The Study of Conversion Surgery for Apatinib in Combination With SOX for Patients With Unresectable Gastric Cancer

Sponsor

Chinese PLA General Hospital (Other)

Overall Status

Unknown status

CT.gov ID

NCT03007446

Collaborator

(none)

Enrollment

Location

Arm

Duration (Months)

0.8

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

This is a Prospective，Single-center，Single-arm，Open-label exploratory clinical trial evaluating the efficacy and safety of Conversion Surgery for Apatinib plus SOX for patients with unresectable gastric cancer.

Condition or Disease	Intervention/Treatment	Phase
Gastric Cancer	Drug: Apatinib Drug: Oxaliplatin Drug: S-1	Phase 2

Detailed Description

Gastric cancer is the second most common cause of cancer-related deaths worldwide, and surgical resection during the early stage has improved treatment outcomes.However, many patients are diagnosed with unresectable advanced or metastatic stage disease losing the radical surgery opportunity. Systemic chemotherapy is the leading treatment that prolongs survival times for such patients.

Approximate 20 patients with unresectable gastric cancer will be enrolled in this study,the investigators will evaluate the efficacy and security of Apatinib + SOX(oxaliplatin+S-1) for unresectable gastric cancer.

Study Design

Study Type:

Interventional

Anticipated Enrollment :

20 participants

Allocation:

N/A

Intervention Model:

Single Group Assignment

Masking:

None (Open Label)

Primary Purpose:

Treatment

Official Title:

The Exploratory Study of Conversion Surgery for Apatinib in Combination With Oxaliplatin/S-1(SOX) for Patients With Unresectable Gastric Cancer

Study Start Date :

Nov 1, 2016

Anticipated Primary Completion Date :

Nov 1, 2018

Anticipated Study Completion Date :

Nov 1, 2018

Arms and Interventions

Arm	Intervention/Treatment
Experimental: Apatinib plus Oxaliplatin/S-1 Apatinib : A starting dose of apatinib was administered 500 mg daily on days 1 through 21 of each 3-week cycle. Oxaliplatin:130 mg/m2，d1，ivgtt，in a 21 day cycle. S-1:40mg，bid，d1-14，po，in a 21 day cycle.	Drug: Apatinib Apatinib :A starting dose of apatinib was administered 500 mg daily Other Names: Apatinib mesylate tablets Drug: Oxaliplatin Oxaliplatin:130 mg/m2，d1，ivgtt，in a 21 day cycle Drug: S-1 S-1:40mg，bid，d1-14，po，in a 21 day cycle.

Arm

Intervention/Treatment

Experimental: Apatinib plus Oxaliplatin/S-1

Apatinib : A starting dose of apatinib was administered 500 mg daily on days 1 through 21 of each 3-week cycle. Oxaliplatin:130 mg/m2，d1，ivgtt，in a 21 day cycle. S-1:40mg，bid，d1-14，po，in a 21 day cycle.

Drug: Apatinib

Apatinib :A starting dose of apatinib was administered 500 mg daily

Other Names:

Apatinib mesylate tablets

Drug: Oxaliplatin

Oxaliplatin:130 mg/m2，d1，ivgtt，in a 21 day cycle

Drug: S-1

S-1:40mg，bid，d1-14，po，in a 21 day cycle.

Outcome Measures

Primary Outcome Measures

reaction rate [4 months]

Secondary Outcome Measures

Objective Response Rate [an expected average of 6 weeks]
Disease-free survival [an expected average of 6 weeks]
Progression-Free Survival [an expected average of 6 weeks]
Overall Survival [3 years]
adverse events [6 months]

Eligibility Criteria

Criteria

Ages Eligible for Study:

18 Years to 70 Years

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Inclusion Criteria:

Histologically proved gastric adenocarcinoma;
At least a unresectable factor before operation via CT, MRI, or PET-CT: difficult resection of locally advanced gastric cancer(T4b); hepatic metastasis (H1; at most five lesions, total diameter ≤8 cm); Peritoneal metastasis(CY1, P1) ;
Definitely diagnosed as unresectable gastric cancer via exploratory laparoscopy or laparotomy;
ECOG performance status 0-2;
Age 18-70 years old, Life expectancy estimated than 3 months;
For results of blood routine test and biochemical tests:
Hgb ≥ 80g/L,
WBC ≥ 4000/mm3,
ANC ≥ 1.5×109/L,
platelets ≥ 80×109/L
ALT and AST ≤ 2.5 x upper normal limit (UNL), and ≤ 5 x UNL（Hematogenous metastases）,
Serum Total bilirubin ≤ 1.5 X UNL,
Serum Creatine ≤ 1.5 x UNL ；
Good cardiac function before the recruitment, no seizure of myocardial infarction in past half years, and controllable hypertension and other coronary heart disease;
Not concomitant with other uncontrollable benign disease before the recruitment(e.g. the infection in the kidney, lung and liver);
informed consent.

Exclusion Criteria:

Subjects with poor-controlled arterial hypertension (systolic blood pressure> 140 mmHg and diastolic blood pressure > 90 mm Hg) despite standard medical management; Coronary heart disease greater than Class I; I-level arrhythmia (including QT interval prolongation, for man ≥ 450 ms, for woman ≥ 470 ms) together with Class I cardiac dysfunction; Patients with positive urinary protein;
Factors that could have an effect on oral medication (such as inability to swallow, chronic diarrhea and intestinal obstruction);
Subjects with high gastrointestinal bleeding risk, including the following conditions: local active ulcer lesions with positive fecal occult blood test (++); history of black stool, or vomiting blood in the past 2 months;
Contraindications include allergy to apatinib and/or its accessories, active bleeding, intestinal perforation, intestinal obstruction, within 30 days after surgery, drugs with poor-controlled hypertension, Class Ⅲ-Ⅳ cardiac dysfunction （NYHA standard）, severe hepatic and renal dysfunction（level 4）if apatinib use is considered;
Abnormal Coagulation (INR>1.5, APTT>1.5 UNL), with tendency of bleed;
Pregnant or lactating women;
Any other condition that might place the patient at undue risk or preclude a patient from completing the study;
Treatment with prior radiotherapy, chemotherapy, Targeted therapy or immunotherapy;
Other conditions regimented at investigators' discretion.