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Randomized Controlled Study of Postoperative Adjuvant Therapy for Gastric Cancer Using TS-1 or TS-1+PSK

Phase 3
Completed
Conditions
Gastric Cancer
Interventions
Registration Number
NCT00216034
Lead Sponsor
Hokuriku-Kinki Immunochemotherapy Study Group
Brief Summary

A randomized controlled study is conducted on patients with resected gastric cancer assigned to postoperative adjuvant therapy of TS-1 alone or PSK combined with TS-1, with the objective to examine or validate the outcome, QOL and prognostic factors (host and tumor factors), and explore the factors enhancing the antitumor effect of TS-1.

Detailed Description

The 5-year survival after gastric cancer surgery remains poor as the cancer advances to stages II, IIIA, IIIB and IV. Tegafur-gimeracil-oteracil potassium (TS-1) is used as the first line treatment for advanced and recurrent gastric cancer. But TS-1 is accompanied by an adverse drug reaction of bone marrow suppression that is not readily seen in conventional oral fluoropyrimidines. Among randomized controlled trials on postoperative adjuvant chemotherapy for gastric cancer, the beneficial results of survival rates using Krestin (PSK) in combination with chemotherapy have been reported. With the objective to enhance the antitumor effect of TS-1 and to improve the QOL of patients, we have planned to validate the clinical significance of combined PSK and TS-1 therapy as postoperative adjuvant therapy for gastric cancer, using in principle the TS-1 regimen of 2-week dosing 1-week off for 6 months followed by 2-week dosing 2-week off for 6 months.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
255
Inclusion Criteria
  • Patients with microscopic stage II or IIIA resectable gastric cancer
  • Patients who have not received preoperative cancer therapy (radiotherapy, chemotherapy or immunotherapy)
  • Patients with serum immunosuppressive acidic protein (IAP) measured within 2 weeks before surgery
  • Patients with no metachronous or synchronous multiple cancer
  • Patients without severe impairment of renal, hepatic and bone marrow functions
  • Patients who are judged to be capable of tolerating surgery
  • Patients with preoperative performance status 0 to 2
  • Patients with no serious concurrent complications (such as bone marrow suppression, diarrhea and infection)
  • Patients who are judged to be capable of tolerating this treatment, and who have given written informed consent to participate in this study
Exclusion Criteria
  • Patients with fresh hemorrhage from the gastrointestinal tract
  • Patients with retention of body fluid necessitating treatment
  • Patients with infection, intestinal palsy or intestinal occlusion
  • Patients who are pregnant or hope to become pregnant during the study period
  • Patients with diabetes treated by continuous use of insulin or showing poor glycemic control
  • Patients with a history of ischemic heart disease
  • Patients with concurrent psychiatric disease or psychotic symptoms, and judged to have difficulties participating in the study
  • Patients receiving continuous administration of steroids
  • Patients who have experienced serious drug allergy in the past
  • Others, patients judged by the investigator or subinvestigator to be inappropriate as subject

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
2Tegafur-gimeracil-oteracil potassium (TS-1)TS-1+PSK Group: The group treated with combination therapy using TS-1 and PSK
2Krestin (PSK)TS-1+PSK Group: The group treated with combination therapy using TS-1 and PSK
1Tegafur-gimeracil-oteracil potassium (TS-1)TS-1 Group: The group treated with TS-1 mono-therapy
Primary Outcome Measures
NameTimeMethod
Time of recurrence (calculation of 3-year disease-free survival and overall survival rates)Five years after surgery
Secondary Outcome Measures
NameTimeMethod
Relations of survival rate with compliance, postoperative complication, QOL, adverse events, recurrence status, and expression of immune or tumor markersFive years after surgery

Trial Locations

Locations (42)

Houyu hospital

🇯🇵

Joyo, Kyoto, Japan

Ishikawa Prefectural Central Hospital

🇯🇵

Kanazawa, Ishikawa, Japan

Shakaihoken Kobe Central Hospital

🇯🇵

Kobe, Hyogo, Japan

Public Central Hospital of Matto Ishikawa

🇯🇵

Hakusan, Ishikawa, Japan

University of Fukui Hospital

🇯🇵

Eiheiji, Fukui, Japan

National Hospital Organization Fukui Hospital

🇯🇵

Tsuruga, Fukui, Japan

Kanazawa Medical University Hospital

🇯🇵

Uchinada, Ishikawa, Japan

Kanazawa University Hospital

🇯🇵

Kanazawa, Ishikawa, Japan

Kanazawa Redcross Hospital

🇯🇵

Kanazawa, Ishikawa, Japan

Saiseikai Kyoto Hospital

🇯🇵

Nagaokakyo, Kyoto, Japan

Kyoto Ohashi General Hospital

🇯🇵

Fushimi, Kyoto, Japan

Fukuchiyama City Hospital

🇯🇵

Fukuchiyama, Kyoto, Japan

Kyoto Prefectural Yosanoumi Hospital

🇯🇵

Yosano, Kyoto, Japan

Nantan General Hospital

🇯🇵

Nantan, Kyoto, Japan

Second Okamoto General Hospital

🇯🇵

Uji, Kyoto, Japan

Marutamachi Hospital

🇯🇵

Nishinokyokurumazaka-cho, Nakagyou-ku Kyoto, Japan

Osaka City University Hospital

🇯🇵

Asahi-machi, Osaka Abeno-ku, Japan

Sumitomo Hospital

🇯🇵

Nakanoshima, Osaka Kita-ku, Japan

Shiga University of Medical Science Hospital

🇯🇵

Otsu, Shiga, Japan

Matsushita Memorial Hospital

🇯🇵

Moriguchi, Osaka, Japan

Midorigaoka Hospital

🇯🇵

Takatsuki, Osaka, Japan

Saiseikai Shigaken Hospital

🇯🇵

Ritto, Shiga, Japan

Shimane University Hospital

🇯🇵

Izumo, Shimane, Japan

Saiseikai Takaoka Hospital

🇯🇵

Takaoka, Toyama, Japan

Kouseiren Takaoka Hoapital

🇯🇵

Takaoka, Toyama, Japan

Yatsuo General Hospital

🇯🇵

Yatsuo, Toyama, Japan

Kitade Hospital

🇯🇵

Gobou, Wakayama, Japan

Toyama Rosai Hospital

🇯🇵

Uozu, Toyama, Japan

Fukui General Hospital

🇯🇵

Fukui, Japan

Fukui Cardio Vascular Center

🇯🇵

Fukui, Japan

Fukui Saiseikai Hospital

🇯🇵

Fukui, Japan

Gifu Municipal Hospital

🇯🇵

Gifu, Japan

University Hospital, Kyoto Prefectural University of Medicine

🇯🇵

Kyoto, Japan

Gifu Prefectural General Medical Center

🇯🇵

Gifu, Japan

Gifu University Hospital

🇯🇵

Gifu, Japan

Nishijin Hospital

🇯🇵

Kyoto, Japan

Kyoto First Red Cross Hospital

🇯🇵

Kyoto, Japan

Nara City Hospital

🇯🇵

Nara, Japan

Toyama Prefectural Central Hospital

🇯🇵

Toyama, Japan

Osaka Railway hospital

🇯🇵

Osaka, Japan

Rokujizo Hospital

🇯🇵

Uji, Kyoto, Japan

National Hospital Organization Maizuru Medical Center

🇯🇵

Maizuru, Kyoto, Japan

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