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Completed

NCT Number: NCT00068380

A Phase II Trial of STI571 in the Treatment of Metastatic Gastric Cancer

Imatinib mesylate may stop the growth of tumor cells by blocking the enzymes necessary for tumor cell growth. This phase II trial is studying how well imatinib mesylate works in treating patients with refractory metastatic and/or unresectable stomach or gastroesophageal junction cancer.

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Key information

Conditions

Recurrent Gastric Cancer Digestive System Diseases Digestive System Neoplasms Gastrointestinal Diseases Gastrointestinal Neoplasms Neoplasms Neoplasms by Site Stage IV Gastric Cancer Stomach Diseases Stomach Neoplasms

Age range

19 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 2

Primary location

City of Hope

Duarte, California, 91010, United States

About this study

PRIMARY OBJECTIVES:

I. To determine the response rate, time to tumor progression, and overall survival in patients with metastatic gastric cancer treated with STI571 who have failed one chemotherapy regimen for metastatic disease.

II. To assess the toxicities of STI571 in these patients. III. To obtain preliminary data on molecular correlates to determine clinical efficacy and toxicity.

OUTLINE: This is a multicenter study. Patients are stratified according to risk (good risk [chemonaïve] vs poor risk [1 prior chemotherapy regimen]).

Patients receive oral imatinib mesylate twice daily on days 1-28. Courses repeat every 4 weeks in the absence of disease progression or unacceptable toxicity.

Patients are followed for 30 days.

PROJECTED ACCRUAL: A total of 21-41 patients will be accrued for this study within 1-1.5 years.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Patients with metastatic and/or unresectable carcinoma of the stomach, who have measurable disease
  • Life expectancy > 3 months
  • Karnofsky Performance Status > 60%
  • Absence of an active infection
  • Granulocyte count of > 1,500/mm^3
  • Hemoglobin (Hgb) >= 9 mg/dl
  • Serum bilirubin =< 1.5 mg/dl, regardless of liver involvement secondary to tumor
  • Platelets > 100,000/mm^3
  • Serum glutamic oxaloacetic transaminase (SGOT) and serum glutamate pyruvate transaminase (SGPT) < 2.5 x the institutional upper limit of normal
  • Calculated creatinine clearance of > 60 ml/min
  • Patients must have signed written informed consent
  • Female patients of child-bearing potential must have a negative blood or urine pregnancy test within two weeks prior to initial study treatment
  • Patients who have had prior chemotherapy or radiation therapy must have recovered from any toxicities prior to study entry
  • Patients must have radiographic imaging to document measurable disease within 28 days prior to initial study therapy

Exclusion criteria

  • Diagnosis of resectable carcinoma of the stomach
  • Major surgery within four weeks of study entry
  • Brain metastasis or known seizure disorder
  • Fertile men and women not using an acceptable method of contraception
  • Pregnant or lactating patients are excluded since STI571 may be harmful to the developing fetus and child
  • Patients known to be HIV positive and receiving HAART are excluded because of possibly pharmacological interactions
  • Active peptic ulceration or active gastrointestinal bleeding or any active bleeding disorders
  • Use of therapeutic doses of coumadin (warfarin) as anticoagulation
  • Medical, social, or psychological factors which would prevent the patient from completing the treatment protocol
  • Patients with serious intercurrent illness which would preclude tolerance and completion of the protocol treatment

Treatment and study plan

imatinib mesylate

Drug

Given orally

Other names: CGP 57148, Gleevec, Glivec

laboratory biomarker analysis

Other

Correlative studies

Primary outcomes

  1. Response Rate

    Time frame: Up to 6 years

    Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by X-Ray, MRI or CT: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), >=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR

  2. Toxicity Summary

    Time frame: Up to 30 days post treatment

    Toxicity assessed by Common Terminology Criteria for Adverse Events (CTCAE) version 2.0. Grade 3 and above adverse events possibly, probably or definitely related to treatment.

  3. Progression-free Survival

    Time frame: From first day of treatment to the first observation of disease progression or death due to any cause, assessed up to 30 days post treatment

    Estimated using the product-limit method of Kaplan and Meier. Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions.

  4. Overall Survival

    Time frame: From first day of treatment to time of death due to any cause, assessed up to 5 years post-treatment

    Will be summarized using the Kaplan-Meier product-limit estimators.

  5. Time to Treatment Failure

    Time frame: From first day of treatment until discontinuation of treatment, assessed up to 30 days post treatment

    Defined as the time from start of treatment to the discontinuation of treatment for any reason, including disease progression, treatment toxicity, patient preference, or death Will be summarized using the Kaplan-Meier product-limit estimators. Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions

  6. Baseline Gene Expression Levels of the Target Genes (PDGF-R and PDGF), Genes Associated With Induction of Apoptosis (Bcl-2, Bax), and Cell Cycle Regulatory Genes (p53, p21, p27

    Time frame: Baseline

    Will summarized overall and according to response and toxicity (if numbers permit), using medians, quartiles and ranges - or if a transformation is found to render the data compatible with the normal assumptions, with means, standard deviations, and confidence intervals. The association with progression-free survival or overall survival will be assessed by dichotomizing the measures of gene expression at the median (or by previously established cut-points) and constructing Kaplan-Meier plots.

Sponsors and collaborators

Lead sponsor

National Cancer Institute (NCI)

Nih

Registry information

Important dates

Study start
2004
Primary completion
2010
Study completion
2010
First posted
Sep 11, 2003
Registry last updated
Jul 11, 2018

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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