Neoadjuvant FOLFIRINOX in the Treatment of Locally Advanced Gastric Cancer

Trial statusRecruiting
Trial phasePhase 2
Trial typeInterventional
Biological sexAll
Age18-75
SponsorInstituto do Cancer do Estado de São Paulo

About this trial

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.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

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.

Disqualifiers

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).

Trial design

Design model

Single group

Treatments tested in this trial

  • FOLFIRINOX

    Drug

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

Treatment groups

27 Participants
are divided into 1 treatment group
Group A: FOLFIRINOXExperimental treatment 1 intervention

Trial outcomes

Primary outcomes

1

Pathologic Complete Response (pCR)

To evaluate the Pathologic Complete Response (pCR).

Time frame
4-8 weeks after neoadjuvant chemotherapy complete

Secondary outcomes

1

Disease-free survival (DFS)

Evaluate Disease-free survival (DFS).

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

Overall survival (OS)

Evaluate Overall survival (OS).

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

R0-resection rate

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

Time frame
4-8 weeks after neoadjuvant chemotherapy complete
4

Rate of Treatment Completion

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

Time frame
4-8 weeks after neoadjuvant chemotherapy complete

Other outcomes

Sponsors and contacts

Click on the lead sponsor to view all of their trials.