E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
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MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 12.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10017758 |
E.1.2 | Term | Gastric cancer |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 12.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10017760 |
E.1.2 | Term | Gastric cancer NOS |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 12.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10017766 |
E.1.2 | Term | Gastric cancer stage IV NOS |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 12.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10017767 |
E.1.2 | Term | Gastric cancer stage IV with metastases |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 12.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10017768 |
E.1.2 | Term | Gastric cancer stage IV without metastases |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 12.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10061967 |
E.1.2 | Term | Gastric cancer stage IV |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 12.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10063916 |
E.1.2 | Term | Metastatic gastric cancer |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To determine the efficacy of cediranib when added to cisplatin plus a fluoropyrimidine compared to cisplatin plus a fluoropyrimidine alone by assessment of overall survival (OS). |
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E.2.2 | Secondary objectives of the trial |
·To determine the efficacy of cediranib when added to cisplatin plus a fluoropyrimidine compared to cisplatin plus a fluoropyrimidine alone by assessment of progression free survival (PFS), objective response rate and duration of response. ·To determine the safety and tolerability of cediranib when added to cisplatin plus a fluoropyrimidine compared to cisplatin plus a fluoropyrimidine alone. ·To determine the effects of cediranib when added to cisplatin plus a fluoropyrimidine compared to cisplatin plus a fluoropyrimidine alone on the global health status/QoL scale of the EORTC QLQ-C30 questionnaire. ·To investigate the pharmacokinetics of cediranib when added to cisplatin plus a fluoropyrimidine.
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Provision of informed consent prior to any study specific procedures 2. Female or male aged 18 years or older 3. Histological or cytological confirmation of gastric adenocarcinoma (including the gastric cardia and esophagogastric junction) 4. Locally advanced or metastatic gastric cancer. In patients with locally advanced disease the cancer must be considered unresectable 5. Patients must have received no prior systemic therapy for advanced disease. Neoadjuvant and adjuvant therapy received > 6 months prior to entry into the study is acceptable 6. WHO Performance score of 0 or 1 7. Able to take oral medication 8. Life expectancy ≥ 12 weeks 9. At least one lesion (measurable or non measurable) that can be accurately assessed by CT or MRI at baseline and follow-up visits. For inclusion in the optional genetic research and biomarker analysis components of the study (blood and archival tumour sampling for DNA extraction and retrospective pharmacogenetic analysis and tumour biomarker analysis), patients must fulfil the following criteria: 10. Provision of written informed consent for blood sampling for genetic research and/or 11. Provision of written informed consent for tumour biomarker analysis
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E.4 | Principal exclusion criteria |
1.Untreated unstable brain or meningeal metastases. Patients with radiological evidence of stable brain metastases are eligible providing that they are asymptomatic and either do not require corticosteroids or have been treated with corticosteroids, with clinical and radiological evidence of stabilisation at least 10 days after discontinuation of steroids 2.Inadequate bone marrow reserve as demonstrated by an absolute neutrophil count ≤1.5 x 10*9/L or platelet count ≤100 x 10*9/L or requiring regular blood transfusions to maintain haemoglobin >8.5g/dL 3.Serum bilirubin ≥ 1.5 x ULRR (except for patients with known documented cases of Gilbert’s syndrome) 4.Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) ≥ 2.5 x ULRR. If liver metastases are present, ALT or AST > 5 x ULRR 5.Serum creatinine > ULRR or a creatinine clearance of ≤ 60mL/min calculated by Cockcroft-Gault 6.Greater than +1 proteinuria on two consecutive dipsticks taken no less than 1 week apart unless urinary protein < 1.5g in a 24 hr period or protein/creatinine ratio < 1.5 7.A history of poorly controlled hypertension or resting BP >150/100 mmHg in the presence or absence of a stable regimen of anti-hypertensive therapy (measurements will be made after the patient has been resting supine for a minimum of 5 minutes. Two or more readings should be taken at 2-minute intervals and averaged. If the first two diastolic readings differ by more than 5 mmHg, then an additional reading should be obtained and averaged) 8.Any evidence of severe or uncontrolled systemic diseases (eg, unstable or uncompensated respiratory, cardiac, hepatic or renal disease) 9.Any unresolved toxicity >CTC grade 1 from previous systemic anti-cancer therapy (including radiotherapy) except haematological toxicity (see exclusion #2) and alopecia 10.Mean QTc with Bazetts correction >470msec in screening ECG or history of familial long QT syndrome 11.Recent (<14 days) major thoracic or abdominal surgery prior to entry into the study, or a surgical incision that is not fully healed 12.Pregnant or breast-feeding women or women of childbearing potential with a positive pregnancy test prior to receiving study medication 13.Known severe hypersensitivity to cediranib, capecitabine (or TS-1 in Japan), cisplatin or any of the excipients of these products 14.History of other malignancies (except for adequately treated basal or squamous cell carcinoma or carcinoma in situ) within 5 years, unless the patient has been disease free for 2 years and there is a tissue diagnosis of advanced gastric adenocarcinoma from a non-target lesion 15.Involvement in the planning and/or conduct of the study (applies to both AstraZeneca staff and/or staff at the study site) 16.Previous enrolment or randomisation in the present study 17.Treatment with an investigational (non-registered) drug within 30 days prior to the first dose of cediranib 18.Other concomitant anti-cancer therapy (including luteinising hormone releasing hormone [LHRH] agonists) except steroids 19.Prior cisplatin therapy within 6 months of the first dose of cediranib 20.Total previous culmulative dose of cisplatin exceeding 300mg/m2 21.Prior therapy with monoclonal antibodies or small molecule inhibitors against VEGF or VEGF receptors, including bevacizumab and cediranib 22.Known DPD (dihydropyrimidine dehydrogenase) deficiency 23.Known neuropathy > Grade 2 24.History of significant gastrointestinal impairment, as judged by the Investigator, that would significantly affect the absorption of cediranib and/or capecitabine 25.Known risk of the patient transmitting HIV via infected blood or with active or chronic hepatitis B or C infection 26.Significant haemorrhage (>30mL bleeding/episode in previous 3 months) or haemoptysis (>5mL fresh blood in previous 4 weeks) 27.Requiring intravenous nutritional support 28.Ascites that require repeated drainage (more than once per week) 29.Arterial thromboembolic event (including ischemic attack) in the previous 12 months Patients will be excluded from the optional genetic research of the study if they do not meet the exclusion criteria specified above, or the following: 30. Previous allogenic bone marrow transplant. 31. Non-leukocyte depleted whole blood transfusion in 120 days of genetic sample collection.
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E.5 End points |
E.5.1 | Primary end point(s) |
Overall survival, defined as the time from randomisation until death by any cause. |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | Yes |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Information not present in EudraCT |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | Information not present in EudraCT |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 6 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 40 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
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E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 4 |
E.8.9.1 | In the Member State concerned months | 3 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 4 |
E.8.9.2 | In all countries concerned by the trial months | 3 |