oxaliplatin combined with fluorouracil and leucovorin in treating patients with recurrent or metastatic cancer of the esophagus or stomach

Conditions: Esophageal Cancer; Gastric Cancer

Summary: rationale: drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. combining more than one drug may kill more tumor cells. purpose: phase ii trial to study the effectiveness of combining oxaliplatin with fluorouracil and leucovorin in treating patients who have recurrent or metastatic cancer of the esophagus or stomach.

objectives: i. determine the response rate in patients with recurrent or metastatic carcinoma of the esophagus or gastric cardia receiving the combination of oxaliplatin, fluorouracil, and leucovorin calcium. ii. determine the duration of response and overall survival of this patient population receiving this regimen. iii. determine the toxicity, including neurotoxicity, of this regimen in this patient population. outline: this is an open-label, multicenter study. patients receive oxaliplatin iv over 2 hours on day 1, then leucovorin calcium iv over 2 hours with fluorouracil iv bolus, followed by fluorouracil iv over 22 hours on days 1 and 2. treatment continues every 2 weeks for a minimum of 3 courses in the absence of disease progression or unacceptable toxicity. patients with stable or responding disease receive at least 3 additional courses of therapy. patients are followed for a minimum of 2 years or until death. projected accrual: a total of 12-37 patients will be accrued for this study over 18 months.

Eligibility criteria:
disease characteristics: histologically or cytologically confirmed carcinoma of the esophagus or gastric cardia stage iv or recurrent bidimensionally measurable disease patient characteristics: age: 18 and over performance status: ecog 0-2 or karnofsky 50-100% life expectancy: not specified hematopoietic: wbc greater than 3,000/mm3 absolute neutrophil count at least 1,500/mm3 platelet count greater than 100,000/mm3 hemoglobin greater than 10 g/dl hepatic: bilirubin normal sgot less than 2 times upper limit of normal (uln) renal: bun less than 1.5 times uln creatinine no greater than 1.5 mg/dl or creatinine clearance at least 50 ml/min cardiovascular: no congestive heart failure no unstable angina pectoris no myocardial infarction within the past 6 months other: not pregnant or nursing fertile patients must use effective contraception during and for 6 months after study no allergy to platinum compounds or antiemetics appropriate for study no uncontrolled concurrent illness no active infection no clinical evidence of peripheral neuropathy by physical exam or history prior concurrent therapy: biologic therapy: no concurrent colony-stimulating factors during the first course of study chemotherapy: more than 4 weeks since prior chemotherapy no more than 1 prior chemotherapy regimen for carcinoma of the esophagus or gastric cardia no prior fluorouracil endocrine therapy: not specified radiotherapy: at least 4 weeks since prior radiotherapy surgery: not specified other: no other concurrent investigational agents no concurrent antiretroviral therapy in hiv-positive patients no other concurrent anticancer agents

Keywords: stage iv gastric cancer recurrent gastric cancer stage iv esophageal cancer recurrent esophageal cancer adenocarcinoma of the stomach adenocarcinoma of the esophagus