 2 hours on day 1. Patients also receive capecitabine PO BID on days 1-14. Treatment repeats every 21 days for 2 courses in the absence of disease progression or unacceptable toxicity. After completion of the second course, patients receive fluorouracil IV continuously on days 1-5 and oxaliplatin IV over 2 hours on days 1, 15, and 29. Patients also undergo radiotherapy 5 days a week for 5.5 weeks in the absence of disease progression or unacceptable toxicity. Approximately 4-12 weeks after completion of radiotherapy, patients undergo surgery. Receives: Drug: capecitabine; Drug: docetaxel; Drug: fluorouracil; Drug: oxaliplatin; Radiation: radiation therapy; Procedure: therapeutic conventional surgery |
| Arm II (oxaliplatin, fluorouracil, radiation, and surgery) | Active comparator | Patients receive fluorouracil IV continuously on days 1-5 and oxaliplatin IV over 2 hours on days 1, 15, and 29. Patients also undergo radiotherapy and then surgery as in Arm I. Receives: Drug: fluorouracil; Drug: oxaliplatin; Radiation: radiation therapy; Procedure: therapeutic conventional surgery |
What is being measured
The primary outcome is the main question the study is designed to answer.
Percentage of Participants With Pathologic Complete Response (PCR)
Pathologic complete response was defined as no gross or microscopic tumor identified with the surgical specimen. All lymph nodes should be free of tumor to document a PCR. If no gross tumor is visible, section around the area of inflammation (nodularity) should be made every 2-3 cm and specimens examined.
Measured: Up to 2 years
Secondary outcomes (4)
Overall Survival
Overall survival was defined as the time from randomization to the time of death from any cause. Overall survival was censored at the date of last follow-up visit for patients who are still alive or loss of follow-up.
Measured: Up to 2 years
Disease-free Survival
Disease-free survival was defined as the time from randomization to the date of recurrent or death, whichever comes first.
Measured: Up to 2 years
Number of Participants Who Experienced a Maximum Grade of 3 or Above Adverse Event
Adverse events were assessed using National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) version 4.0.
Measured: Up to 2 years
Percentage of Participants With Overall Clinical Tumor Response (CR or PR)
Overall clinical tumor response rate was defined as the percentage of evaluable participants who achieved either complete response (CR) or partial response (PR) noted on the objective status from pre-surgical staging (for arm II) or either from pre-RT or pre-surgical staging (for arm I).> CR was defined as disappearance of all non-target lesion (TL) and normalization of tumor biomarker level, all lymph nodes (LN) must be non-pathological in size (<1 cm short axis); or disappearance of all TL and normalization of tumor biomarkers, any pathological LN (whether target or non-target) must have reduction in short axis to <1 cm; or >=30% decrease in the sum of the diameters of TL taking as reference the baseline sum of the diameters.
Measured: Up to 2 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted13 Jul 2009 (estimated)
- Study startJan 2010
- Primary completionDec 2013
- Study completionMar 2018
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Adenocarcinoma of the Gastroesophageal JunctionStudies of the same condition, open and under way.
- More trials run by Alliance for Clinical Trials in OncologyThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 73 participants (actual)
Sponsor and investigators
- Lead sponsor
- Alliance for Clinical Trials in Oncology
- Sponsor type
- University, hospital or other
- Collaborators
- National Cancer Institute (NCI)
- Responsible party
- Sponsor
- Investigators
- Steven R. Alberts, MD, Study chair, Mayo Clinic
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00938470
- Sponsor's protocol ID
- NCCTG-N0849
- Other IDs
- NCI-2011-01930, CDR0000646724
- Status last verified
- Mar 2018
- First submitted
- 10 Jul 2009
- Last updated
- 29 Mar 2018
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
Publications
Yoon HH, Ou FS, Soori GS, Shi Q, Wigle DA, Sticca RP, Miller RC, Leenstra JL, Peller PJ, Ginos B, Heying E, Wu TT, Drevyanko TF, Ko S, Mattar BI, Nikcevich DA, Behrens RJ, Khalil MF, Kim GP, Alberts SR. Induction versus no induction chemotherapy before neoadjuvant chemoradiotherapy and surgery in oesophageal adenocarcinoma: a multicentre randomised phase II trial (NCCTG N0849 [Alliance]). Eur J Cancer. 2021 Jun;150:214-223. doi: 10.1016/j.ejca.2021.03.025. Epub 2021 Apr 29.
PubMed 33934058
Study at a glance
From the registry record, last updated by the sponsor on 29 Mar 2018. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Randomized Phase II Trial of Extended Neoadjuvant Therapy for Locally Advanced Adenocarcinoma of the Esophagus, Gastroesophageal Junction, and Gastric Cardia
- ClinicalTrials.gov ID
- NCT00938470
- Acronym / sponsor ID
- NCCTG-N0849
- Keywords
- adenocarcinoma of the esophagus, adenocarcinoma of the gastroesophageal junction, stage IIIA gastric cancer, stage IIIB gastric cancer, stage IIIC gastric cancer, stage IIIA esophageal cancer, stage IIIB esophageal cancer, stage IIIC esophageal cancer
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 73 participants (actual)
- Lead sponsor
- Alliance for Clinical Trials in OncologyUniversity, hospital or other
- Collaborators
- National Cancer Institute (NCI)
- Study start
- Jan 2010
- Primary completion
- Dec 2013 (actual)
- Study completion
- Mar 2018 (actual)
- First posted
- 13 Jul 2009 (estimated)
- Results
- Posted 10 Apr 2017
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This randomized phase II trial studies how well docetaxel, oxaliplatin, capecitabine, fluorouracil, and radiation therapy works compared with fluorouracil when given together with oxaliplatin and radiation therapy in treating patients with cancer of the esophagus or gastroesophageal junction that has spread from where it started to nearby tissue or lymph nodes. Drugs used in chemotherapy, such as docetaxel, oxaliplatin, capecitabine, and fluorouracil, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from dividing. Radiation therapy uses high-energy x-rays to kill tumor cells. Giving more than one drug (combination chemotherapy) together with radiation therapy before surgery may make the tumor smaller and reduce the amount of normal tissue that needs to be removed.
Detailed description
PRIMARY OBJECTIVES:
- To assess and compare the pathologic complete response (PCR) rate of patients in Arm A receiving the sequence docetaxel, oxaliplatin, and capecitabine (DOC) followed by 5-fluorouracil (5-FU), oxaliplatin, and radiation therapy (RT) with patients in Arm B receiving only 5-FU, oxaliplatin and RT in patients with potentially resectable adenocarcinoma (ACA) of the esophagus, gastroesophageal junction (GEJ), or gastric cardia.
SECONDARY OBJECTIVES:
- To assess the adverse event (AE) profile and safety of the proposed treatment in this population.
II. To assess and compare the overall survival (OS) between treatment arms. III. To assess and compare the disease-free survival between treatment arms. IV. To assess and compare the clinical tumor response rate of the proposed regiments when administered before surgery between treatment arms.
OUTLINE: Patients are randomized to 1 of 2 treatment arms.
ARM I: Patients receive docetaxel intravenously (IV) over 1 hour and oxaliplatin IV over 2 hours on day 1. Patients also receive capecitabine orally (PO) twice daily (BID) on days 1-14. Treatment repeats every 21 days for 2 courses in the absence of disease progression or unacceptable toxicity. After completion of the second course, patients receive fluorouracil* IV continuously on days 1-5 and oxaliplatin IV over 2 hours on days 1, 15, and 29. Patients also undergo radiotherapy** 5 days a week for 5.5 weeks in the absence of disease progression or unacceptable toxicity. Approximately 4-12 weeks after completion of radiotherapy, patients undergo surgery.
ARM II: Patients receive fluorouracil IV continuously on days 1-5 and oxaliplatin IV over 2 hours on days 1, 15, and 29. Patients also undergo radiotherapy and then surgery as in Arm I.
- NOTE: * Fluorouracil continuous IV infusion begins within 24 hours of radiotherapy and ends within 24 hours of radiotherapy completion.
- NOTE: ** Radiotherapy should begin within 2-6 weeks after completion of 2 courses of docetaxel, oxaliplatin, and capecitabine.
After completion of study treatment, patients are followed up every 3 months for 2 years.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Arm I (combination chemotherapy, radiation therapy, surgery) | Experimental | Drug: capecitabine, Drug: docetaxel, Drug: fluorouracil, Drug: oxaliplatin, Radiation: radiation therapy, Procedure: therapeutic conventional surgeryPatients receive docetaxel IV over 1 hour and oxaliplatin IV over 2 hours on day 1. Patients also receive capecitabine PO BID on days 1-14. Treatment repeats every 21 days for 2 courses in the absence of disease progression or unacceptable toxicity. After completion of the second course, patients receive fluorouracil IV continuously on days 1-5 and oxaliplatin IV over 2 hours on days 1, 15, and 29. Patients also undergo radiotherapy 5 days a week for 5.5 weeks in the absence of disease progression or unacceptable toxicity. Approximately 4-12 weeks after completion of radiotherapy, patients undergo surgery. |
| Arm II (oxaliplatin, fluorouracil, radiation, and surgery) | Active comparator | Drug: fluorouracil, Drug: oxaliplatin, Radiation: radiation therapy, Procedure: therapeutic conventional surgeryPatients receive fluorouracil IV continuously on days 1-5 and oxaliplatin IV over 2 hours on days 1, 15, and 29. Patients also undergo radiotherapy and then surgery as in Arm I. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (16 listed)
- Histological confirmation of adenocarcinoma of the esophagus, gastroesophageal (GE) junction, or gastric cardia
- Tumor must be considered surgically resectable; Note: patients with T4N0M0 tumors that are potentially resectable are also eligible
- Nodal involvement: patients with involvement of celiac nodes, (stations 15-20) are eligible if the primary lesion is mid-thoracic, distal esophagus or GE junction; patients with supraclavicular node involvement are eligible with upper thoracic esophagus primary lesions
- Capable of swallowing pills
- Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0, 1, or 2
Key exclusion criteria (14 listed)
- Evidence of distant metastases
- Palpable supraclavicular nodes, biopsy-proven involvement of supraclavicular nodes, or radiographically involved supraclavicular nodes (> 1.5 cm in greatest dimension) for lesions in mid-thoracic, distal thoracic or GE junction
- T1N0M0 or T2N0M0 tumor stage
- Any of the following
- Co-morbid systemic illnesses or other severe concurrent disease which, in the judgment of the investigator, would make the patient inappropriate for entry into this study or interfere significantly with the proper assessment of safety and toxicity of the prescribed regimens
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| capecitabineGiven PO | Drug | Arm I (combination chemotherapy, radiation therapy, surgery) |
| docetaxelGiven IV | Drug | Arm I (combination chemotherapy, radiation therapy, surgery) |
| fluorouracilGiven IV | Drug | Arm I (combination chemotherapy, radiation therapy, surgery), Arm II (oxaliplatin, fluorouracil, radiation, and surgery) |
| oxaliplatinGiven IV | Drug | Arm I (combination chemotherapy, radiation therapy, surgery), Arm II (oxaliplatin, fluorouracil, radiation, and surgery) |
| radiation therapyUndergo radiation therapy | Radiation | Arm I (combination chemotherapy, radiation therapy, surgery), Arm II (oxaliplatin, fluorouracil, radiation, and surgery) |
| therapeutic conventional surgeryUndergo surgery | Procedure or surgery | Arm I (combination chemotherapy, radiation therapy, surgery), Arm II (oxaliplatin, fluorouracil, radiation, and surgery) |
Primary outcome
Percentage of Participants With Pathologic Complete Response (PCR)
Time frame: Up to 2 years
Pathologic complete response was defined as no gross or microscopic tumor identified with the surgical specimen. All lymph nodes should be free of tumor to document a PCR. If no gross tumor is visible, section around the area of inflammation (nodularity) should be made every 2-3 cm and specimens examined.
4 secondary outcomes
Overall Survival
Time frame: Up to 2 years
Disease-free Survival
Time frame: Up to 2 years
Number of Participants Who Experienced a Maximum Grade of 3 or Above Adverse Event
Time frame: Up to 2 years
Percentage of Participants With Overall Clinical Tumor Response (CR or PR)
Time frame: Up to 2 years
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 29 Mar 2018.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 33934058Yoon HH, Ou FS, Soori GS, Shi Q, Wigle DA, Sticca RP, Miller RC, Leenstra JL, Peller PJ, Ginos B, Heying E, Wu TT, Drevyanko TF, Ko S, Mattar BI, Nikcevich DA, Behrens RJ, Khalil MF, Kim GP, Alberts SR. Induction versus no induction chemotherapy before neoadjuvant chemoradiotherapy and surgery in oesophageal adenocarcinoma: a multicentre randomised phase II trial (NCCTG N0849 [Alliance]). Eur J Cancer. 2021 Jun;150:214-223. doi: 10.1016/j.ejca.2021.03.025. Epub 2021 Apr 29.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Steven R. Alberts, MD study chair
Mayo Clinic
187 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing capecitabine, docetaxel and fluorouracil in people with Adenocarcinoma of the Gastroesophageal Junction and Esophageal Cancer, run by Alliance for Clinical Trials in Oncology at 187 sites in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 16 inclusion and 14 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 29 Mar 2018. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 187 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 10 Apr 2017). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Percentage of Participants With Pathologic Complete Response (PCR) (time frame: Up to 2 years). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00938470, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Mar 2018.