Trial Outcomes & Findings for Pemetrexed Plus Cisplatin as First-Line Treatment in Stage IV or Recurrence of Gastric Cancer (NCT NCT00415168)

NCT ID: NCT00415168

Last Updated: 2010-08-17

Results Overview

Tumor responder is defined as participants exhibiting a best overall study response of complete response (CR; disappearance of all target lesions) or partial response (PR; 30% decrease in sum of longest diameter of target lesions). Non-responders are those who did not meet the above criteria.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

53 participants

Primary outcome timeframe

Baseline to time of response up to six or eight 21-day cycles of treatment

Results posted on

2010-08-17

Participant Flow

56 participants signed informed consent and 3 participants were screen failures.

Participant milestones

Participant milestones
Measure
Pemetrexed + Cisplatin
Pemetrexed 700 milligrams/meters squared (mg/m2) plus cisplatin 75 mg/m2, intravenous (IV), every 21 days for 6 cycles
Overall Study
STARTED
53
Overall Study
Completed Treatment
15
Overall Study
COMPLETED
1
Overall Study
NOT COMPLETED
52

Reasons for withdrawal

Reasons for withdrawal
Measure
Pemetrexed + Cisplatin
Pemetrexed 700 milligrams/meters squared (mg/m2) plus cisplatin 75 mg/m2, intravenous (IV), every 21 days for 6 cycles
Overall Study
Death
26
Overall Study
Lost to Follow-up
3
Overall Study
Physician Decision
13
Overall Study
Sponsor Decision
4
Overall Study
Withdrawal by Subject
6

Baseline Characteristics

Pemetrexed Plus Cisplatin as First-Line Treatment in Stage IV or Recurrence of Gastric Cancer

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Pemetrexed + Cisplatin
n=53 Participants
Pemetrexed 700 milligrams/meters squared (mg/m2) plus cisplatin 75 mg/m2, intravenous (IV), every 21 days for 6 cycles
Age Continuous
54.3 years
STANDARD_DEVIATION 9.85 • n=99 Participants
Sex: Female, Male
Female
25 Participants
n=99 Participants
Sex: Female, Male
Male
28 Participants
n=99 Participants
Race/Ethnicity, Customized
Caucasian
53 participants
n=99 Participants
Region of Enrollment
Russian Federation
53 participants
n=99 Participants
Eastern Cooperative Oncology Group (ECOG) Performance Status
0 - Fully Active
16 participants
n=99 Participants
Eastern Cooperative Oncology Group (ECOG) Performance Status
1 - Ambulatory, Restricted Strenuous Activity
37 participants
n=99 Participants

PRIMARY outcome

Timeframe: Baseline to time of response up to six or eight 21-day cycles of treatment

Population: All patients enrolled in the study with a histologically confirmed diagnosis of adenocarcinoma of the gastric, disease status of measurable disease with presence of at least 1 measurable lesion, with no concurrent administration of any other tumor therapy or known or suspected brain metastasis who received at least 1 dose of study therapy.

Tumor responder is defined as participants exhibiting a best overall study response of complete response (CR; disappearance of all target lesions) or partial response (PR; 30% decrease in sum of longest diameter of target lesions). Non-responders are those who did not meet the above criteria.

Outcome measures

Outcome measures
Measure
Pemetrexed + Cisplatin
n=53 Participants
Pemetrexed 700 milligrams/meters squared (mg/m2) plus cisplatin 75 mg/m2, intravenous (IV), every 21 days for 6 cycles
Percentage of Participants With Objective Response (Objective Response Rate)
Responder
32.1 percentage of responders
Interval 19.9 to 46.3
Percentage of Participants With Objective Response (Objective Response Rate)
Non-Responder
67.9 percentage of responders
Interval 53.7 to 80.1

SECONDARY outcome

Timeframe: Time of response to progressive disease up to six or eight 21-day cycles of treatment; maximum duration of study follow-up was 17.4 months

Population: Full Analysis Set: This analysis set includes all data from all patients receiving at least one dose of the study drug.

Measured from the time of first documentation of CR or PR (whichever status is first recorded) until the date of time to disease progression.

Outcome measures

Outcome measures
Measure
Pemetrexed + Cisplatin
n=53 Participants
Pemetrexed 700 milligrams/meters squared (mg/m2) plus cisplatin 75 mg/m2, intravenous (IV), every 21 days for 6 cycles
Duration of Response
3.8 months
Interval 3.3 to 4.7

SECONDARY outcome

Timeframe: Baseline to measured progressive disease or death up to six or eight 21-day cycles of treatment; maximum duration of study follow-up was 17.4 months

Population: Full Analysis Set: This analysis set includes all data from all patients receiving at least one dose of the study drug.

Defined as time from baseline to the date of disease progression or death on study, whichever occurs first. The PFS 1 definition from the United States Food and Drug Administration (FDA) draft guidance on clinical endpoints was used (FDA 2005).

Outcome measures

Outcome measures
Measure
Pemetrexed + Cisplatin
n=53 Participants
Pemetrexed 700 milligrams/meters squared (mg/m2) plus cisplatin 75 mg/m2, intravenous (IV), every 21 days for 6 cycles
Progression Free Survival (PFS)
3.7 months
Interval 2.7 to 5.2

SECONDARY outcome

Timeframe: Baseline to date of death from any cause up to six or eight 21-day cycles of treatment; maximum duration of study follow-up was 17.4 months

Population: Full Analysis Set: This analysis set includes all data from all patients receiving at least one dose of the study drug.

Defined as the time from baseline to date of death due to any cause. Survival time is censored at the date of last contact for patients who are still alive or lost to follow up.

Outcome measures

Outcome measures
Measure
Pemetrexed + Cisplatin
n=53 Participants
Pemetrexed 700 milligrams/meters squared (mg/m2) plus cisplatin 75 mg/m2, intravenous (IV), every 21 days for 6 cycles
Overall Survival
8.8 months
Interval 6.0 to 9.5

SECONDARY outcome

Timeframe: Baseline through six or eight 21-day cycles of treatment, up to 30 days after study drug discontinuation

Population: Full Analysis Set: This analysis set includes all data from all patients receiving at least one dose of the study drug.

Common toxicity criteria (CTC) Grade 3 (severe) or 4 (life-threatening or disabling) laboratory toxicity possibly related to study therapy. A grading (severity) scale is provided for each event term. Grades range from 0 (none) to 5 (death).

Outcome measures

Outcome measures
Measure
Pemetrexed + Cisplatin
n=53 Participants
Pemetrexed 700 milligrams/meters squared (mg/m2) plus cisplatin 75 mg/m2, intravenous (IV), every 21 days for 6 cycles
Number of Participants With Pharmacology Toxicity - Grade 3 or 4 Laboratory Toxicity Possibly Related to Study Therapy
Any Grade 3 or 4 Laboratory Toxicity
29 participants
Number of Participants With Pharmacology Toxicity - Grade 3 or 4 Laboratory Toxicity Possibly Related to Study Therapy
Bone/Blood Marrow - Other
1 participants
Number of Participants With Pharmacology Toxicity - Grade 3 or 4 Laboratory Toxicity Possibly Related to Study Therapy
Lymphopenia
1 participants
Number of Participants With Pharmacology Toxicity - Grade 3 or 4 Laboratory Toxicity Possibly Related to Study Therapy
Platelets
4 participants
Number of Participants With Pharmacology Toxicity - Grade 3 or 4 Laboratory Toxicity Possibly Related to Study Therapy
Hemoglobin
6 participants
Number of Participants With Pharmacology Toxicity - Grade 3 or 4 Laboratory Toxicity Possibly Related to Study Therapy
Leukocytes (Total White Blood Cells)
15 participants
Number of Participants With Pharmacology Toxicity - Grade 3 or 4 Laboratory Toxicity Possibly Related to Study Therapy
Neutrophils/Granulocytes
29 participants
Number of Participants With Pharmacology Toxicity - Grade 3 or 4 Laboratory Toxicity Possibly Related to Study Therapy
Uric Acid Serum-High
1 participants
Number of Participants With Pharmacology Toxicity - Grade 3 or 4 Laboratory Toxicity Possibly Related to Study Therapy
Metabolic/Laboratory - Other
3 participants

SECONDARY outcome

Timeframe: Baseline through six or eight 21-day cycles of treatment, up to 30 days after study drug discontinuation

Population: Full Analysis Set: This analysis set includes all data from all patients receiving at least one dose of the study drug.

Common toxicity criteria (CTC) Grade 3 (severe) or 4 (life-threatening or disabling) non-laboratory toxicity possibly related to study therapy. A grading (severity) scale is provided for each event term. Grades range from 0 (none) to 5 (death).

Outcome measures

Outcome measures
Measure
Pemetrexed + Cisplatin
n=53 Participants
Pemetrexed 700 milligrams/meters squared (mg/m2) plus cisplatin 75 mg/m2, intravenous (IV), every 21 days for 6 cycles
Number of Participants With Pharmacology Toxicity - Grade 3 or 4 Non-Laboratory Toxicity Possibly Related to Study Therapy
Any Grade 3 or 4 Non-Laboratory Toxicity
5 participants
Number of Participants With Pharmacology Toxicity - Grade 3 or 4 Non-Laboratory Toxicity Possibly Related to Study Therapy
Anorexia
1 participants
Number of Participants With Pharmacology Toxicity - Grade 3 or 4 Non-Laboratory Toxicity Possibly Related to Study Therapy
Diarrhea
1 participants
Number of Participants With Pharmacology Toxicity - Grade 3 or 4 Non-Laboratory Toxicity Possibly Related to Study Therapy
Renal Failure
1 participants
Number of Participants With Pharmacology Toxicity - Grade 3 or 4 Non-Laboratory Toxicity Possibly Related to Study Therapy
Vomiting
1 participants
Number of Participants With Pharmacology Toxicity - Grade 3 or 4 Non-Laboratory Toxicity Possibly Related to Study Therapy
Nausea
2 participants
Number of Participants With Pharmacology Toxicity - Grade 3 or 4 Non-Laboratory Toxicity Possibly Related to Study Therapy
Fatigue
3 participants

SECONDARY outcome

Timeframe: During study drug therapy up to six or eight 21-day cycles or treatment; maximum duration of study follow-up was 17.4 months

Population: Full Analysis Set: This analysis set includes all data from all patients receiving at least one dose of the study drug.

Outcome measures

Outcome measures
Measure
Pemetrexed + Cisplatin
n=53 Participants
Pemetrexed 700 milligrams/meters squared (mg/m2) plus cisplatin 75 mg/m2, intravenous (IV), every 21 days for 6 cycles
Number of Participants Who Died During the Study
Pancytopenia
1 participants
Number of Participants Who Died During the Study
Study Disease
18 participants
Number of Participants Who Died During the Study
Cardiac Failure Acute
1 participants
Number of Participants Who Died During the Study
Death (General Disorders/Administration Site Cond)
1 participants
Number of Participants Who Died During the Study
Intestinal Hemorrhage
1 participants
Number of Participants Who Died During the Study
Sudden Death
3 participants
Number of Participants Who Died During the Study
Multi-Organ Failure
1 participants

Adverse Events

Pemetrexed + Cisplatin

Serious events: 9 serious events
Other events: 49 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Pemetrexed + Cisplatin
n=53 participants at risk
Pemetrexed 700 milligrams/meters squared (mg/m2) plus cisplatin 75 mg/m2, intravenous (IV), every 21 days for 6 cycles
Blood and lymphatic system disorders
Pancytopenia
3.8%
2/53 • Number of events 2
Cardiac disorders
Cardiac failure acute
1.9%
1/53 • Number of events 1
Gastrointestinal disorders
Abdominal pain
1.9%
1/53 • Number of events 1
Gastrointestinal disorders
Gastrointestinal haemorrhage
1.9%
1/53 • Number of events 2
Gastrointestinal disorders
Intestinal haemorrhage
1.9%
1/53 • Number of events 1
General disorders
Chest pain
1.9%
1/53 • Number of events 1
General disorders
Death
1.9%
1/53 • Number of events 1
General disorders
Multi-organ failure
1.9%
1/53 • Number of events 1
General disorders
Sudden death
5.7%
3/53 • Number of events 3
Nervous system disorders
Haemorrhagic stroke
1.9%
1/53 • Number of events 1
Renal and urinary disorders
Renal failure acute
1.9%
1/53 • Number of events 1
Respiratory, thoracic and mediastinal disorders
Pulmonary embolism
1.9%
1/53 • Number of events 1

Other adverse events

Other adverse events
Measure
Pemetrexed + Cisplatin
n=53 participants at risk
Pemetrexed 700 milligrams/meters squared (mg/m2) plus cisplatin 75 mg/m2, intravenous (IV), every 21 days for 6 cycles
Blood and lymphatic system disorders
Anaemia
18.9%
10/53 • Number of events 10
Blood and lymphatic system disorders
Leukopenia
24.5%
13/53 • Number of events 34
Blood and lymphatic system disorders
Neutropenia
56.6%
30/53 • Number of events 67
Blood and lymphatic system disorders
Thrombocytopenia
5.7%
3/53 • Number of events 3
Gastrointestinal disorders
Abdominal pain
9.4%
5/53 • Number of events 5
Gastrointestinal disorders
Diarrhoea
7.5%
4/53 • Number of events 5
Gastrointestinal disorders
Nausea
26.4%
14/53 • Number of events 45
Gastrointestinal disorders
Stomatitis
5.7%
3/53 • Number of events 3
Gastrointestinal disorders
Vomiting
17.0%
9/53 • Number of events 12
General disorders
Fatigue
24.5%
13/53 • Number of events 26
General disorders
Pyrexia
9.4%
5/53 • Number of events 5
Investigations
Creatinine renal clearance decreased
5.7%
3/53 • Number of events 4
Investigations
Haemoglobin decreased
18.9%
10/53 • Number of events 13
Investigations
Neutrophil count decreased
15.1%
8/53 • Number of events 14
Investigations
Platelet count decreased
15.1%
8/53 • Number of events 9
Investigations
Weight decreased
9.4%
5/53 • Number of events 5
Investigations
White blood cell count decreased
20.8%
11/53 • Number of events 18
Skin and subcutaneous tissue disorders
Alopecia
5.7%
3/53 • Number of events 3
Skin and subcutaneous tissue disorders
Rash
5.7%
3/53 • Number of events 5

Additional Information

Chief Medical Officer

Eli Lilly and Company

Phone: 800-545-5979

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place

Restriction type: GT60