Adenocarcinoma of the Esophagogastric JunctionPhase 2MEMORINCT02287129
Evaluation for the Individualization of Therapy in Adenocarcinomas of the Gastroesophageal Junction
A Phase 2 study testing Oxaliplatin, Epirubicin and Capecitabine in people with Adenocarcinoma of the Esophagogastric Junction, run by Technical University of Munich at 1 site in Germany.
Trial summary
Metabolic and Molecular Response evaluation for the individualization of therapy in adenocarcinomas of the gastroesophageal junction by evaluation of the R0 resection rate for patients with metabolically (ie, according to PET criteria) chemotherapy-resistant locally advanced AEG, who receive an intensified neoadjuvant… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Adenocarcinoma of the Esophagogastric Junction
- What is being tested?
- Oxaliplatin, Epirubicin and Capecitabine
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 75 participants
- Where
- 1 siteGermany
- Study dates
- 5 Dec 2014to 7 Aug 2020
- Phase
- Phase 2
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Histologically confirmed AEG I-III
- Potentially R0 - resectable AEG and primary tumor category UT2 -4
- Functional operability : Exclusion of OP - limiting comorbidities
- Intense FDG tracer uptake of the tumor during Baseline PET/CT examination and thus suitability for monitoring and early response prediction by FDG - PET ( [ 18F ] - FDG uptake in the tumor at baseline > 1.35 x liver SUV + 2 x standard deviation of the liver SUV)
- Performance status (ECOG ) 0 or 1
- Age : ≥ 18
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- creatinine clearance > 60ml/min measured in a 24 h urine or calculated with the Cockgroft -Gault formula
- bilirubin ≤ 1.5 times upper limit of normal , serum transaminases (GOT
- / GPT ) ≤ 3 times ULN
- leukocytes ≥ 3.5 g / l, platelet ≥ 100 g / l
- Negative pregnancy test (determination of beta- HCG in urine or serum) in women of childbearing potential
- A signed consent form after implementation of medical education
Who cannot join
- Existing distant metastases (M1b)
- Tumor infiltration into the tracheobronchial system
- Previous radiotherapy targeted at the thorax
- Lack of ability of the patient to adhere to the protocol rules
- Manifest heart failure despite optimal medication> NYHA I
- existing angina pectoris at rest or undergoing stress without clarification via interventional cardiology and / or myocardial infarction within the last 6 months
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- Existing pregnancy or lactation
- childbearing or fertility without using recognized safe methods of contraception
- Coexisting other malignant diseases with the exception of a non-melanomatuous, localized skin tumor or carcinoma in situ of the cervix
- absence of a signed consent form
Trial locations and contacts
1 site in 1 country.
Germany1 site
2nd department of the Medical Clinic of the Technical University Munich
Munich, Bavaria, 81675
About this study
Official title: Metabolic and Molecular Response Evaluation for the Individualization of Therapy in Adenocarcinomas of the Gastroesophageal Junction
Metabolic and Molecular Response evaluation for the individualization of therapy in adenocarcinomas of the gastroesophageal junction by evaluation of the R0 resection rate for patients with metabolically (ie, according to PET criteria) chemotherapy-resistant locally advanced AEG, who receive an intensified neoadjuvant chemoradiotherapy (INRCT). Additonal efforts will be done by investigation of molecular and metabolic biomarkers in relation to their predictive and prognostic value by correlating them with histopathologic responses and clinical outcome in an exploratory approach.
Read the detailed description
Adenocarcinomas of the esophagus and the esophagogastric junction (AEG) are clinically-topographically divided into subtypes I-III according to the Siewert classification and show an increased incidence. Neoadjuvant and/or perioperative chemotherapy or preoperative radiochemotherapy is well established in the management of AEG. However, a significant number of patients do not respond to preoperative chemotherapy, suffering from toxicity and facing a worse outcome due to lower R0 resection rates. Previous results from the MUNICON-1 and MUNICON-2 trials have shown that PET-based therapy individualization can be successfully integrated in neoadjuvant treatment algorithms.
Tumor-free resection edges (R0) constitute the greatest prognostic advantage in terms of overall survival. However, the R0 resection rates for patients who, according to early metabolic response evaluation, have not responded to the chemotherapy, have not been satisfactory, even after conversion to an - albeit moderate - radiochemotherapy in the MUNICON-2 trial. Thus, this patient population (so-called non responders) so far lack a beneficial neoadjuvant therapy modality.
Based on these results, the primary goal of MEMORI study is to evaluate the R0 resection rate for patients with metabolically (ie, according to PET criteria) chemotherapy-resistant locally advanced AEG, who receive an intensified neoadjuvant chemoradiotherapy (INRCT). Secondary it is planned to investigate molecular and metabolic biomarkers in relation to their predictive and prognostic value by correlating them with histopathologic responses and clinical outcome in an exploratory approach.
- Being tested
- Oxaliplatin, Epirubicin, Capecitabine, 5-FU, Carboplatin
- Keywords
- Potentially R0 - resectable AEG and primary tumor category, Histologically confirmed AEG I-III, Functional operability, Intense FDG tracer uptake of the tumor
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
OxaliplatinDrug
Also called Oxaliplan
130 mg/m2
EpirubicinDrug
Also called Epi Teva
50 mg/m2
CapecitabineDrug
Also called Xeloda
625 mg/m2
5-FUDrug
Also called 5-FU medac
200 mg/m2
CarboplatinDrug
Also called Carboplatin SUN
2 mg/ml min
PaclitaxelDrug
Also called Taxomedac
50 mg/m2
radiationRadiation
Also called intensitive neoadjuvant radiochemotherapy (INRCT)
total dosage 41,4 Gy
BiopsyProcedure or surgery
Also called esophagogastroduodenoscopy
translational analysis
| Study group | Role | What they receive |
|---|---|---|
| Non-Responder | Experimental | Oxaliplatin Epirubicin Capecitabine 5-FU Carboplatin Paclitaxel Radiation Biopsy Receives: Drug: Oxaliplatin; Drug: Epirubicin; Drug: Capecitabine; Drug: 5-FU; Drug: Carboplatin; Drug: Paclitaxel; Radiation: radiation; Procedure: Biopsy |
| Responder | Active comparator | Oxaliplatin Epirubicin Capecitabine 5-FU Biopsy Receives: Drug: Oxaliplatin; Drug: Epirubicin; Drug: Capecitabine; Drug: 5-FU; Procedure: Biopsy |
What is being measured
The primary outcome is the main question the study is designed to answer.
R0 resection rate
R0 resection rate of patients suffering from metabolically (following PET criteria) chemotherapy-resistant, locally advanced AEG, who receive a more intensive neoadjuvant radio-chemotherapy (INRCT)
Measured: 1 day of surgery (in between day 28 to day 43 after radio-chemotherapy)
Secondary outcomes (8)
Regression
Histological regression defined by Becker Criteria
Measured: 1 day of surgery (in between day 28 to day 43 after radio-chemotherapy)
Overall survival
Overall survival defined as period from start of study to death (if necessary censored by end of follow-up period)
Measured: from day 0 to follow up visit 6 (24 months after surgery)
Disease-free survival
Disease-free survival, defined as period from start of study to earlier occurring event: death or relapse until end of follow-up; Relapse will be separated into events of "local failure", "distant failure" and "local and distant failure"
Measured: from day 0 to follow up visit 6 (24 months after surgery)
QLQ-C30
Quality of life, analyzed via EORTC QLQ-C30 questionnaires
Measured: from day 0 to follow up visit 6 (24 months after surgery)
Metabilic response rate
Metabolic response rate under neoadjuvant chemotherapy
Measured: from day 0 to one time point of time period day 14 to 28 after chemotherapy
Translational analysis
Translational analysis for identification of tumor determinants relevant for prognosis and therapy
Measured: 1 day of surgery (in between day 28 to day 43 after radio-chemotherapy)
Adverse Events
Occurence of AEs
Measured: from day 0 to follow up visit 6 (24 months after surgery)
QLQ-OG25
Quality of life, analyzed via EORTC QLQ-OG25 questionnaires
Measured: from day 0 to follow up visit 6 (24 months after surgery)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted10 Nov 2014 (estimated)
- Study start5 Dec 2014
- Primary completion7 Aug 2020
- Study completion7 Aug 2020
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Adenocarcinoma of the Esophagogastric JunctionStudies of the same condition, open and under way.
- More trials run by Technical University of MunichThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 75 participants (actual)
Sponsor and investigators
- Lead sponsor
- Technical University of Munich
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Jens Siveke, Prof. Dr., Principal investigator, II. Medizinische Klinik, Klinikum rechts der Isar (MRI) der TUM,Ismaninger Str. 22
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02287129
- Sponsor's protocol ID
- MEM-0000-SIV-0028-I
- Acronym
- MEMORI
- Status last verified
- Nov 2023
- First submitted
- 7 Oct 2014
- Last updated
- 28 Nov 2023
- Results posted
- No
- Data monitoring committee
- No
Study at a glance
From the registry record, last updated by the sponsor on 28 Nov 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Metabolic and Molecular Response Evaluation for the Individualization of Therapy in Adenocarcinomas of the Gastroesophageal Junction
- ClinicalTrials.gov ID
- NCT02287129
- Acronym / sponsor ID
- MEMORI / MEM-0000-SIV-0028-I
- Keywords
- Potentially R0 - resectable AEG and primary tumor category, Histologically confirmed AEG I-III, Functional operability, Intense FDG tracer uptake of the tumor
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 75 participants (actual)
- Lead sponsor
- Technical University of MunichUniversity, hospital or other
- Study start
- 5 Dec 2014 (actual)
- Primary completion
- 7 Aug 2020 (actual)
- Study completion
- 7 Aug 2020 (actual)
- First posted
- 10 Nov 2014 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Metabolic and Molecular Response evaluation for the individualization of therapy in adenocarcinomas of the gastroesophageal junction by evaluation of the R0 resection rate for patients with metabolically (ie, according to PET criteria) chemotherapy-resistant locally advanced AEG, who receive an intensified neoadjuvant chemoradiotherapy (INRCT). Additonal efforts will be done by investigation of molecular and metabolic biomarkers in relation to their predictive and prognostic value by correlating them with histopathologic responses and clinical outcome in an exploratory approach.
Detailed description
Adenocarcinomas of the esophagus and the esophagogastric junction (AEG) are clinically-topographically divided into subtypes I-III according to the Siewert classification and show an increased incidence. Neoadjuvant and/or perioperative chemotherapy or preoperative radiochemotherapy is well established in the management of AEG. However, a significant number of patients do not respond to preoperative chemotherapy, suffering from toxicity and facing a worse outcome due to lower R0 resection rates. Previous results from the MUNICON-1 and MUNICON-2 trials have shown that PET-based therapy individualization can be successfully integrated in neoadjuvant treatment algorithms.
Tumor-free resection edges (R0) constitute the greatest prognostic advantage in terms of overall survival. However, the R0 resection rates for patients who, according to early metabolic response evaluation, have not responded to the chemotherapy, have not been satisfactory, even after conversion to an - albeit moderate - radiochemotherapy in the MUNICON-2 trial. Thus, this patient population (so-called non responders) so far lack a beneficial neoadjuvant therapy modality.
Based on these results, the primary goal of MEMORI study is to evaluate the R0 resection rate for patients with metabolically (ie, according to PET criteria) chemotherapy-resistant locally advanced AEG, who receive an intensified neoadjuvant chemoradiotherapy (INRCT). Secondary it is planned to investigate molecular and metabolic biomarkers in relation to their predictive and prognostic value by correlating them with histopathologic responses and clinical outcome in an exploratory approach.
Study design
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Non-Responder | Experimental | Drug: Oxaliplatin, Drug: Epirubicin, Drug: Capecitabine, Drug: 5-FU, Drug: Carboplatin, Drug: Paclitaxel, Radiation: radiation, Procedure: BiopsyOxaliplatin Epirubicin Capecitabine 5-FU Carboplatin Paclitaxel Radiation Biopsy |
| Responder | Active comparator | Drug: Oxaliplatin, Drug: Epirubicin, Drug: Capecitabine, Drug: 5-FU, Procedure: BiopsyOxaliplatin Epirubicin Capecitabine 5-FU Biopsy |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (12 listed)
- Histologically confirmed AEG I-III
- Potentially R0 - resectable AEG and primary tumor category UT2 -4
- Functional operability : Exclusion of OP - limiting comorbidities
- Intense FDG tracer uptake of the tumor during Baseline PET/CT examination and thus suitability for monitoring and early response prediction by FDG - PET ( [ 18F ] - FDG uptake in the tumor at baseline > 1.35 x liver SUV + 2 x standard deviation of the liver SUV)
- Performance status (ECOG ) 0 or 1
Key exclusion criteria (10 listed)
- Existing distant metastases (M1b)
- Tumor infiltration into the tracheobronchial system
- Previous radiotherapy targeted at the thorax
- Lack of ability of the patient to adhere to the protocol rules
- Manifest heart failure despite optimal medication> NYHA I
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| OxaliplatinAlso: Oxaliplan130 mg/m2 | Drug | Non-Responder, Responder |
| EpirubicinAlso: Epi Teva50 mg/m2 | Drug | Non-Responder, Responder |
| CapecitabineAlso: Xeloda625 mg/m2 | Drug | Non-Responder, Responder |
| 5-FUAlso: 5-FU medac200 mg/m2 | Drug | Non-Responder, Responder |
| CarboplatinAlso: Carboplatin SUN2 mg/ml min | Drug | Non-Responder |
| PaclitaxelAlso: Taxomedac50 mg/m2 | Drug | Non-Responder |
| radiationAlso: intensitive neoadjuvant radiochemotherapy (INRCT)total dosage 41,4 Gy | Radiation | Non-Responder |
| BiopsyAlso: esophagogastroduodenoscopytranslational analysis | Procedure or surgery | Non-Responder, Responder |
Primary outcome
R0 resection rate
Time frame: 1 day of surgery (in between day 28 to day 43 after radio-chemotherapy)
R0 resection rate of patients suffering from metabolically (following PET criteria) chemotherapy-resistant, locally advanced AEG, who receive a more intensive neoadjuvant radio-chemotherapy (INRCT)
8 secondary outcomes
Regression
Time frame: 1 day of surgery (in between day 28 to day 43 after radio-chemotherapy)
Overall survival
Time frame: from day 0 to follow up visit 6 (24 months after surgery)
Disease-free survival
Time frame: from day 0 to follow up visit 6 (24 months after surgery)
QLQ-C30
Time frame: from day 0 to follow up visit 6 (24 months after surgery)
Metabilic response rate
Time frame: from day 0 to one time point of time period day 14 to 28 after chemotherapy
Translational analysis
Time frame: 1 day of surgery (in between day 28 to day 43 after radio-chemotherapy)
Adverse Events
Time frame: from day 0 to follow up visit 6 (24 months after surgery)
QLQ-OG25
Time frame: from day 0 to follow up visit 6 (24 months after surgery)
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 28 Nov 2023.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Jens Siveke, Prof. Dr. principal investigator
II. Medizinische Klinik, Klinikum rechts der Isar (MRI) der TUM,Ismaninger Str. 22
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Oxaliplatin, Epirubicin and Capecitabine in people with Adenocarcinoma of the Esophagogastric Junction, run by Technical University of Munich at 1 site in Germany.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 12 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 28 Nov 2023. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Germany. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
R0 resection rate (time frame: 1 day of surgery (in between day 28 to day 43 after radio-chemotherapy)). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Nov 2023.