UMIN-CTR Clinical Trial

Public title

IPD meta-analysis of biweekly irinotecan plus cisplatin and irinotecan alone as second-line treatment for advanced gastric cancer: TCOG GI-0801BIRIP and ECRIN TRICS RCTs

Acronym

Meta-analysis of TCOG GI-0801BIRIP and ECRIN TRICS RCTs as second-line treatment for advanced gastric cancer

Scientific Title

IPD meta-analysis of biweekly irinotecan plus cisplatin and irinotecan alone as second-line treatment for advanced gastric cancer: TCOG GI-0801BIRIP and ECRIN TRICS RCTs

Scientific Title:Acronym

Meta-analysis of TCOG GI-0801BIRIP and ECRIN TRICS RCTs as second-line treatment for advanced gastric cancer

Region

Japan

Condition

Advanced gastric cancer

Classification by specialty

Gastroenterology	Hematology and clinical oncology	Gastrointestinal surgery

Classification by malignancy

Malignancy

Genomic information

NO

Narrative objectives1

The purpose of the study is to evaluate the efficacy and safety of biweekly CPT-11 plus CDDP comparing to CPT-11 monotherapy in patients with advanced gastric cancer who had received S-1 based first line chemotherapy.
1. Comparison of effectiveness between biweekly irinotecan plus cisplatin vs. irinotecan alone
2. To identify subgroups, biomarkers, most likely benefit from each treatment: previous treatment with cisplatin, histological cancer types etc.
3. Comparison of effectiveness between patients who relapsed during or within 6 months after adjuvant chemotherapy and patients after first line chemotherapy.

Basic objectives2

Safety,Efficacy

Basic objectives -Others

Trial characteristics_1

Exploratory

Trial characteristics_2

Explanatory

Developmental phase

Not applicable

Primary outcomes

Overall survival: OS

Key secondary outcomes

PFS: Progression-free survival
TTF: time to treatment failure
RR: Response rate
DCR: Disease control rate
Adverse events

Study type

Others,meta-analysis etc

Basic design

Randomization

Randomization unit

Blinding

Control

Stratification

Dynamic allocation

Institution consideration

Blocking

Concealment

No. of arms

Purpose of intervention

Type of intervention

Interventions/Control_1

Interventions/Control_2

Interventions/Control_3

Interventions/Control_4

Interventions/Control_5

Interventions/Control_6

Interventions/Control_7

Interventions/Control_8

Interventions/Control_9

Interventions/Control_10

Age-lower limit

20

years-old

<=

Age-upper limit

Not applicable

Gender

Male and Female

Key inclusion criteria

1.With pathologically proven gastric cancer
2. S-1 failure for Patients with Advanced and Recurrent Gastric Cancer
3. ECOG performance status<=2
4. Age 20 years old or more
5. Life expectancy estimated>=12 weeks
6. Sufficient organ functions

Key exclusion criteria

(1) Blood transfusion, blood products, or hematopoietic factor products, such as G-CSF, within 14 days before enrollment of this study.
(2) Present and/or drug hypersensitivity or severe drug allergy.
(3) Active double cancer.
(4) With uncontrolled pleural effusion or ascites.
(5) With pericardial effusion.
(6) With infectious disease which needs treatment.
(7) With symptomatic brain metastasis.
(8) With marked ECG abnormalities.
(9) With serve heart diseases, such as congestive heart failure, symptomatic coronary artery disease, inadequately controlled arrhythmia, myocardial infarction during the previous 12 months, etc.
(10) With severe pulmonary disease (interstitial pneumonia, pulmonary fibrosis, severe pulmonary emphysema, etc.).
(11) With fresh gastrointestinal hemorrhage.
(12) Watery stool (diarrhea).
(13) Intestinal paralysis or ileus.
(14) With a history of central nervous system disorder.
(15) With senile dementia.
(16) With psycologic disorder which disturbs recruiting to the study
(17)Uncontrolled diabetes mellitus.
(18) Receiving atazanavir sulfate.
(19) Pregnant and/or nursing women.
(20) Inappropriate recruit to the study judged by an investigator in charge.

Target sample size

298

Name of lead principal investigator

1st name
Middle name
Last name	Wasaburo Koizum

Organization

Kitasato University

Division name

Department of Gastroenterology

Zip code

Address

1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0374, Japan

TEL

042-778-8111

Email

koizumi@med.kitasato-u.ac.jp

Name of contact person

1st name
Middle name
Last name	Kazuhiro Nishikawa

Organization

Osaka National Hospital

Division name

Department of Surgery

Zip code

Address

2-1-14, Houenzaka, Chuo-ku, Osaka, 540-0006

TEL

06-6942-1331

Homepage URL

Email

kazuno13@hotmail.co.jp

Institute

Epidemiological and Clinical research Information Network (ECRIN)

Institute

Department

Personal name

Organization

None

Organization

Division

Category of Funding Organization

Non profit foundation

Nationality of Funding Organization

Co-sponsor

Name of secondary funder(s)

Organization

Address

Tel

Email

Secondary IDs

NO

Study ID_1

Org. issuing International ID_1

Study ID_2

Org. issuing International ID_2

IND to MHLW

Institutions

Date of disclosure of the study information

2017

Year

01

Month

05

Day

URL releasing protocol

Publication of results

Published

URL related to results and publications

Number of participants that the trial has enrolled

Results

Cumulative data from eligible 290 patients from these two trials were evaluated. OS were 12.3 in BIRIP group and 11.3 months in CPT-11 group (HR 0.87; P = 0.272). PFS was significantly longer in BIRIP group (4.3months) than in CPT-11 group (3.3months; HR 0.77, P = 0.035). The response rate was 20.5% in BIRIP group and 16.0% in CPT-11 group (P = 0.361). However, the disease control rate was significantly better in BIRIP group (72.1%) than in CPT-11 group (59.2%) (P = 0.032). The incidences of grade 3 or worse adverse events did not differ between the two groups.

Results date posted

Results Delayed

Results Delay Reason

Date of the first journal publication of results

Baseline Characteristics

Participant flow

Adverse events

Outcome measures

Plan to share IPD

IPD sharing Plan description

Recruitment status

Completed

Date of protocol fixation

2016

Year

12

Month

22

Day

Date of IRB

Anticipated trial start date

2017

Year

01

Month

10

Day

Last follow-up date

Date of closure to data entry

Date trial data considered complete

Date analysis concluded

2018

Year

02

Month

17

Day

Other related information

Two randomized trials of biweekly CPT-11 plus CDDP versus CPT-11 alone in second line, TCOG GI-0801BIRIP trial and ECRIN TRICS trial were done without overall survival benefit; although there were trends for better survival for CPT-11 plus CDDP.
Based on these findings, we conducted meta-analysis to compare the efficacy and safety of biweekly CPT-11 plus CDDP and CPT-11 monotherapy in 300 patients who enrolled these two recent randomized trials. Also we identify subgroups who would benefit from each treatment.

Registered date

2016

Year

12

Month

22

Day

Last modified on

2018

Year

12

Month

26

Day

Link to view the page

Value
https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000029146