A Randomized, Double Blind Study Evaluating Paclitaxel With and Without RAD001 in Patients With Gastric Carcinoma After Prior Chemotherapy (AIO-STO-0111)

• ClinicalTrials.gov Identifier: NCT01248403
• Recruitment Status: Completed
• First Posted: November 25, 2010
• Last Update Posted: January 29, 2020
• Sponsor: Krankenhaus Nordwest
• Information provided by (Responsible Party): Prof. Dr. S.E. Al-Batran, Krankenhaus Nordwest

Study Description

Brief Summary:

Adult patients with gastric carcinoma which has progressed after initial treatment with a fluoropyrimidines-containing regimen will be treated with paclitaxel plus RAD001 or plus placebo. The hypothesis is that patients with RAD001 have significantly prolonged overall survival compared to patients who are treated with paclitaxel alone.

Condition or disease	Intervention/treatment	Phase
Advanced Gastric Cancer; Esophagogastric Junction Cancer	Drug: Paclitaxel; Drug: RAD001	Phase 3

Detailed Description:

This is a randomized, double-blind, phase III two-arm multi-center study aiming at estimating the relative efficacy of the combination of RAD001 and paclitaxel versus that of paclitaxel alone as second-, third- or fourth-line treatment in terms of hazard ratio of overall survival in patients with gastric cancer who have relapsed after one treatment regimen containing a fluoropyrimidine (e.g., 5-FU, S-1, capecitabine and other 5-FU prodrugs or derivatives). Patients will be randomized in a 1:1 ratio for a total of 240 patients per treatment arm. Randomization will be stratified according to performance status (0-1 versus 2), prior taxan use (yes vs. no) and treatment line (2nd versus 3rd/4th line).

Study treatment will be continued until progression or intolerable toxicity. Patients will be seen at baseline/screening, and weekly for paclitaxel administration and safety assessment until disease progression or discontinuation of trial therapy for other reasons. Radiological tumor assessment will be performed every second cycle (every 8 weeks) or earlier if clinically indicated. Post-study follow-up will be completed every 8 weeks for survival.

Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 300 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Masking: Triple (Participant, Care Provider, Investigator)
• Primary Purpose: Treatment
• Official Title: A Randomized, Double-blind, Multi-center Phase III Study Evaluating Paclitaxel With and Without RAD001 in Patients With Gastric Carcinoma Who Have Progressed After Therapy With a Fluoropyrimidine-containing Regimen
• Actual Study Start Date: October 2011
• Actual Primary Completion Date: July 2017
• Actual Study Completion Date: October 2019

Arms and Interventions

Arm	Intervention/treatment
Active Comparator: paclitaxel + placebo; Paclitaxel 80 mg/m2 on day 1, day 8 and day 15 of every 28-day cycle. + Placebo (2 tablets / day) d1-d28	Drug: Paclitaxel; Paclitaxel 80 mg/m2 on day 1, day 8 and day 15 of every 28-day cycle.
Experimental: paclitaxel + RAD001; Paclitaxel 80 mg/m2 on day 1, day 8 and day 15 of every 28-day cycle. + RAD001 10mg (2 x5 mg tablets / day) d1-d28	Drug: Paclitaxel; Paclitaxel 80 mg/m2 on day 1, day 8 and day 15 of every 28-day cycle.; Drug: RAD001; RAD001 10mg (2 x5 mg tablets / day) d1-d28; Other Names: Everolimus; Certican

Outcome Measures

Primary Outcome Measures :

1. overall survival [ Time Frame: 6 months follow-up ]

Secondary Outcome Measures :

1. best overall response [ Time Frame: staging every 8 weeks ]
2. progression-free survival [ Time Frame: staging every 8 weeks ]
3. number of participants with adverse events as a measure of safety and tolerability [ Time Frame: every week until end of treatment ]
4. disease control rate [ Time Frame: every 8 weeks ]
   responders + stable disease ≥12 weeks

Eligibility Criteria

• Ages Eligible for Study: 18 Years and older (Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Criteria

Inclusion Criteria:

• Male or female patients ≥ 18 years old
• Histologically or cytologically confirmed and documented gastric adenocarcinoma. Adenocarcinomata of the gastro-esophageal junction will be allowed, if they have advanced disease (inoperable, recurrent or metastatic disease).
• Documented progressive disease during/after one, two or three prior treatments containing 5FU and/or its precursors or derivatives in the palliative setting
• At least one measurable or evaluable lesion by RECIST as determined by Computed Tomography (CT) Scan or Magnetic Resonance Imaging (MRI)
• ECOG performance status of 0, 1 or 2

• The following laboratory parameters:

  • Absolute neutrophil count ≥ 1.5 x 109/L
  • Platelets ≥ 100 x 109/L
  • Hemoglobin (Hgb) ≥ 9 g/dL
  • Serum creatinine ≤ 2 x Upper Limit of Normal (ULN)
  • Adequate liver function:
  • Total serum calcium (corrected for serum albumin) or ionized calcium ≥ LLN
• Women of childbearing potential must have a negative serum pregnancy test within 7 days of the first administration of study treatments and must be willing to use adequate methods of contraception during the study and for 3 months after last study drug administration.
• Written informed consent

Exclusion Criteria:

• Current treatment with any anti cancer therapy or treatment with anti cancer therapy ≤ 2 weeks prior to study treatment start unless rapidly progressing disease is measured
• Known hypersensitivity to RAD001 (everolimus) or to its excipients, or to other rapamycins (e.g. sirolimus, temsirolimus)
• Known prior history of hypersensitivity to paclitaxel.
• Paclitaxel refractory disease, which is defined as a disease progression under or within 12 weeks of last taxan treatment
• Chronic treatment with steroids (except for oral, topical or local injection) or another immunosuppressive agent
• Major surgery ≤ 2 weeks prior to starting study treatment or patients who have not recovered from such therapy
• Lack of resolution of all acute toxic effects (excluding alopecia) of prior chemotherapy, prior radiotherapy, or surgical procedure to National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) grade <= 1. Note: Neuropathy due to prior chemotherapy is allowed.

• Unstable CNS disease

  • Requiring increasing doses of steroids to maintain stable neurological status
  • Deteriorating / changing neurological status
• Known history of HIV seropositivity (HIV testing is not mandatory) or Hepatitis B or C.
• Active, bleeding diathesis or on oral anti-vitamin K medication (except low dose warfarin, as long as the INR is <= 2.0)
• Any other severe and/or uncontrolled medical conditions

Contacts and Locations

Locations

Germany

Krankenhaus Nordwest

Frankfurt/Main, Germany, 60488

Sponsors and Collaborators

Krankenhaus Nordwest

Investigators

• Principal Investigator: Salah-Eddin Al-Batran, MD; Institute of Clinical Cancer Research (IKF), UCT - University Cancer Center, Frankfurt, Germany

More Information

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Lorenzen S, Knorrenschild JR, Pauligk C, Hegewisch-Becker S, Seraphin J, Thuss-Patience P, Kopp HG, Dechow T, Vogel A, Luley KB, Pink D, Stahl M, Kullmann F, Hebart H, Siveke J, Egger M, Homann N, Probst S, Goetze TO, Al-Batran SE. Phase III randomized, double-blind study of paclitaxel with and without everolimus in patients with advanced gastric or esophagogastric junction carcinoma who have progressed after therapy with a fluoropyrimidine/platinum-containing regimen (RADPAC). Int J Cancer. 2020 Nov 1;147(9):2493-2502. doi: 10.1002/ijc.33025. Epub 2020 May 7.

• Responsible Party: Prof. Dr. S.E. Al-Batran, Principal Investigator, Krankenhaus Nordwest
• ClinicalTrials.gov Identifier: NCT01248403
• Other Study ID Numbers: CRAD001RDE35T
• First Posted: November 25, 2010
• Last Update Posted: January 29, 2020
• Last Verified: January 2020

Individual Participant Data (IPD) Sharing Statement:

• Plan to Share IPD: No
• Plan Description: No IPD will be shared.

Keywords provided by Prof. Dr. S.E. Al-Batran, Krankenhaus Nordwest:

RAD001; Paclitaxel; gastric cancer; advanced gastric or esophagogastric junction cancer

Additional relevant MeSH terms:

Stomach Neoplasms; Neoplasms; Gastrointestinal Neoplasms; Digestive System Neoplasms; Neoplasms by Site; Digestive System Diseases; Gastrointestinal Diseases; Stomach Diseases; Paclitaxel; Everolimus; Antineoplastic Agents, Phytogenic; Antineoplastic Agents; Tubulin Modulators; Antimitotic Agents; Mitosis Modulators; Molecular Mechanisms of Pharmacological Action; MTOR Inhibitors; Protein Kinase Inhibitors; Enzyme Inhibitors; Immunosuppressive Agents; Immunologic Factors; Physiological Effects of Drugs