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NCT Number: NCT03825861

Neoadjuvant FOLFIRINOX in the Treatment of Locally Advanced Gastric Cancer

Phase II single-arm study designed to evaluate the efficacy and safety of preoperative chemotherapy with FOLFIRINOX regimen. The investigators will include 27 patients with resectable locally advanced gastric cancer. They will receive preoperative chemotherapy with FOLFIRINOX regimen by long-term catheter every 14 days for 8 cycles accounting for a total of 4 months of systemic treatment. In the period between 4 and 8 weeks of the last cycle, restaging tests will be performed and if there is no metastatic progression of disease, the patient will undergo surgical treatment with curative intention. The objective is to evaluate whether preoperative treatment with FOLFIRINOX regimen involving continuous infusion and bolus infusion of 5-fluoruracil, irinotecan bolus and oxaliplatin bolus is effective and safe in the neoadjuvant treatment of locally advanced gastric cancer.

The planned recruitment period is 48 months (4 years). There will be a total of 4 months of preoperative chemotherapy. In case of limiting toxicity or disease progression, chemotherapy will be suspended and patients may undergo resection of the primary neoplasia at the discretion of the surgical team of the institution. Patients will be followed for 5 years after entry of the last participant in the protocol for OS and PFS evaluation. The end of the study will occur when the last participant completes their last follow-up visit, which should occur no later than 60 months after enrollment in the study.

Recruiting

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Key information

Age range

18 year–75 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 2

Primary location

Instituto do Câncer do Estado de São Paulo

São Paulo, 01246-000, Brazil

Location status: Recruiting

Location contact

Tiago Castria, MD PhD

CONTACT

[email protected]

+5511 3893-2000

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Histological diagnosis of gastric adenocarcinoma that is amenable to surgical resection at diagnosis, with locally advanced disease criteria for clinical evaluation (T3 tumors, T4 tumors and / or regional lymph node involvement).
  • Absence of metastatic disease at a distance (computerized tomography, diagnostic laparoscopy and peritoneal lavage).
  • Age 18-75 years.
  • Clinical functionality by the ECOG scale between 0 and 1.
  • Preserved renal function (creatinine clearance greater than 50 mL / min).
  • Signature of Informed Consent Form

Exclusion criteria

  • Active neoplasm of another primary site other than non-melanoma skin carcinoma.
  • Lesions of the esophagogastric transition
  • Unresectable lesions by computed tomography and / or diagnostic laparoscopy.
  • Obstructive tumors (acute intestinal occlusion or subocclusion).
  • Tumors with signs of significant or persistent bleeding.
  • Carcinoma in situ.
  • Different histological type of adenocarcinoma.
  • Gastric stump tumors.
  • Previous chemotherapeutic or radiotherapy treatment.
  • Current pregnancy or breastfeeding.
  • Total bilirubin above 1.5mg / dL.
  • Hepatic transaminases greater than 1.5 times the upper limit of normality.
  • Decompensated and / or symptomatic cardiomyopathy: congestive heart failure with functional class greater than 2 by the New York Heart Association; active coronary disease; uncontrolled cardiac arrhythmia; history of acute myocardial infarction in the last 6 months.
  • Psychological, familial, social or even geographical condition that potentially hinders adherence to the study protocol and the pre-established follow-up.
  • Current or previous psychiatric or neurological diagnosis that is decompensated, compromises the cognition, functionality or adherence to the proposed treatment.
  • Other comorbidities that are decompensated at the time of treatment.
  • Pregnant or breastfeeding women.

Treatment and study plan

Folfirinox

Drug

Oxaliplatin 85mg/m2, Leucovorin 200mg/m2, Irinotecan 180mg/m2, 5-FU 400mg/m2 bolus followed by 2400mg/m2 continuous infusion.

Primary outcomes

  1. Pathologic Complete Response (pCR)

    Time frame: 4-8 weeks after neoadjuvant chemotherapy complete

    To evaluate the Pathologic Complete Response (pCR).

Secondary outcomes

  1. Disease-free survival (DFS)

    Time frame: At 2, 3 and 5 years after preoperative treatment with FOLFIRINOX regimen.

    Evaluate Disease-free survival (DFS).

  2. Overall survival (OS)

    Time frame: At 2, 3 and 5 years after preoperative treatment with FOLFIRINOX regimen.

    Evaluate Overall survival (OS).

  3. R0-resection rate

    Time frame: 4-8 weeks after neoadjuvant chemotherapy complete

    Evaluate the R0 resection rate (absence of microscopic residual disease).

  4. Rate of Treatment Completion

    Time frame: 4-8 weeks after neoadjuvant chemotherapy complete

    Evaluate the rate of completion of treatment (chemotherapy and surgical approach).

  5. Rate of adverse events

    Time frame: Through neoadjuvant chemotherapy (4 months)

    Rate and description of adverse events

  6. Rate of Disease Progression

    Time frame: Through neoadjuvant chemotherapy (4 months)

    Evaluate the rate of disease progression.

Study contacts

Contact information is provided by the study sponsor or research team.

Tiago B. Castria, MD PhD

CONTACT

[email protected]

+551138934531

Sponsors and collaborators

Lead sponsor

Instituto do Cancer do Estado de São Paulo

Other

Registry information

Acronym: FOLFIRINOX

Important dates

Study start
2017
Primary completion
2026
Study completion
2026
First posted
Jan 31, 2019
Registry last updated
Nov 10, 2020

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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