Irinotecan Versus Only Best Supportive Care for Gastric Cancer

Study Overview
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Brief Summary
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The median survival at progression after first-line chemotherapy for metastatic gastric cancer is about 2.5 months. There are no data which a possible benefit of second line therapy. for this reason a trial which investigates a possible benefit or chemotherapy compared to best supportive care as second line treatment is urgently necessary. Irinotecan shows response rates of 20% in the first line therapy with high rates od disease stabilization. There are few trials investigating irinotecan in the second line setting. Response rates of 20% are reported in tis setting. Irinotecan is supplied without costs from the company Pfizer.

Detailed Description
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Metastatic gastric cancer, progressive disease after one palliative chemotherapy Arm A: Irinotecan 250/350 mg/m2 q3w Cycle:250mg/m2/ 30min Cycle:If no toxicity>2° CTC, nor Leuko-thrombopenia>3° occured, dose is increased to 350mg/m2 Arm B. Best supportive care

Official Title
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Randomized Phase III Study With Irinotecan+Best Supportive Care Versus Only Best Supportive Care as Second Line Therapy for Metastatic Gastric Cancer

Conditions
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Stomach Neoplasm, Neoplasm Metastasis

Intervention / Treatment
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* Drug: Irinotecan


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patient with histologically proven adenocarcinoma of stomach or the gastro-esophageal junction Patient with distant metastases laparoscopically proven operative incurability of an locally advanced gastric cancer or patient with a tumor recurrence after gastrectomy Patient with progressive disease under a palliative first-line chemotherapy or progressive disease within 6 months after termination of a first-line chemotherapy, defined as objective progression by imaging techniques according to WHO criteria Age 18 and 75 years Sufficient liver function, defined as serum-bilirubin <1,5 mg/dl (1,5 upper normal limit), ALT und AST < 3x upper normal limit Sufficient renal function, defined as serum creatinine < 1,25 x upper normal limit or creatinine clearance >60ml/min calculated according to Crockroft-Gault Contraction for patient with reproductive potential Karnofsky-Index >60% Measurable or evaluable tumor manifestation Exclusion Criteria: Tumor progression later than 6 months after termination of first-line chemotherapy KI 50% or less Patient who have already received a second line chemotherapy for the metastatic setting (adjuvant chemotherapy and one line of palliative chemotherapy os allowed, biologic prior therapies are allowed) Prior or current second malignancy despite of basal carcinoma of the skin and curatively treated carcinoma in situ of the cervix Uncontrolled infection CNS metastases Other severe medical illness Prior major surgery less than 2 weeks ago Parallel treatment with another experimental therapy Parallel treatment with another therapy aiming at tumor reduction Chronic diarrhea, subileus Chronic inflammatory bowel disease or intestinal obstruction Pretreatment with irinotecan

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 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

Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: Single


Arms and Interventions

| Intervention/Treatment |
| --- |
|Drug: Irinotecan|nan|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| median survival |  |  | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| quality of life, response rates, time to tumor progression, toxicity |  |  | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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gastric cancer, metastatic, irinotecan