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Stomach NeoplasmPhase 3NCT03023436

Cytoreductive Surgery Combined With HIPEC and Chemotherapy for Gastric Cancer With Peritoneal Metastasis

A Phase 3 study testing Cytoreductive surgery, Hyperthermic Intraperitoneal Chemotherapy and Fluoropyrimidine in people with Stomach Neoplasm, run by Nanfang Hospital, Southern Medical University at 13 sites in China.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

This study evaluates the survival benefit and safety of cytoreductive surgery(CRS) combined with HIPEC and chemotherapy in gastric cancer with peritoneal metastasis. Read more about this study

Who is it for?
Ages 19 to 74 years
Conditions the study is for
Stomach Neoplasm
What is being tested?
Cytoreductive surgery, Hyperthermic Intraperitoneal Chemotherapy and Fluoropyrimidine
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
220 participants
Where
13 sitesChina
Study dates
Jan 2016to Jun 2022
Phase
Phase 3
Are there results?
None posted in the registry

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 19 to 74 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age from over 18 to under 75 years
  • Histologically proven primary gastric adenocarcinoma confirmed pathologically by endoscopic biopsy
  • Diagnosed with clinical T1-4N0-3M1(distant metastases confined to peritoneum, P1)according to the American Joint Committee on Cancer(AJCC) Cancer Staging Manual Seventh Edition by laparoscopic exploration
  • Localized peritoneal metastasis with peritoneal cancer index(PCI) less than 20
  • Resection of primary tumor and metastasis is anticipated to reach the CC0 status(no residual tumor )
  • Performance status of 0 or 1 on Eastern Cooperative Oncology Group(ECOG) scale
  • Written informed consent

Who cannot join

  • Adenocarcinoma of esophageal-gastric junction(AEG) that requires thoracotomy
  • Distant metastases not confined to peritoneum, including liver (H1), para-aortic lymphnode (stations 16a1 and/or b2), lung, brain, bone and other organs
  • Histologically proven Human epidermal growth factor receptor 2(HER2)-neu overexpressing adenocarcinoma
  • History of previous neoadjuvant chemotherapy , radiotherapy or clinical trial treatment within 3 months
  • Contraindication for anesthesia, surgery, chemotherapeutic agents or HIPEC
  • Women of child-bearing potential who are pregnant or breastfeeding
Show all 12Show fewer
  • History of prior/other malignancies within the 5 years prior to enrollment
  • Cerebrovascular accident occurred within 6 months (myocardial infarction, unstable angina, cerebral infarction, or cerebral hemorrhage)
  • History of continuous systematic administration of corticosteroids within one month
  • Requirement of simultaneous surgery for other disease
  • Emergency surgery due to complication (bleeding, obstruction or perforation) caused by gastric cancer
  • FEV1<50% of predicted values

Trial locations and contacts

13 sites in 1 country.

Guoxin Li, M.D., Ph.D. contact

+86-138-0277-1450

gzliguoxin@163.com

Hao Liu, M.D., Ph.D. contact

+86-138-2215-8578

liuhaofbi@163.com

13 sites in 1 country

China13 sites, 13 recruiting
  • Peking University Cancer Hospital

    Beijing, Beijing Municipality, 100-142

    Xiangqian Su, M.D., Ph.D., +86-138-0126-2916

    Xiangqian Su, M.D., Ph.D

    Recruiting
  • West China Hospital, Sichuan University

    Chengdu, Sichuan, 610-041

    Jiankun Hu, M.D., Ph.D., +86-189-8060-1504, hujkwch@126.com

    Jiankun Hu, M.D.,Ph.D.

    Recruiting
  • Fujian Provincial Hospital

    Fuzhou, Fujian, 350-014

    Liangxiang Huang, M.D., Ph.D., 0086-138-5902-0211

    Liangxiang Huang, M.D., Ph.D.

    Recruiting
  • Sun Yat-sen University Cancer Center

    Guangzhou, Guangdong, 510-060

    Zhiwei Zhou, M.D., Ph.D., +86-139-0222-2859, zhouzhw@sysucc.org.cn

    Zhiwei Zhou, M.D., Ph.D.

    Recruiting
  • Guangdong General Hospital

    Guangzhou, Guangdong, 510-080

    Yong Li, M.D., Ph.D., +86-138-2217-7479, yuan821007@126.com

    Yong Li, M.D., Ph.D.

    Recruiting
  • Cancer Center of Guangzhou Medical University

    Guangzhou, Guangdong, 510-095

    Shuzhong Cui, M.D., Ph.D., +86-138-0251-3800, cuishuzhong@126.com

    cuishuzhong@126.com Cui, M.D., Ph.D.

    Recruiting
  • Zhujiang Hospital of Southern Medical University

    Guangzhou, Guangdong, 510-280

    Jinlong Yu, M.D., Ph.D., +86-131-8909-7861, yujinlong640506@163.com

    Jinlong Yu, M.D., Ph.D.

    Recruiting
  • Nanfang Hospital, Southern Medical University

    Guangzhou, Guangdong, 510-515

    Guoxin Li, M.D., Ph.D., +86-138-0277-1450, gzliguoxin@163.com

    Hao Liu, M.D., Ph.D., +86-138-2215-8578, liuhaofbi@163.com

    Recruiting
  • The Third Affiliated Hospital of Sun Yat-sen University

    Guangzhou, Guangdong, 510-630

    Hong-Bo Wei, M.D., Ph.D., 0086-18922102969, drweihb@126.com

    Bo Wei, M.D., 0086-13527794069, sanpi2013@163.com

    Recruiting
  • The Sixth Affiliated Hospital of Sun Yat-sen University

    Guangzhou, Guangdong, 510-655

    Junsheng Peng, M.D., Ph.D., +86-138-0296-3578, pengsir1010@126.com

    Junsheng Peng, M.D., Ph.D.

    Recruiting
  • Meizhou People's Hospital

    Meizhou, Guangdong, 514-031

    Zuguang Wu, M.D., +86-135-0252-3063, wuzg1913@163.com

    Zuguang Wu, M.D.

    Recruiting
  • Zhongshan Hospital, Fudan University

    Shanghai, Shanghai Municipality, 200-032

    Yihong Sun, M.D., Ph.D., +86-137-0173-5406, yihongsun@medmail.com.cn

    Yihong Sun, M.D., Ph.D.

    Recruiting
  • Zhongshan City People Hospital

    Zhongshan, Guangdong, 528-403

    Hong Chen, M.D., Ph.D., +86-135-9084-3781, cenhong228@sohu.com

    Hong Chen, M.D., Ph.D.

    Recruiting

Other trials in China

About this study

Official title: Cytoreductive Surgery Combined With Hyperthermic Intraperitoneal Chemotherapy and Systemic Chemotherapy in Gastric Cancer With Regional Peritoneal Metastasis, a Multicenter and Single-arm Phase III Study

This study evaluates the survival benefit and safety of cytoreductive surgery(CRS) combined with HIPEC and chemotherapy in gastric cancer with peritoneal metastasis.

Read the detailed description

Peritoneal metastasis is one of the most frequent non-curable factors in advanced gastric cancer with poor prognosis, the median survival time of patients is less than 1 year and even worse in China. Recently, several new modalities have been developed and reported to improve survival, including the new chemotherapeutic agents, molecular targeting agents and hyperthermic intraperitoneal chemotherapy(HIPEC).Still, the long-term outcomes based on multicenter randomized clinical trials (RCTs) are awaited.

The surgical approach to metastatic lesions has been proved to play a very crucial role in prolonging the survival of metastatic colorectal patients, which might be able to cure patients with the operation aiming at R0 resection. For patients with metastatic gastric cancer, surgical intervention of primary tumor and measurable metastatic lesion is technically feasible, while the survival benefit is controversial. Even though the REGATTA trial demonstrated that the removal of the primary tumor is not necessarily beneficial, the role of operation aiming at R0 resection combined with new regimens like HIPEC and new chemotherapeutic agents is still confusing and new categories of classification for metastatic gastric cancer based on the treatment response is needed.

In order to evaluate the survival benefit and safety of cytoreductive surgery(CRS) and HIPEC before beginning chemotherapy in gastric cancer with peritoneal metastasis, patients who fulfill the inclusion and exclusion criteria will be recruited in this study and receive CRS, HIPEC and chemotherapy. Chemotherapy regimen based on cisplatin and fluorouracil(CF) are recommended. Patients are followed up for 2 years and the safety and survival outcome will be analyzed.

Being tested
Cytoreductive surgery, Hyperthermic Intraperitoneal Chemotherapy, Fluoropyrimidine, Cisplatin
Keywords
Stomach Neoplasms, Cytoreduction Surgical Procedures
Medical subject headings
Stomach Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Cytoreductive surgeryProcedure or surgery

    Also called CRS , Cytoreduction Surgical Procedures

    Gastrectomy with D2 lymph node dissection and Metastasectomy for peritoneal metastatic sites only.

    A total, distal, or proximal gastrectomy and the type of reconstruction will be selected according to the surgeon's experience.

    Metastasectomy is limited to peritoneal metastatic sites only to render the patient no evidence of disease (NED) with at least 1cm negative margins when possible.

  • Hyperthermic Intraperitoneal ChemotherapyProcedure or surgery

    Also called HIPEC

    Docetaxel 120 mg diluted in 5.0 L of saline is forced into the abdomen through the inflow catheter by a pump and pulled out through the drains as a heated intraperitoneal perfusion.A heat exchanger keeps the intraperitoneal fluid at 43±0.5℃ and duration limited to 70 minutes.24 hours after cytoreductive surgery no less than 2 cycles postoperative chemotherapy will be recommended.

  • FluoropyrimidineDrug

    Also called fluorouracil or capecitabine

    CF regimens or other first line regimens based on Fluoropyrimidine and Platinum according to the NCCN Guidelines(Gastric Cancer,version 3.2016) are recommended.Regimens and dosing schedules are not limited in this trial.

  • CisplatinDrug

    Also called cis-diamine dichloroplatinum(CDDP)

    CF regimens or other first line regimens based on Fluoropyrimidine and Platinum according to the NCCN Guidelines(Gastric Cancer,version 3.2016) are recommended.Regimens and dosing schedules are not limited in this trial.

Study groups in NCT03023436
Study groupRoleWhat they receive
CRS + HIPEC + Systemic ChemotherapyExperimentalCytoreductive surgery(CRS) followed by Hyperthermic Intraperitoneal Chemotherapy(HIPEC) and systemic chemotherapy will be performed for the treatment of patients assigned to this group. CF regimens or other first line regimens based on Fluoropyrimidine and Cisplatin according to the National Comprehensive Cancer Network(NCCN) Guidelines (Gastric Cancer,version 3.2016) are recommended.Regimens and dosing schedules are not limited in this trial.
Receives: Procedure: Cytoreductive surgery; Procedure: Hyperthermic Intraperitoneal Chemotherapy; Drug: Fluoropyrimidine; Drug: Cisplatin

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. 2-year Median survival time

    The time point when the cumulative survival rate is 50% according to the survival curve.

    Measured: 24 months

Secondary outcomes (3)
  1. 2-year overall survival rate

    Overall survival rate calculated according to the survival curve.

    Measured: 24 months

  2. Progression free survival rate

    Progression free survival rate calculated according to the disease progression curve.

    Measured: 24 months

  3. Morbidity and mortality

    The early complication and mortality are defined as the event observed within 30 days after intervention, while the time frame for late complication is the period beyond 30 days after intervention to the end of month 24th. Complications are ranked from grade 0-5 according to CTCAE V4.0

    Measured: 30 days; 24 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted18 Jan 2017 (estimated)
  2. Study startJan 2016
  3. Primary completionJun 2022 (estimated)
  4. Study completionJun 2022 (estimated)

Resources

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 3
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
220 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03023436
Sponsor's protocol ID
CLASS - 05
Status last verified
Sep 2019
First submitted
9 Jan 2017
Last updated
13 Sep 2019
Results posted
No
Data monitoring committee
Yes
Individual data sharing
No

Publications

  • Van Cutsem E, Moiseyenko VM, Tjulandin S, Majlis A, Constenla M, Boni C, Rodrigues A, Fodor M, Chao Y, Voznyi E, Risse ML, Ajani JA; V325 Study Group. Phase III study of docetaxel and cisplatin plus fluorouracil compared with cisplatin and fluorouracil as first-line therapy for advanced gastric cancer: a report of the V325 Study Group. J Clin Oncol. 2006 Nov 1;24(31):4991-7. doi: 10.1200/JCO.2006.06.8429.

    PubMed 17075117
  • Koizumi W, Narahara H, Hara T, Takagane A, Akiya T, Takagi M, Miyashita K, Nishizaki T, Kobayashi O, Takiyama W, Toh Y, Nagaie T, Takagi S, Yamamura Y, Yanaoka K, Orita H, Takeuchi M. S-1 plus cisplatin versus S-1 alone for first-line treatment of advanced gastric cancer (SPIRITS trial): a phase III trial. Lancet Oncol. 2008 Mar;9(3):215-21. doi: 10.1016/S1470-2045(08)70035-4. Epub 2008 Feb 20.

    PubMed 18282805
  • Bang YJ, Van Cutsem E, Feyereislova A, Chung HC, Shen L, Sawaki A, Lordick F, Ohtsu A, Omuro Y, Satoh T, Aprile G, Kulikov E, Hill J, Lehle M, Ruschoff J, Kang YK; ToGA Trial Investigators. Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): a phase 3, open-label, randomised controlled trial. Lancet. 2010 Aug 28;376(9742):687-97. doi: 10.1016/S0140-6736(10)61121-X. Epub 2010 Aug 19.

    PubMed 20728210
  • Fujitani K, Yang HK, Mizusawa J, Kim YW, Terashima M, Han SU, Iwasaki Y, Hyung WJ, Takagane A, Park DJ, Yoshikawa T, Hahn S, Nakamura K, Park CH, Kurokawa Y, Bang YJ, Park BJ, Sasako M, Tsujinaka T; REGATTA study investigators. Gastrectomy plus chemotherapy versus chemotherapy alone for advanced gastric cancer with a single non-curable factor (REGATTA): a phase 3, randomised controlled trial. Lancet Oncol. 2016 Mar;17(3):309-318. doi: 10.1016/S1470-2045(15)00553-7. Epub 2016 Jan 26.

    PubMed 26822397
  • Hu Y, Huang C, Sun Y, Su X, Cao H, Hu J, Xue Y, Suo J, Tao K, He X, Wei H, Ying M, Hu W, Du X, Chen P, Liu H, Zheng C, Liu F, Yu J, Li Z, Zhao G, Chen X, Wang K, Li P, Xing J, Li G. Morbidity and Mortality of Laparoscopic Versus Open D2 Distal Gastrectomy for Advanced Gastric Cancer: A Randomized Controlled Trial. J Clin Oncol. 2016 Apr 20;34(12):1350-7. doi: 10.1200/JCO.2015.63.7215. Epub 2016 Feb 22.

    PubMed 26903580
  • Geng X, Liu H, Lin T, Hu Y, Chen H, Zhao L, Mou T, Qi X, Yu J, Li G. Survival benefit of gastrectomy for gastric cancer with peritoneal carcinomatosis: a propensity score-matched analysis. Cancer Med. 2016 Oct;5(10):2781-2791. doi: 10.1002/cam4.877. Epub 2016 Sep 20.

    PubMed 27650694

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Cytoreductive surgery, Hyperthermic Intraperitoneal Chemotherapy and Fluoropyrimidine in people with Stomach Neoplasm, run by Nanfang Hospital, Southern Medical University at 13 sites in China.

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 7 inclusion and 12 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: status not confirmed, as of the sponsor's last update on 13 Sep 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 13 sites in China. 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 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Guoxin Li, M.D., Ph.D. (+86-138-0277-1450, gzliguoxin@163.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

2-year Median survival time (time frame: 24 months). 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 NCT03023436, which also lists 6 linked publications.

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 13 Sep 2019.

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