Gefitinib in Treating Patients With Esophageal Cancer That is Progressing After Chemotherapy

Study Overview
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Brief Summary
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RATIONALE: Gefitinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth and by blocking blood flow to the tumor. It is not yet known whether gefitinib is more effective than a placebo in treating esophageal cancer. PURPOSE: This randomized phase III trial is studying gefitinib to see how well it works compared with a placebo in treating patients with esophageal cancer that is progressing after chemotherapy.

Detailed Description
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OBJECTIVES: Primary To assess whether gefitinib vs placebo will improve overall survival of patients with esophageal or gastroesophageal junction cancer. Secondary To assess the toxicity of gefitinib monotherapy in these patients. To assess whether gefitinib vs placebo will have a significant positive or negative impact upon quality of life of these patients. To assess the impact gefitinib vs placebo will have on progression-free survival of these patients. OUTLINE: This is a multicenter study. Arm A: Patients receive oral gefitinib once daily. Treatment continues in the absence of disease progression or unacceptable toxicity. Arm B: Patients receive oral placebo once daily. Treatment continues in the absence of disease progression or unacceptable toxicity. Blood samples are collected for genetic and translational studies. Patient's quality of life is assessed at baseline and periodically during the study with completion of EORTC Quality of Life Questionnaire (QLQ-C30) version 3.0. After completion of study treatment, patients are followed up every 8 weeks.

Official Title
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Phase III Randomized, Double-Blind, Placebo-Controlled Trial of Gefitinib (Iressa®) Versus Placebo in Esophageal Cancer Progressing After Chemotherapy

Conditions
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Adenocarcinoma of the Gastroesophageal Junction, Esophageal Cancer

Intervention / Treatment
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* Procedure: quality-of-life assessment


Participation Criteria
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Eligibility Criteria
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DISEASE CHARACTERISTICS: Histologically confirmed esophageal cancer or gastroesophageal junction tumor including the following subtypes: Adenocarcinoma Squamous cell cancer Poorly differentiated epithelial malignancy Gastroesophageal junction with Siewert type I or II tumors Failure after no more than 2 prior chemotherapy regimens and 1 chemoradiation course Measurable or evaluable disease by CT scan Patients with brain metastases must be stable and have received cranial irradiation prior to entry PATIENT CHARACTERISTICS: WHO performance status 0-2 Serum bilirubin ≤ 3 times the upper limit of normal (ULN) AST/ALT ≤ 2.5 times ULN (≤ 5 x in presence of liver metastases) Able to take oral tablets (whole or dispersed) No evidence of clinically active interstitial lung disease (patients with chronic, stable, radiographic changes who are asymptomatic allowed) No known severe hypersensitivity to gefitinib or any of the excipients of this product No prior other malignancy likely to confound results or interfere with gefitinib therapy No medical condition considered to interfere with the safe participation in the trial Not pregnant Fertile patients must use effective contraception PRIOR CONCURRENT THERAPY: See Disease Characteristics No chemotherapy (including oral) within the past 6 weeks No radiotherapy to site of measurable or evaluable disease within the past 4 weeks No other concurrent cytotoxic chemotherapy, immunotherapy, hormonal therapy (excluding contraceptives and replacement steroids) or experimental medications

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Gefitinib 500mg once daily<br>Gefitinib 500mg once daily | Procedure: quality-of-life assessment<br> <br> |
| Placebo Comparator: Placebo<br>Gefitinib 500mg once daily | Procedure: quality-of-life assessment<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Overall survival |  | 4, 8, 12, 16 weeks then every 8 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Toxicity and safety |  | 4, 8, 12, 16 weeks then every 8 weeks | 
| Quality of life |  | 4, 8 and 12 weeks | 
| Progression-free survival |  | 4, 8, 12, 16 weeks then every 8 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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adenocarcinoma of the gastroesophageal junction, adenocarcinoma of the esophagus, squamous cell carcinoma of the esophagus, recurrent esophageal cancer, stage IA esophageal cancer, stage IB esophageal cancer, stage IIA esophageal cancer, stage IIB esophageal cancer, stage IIIA esophageal cancer, stage IIIB esophageal cancer, stage IIIC esophageal cancer, stage IV esophageal cancer