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Esophageal CancerPhase 2OMEC-5NCT07000253

Timing of Comprehensive Local Treatment After First-Line Systemic Therapy in Oligometastatic Esophageal or Gastric Adenocarcinoma

A Phase 2 study testing Chemotherapy, Targeted Systemic Therapy and Immunotherapy in people with Esophageal Cancer and Gastric (Stomach) Cancer, run by Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA) at 5 sites in 3 countries.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Purpose of the Study: This clinical study investigates whether a shorter or longer duration of systemic therapy before local treatment (surgery or radiation) results in better disease control in patients with esophageal or gastric cancer with a limited number of metastases, also known as oligometastases. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Chemotherapy, Targeted Systemic Therapy and Immunotherapy
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
290 participants
Where
5 sitesin 3 countries
Study dates
29 Apr 2026to Jan 2034
Phase
Phase 2
Are there results?
Not yet: the study is under way

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

  • Age ≥18 years
  • Ability to provide written informed consent
  • Histologically confirmed esophageal, gastric or gastroesophageal junction tumor with oligometastatic (M1) disease defined according to the OMEC consensus statement:
  • One organ with ≤3 metastases or 1 involved extra-regional lymph node station (based on the TNM 8 classification)
  • ≤3 unilobar liver metastases or ≤2 bilobar liver metastases
  • ≤ 3 unilateral lung metastases
Show all 19Show fewer
  • Unilateral adrenal gland involvement
  • Metastasis confined to 1 bone structure or 1 soft tissue compartment
  • Synchronous oligometastatic disease with a resectable primary tumor or metachronous oligometastatic disease (in the event of a locoregional recurrence this should be resectable)
  • Metastases should be deemed amenable by the international multidisciplinary expert team for radical local treatment
  • WHO performance status 0-2
  • Indication for checkpoint inhibition and/or targeted therapy
  • PD-L1 with a CPS of 1 or higher as per local clinical practice for immunotherapy use
  • HER2 overexpression as per local clinical practice for trastuzumab use
  • Claudin 18.2 overexpression as per local clinical practice for zolbetuximab use.
  • Any other biomarker that allows targeted therapy in first line approved by EMA
  • No prior systemic therapy for metastatic disease
  • CT-scan ≤8 weeks prior to inclusion
  • Ability to undergo local treatment and start systemic treatment beyond 18 weeks of total systemic treatment.

Who cannot join

  • Squamous cell carcinoma
  • Brain metastases
  • Peritoneal or pleural carcinomatosis
  • Patients with MSI dMMR
  • Uncontrolled immunodeficiency (e.g. AIDS)
  • Peripheral neuropathy >CTCAE grade 1, precluding start of full dose oxaliplatin treatment
Show all 18Show fewer
  • Both organ metastasis and extra-regional lymph node metastasis
  • Conditions precluding local treatment or systemic therapy for oligometastatic disease:
  • Serious medical comorbidities precluding local treatment (e.g., interstitial lung disease in patients with pulmonary metastasis)
  • Clinical or radiological evidence of spinal cord compression or epidural tumor within 2 mm of the spinal cord
  • Simultaneous other malignancy or previous other malignancy with a disease-free period of <5 years, except adequately treated non-melanoma skin cancer or in-situ cancers
  • Uncontrolled (bacterial) infections
  • Significant concomitant diseases preventing the safe administration of study drugs or likely to interfere with study assessments
  • Uncontrolled angina pectoris, cardiac failure or clinically significant arrhythmias
  • Continuous use of immunosuppressive agents equivalent to >10 mg daily prednisone
  • Concurrent use of the antiviral agent sorivudine or chemically related analogues, such as brivudine
  • Pregnancy or breast feeding
  • Patients (M/F) with reproductive potential not implementing adequate contraceptive measures

Trial locations and contacts

5 sites in 3 countries. Contact the study team or a site near you to ask about taking part.

Hanneke van Laarhoven, MD, PhD, PhD contact

+31204444321

h.vanlaarhoven@amsterdamumc.nl

Richard van Hillgersberg, MD, PhD contact

r.vanhillegersberg@umcutrechht.nl

5 sites in 3 countries

Netherlands2 sites, 2 recruiting
  • Amsterdam University Medical Center

    Amsterdam

    Hanneke van Laarhoven, MD, PhD, PhD, +31204444321, h.vanlaarhoven@amsterdamumc.nl

    Peter van Rossum, MD, PhD, p.s.n.vanrossum@amsterdamumc.nl

    Recruiting
  • UMC Utrecht

    Utrecht

    Richard van Hillegersberg, +313088 755 5555, r.vanhillgersberg@umcutrecht.nl

    Not yet recruiting

Other trials in Netherlands

Norway2 sites, 2 recruiting
  • University of Oslo

    Oslo

    Recruiting
  • University of North Norway

    Tromsø

    Recruiting

Other trials in Norway

Spain1 site, 1 recruiting
  • Instituto de Investigación Sanitaria - INCLIVA

    Valencia

    Recruiting

Other trials in Spain

About this study

Official title: Timing of Minimally Invasive Local Treatment After First-Line Systemic Therapy in Oligometastatic Esophageal or Gastric Adenocarcinoma: A Randomized Prospective Clinical Study (OMEC-5)

Purpose of the Study:

This clinical study investigates whether a shorter or longer duration of systemic therapy before local treatment (surgery or radiation) results in better disease control in patients with esophageal or gastric cancer with a limited number of metastases, also known as oligometastases.

Read more

Background:

In about 25% of patients with advanced esophageal or gastric cancer, the disease spreads to only a few sites (oligometastatic disease). Prior studies suggest that local treatment after systemic therapy may extend survival in this subgroup. However, it is unclear how long systemic therapy should last before initiating local treatment. The OMEC-5 study aims to clarify this.

Study Design:

Initiated by Amsterdam UMC and UMCU and conducted in multiple hospitals across Europe.

Total of 414 patients to be enrolled.

Duration: ~53 months (35 months enrollment + 18 months follow-up).

Approved by the medical ethics committee at Amsterdam UMC.

Procedure:

Eligibility screening: Includes physical exam, blood tests (incl. circulating tumor cells), medical history review, and confirmation of oligometastases by an expert panel.

Initial treatment: All participants receive 4 months of standard systemic therapy (chemotherapy + immunotherapy and/or targeted therapy depending on tumor markers like HER2 or Claudin 18.2).

Response assessment (Review 1): Imaging and/or laparoscopic examination.

If oligometastases persist and tumors have not progressed, participants are randomized into two groups:

Group A (longer systemic therapy): 4 more months of systemic therapy, then local treatment if disease is stable, followed by 4 months of immunotherapy ± targeted therapy.

Group B (shorter systemic therapy): Immediate local treatment followed by 4 months of systemic therapy, then reassessment and potentially 4 months of immunotherapy ± targeted therapy.

Follow-up: Regular scans and quality-of-life questionnaires (5 times), and periodic blood sampling (4 times).

Treatments Involved:

Chemotherapy: CapOx or FOLFOX

Immunotherapy: nivolumab or pembrolizumab

Targeted therapy: trastuzumab (HER2-positive) or zolbetuximab (Claudin 18.2-positive)

Potential Benefits and Risks:

Patients may benefit from better disease control and a personalized treatment strategy.

Known side effects relate to the standard treatments used (chemo, immuno, targeted therapies), and no extra medical risk is expected beyond routine care.

Possible inconveniences include blood draws, scans, minor surgery (laparoscopy), and time investment.

Data and Sample Handling:

Personal data and tumor/blood samples for exploratory research (if patients consent) are coded and securely stored.

Data may be used for future cancer research if the patient consents.

Participants can withdraw at any time.

Confidentiality and Privacy:

Patient data are kept confidential, and participants have rights to access or delete their data. Privacy measures comply with GDPR and Dutch law.

Compensation and Insurance:

Participation is voluntary, with no financial compensation. Standard treatment costs are covered by healthcare insurance. No extra insurance is required, as the treatment aligns with standard care practices.

Being tested
Chemotherapy, Targeted Systemic Therapy, Immunotherapy, Surgery, Radiotherapy
Medical subject headings
Esophageal Neoplasms, Stomach Neoplasms, Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • ChemotherapyDrug

    Chemotherapy preferably CapOx (capecitabine + oxaliplatin) or FOLFOX (5-fluoruracil, leucovorin and oxaliplatin) will be combined with immunotherapy (preferably nivolumab or pembrolizumab) and/or targeted therapy (for example trastuzumab in the case of HER2 overexpression or zolbetuximab in the case of Claudin 18.2 overexpression). These regiments are the standard-of-care (SOC) combination therapies used in this study. Acceptable chemotherapy regimens predominantly for Asian centers include SOX (S-1 and Oxaliplatin).

  • Targeted Systemic TherapyDrug

    Biomarker selected patients will receive trastuzumab, zolbetuximab or any other targeted agent according to standard of care.

  • ImmunotherapyDrug

    Biomarker selected patients will recieve checkpoint inhibitors according to standard care

  • SurgeryProcedure or surgery

    If the primary tumor is present, this tumor will be surgically removed. Metastases may also be removed by surgery.

  • RadiotherapyRadiation

    Metastases may be irradiated

Study groups in NCT07000253
Study groupRoleWhat they receive
long duration of systemic therapyExperimentalPatients with no disease progression at 4 months (18 weeks) after systemic therapy with oxaliplatin, fluorpyrimidine, checkpoint inhibitor and/or taregted therapy and fit for local treatment will receive 4 additional months of systemic therapy and subsequent evaluation for local treatment to all disease sites.
Receives: Drug: Chemotherapy; Drug: Targeted Systemic Therapy; Drug: Immunotherapy; Procedure: Surgery; Radiation: Radiotherapy
Short duration of systemic therapyActive comparatorPatients with no disease progression at 4 months (18 weeks) after systemic therapy oxaliplatin, fluorpyrimidine, checkpoint inhibitor and/or targeted therapy and fit for local treatment will recieve direct local treatment to all disease sites.
Receives: Drug: Chemotherapy; Drug: Targeted Systemic Therapy; Drug: Immunotherapy; Procedure: Surgery; Radiation: Radiotherapy

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. progression free survival

    the time interval from the date of randomization to the date of first occurrence of the following events (or last follow-up) up to 53 months after study initiation:

    • Disease progression (consisting of either progression in the number of metastases, recurrence at surgically treated metastasis, progression of ablated or irradiated metastasis, or recurrence of the primary tumor or regional lymph node metastasis)
    • Death due to any cause.

    Measured: the time interval from the date of randomization to the date of first occurrence of the following events (or last follow-up) up to 53 months after study initiation: Disease progression, death

Secondary outcomes (2)
  1. Overall survival (OS)

    Measured: Interval between randomization and death or last follow-up up to 53 months after study initiation

  2. 2. Quality of Life (QoL)

    Measured by the Summary Score of the EORTC QLQ-C30

    Measured: At 12 months after randomization.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted2 Jun 2025
  2. Study start29 Apr 2026
  3. Primary completionNov 2031 (estimated)
  4. Study completionJan 2034 (estimated)

Resources

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
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
290 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07000253
Sponsor's protocol ID
OMEC-5
Acronym
OMEC-5
Status last verified
Sep 2026
First submitted
8 May 2025
Last updated
10 Sep 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Chemotherapy, Targeted Systemic Therapy and Immunotherapy in people with Esophageal Cancer and Gastric (Stomach) Cancer, run by Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA) at 5 sites in 3 countries.

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 19 inclusion and 18 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: looking for participants now, as of the sponsor's last update on 10 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 5 sites in Netherlands, Norway, Spain. 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?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Hanneke van Laarhoven, MD, PhD, PhD (+31204444321, h.vanlaarhoven@amsterdamumc.nl), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

progression free survival (time frame: the time interval from the date of randomization to the date of first occurrence of the following events (or last follow-up) up to 53 months after study initiation: Disease progression, death). 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 10 Sep 2026.

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