Phase IV Multi-Institutional Randomized Trial of Capecitabine Plus Oxaliplatin With Herceptin in Patients With Potentially Resectable HER-2 Positive Gastric Cancer With Liver Metastasis
Phase IV Multi-Institutional Randomized Trial of Capecitabine Plus Oxaliplatin With Herceptin in Patients With Potentially Resectable HER-2 Positive Gastric Cancer With Liver Metastasis
Stage I：preoperative therapy
The investigators assessed whether the addition of a perioperative regimen of XELOX regimen with herceptin to improves R0 resection rate and survival among patients with potentially resectable HER-2 positive gastric cancer with liver metastasis.
Inclusion Criteria:
1.Pathological tissue were gastric cancer by gastric and liver biopsy.
2.Immunohistochemistry confirmed HER-2 (+)or FISH(+).
3.gastric cancer with liver metastasis were not able to resectable lesions.
4.Patients•had not received radiotherapy past and not other organ metastasis and peritoneal metastasis.
5.ECOG performance status 0-1.
6.Inadequate hematopoietic function： Hemoglobin≥90g/L; ANC≥1,500/mm3;Platelet≥100,000/mm3 7.Inadequate organ function which is defined as below: Total bilirubin≤1.5 pper limit of normal range (ULN); ALT / AST≤2.5 upper limit of normal range (ULN) (≤5.0 x ULN if hepatic metastasis); serum creatinine≤1.5 pper limit of normal range (ULN), Serum albumin≥30g/L.
8.expectancy must be more than 3 months. 9.the random blood or urine pregnancy test in fertile woman must be the negative results in pregnancy test in 7 days.
10.Patients for male and female used reliable contraception contraceptive method until the end of study 30 days later.
11.The operation can complete the D2 operation(LNM≥15).
12.LVEF≥50%
Exclusion Criteria:
1. Patients with other extrahepatic metastasis Include peritoneal metastasis.
3. Patients with other malignancy in 5 years.
4. Patients with peripheral nerve disease,two hydrogen pyrimidine dehydrogenase( DPD )deficiency,upper digestive tract obstruction or from malabsorption syndrome.
5.Patients with hypertension failed to control, active bleeding, 3~4 proteinuria, heal the wound, romboembolism, heart failure, clinical symptoms of heart disease.
6.Patients have obvious peripheral nervous system disorders,mental disorders and disorders of the central nervous system history.
7.Patients have history of organ transplantation.
8.Patients with any medical or psychiatric condition or disease which, in the investigator's judgment, would make the patient inappropriate for entry into this study.
9.Patients combined antitumor drug outside the research program.