Phase I/II Study of the Combination of Oxaliplatin / Docetaxel and ZACTIMA for the Treatment of Advanced Cancers of the Esophagus and Gastroesophageal Junction
OBJECTIVES:
Primary
- To determine the maximum tolerated dose of vandetanib when administered with
oxaliplatin and docetaxel in patients with advanced cancer of the esophagus or
gastroesophageal junction. (Phase I)
- To evaluate the toxicity of this regimen in these patients. (Phase I)
- To determine the progression-free survival of these patients. (Phase II)
Secondary
- To determine the response rate in patients treated with oxaliplatin and docetaxel with
or without vandetanib. (Phase II)
- To determine the overall survival of patients treated with these regimens. (Phase II)
- To determine the toxicity of these regimens in these patients. (Phase II)
- To determine whether tumor characteristics (e.g., EGFR/ErbB2 expression, activation and
mutational status of the EGFR and ErbB2 pathway [total and phosphorylated EGFR and
ErbB2, mutational and FISH analysis] and tumoral expression of HIF1-alpha) may have an
association with response and outcome. (Phase II)
OUTLINE: This is a multicenter, phase I, dose-escalation study of vandetanib followed by a
randomized phase II study.
Patients are stratified according to histology (adenosarcoma vs squamous cell carcinoma) and
prior neoadjuvant/adjuvant chemotherapy/chemoradiotherapy (yes vs no). Patients are
randomized to 1 of 2 treatment arms. Patients in phase I receive treatment as in phase II
arm I.
- Phase II arm I: Patients receive docetaxel IV over 1 hour on days 1 and 8, oxaliplatin
IV over 2 hours on day 1, and oral vandetanib (at the maximum tolerated dose determined
in phase I) once daily on days 1-21. Treatment repeats every 21 days for up to 8
courses in the absence of disease progression or unacceptable toxicity. Patients with
responding or stable disease may continue to receive vandetanib beyond 8 courses in the
absence of disease progression or unacceptable toxicity.
- Phase II arm II: Patients receive docetaxel and oxaliplatin as in arm I. Patients also
receive an oral placebo once daily on days 1-21. Treatment repeats every 21 days for up
to 8 courses in the absence of disease progression or unacceptable toxicity. Patients
with responding or stable disease may continue to receive vandetanib beyond 8 courses
in the absence of disease progression or unacceptable toxicity.
Patients enrolled in phase II submit baseline tumor tissue samples for correlative
laboratory studies, including analysis of EGFR and ErbB2 by mutational, FISH, and IHC
analysis and HIF1-alpha expression by IHC analysis.
Interventional
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
Maximum tolerated dose of vandetanib when administered with oxaliplatin and docetaxel (Phase I)
Each cycle of treatment consists of 21 days. Dose-limiting toxicities will be defined during cycle 1 of therapy. Patients will need to be observed for at least 2 cycles. A maximum of eight cycles of chemotherapy will be allowed.
Yes
Afshin Dowlati, MD
Principal Investigator
Case Medical Center, University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center
United States: Institutional Review Board
CASE6507
NCT00732745
October 2008
Name | Location |
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Case Medical Center, University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center | Cleveland, Ohio 44106-5065 |