RATIONALE: Bortezomib may stop the growth of tumor cells by blocking the enzymes necessary for their growth.

PURPOSE: Phase II trial to study the effectiveness of bortezomib in treating patients who have unresectable or metastatic gastric cancer or gastroesophageal junction adenocarcinoma.

Condition	Treatment or Intervention	Phase
recurrent gastric cancer stage III gastric cancer stage IV gastric cancer adenocarcinoma of the stomach	Drug: bortezomib  Procedure: enzyme inhibitor therapy	Phase II

Further Study Details: 

OBJECTIVES: Primary

• Determine the efficacy of bortezomib in patients with unresectable or metastatic gastric or gastroesophageal junction adenocarcinoma.

Secondary

• Determine the toxicity of this drug in these patients.
• Determine possible predictors of response to this drug, using pretreatment tumor immunohistochemistry, in these patients.

OUTLINE: This is an open-label, nonrandomized, multicenter study.

Patients receive bortezomib IV over 3-5 seconds on days 1, 4, 8, and 11. Courses repeat every 3 weeks in the absence of disease progression or unacceptable toxicity.

Patients are followed every 3 months for 1 year.

PROJECTED ACCRUAL: A total of 15-33 patients will be accrued for this study within 5-12 months.

Ages Eligible for Study:  18 Years and above,  Genders Eligible for Study:  Both

Criteria

DISEASE CHARACTERISTICS:

• Histologically or cytologically confirmed unresectable or metastatic gastric or gastroesophageal junction adenocarcinoma
• Siewert’s class II or III disease
• Measurable disease
• At least 1 unidimensionally measurable lesion at least 20 mm by conventional techniques OR at least 10 mm by spiral CT scan
• No history of known or active brain metastases or primary brain tumors

PATIENT CHARACTERISTICS: Age

• 18 and over

Performance status

• Karnofsky 60-100% OR
• ECOG 0-2

Life expectancy

• Not specified

Hematopoietic

• WBC at least 3,000/mm^3
• Absolute neutrophil count at least 1,000/mm^3
• Platelet count at least 100,000/mm^3

Hepatic

• Bilirubin no greater than 1.5 mg/dL
• AST and ALT no greater than 3 times upper limit of normal (ULN) (5 times ULN if liver metastases are present)

Renal

• Creatinine no greater than 1.5 mg/dL

Cardiovascular

• No prior cerebrovascular event
• No prior orthostatic hypotension
• No myocardial infarction within the past 6 months
• No peripheral vascular disease requiring surgical management
• No evidence of acute ischemia or significant conduction abnormality by EKG

Other

• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception during and for at least 2 months after study participation
• No evidence of peripheral neuropathy
• No prior allergic reaction attributed to compounds of similar chemical or biological composition to bortezomib
• No other malignancy within the past 3 years except basal cell skin cancer, carcinoma in situ of the cervix, or adequately treated nonmetastatic prostate cancer
• No ongoing or active infection
• No psychiatric illness or social situation that would preclude study participation
• No other concurrent uncontrolled illness that would preclude study participation
• No other medical condition or reason that would preclude study participation

PRIOR CONCURRENT THERAPY: Biologic therapy

• More than 3 weeks since prior immunotherapy
• No concurrent biological or immunological agents

Chemotherapy

• No more than 1 prior chemotherapy regimen (including adjuvant chemotherapy)
• More than 3 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin)
• No concurrent chemotherapy

Endocrine therapy

• Not specified

Radiotherapy

• More than 3 weeks since prior radiotherapy
• No concurrent radiotherapy

Surgery

• Not specified

Other

• Recovered from all prior therapy
• No other concurrent investigational agents
• No other concurrent anticancer agent or therapy

Illinois
      University of Chicago Cancer Research Center, Chicago,  Illinois,  60637-1470,  United States
New York
      Memorial Sloan-Kettering Cancer Center, New York,  New York,  10021,  United States
      Queens Cancer Center of Queens Hospital, Jamaica,  New York,  11432,  United States
Wisconsin
      University of Wisconsin Comprehensive Cancer Center, Madison,  Wisconsin,  53792-3236,  United States

Study chairs or principal investigators

Manish A. Shah, MD,  Principal Investigator,  Memorial Sloan-Kettering Cancer Center   
Gary K. Schwartz, MD,  Principal Investigator,  Memorial Sloan-Kettering Cancer Center   

Study ID Numbers:  CDR0000341565; MSKCC-03101; NCI-6003; NCT00074009
Record last reviewed:  January 2005
Last Updated:  January 7, 2005
Record first received:  December 10, 2003
ClinicalTrials.gov Identifier:  NCT00074009
Health Authority: United States: Federal Government
ClinicalTrials.gov processed this record on 2005-04-08