Study of Modified Docetaxel, Cisplatin, and Fluorouracil (mDCF) in Unresectable or Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma

Sponsor
Memorial Sloan Kettering Cancer Center (Other)
Overall Status
Completed
CT.gov ID
NCT00515411
Collaborator
Sanofi (Industry), Roche-Genentech (Industry), City of Hope National Medical Center (Other), Piedmont Hospital Research Institute (Other), Medical College of Wisconsin (Other), Queens Health Network (Other), Weill Medical College of Cornell University (Other), Memorial Cancer Institute, Florida (Other), University of Pittsburgh (Other), Long Island Jewish Medical Center (Other), Nebraska Cancer Specialists Methodist Estabrook Cancer Center (Other)
111
15
3
144.1
7.4
0.1

Study Details

Study Description

Brief Summary

Chemotherapy given together is a standard way to treat your cancer. One standard treatment includes a combination of docetaxel, cisplatin, and fluorouracil. However, the original combination of these three drugs can cause many side effects. This study is being done to find out if these three drugs can be given at lower doses more often, with fewer side effects and still maintain the same benefit as the standard way of giving this three drug combination. If your tumor overexpresses a protein called Her2, you are also eligible to receive trastuzumab with chemotherapy. Trastuzumab is a medicine that has been approved by the US Food and Drug Administration for the treatment of Her2 positive breast cancer. Trastuzumab is now also a standard treatment in combination with chemotherapy for the treatment of Her2 positive stomach cancer. If your tumor is Her2 positive, you would receive the modified administration schedule of docetaxel, cisplatin, and fluorouracil with trastuzumab.

Condition or Disease Intervention/Treatment Phase
  • Drug: Docetaxel, Leucovorin, Fluorouracil, Cisplatin
  • Drug: Docetaxel, Cisplatin, Fluorouracil, Neulasta, or Neupogen
  • Drug: Docetaxel, Leukvorin, Flurouracil, Cisplatin, Trastuzumab
Phase 2

Study Design

Study Type:
Interventional
Actual Enrollment :
111 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
None (Open Label)
Primary Purpose:
Treatment
Official Title:
A Phase II Study of Modified Docetaxel, Cisplatin, and Fluorouracil (mDCF) in Patients With Unresectable or Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma
Actual Study Start Date :
Oct 23, 2006
Actual Primary Completion Date :
Oct 26, 2018
Actual Study Completion Date :
Oct 26, 2018

Arms and Interventions

Arm Intervention/Treatment
Active Comparator: Arm A, - Modified DCF

Drug Dose (mg/m2) Schedule Docetaxel 40 Day 1 IVPB (60 min) Leucovorin 400 Day 1 IVPB (30 min) Fluorouracil 400 IVP day 1 Fluorouracil 1000 mg/m2/d daily x 2 days Cisplatin 40 Day 2 OR 3 IVPB (30 min) Arm A is repeated every 2 weeks, and a cycle will be considered 6 weeks (eg 3 treatments).

Drug: Docetaxel, Leucovorin, Fluorouracil, Cisplatin
Drug Dose (mg/m2) Schedule Docetaxel 40 Day 1 IVPB (60 min) Leucovorin 400 Day 1 IVPB (30 min) Fluorouracil 400 IVP day 1 Fluorouracil 1000 IVCI x 48 hours Cisplatin 40 Day 2 OR 3 IVPB (30 min)

Active Comparator: ARM B - Parent DCF with G-CSF

Docetaxel 75 Day 1 IVPB (60 min) Cisplatin 75 Day 1 IVPB (60 min) Fluorouracil 750 IVCI daily x 5 days Neulasta 6 mg subcut on d 8, 9, or 10 or Neupogen 300 or 480 mcg* subcut x 7 d 10-17 * 300 mcg for weight < 60 kg, 480 mcg for weight > 60 kg

Drug: Docetaxel, Cisplatin, Fluorouracil, Neulasta, or Neupogen
Drug Dose (mg/m2) Schedule Docetaxel 75 Day 1 IVPB (60 min) Cisplatin 75 Day 1 IVPB (60 min) Fluorouracil 750 IVCI daily x 5 days Neulasta 6 mg subcut on d 8, 9, or 10 or Neupogen 300 or 480 mcg* subcut x 7 d 10-17 * 300 mcg for weight < 60 kg, 480 mcg for weight > 60 kg Arm B is repeated every 3 weeks, and a cycle will be considered every 6 weeks (eg 2 treatments). Tumor assessments will be performed following the completion of every cycle for the first 6 cycles, and then every 2 cycles thereafter.

Active Comparator: Arm C - Modifid DCF + Trastuzumab

Treatment for Her2 Positive Participants Docetaxel 40 Day 1 IVPB (60 min) Leucovorin 400 Day 1 IVPB (30 min) Fluorouracil 400 IVP day 1 Fluorouracil 1000 mg/m2/d daily x 2 days Cisplatin 40 Day 2 OR 3 IVPB (30 min) Trastuzumab Administered on an every 2 week dosing schedule. Initial loading dose of 6 mg/kg over 90 minutes, followed by trastuzumab 4 mg/kg every 2 weeks over 30 minutes.

Drug: Docetaxel, Leukvorin, Flurouracil, Cisplatin, Trastuzumab
Treatment for Her2 Positive Participants Docetaxel 40 Day 1 IVPB (60 min) Leucovorin 400 Day 1 IVPB (30 min) Fluorouracil 400 IVP day 1 Fluorouracil 1000 mg/m2/d daily x 2 days Cisplatin 40 Day 2 OR 3 IVPB (30 min) Trastuzumab Administered on an every 2 week dosing schedule. Initial loading dose of 6 mg/kg over 90 minutes, followed by trastuzumab 4 mg/kg every 2 weeks over 30 minutes.

Outcome Measures

Primary Outcome Measures

  1. 6 Month Progression Free Survival (PFS) [From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 6 months]

    Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), 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", or similar definition as accurate and appropriate

Secondary Outcome Measures

  1. Overall Survival [From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 43 months]

    Overall survival measured in months

Eligibility Criteria

Criteria

Ages Eligible for Study:
18 Years and Older
Sexes Eligible for Study:
All
Accepts Healthy Volunteers:
No
Inclusion Criteria:
  • Patients must have histologically or cytologically confirmed metastatic or unresectable gastric or gastroesophageal junction (GEJ) adenocarcinoma. GEJ adenocarcinoma may be classified according to Siewert's classification type I, II, or III[43].

  • Histological documentation of local recurrence or metastasis is strongly encouraged, unless the risk of such a procedure outweighs the potential benefit of confirming the metastatic disease.

  • If no histologic confirmation, then the metastases or recurrence will require documentation by a 2nd radiographic procedure (eg. PET/CT scan or MRI in addition to the CT scan). If the imaging procedure does not confirm recurrent or metastatic disease, biopsy confirmation will be required.

  • Patients must have disease that can be evaluated radiographically. This may be measurable disease or non-measurable disease. Measurable disease is defined as that which can be measured in at least one dimension as > 20 mm with conventional techniques, or >10 mm by high resolution imaging. Disease that is identified on radiology studies, but does not meet the criteria for measurable disease, is considered non-measurable.

  • Patients may have received no prior chemotherapy for metastatic or unresectable disease. Patients may have received prior adjuvant therapy (chemotherapy and/or chemoradiation) if more than 6 months have elapsed between the end of adjuvant therapy and registration. Patients may not have received prior docetaxel or cisplatin.

  • Age 18 years or older.

  • Karnofsky performance status > than or = to 70% (ECOG performance status 0-1).

  • Peripheral neuropathy < than or = to grade 1.

  • Hematologic (minimal values):

  • White blood cell count > than or = to 3000/mm3

  • Absolute neutrophil count > than or = to 1500 cells/ mm3

  • Hemoglobin > than or = to 9.0 g/dl

  • Platelet count > than or = to 100,000 / mm3

  • Hepatic (minimal values):

  • Total bilirubin < or = to 1.5

    • AST and ALT and Alkaline phosphatase must be within the eligible range. In determining eligibility, the more abnormal of the two values (AST or ALT) should be used. Patients with alkaline phosphatase elevation secondary to the bony metastases rather than liver dysfunction may proceed with treatment on protocol after discussion with the principal investigator.
  • Kidney function (minimal values):
  • Serum creatinine < than or = to 1.5 mg/dl - if serum creatinine is 1.2-1.5 mg/dl, the creatinine clearance (either measured or calculated) must be 50 ml/min or greater
  • The patient has a PT (INR) < than or = to 1.5 and an PTT < than or = to 3 seconds above the upper limits of normal if the patient is not on anticoagulation. If a patient is on full-dose anticoagulants, the following criteria should be met for enrollment:

  • The patient must have an in-range INR (usually between 2 and 3) on a stable dose of warfarin or on stable dose of LMW heparin

  • The patient must not have active bleeding or pathological conditions that carry high risk of bleeding (e.g. tumor involving major vessels, known varices)

  • Women of childbearing potential have a negative pregnancy test.

  • Men and women of childbearing potential must be willing to consent to using effective contraception while on treatment and for at least 3 months thereafter.

  • Ability to understand informed consent and signing of written informed consent document prior to initiation of protocol therapy.

  • Patients must have HER2-positive (FISH+ or IHC 3+) metastatic or unresectable gastric or gastroesophageal junction (GEJ) adenocarcinoma to be eligible for trastuzumab. For the purposes of this protocol, FISH+ is defined as HER2:CEP17 ratio ≥ 2.0. Biopsy samples with cohesive IHC3+ or FISH+ clones are considered HER2 positive irrespective of size, i.e.<10%. FISH+ defined as >2 HER2:CEP17.

  • Patients who are receiving trastuzumab must have a left ventricular ejection fraction of ≥ 50%.

Exclusion Criteria:
  • Patients who have received previous chemotherapy for the treatment of metastatic or unresectable gastric or GEJ adenocarcinoma are ineligible.

  • Patients who have received previous pre- or post-operative chemotherapy or chemoradiation are ineligible if therapy was completed less than 6 months prior to study registration. Patients must have recovered from adverse events from any previous therapy.

  • Patients who have received previous docetaxel or cisplatin.

  • Patients with a history of another neoplastic disease within the past three years, excluding basal cell carcinoma of the skin, cervical carcinoma in situ, or nonmetastatic prostate cancer.

  • Patients with brain or central nervous system metastases, including leptomeningeal disease.

  • Pregnant (positive pregnancy test) or breast feeding.

  • Serious, non-healing wound, ulcer, or bone fracture.

  • Significant cardiac disease as defined as:

unstable angina, New York Heart Association (NYHA) grade II or greater, congestive heart failure, history of myocardial infarction within 6 months

  • Evidence of bleeding diathesis or coagulopathy.

  • History of a stroke or CVA within 6 months

  • Clinically significant peripheral vascular disease.

  • Clinically significant hearing loss or ringing in the ears.

  • Patients with a history of severe hypersensitivity reaction to Taxotere® or other drugs formulated with polysorbate 80.

  • Inability to comply with study and/or follow-up procedures.

  • Patients with any other medical condition or reason, in that investigator's opinion, makes the patient unstable to participate in a clinical trial.

  • For patients who are Her2 positive and will be treated on the trastuzumab + mDCF cohort, prior trastuzumab treatment is not allowed.

  • For patients who are Her2 positive and will be treated on the trastuzumab+mDCF cohort, left ventricular function <50%

Contacts and Locations

Locations

Site City State Country Postal Code
1 City of Hope Cancer Center Duarte California United States 91010
2 Memorial Cancer Institute Pembroke Pines Florida United States 33025
3 Piedmont Hospital Research Institute Atlanta Georgia United States 30309
4 Nebraska Cancer Specialists, Methodist Estabrook Cancer Center Omaha Nebraska United States 68114
5 Memoral Sloan Kettering Cancer Center Basking Ridge New Jersey United States
6 Memorial Sloan-Kettering Cancer Center @ Suffolk Commack New York United States 11725
7 Queens Cancer Center of Queens Hospital Jamaica New York United States 11432
8 Long Island Jewish Medical Center New Hyde Park New York United States 11040
9 Weill Medical College of Cornell University New York New York United States 10021
10 Memorial Sloan Kettering Cancer Center 1275 York Avenue New York New York United States 10065
11 Memorial Sloan Kettering at Mercy Medical Center Rockville Centre New York United States
12 Memoral Sloan Kettering Cancer Center@Phelps Memorial Hospital Sleepy Hollow New York United States
13 University Hospital of Cleveland Cleveland Ohio United States 44106
14 University of Pittsburgh Cancer Institute Pittsburgh Pennsylvania United States 15232
15 Medical College of Wisconsin Milwaukee Wisconsin United States 53226

Sponsors and Collaborators

  • Memorial Sloan Kettering Cancer Center
  • Sanofi
  • Roche-Genentech
  • City of Hope National Medical Center
  • Piedmont Hospital Research Institute
  • Medical College of Wisconsin
  • Queens Health Network
  • Weill Medical College of Cornell University
  • Memorial Cancer Institute, Florida
  • University of Pittsburgh
  • Long Island Jewish Medical Center
  • Nebraska Cancer Specialists Methodist Estabrook Cancer Center

Investigators

  • Principal Investigator: Yelena Janjigian, MD, Memorial Sloan Kettering Cancer Center

Study Documents (Full-Text)

More Information

Additional Information:

Publications

None provided.
Responsible Party:
Memorial Sloan Kettering Cancer Center
ClinicalTrials.gov Identifier:
NCT00515411
Other Study ID Numbers:
  • 06-103
First Posted:
Aug 13, 2007
Last Update Posted:
Dec 10, 2019
Last Verified:
Oct 1, 2018

Study Results

Participant Flow

Recruitment Details
Pre-assignment Detail
Arm/Group Title Arm A, - Modified DCF ARM B - Parent DCF With G-CSF Arm C - Modified DCF+ Trastuzumab
Arm/Group Description Drug Dose (mg/m2) Schedule Docetaxel 40 Day 1 IVPB (60 min) Leucovorin 400 Day 1 IVPB (30 min) Fluorouracil 400 IVP day 1 Fluorouracil 1000 mg/m2/d daily x 2 days Cisplatin 40 Day 2 OR 3 IVPB (30 min) Arm A is repeated every 2 weeks, and a cycle will be considered 6 weeks (eg 3 treatments). Docetaxel, Leucovorin, Fluorouracil, Cisplatin: Drug Dose (mg/m2) Schedule Docetaxel 40 Day 1 IVPB (60 min) Leucovorin 400 Day 1 IVPB (30 min) Fluorouracil 400 IVP day 1 Fluorouracil 1000 IVCI x 48 hours Cisplatin 40 Day 2 OR 3 IVPB (30 min) Docetaxel 75 Day 1 IVPB (60 min) Cisplatin 75 Day 1 IVPB (60 min) Fluorouracil 750 IVCI daily x 5 days Neulasta 6 mg subcut on d 8, 9, or 10 or Neupogen 300 or 480 mcg* subcut x 7 d 10-17 * 300 mcg for weight < 60 kg, 480 mcg for weight > 60 kg Docetaxel, Cisplatin, Fluorouracil, Neulasta, or Neupogen: Drug Dose (mg/m2) Schedule Docetaxel 75 Day 1 IVPB (60 min) Cisplatin 75 Day 1 IVPB (60 min) Fluorouracil 750 IVCI daily x 5 days Neulasta 6 mg subcut on d 8, 9, or 10 or Neupogen 300 or 480 mcg* subcut x 7 d 10-17 * 300 mcg for weight < 60 kg, 480 mcg for weight > 60 kg Arm B is repeated every 3 weeks, and a cycle will be considered every 6 weeks (eg 2 treatments). Tumor assessments will be performed following the completion of every cycle for the first 6 cycles, and then every 2 cycles thereafter. Treatment for Her2 Positive Participants Docetaxel 40 Day 1 IVPB (60 min) Leucovorin 400 Day 1 IVPB (30 min) Fluorouracil 400 IVP day 1 Fluorouracil 1000 mg/m2/d daily x 2 days Cisplatin 40 Day 2 OR 3 IVPB (30 min) Trastuzumab Administered on an every 2 week dosing schedule. Initial loading dose of 6 mg/kg over 90 minutes, followed by trastuzumab 4 mg/kg every 2 weeks over 30 minutes.
Period Title: Overall Study
STARTED 54 31 26
COMPLETED 54 31 26
NOT COMPLETED 0 0 0

Baseline Characteristics

Arm/Group Title Arm A, - Modified DCF ARM B - Parent DCF With G-CSF Arm C - Modified DCF+ Trastuzumab Total
Arm/Group Description Drug Dose (mg/m2) Schedule Docetaxel 40 Day 1 IVPB (60 min) Leucovorin 400 Day 1 IVPB (30 min) Fluorouracil 400 IVP day 1 Fluorouracil 1000 mg/m2/d daily x 2 days Cisplatin 40 Day 2 OR 3 IVPB (30 min) Arm A is repeated every 2 weeks, and a cycle will be considered 6 weeks (eg 3 treatments). Docetaxel, Leucovorin, Fluorouracil, Cisplatin: Drug Dose (mg/m2) Schedule Docetaxel 40 Day 1 IVPB (60 min) Leucovorin 400 Day 1 IVPB (30 min) Fluorouracil 400 IVP day 1 Fluorouracil 1000 IVCI x 48 hours Cisplatin 40 Day 2 OR 3 IVPB (30 min) Docetaxel 75 Day 1 IVPB (60 min) Cisplatin 75 Day 1 IVPB (60 min) Fluorouracil 750 IVCI daily x 5 days Neulasta 6 mg subcut on d 8, 9, or 10 or Neupogen 300 or 480 mcg* subcut x 7 d 10-17 * 300 mcg for weight < 60 kg, 480 mcg for weight > 60 kg Docetaxel, Cisplatin, Fluorouracil, Neulasta, or Neupogen: Drug Dose (mg/m2) Schedule Docetaxel 75 Day 1 IVPB (60 min) Cisplatin 75 Day 1 IVPB (60 min) Fluorouracil 750 IVCI daily x 5 days Neulasta 6 mg subcut on d 8, 9, or 10 or Neupogen 300 or 480 mcg* subcut x 7 d 10-17 * 300 mcg for weight < 60 kg, 480 mcg for weight > 60 kg Arm B is repeated every 3 weeks, and a cycle will be considered every 6 weeks (eg 2 treatments). Tumor assessments will be performed following the completion of every cycle for the first 6 cycles, and then every 2 cycles thereafter. Treatment for Her2 Positive Participants Docetaxel 40 Day 1 IVPB (60 min) Leucovorin 400 Day 1 IVPB (30 min) Fluorouracil 400 IVP day 1 Fluorouracil 1000 mg/m2/d daily x 2 days Cisplatin 40 Day 2 OR 3 IVPB (30 min) Trastuzumab Administered on an every 2 week dosing schedule. Initial loading dose of 6 mg/kg over 90 minutes, followed by trastuzumab 4 mg/kg every 2 weeks over 30 minutes. Total of all reporting groups
Overall Participants 54 31 26 111
Age (Count of Participants)
<=18 years
0
0%
0
0%
0
0%
0
0%
Between 18 and 65 years
40
74.1%
23
74.2%
24
92.3%
87
78.4%
>=65 years
14
25.9%
8
25.8%
2
7.7%
24
21.6%
Sex: Female, Male (Count of Participants)
Female
14
25.9%
9
29%
3
11.5%
26
23.4%
Male
40
74.1%
22
71%
23
88.5%
85
76.6%
Race (NIH/OMB) (Count of Participants)
American Indian or Alaska Native
0
0%
1
3.2%
0
0%
1
0.9%
Asian
5
9.3%
1
3.2%
2
7.7%
8
7.2%
Native Hawaiian or Other Pacific Islander
0
0%
0
0%
0
0%
0
0%
Black or African American
2
3.7%
2
6.5%
0
0%
4
3.6%
White
45
83.3%
27
87.1%
22
84.6%
94
84.7%
More than one race
1
1.9%
0
0%
0
0%
1
0.9%
Unknown or Not Reported
1
1.9%
0
0%
2
7.7%
3
2.7%
Region of Enrollment (Count of Participants)
United States
54
100%
31
100%
26
100%
111
100%

Outcome Measures

1. Primary Outcome
Title 6 Month Progression Free Survival (PFS)
Description Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), 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", or similar definition as accurate and appropriate
Time Frame From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 6 months

Outcome Measure Data

Analysis Population Description
[Not Specified]
Arm/Group Title Arm A, - Modified DCF ARM B - Parent DCF With G-CSF Arm C - Modified DCF+ Trastuzumab
Arm/Group Description Drug Dose (mg/m2) Schedule Docetaxel 40 Day 1 IVPB (60 min) Leucovorin 400 Day 1 IVPB (30 min) Fluorouracil 400 IVP day 1 Fluorouracil 1000 mg/m2/d daily x 2 days Cisplatin 40 Day 2 OR 3 IVPB (30 min) Arm A is repeated every 2 weeks, and a cycle will be considered 6 weeks (eg 3 treatments). Docetaxel, Leucovorin, Fluorouracil, Cisplatin: Drug Dose (mg/m2) Schedule Docetaxel 40 Day 1 IVPB (60 min) Leucovorin 400 Day 1 IVPB (30 min) Fluorouracil 400 IVP day 1 Fluorouracil 1000 IVCI x 48 hours Cisplatin 40 Day 2 OR 3 IVPB (30 min) Docetaxel 75 Day 1 IVPB (60 min) Cisplatin 75 Day 1 IVPB (60 min) Fluorouracil 750 IVCI daily x 5 days Neulasta 6 mg subcut on d 8, 9, or 10 or Neupogen 300 or 480 mcg* subcut x 7 d 10-17 * 300 mcg for weight < 60 kg, 480 mcg for weight > 60 kg Docetaxel, Cisplatin, Fluorouracil, Neulasta, or Neupogen: Drug Dose (mg/m2) Schedule Docetaxel 75 Day 1 IVPB (60 min) Cisplatin 75 Day 1 IVPB (60 min) Fluorouracil 750 IVCI daily x 5 days Neulasta 6 mg subcut on d 8, 9, or 10 or Neupogen 300 or 480 mcg* subcut x 7 d 10-17 * 300 mcg for weight < 60 kg, 480 mcg for weight > 60 kg Arm B is repeated every 3 weeks, and a cycle will be considered every 6 weeks (eg 2 treatments). Tumor assessments will be performed following the completion of every cycle for the first 6 cycles, and then every 2 cycles thereafter. Treatment for Her2 Positive Participants Docetaxel 40 Day 1 IVPB (60 min) Leucovorin 400 Day 1 IVPB (30 min) Fluorouracil 400 IVP day 1 Fluorouracil 1000 mg/m2/d daily x 2 days Cisplatin 40 Day 2 OR 3 IVPB (30 min) Trastuzumab Administered on an every 2 week dosing schedule. Initial loading dose of 6 mg/kg over 90 minutes, followed by trastuzumab 4 mg/kg every 2 weeks over 30 minutes.
Measure Participants 54 31 26
Mean (95% Confidence Interval) [percentage of paticipants]
63
53
73
2. Secondary Outcome
Title Overall Survival
Description Overall survival measured in months
Time Frame From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 43 months

Outcome Measure Data

Analysis Population Description
[Not Specified]
Arm/Group Title Arm A, - Modified DCF ARM B - Parent DCF With G-CSF Arm C - Modified DCF+ Trastuzumab
Arm/Group Description Drug Dose (mg/m2) Schedule Docetaxel 40 Day 1 IVPB (60 min) Leucovorin 400 Day 1 IVPB (30 min) Fluorouracil 400 IVP day 1 Fluorouracil 1000 mg/m2/d daily x 2 days Cisplatin 40 Day 2 OR 3 IVPB (30 min) Arm A is repeated every 2 weeks, and a cycle will be considered 6 weeks (eg 3 treatments). Docetaxel, Leucovorin, Fluorouracil, Cisplatin: Drug Dose (mg/m2) Schedule Docetaxel 40 Day 1 IVPB (60 min) Leucovorin 400 Day 1 IVPB (30 min) Fluorouracil 400 IVP day 1 Fluorouracil 1000 IVCI x 48 hours Cisplatin 40 Day 2 OR 3 IVPB (30 min) Docetaxel 75 Day 1 IVPB (60 min) Cisplatin 75 Day 1 IVPB (60 min) Fluorouracil 750 IVCI daily x 5 days Neulasta 6 mg subcut on d 8, 9, or 10 or Neupogen 300 or 480 mcg* subcut x 7 d 10-17 * 300 mcg for weight < 60 kg, 480 mcg for weight > 60 kg Docetaxel, Cisplatin, Fluorouracil, Neulasta, or Neupogen: Drug Dose (mg/m2) Schedule Docetaxel 75 Day 1 IVPB (60 min) Cisplatin 75 Day 1 IVPB (60 min) Fluorouracil 750 IVCI daily x 5 days Neulasta 6 mg subcut on d 8, 9, or 10 or Neupogen 300 or 480 mcg* subcut x 7 d 10-17 * 300 mcg for weight < 60 kg, 480 mcg for weight > 60 kg Arm B is repeated every 3 weeks, and a cycle will be considered every 6 weeks (eg 2 treatments). Tumor assessments will be performed following the completion of every cycle for the first 6 cycles, and then every 2 cycles thereafter. Treatment for Her2 Positive Participants Docetaxel 40 Day 1 IVPB (60 min) Leucovorin 400 Day 1 IVPB (30 min) Fluorouracil 400 IVP day 1 Fluorouracil 1000 mg/m2/d daily x 2 days Cisplatin 40 Day 2 OR 3 IVPB (30 min) Trastuzumab Administered on an every 2 week dosing schedule. Initial loading dose of 6 mg/kg over 90 minutes, followed by trastuzumab 4 mg/kg every 2 weeks over 30 minutes.
Measure Participants 54 31 26
Median (95% Confidence Interval) [months]
18.8
12.6
24.9

Adverse Events

Time Frame 2 years
Adverse Event Reporting Description
Arm/Group Title Arm A, - Modified DCF ARM B - Parent DCF With G-CSF Arm C - Modified DCF+ Trastuzumab
Arm/Group Description Drug Dose (mg/m2) Schedule Docetaxel 40 Day 1 IVPB (60 min) Leucovorin 400 Day 1 IVPB (30 min) Fluorouracil 400 IVP day 1 Fluorouracil 1000 mg/m2/d daily x 2 days Cisplatin 40 Day 2 OR 3 IVPB (30 min) Arm A is repeated every 2 weeks, and a cycle will be considered 6 weeks (eg 3 treatments). Docetaxel, Leucovorin, Fluorouracil, Cisplatin: Drug Dose (mg/m2) Schedule Docetaxel 40 Day 1 IVPB (60 min) Leucovorin 400 Day 1 IVPB (30 min) Fluorouracil 400 IVP day 1 Fluorouracil 1000 IVCI x 48 hours Cisplatin 40 Day 2 OR 3 IVPB (30 min) Docetaxel 75 Day 1 IVPB (60 min) Cisplatin 75 Day 1 IVPB (60 min) Fluorouracil 750 IVCI daily x 5 days Neulasta 6 mg subcut on d 8, 9, or 10 or Neupogen 300 or 480 mcg* subcut x 7 d 10-17 * 300 mcg for weight < 60 kg, 480 mcg for weight > 60 kg Docetaxel, Cisplatin, Fluorouracil, Neulasta, or Neupogen: Drug Dose (mg/m2) Schedule Docetaxel 75 Day 1 IVPB (60 min) Cisplatin 75 Day 1 IVPB (60 min) Fluorouracil 750 IVCI daily x 5 days Neulasta 6 mg subcut on d 8, 9, or 10 or Neupogen 300 or 480 mcg* subcut x 7 d 10-17 * 300 mcg for weight < 60 kg, 480 mcg for weight > 60 kg Arm B is repeated every 3 weeks, and a cycle will be considered every 6 weeks (eg 2 treatments). Tumor assessments will be performed following the completion of every cycle for the first 6 cycles, and then every 2 cycles thereafter. Treatment for Her2 Positive Participants Docetaxel 40 Day 1 IVPB (60 min) Leucovorin 400 Day 1 IVPB (30 min) Fluorouracil 400 IVP day 1 Fluorouracil 1000 mg/m2/d daily x 2 days Cisplatin 40 Day 2 OR 3 IVPB (30 min) Trastuzumab Administered on an every 2 week dosing schedule. Initial loading dose of 6 mg/kg over 90 minutes, followed by trastuzumab 4 mg/kg every 2 weeks over 30 minutes.
All Cause Mortality
Arm A, - Modified DCF ARM B - Parent DCF With G-CSF Arm C - Modified DCF+ Trastuzumab
Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 37/54 (68.5%) 30/31 (96.8%) 22/26 (84.6%)
Serious Adverse Events
Arm A, - Modified DCF ARM B - Parent DCF With G-CSF Arm C - Modified DCF+ Trastuzumab
Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 26/54 (48.1%) 23/31 (74.2%) 13/26 (50%)
Blood and lymphatic system disorders
Blood/Bone Marrow, other 1/54 (1.9%) 0/31 (0%) 0/26 (0%)
Febrile neutropenia 4/54 (7.4%) 5/31 (16.1%) 0/26 (0%)
Hemoglobin 4/54 (7.4%) 2/31 (6.5%) 4/26 (15.4%)
Hemorrhage/Bleeding, other 0/54 (0%) 2/31 (6.5%) 0/26 (0%)
Cardiac disorders
Atrial Fibrillation 0/54 (0%) 0/31 (0%) 1/26 (3.8%)
Atrial tachycardia/Paroxysmal Atrial Tachycardia 1/54 (1.9%) 0/31 (0%) 0/26 (0%)
Cardiac General, other 0/54 (0%) 2/31 (6.5%) 1/26 (3.8%)
Left ventricular systolic dysfunction 0/54 (0%) 0/31 (0%) 1/26 (3.8%)
Pain - Cardiac/heart 1/54 (1.9%) 0/31 (0%) 0/26 (0%)
Gastrointestinal disorders
Colitis 1/54 (1.9%) 0/31 (0%) 1/26 (3.8%)
Colitis, infectious 1/54 (1.9%) 0/31 (0%) 0/26 (0%)
Constipation 3/54 (5.6%) 2/31 (6.5%) 0/26 (0%)
Diarrhea 3/54 (5.6%) 4/31 (12.9%) 5/26 (19.2%)
Distension/bloating, abdominal 0/54 (0%) 1/31 (3.2%) 0/26 (0%)
Dysphagia (Difficulty swallowing) 0/54 (0%) 0/31 (0%) 2/26 (7.7%)
Fistula, GI- Small bowel NOS 1/54 (1.9%) 0/31 (0%) 0/26 (0%)
Gastrointestinal, other 3/54 (5.6%) 0/31 (0%) 0/26 (0%)
Hemorrhage, Stoma (GI) 1/54 (1.9%) 0/31 (0%) 0/26 (0%)
Hemorrhage, Stomach 0/54 (0%) 1/31 (3.2%) 1/26 (3.8%)
Hemorrhage, Upper GI NOS 1/54 (1.9%) 0/31 (0%) 1/26 (3.8%)
Ileus, GI (func obstruction of bowel) 3/54 (5.6%) 0/31 (0%) 0/26 (0%)
Leak, GI- Leak NOS 0/54 (0%) 1/31 (3.2%) 0/26 (0%)
Mucositis (Clin exam)- Oral cavity 1/54 (1.9%) 1/31 (3.2%) 0/26 (0%)
Mucositis (func/sympt)- Oral cavity 0/54 (0%) 2/31 (6.5%) 0/26 (0%)
Nausea 8/54 (14.8%) 9/31 (29%) 2/26 (7.7%)
Obstruction, GI- Colon 0/54 (0%) 1/31 (3.2%) 0/26 (0%)
Obstruction, GI- Small bowel NOS 2/54 (3.7%) 2/31 (6.5%) 0/26 (0%)
Obstruction, GI- Stomach 1/54 (1.9%) 0/31 (0%) 0/26 (0%)
Pain - Abdomen NOS 8/54 (14.8%) 6/31 (19.4%) 1/26 (3.8%)
Pain - Stomach 2/54 (3.7%) 0/31 (0%) 0/26 (0%)
Perforation, GI- Cecum 0/54 (0%) 1/31 (3.2%) 0/26 (0%)
Ulcer, Esophagus 0/54 (0%) 1/31 (3.2%) 0/26 (0%)
Vomiting 8/54 (14.8%) 10/31 (32.3%) 3/26 (11.5%)
General disorders
Death not assoc w CTCAE term- Death NOS 2/54 (3.7%) 0/31 (0%) 2/26 (7.7%)
Death not assoc w CTCAE term-Disease prog NOS 1/54 (1.9%) 4/31 (12.9%) 0/26 (0%)
Localized Edema - trunk/genital 0/54 (0%) 1/31 (3.2%) 0/26 (0%)
Fatigue (asthenia, lethargy, malaise) 4/54 (7.4%) 4/31 (12.9%) 5/26 (19.2%)
Fever (in the absence of neutropenia) 2/54 (3.7%) 0/31 (0%) 5/26 (19.2%)
Pain - Other (specify) 0/54 (0%) 0/31 (0%) 1/26 (3.8%)
Hepatobiliary disorders
Cholecystitis 0/54 (0%) 1/31 (3.2%) 0/26 (0%)
Immune system disorders
Allerg react/hypersens (incl drug fever) 2/54 (3.7%) 0/31 (0%) 0/26 (0%)
Infections and infestations
Inf norm ANC/gr1/2 neut-Catheter-related 1/54 (1.9%) 0/31 (0%) 0/26 (0%)
Inf norm ANC/gr1/2 neut-Urinary(bladder) 0/54 (0%) 1/31 (3.2%) 1/26 (3.8%)
Inf unknown ANC-Abdomen NOS 1/54 (1.9%) 0/31 (0%) 0/26 (0%)
Infection w/ Gr 3/4 neut, Lung (pneumonia) 1/54 (1.9%) 0/31 (0%) 0/26 (0%)
Infection, other 2/54 (3.7%) 2/31 (6.5%) 2/26 (7.7%)
Injury, poisoning and procedural complications
Wound complication, non-infectious 1/54 (1.9%) 0/31 (0%) 0/26 (0%)
Investigations
Creatinine 0/54 (0%) 1/31 (3.2%) 0/26 (0%)
INR 1/54 (1.9%) 0/31 (0%) 0/26 (0%)
Leukocytes (total WBC) 2/54 (3.7%) 1/31 (3.2%) 2/26 (7.7%)
Lymphopenia 0/54 (0%) 0/31 (0%) 1/26 (3.8%)
Metabolic/Lab - Other (specify) 1/54 (1.9%) 0/31 (0%) 0/26 (0%)
Neutrophils/granulocytes (ANC/AGC) 5/54 (9.3%) 1/31 (3.2%) 1/26 (3.8%)
Metabolism and nutrition disorders
Anorexia 2/54 (3.7%) 1/31 (3.2%) 1/26 (3.8%)
Calcium, low (hypocalcemia) 0/54 (0%) 0/31 (0%) 2/26 (7.7%)
Dehydration 5/54 (9.3%) 7/31 (22.6%) 4/26 (15.4%)
Glucose, high (hyperglycemia) 1/54 (1.9%) 0/31 (0%) 2/26 (7.7%)
Phosphate, low (hypophosphatemia) 0/54 (0%) 0/31 (0%) 1/26 (3.8%)
Potassium, low (hypokalemia) 0/54 (0%) 0/31 (0%) 1/26 (3.8%)
Sodium, low (hyponatremia) 4/54 (7.4%) 0/31 (0%) 0/26 (0%)
Musculoskeletal and connective tissue disorders
Muscle weakness - Right-sided 1/54 (1.9%) 2/31 (6.5%) 0/26 (0%)
Pain - Back 1/54 (1.9%) 0/31 (0%) 0/26 (0%)
Pain - Chest wall 1/54 (1.9%) 0/31 (0%) 0/26 (0%)
Pain - Chest/thorax NOS 0/54 (0%) 2/31 (6.5%) 1/26 (3.8%)
Pain - Extremity-limb 0/54 (0%) 1/31 (3.2%) 1/26 (3.8%)
Pain - Neck 2/54 (3.7%) 0/31 (0%) 0/26 (0%)
Nervous system disorders
CNS cerebrovascular ischemia 0/54 (0%) 0/31 (0%) 1/26 (3.8%)
Dizziness 0/54 (0%) 0/31 (0%) 1/26 (3.8%)
Pain - Head/headache 0/54 (0%) 0/31 (0%) 1/26 (3.8%)
Seizure 0/54 (0%) 1/31 (3.2%) 0/26 (0%)
Syncope (fainting) 4/54 (7.4%) 1/31 (3.2%) 2/26 (7.7%)
Respiratory, thoracic and mediastinal disorders
Aspiration 1/54 (1.9%) 0/31 (0%) 0/26 (0%)
Cough 0/54 (0%) 0/31 (0%) 1/26 (3.8%)
Dyspnea (shortness of breath) 2/54 (3.7%) 3/31 (9.7%) 1/26 (3.8%)
Pain - Throat/pharynx/larynx 0/54 (0%) 0/31 (0%) 1/26 (3.8%)
Pneumothorax 0/54 (0%) 0/31 (0%) 1/26 (3.8%)
Vascular disorders
Hematoma 1/54 (1.9%) 0/31 (0%) 0/26 (0%)
Hypotension 2/54 (3.7%) 1/31 (3.2%) 0/26 (0%)
Thrombosis/embolism (vascular access-related) 1/54 (1.9%) 1/31 (3.2%) 0/26 (0%)
Thrombosis/thrombus/embolism 5/54 (9.3%) 2/31 (6.5%) 1/26 (3.8%)
Other (Not Including Serious) Adverse Events
Arm A, - Modified DCF ARM B - Parent DCF With G-CSF Arm C - Modified DCF+ Trastuzumab
Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 26/54 (48.1%) 23/31 (74.2%) 13/26 (50%)
Blood and lymphatic system disorders
Blood/Bone Marrow, other 1/54 (1.9%) 0/31 (0%) 0/26 (0%)
Febrile neutropenia 4/54 (7.4%) 5/31 (16.1%) 0/26 (0%)
Hemoglobin 4/54 (7.4%) 2/31 (6.5%) 4/26 (15.4%)
Cardiac disorders
Atrial fibrillation 0/54 (0%) 0/31 (0%) 1/26 (3.8%)
Atrial tachycardia/Paroxysmal Atrial Tachycardia 1/54 (1.9%) 0/31 (0%) 0/26 (0%)
Cardiac General, other 0/54 (0%) 2/31 (6.5%) 0/26 (0%)
Left ventricular systolic dysfunction 0/54 (0%) 0/31 (0%) 1/26 (3.8%)
Pain - Cardiac/heart 1/54 (1.9%) 0/31 (0%) 0/26 (0%)
Gastrointestinal disorders
Colitis 1/54 (1.9%) 0/31 (0%) 1/26 (3.8%)
Constipation 3/54 (5.6%) 2/31 (6.5%) 0/26 (0%)
Diarrhea 3/54 (5.6%) 4/31 (12.9%) 5/26 (19.2%)
Distension/bloating, abdominal 0/54 (0%) 1/31 (3.2%) 0/26 (0%)
Dysphagia (Difficulty swallowing) 0/54 (0%) 0/31 (0%) 2/26 (7.7%)
Fistula, GI- Small bowel NOS 1/54 (1.9%) 0/31 (0%) 0/26 (0%)
Gastrointestinal, other 3/54 (5.6%) 0/31 (0%) 0/26 (0%)
Hemorrhage, Stoma (GI) 1/54 (1.9%) 0/31 (0%) 0/26 (0%)
Hemorrhage, Stomach 0/54 (0%) 1/31 (3.2%) 1/26 (3.8%)
Hemorrhage, Upper GI NOS 1/54 (1.9%) 0/31 (0%) 1/26 (3.8%)
Ileus, GI (func obstruction of bowel) 3/54 (5.6%) 0/31 (0%) 0/26 (0%)
Leak, GI- Leak NOS 0/54 (0%) 1/31 (3.2%) 0/26 (0%)
Mucositis (Clin exam)- Oral cavity 1/54 (1.9%) 1/31 (3.2%) 0/26 (0%)
Mucositis (func/sympt)- Oral cavity 0/54 (0%) 2/31 (6.5%) 0/26 (0%)
Nausea 8/54 (14.8%) 9/31 (29%) 2/26 (7.7%)
Obstruction, GI- Colon 0/54 (0%) 1/31 (3.2%) 0/26 (0%)
Obstruction, GI- Small bowel NOS 2/54 (3.7%) 2/31 (6.5%) 0/26 (0%)
Obstruction, GI- Stomach 1/54 (1.9%) 0/31 (0%) 0/26 (0%)
Pain - Abdomen NOS 8/54 (14.8%) 6/31 (19.4%) 1/26 (3.8%)
Pain - Stomach 2/54 (3.7%) 0/31 (0%) 0/26 (0%)
Perforation, GI- Cecum 0/54 (0%) 1/31 (3.2%) 0/26 (0%)
Ulcer, Esophagus 0/54 (0%) 1/31 (3.2%) 0/26 (0%)
Vomiting 8/54 (14.8%) 10/31 (32.3%) 3/26 (11.5%)
General disorders
Death not assoc w CTCAE term- Death NOS 2/54 (3.7%) 0/31 (0%) 2/26 (7.7%)
Death not assoc w CTCAE term-Disease prog NOS 1/54 (1.9%) 4/31 (12.9%) 0/26 (0%)
Edema: trunk/genital 0/54 (0%) 1/31 (3.2%) 0/26 (0%)
Fatigue (asthenia, lethargy, malaise) 4/54 (7.4%) 4/31 (12.9%) 5/26 (19.2%)
Fever (in the absence of neutropenia) 2/54 (3.7%) 0/31 (0%) 5/26 (19.2%)
Pain - Other (specify) 0/54 (0%) 0/31 (0%) 1/26 (3.8%)
Hepatobiliary disorders
Cholecystitis 0/54 (0%) 1/31 (3.2%) 0/26 (0%)
Immune system disorders
Allerg react/hypersens (incl drug fever) 2/54 (3.7%) 0/31 (0%) 0/26 (0%)
Infections and infestations
Colitis, infectious 1/54 (1.9%) 0/31 (0%) 0/26 (0%)
Inf norm ANC/gr1/2 neut-Catheter-related 1/54 (1.9%) 0/31 (0%) 0/26 (0%)
Inf norm ANC/gr1/2 neut-Urinary(bladder) 0/54 (0%) 1/31 (3.2%) 1/26 (3.8%)
Inf unknown ANC-Abdomen NOS 1/54 (1.9%) 0/31 (0%) 0/26 (0%)
Infection w/ Gr 3/4 neut, Lung (pneumonia) 1/54 (1.9%) 0/31 (0%) 0/26 (0%)
Infection, other 2/54 (3.7%) 2/31 (6.5%) 2/26 (7.7%)
Injury, poisoning and procedural complications
Hemorrhage/Bleeding, other 0/54 (0%) 2/31 (6.5%) 0/26 (0%)
Wound complication, non-infectious 1/54 (1.9%) 0/31 (0%) 0/26 (0%)
Investigations
Creatinine 0/54 (0%) 1/31 (3.2%) 0/26 (0%)
INR 1/54 (1.9%) 0/31 (0%) 0/26 (0%)
Leukocytes (total WBC) 2/54 (3.7%) 1/31 (3.2%) 2/26 (7.7%)
Lymphopenia 0/54 (0%) 0/31 (0%) 1/26 (3.8%)
Metabolic/Lab - Other (specify) 1/54 (1.9%) 0/31 (0%) 0/26 (0%)
Neutrophils/granulocytes (ANC/AGC) 5/54 (9.3%) 1/31 (3.2%) 1/26 (3.8%)
Metabolism and nutrition disorders
Anorexia 2/54 (3.7%) 1/31 (3.2%) 1/26 (3.8%)
Calcium, low (hypocalcemia) 0/54 (0%) 0/31 (0%) 2/26 (7.7%)
Dehydration 5/54 (9.3%) 7/31 (22.6%) 4/26 (15.4%)
Glucose, high (hyperglycemia) 1/54 (1.9%) 0/31 (0%) 2/26 (7.7%)
Phosphate, low (hypophosphatemia) 0/54 (0%) 0/31 (0%) 1/26 (3.8%)
Potassium, low (hypokalemia) 0/54 (0%) 0/31 (0%) 1/26 (3.8%)
Sodium, low (hyponatremia) 4/54 (7.4%) 0/31 (0%) 0/26 (0%)
Musculoskeletal and connective tissue disorders
Muscle weakness - Right-sided 1/54 (1.9%) 2/31 (6.5%) 0/26 (0%)
Pain - Back 1/54 (1.9%) 0/31 (0%) 0/26 (0%)
Pain - Chest wall 1/54 (1.9%) 0/31 (0%) 0/26 (0%)
Pain - Chest/thorax NOS 0/54 (0%) 2/31 (6.5%) 1/26 (3.8%)
Pain - Extremity-limb 0/54 (0%) 1/31 (3.2%) 1/26 (3.8%)
Pain - Neck 2/54 (3.7%) 0/31 (0%) 0/26 (0%)
Nervous system disorders
CNS cerebrovascular ischemia 0/54 (0%) 0/31 (0%) 1/26 (3.8%)
Dizziness 0/54 (0%) 0/31 (0%) 1/26 (3.8%)
Pain - Head/headache 0/54 (0%) 0/31 (0%) 1/26 (3.8%)
Seizure 0/54 (0%) 1/31 (3.2%) 0/26 (0%)
Syncope (fainting) 4/54 (7.4%) 1/31 (3.2%) 2/26 (7.7%)
Respiratory, thoracic and mediastinal disorders
Aspiration 1/54 (1.9%) 0/31 (0%) 0/26 (0%)
Cough 0/54 (0%) 0/31 (0%) 1/26 (3.8%)
Dyspnea (shortness of breath) 2/54 (3.7%) 3/31 (9.7%) 1/26 (3.8%)
Pain - Throat/pharynx/larynx 0/54 (0%) 0/31 (0%) 1/26 (3.8%)
Pneumothorax 0/54 (0%) 0/31 (0%) 1/26 (3.8%)
Vascular disorders
Hematoma 1/54 (1.9%) 0/31 (0%) 0/26 (0%)
Hypotension 2/54 (3.7%) 1/31 (3.2%) 0/26 (0%)
Thrombosis/embolism (vascular access-related) 1/54 (1.9%) 1/31 (3.2%) 0/26 (0%)
Thrombosis/thrombus/embolism 5/54 (9.3%) 2/31 (6.5%) 1/26 (3.8%)

Limitations/Caveats

[Not Specified]

More Information

Certain Agreements

All Principal Investigators ARE employed by the organization sponsoring the study.

There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.

Results Point of Contact

Name/Title Dr. Yelena Janjigian, MD
Organization Memorial Sloan Kettering Cancer Center
Phone 646-888-4186
Email janjigiy@mskcc.org
Responsible Party:
Memorial Sloan Kettering Cancer Center
ClinicalTrials.gov Identifier:
NCT00515411
Other Study ID Numbers:
  • 06-103
First Posted:
Aug 13, 2007
Last Update Posted:
Dec 10, 2019
Last Verified:
Oct 1, 2018