
Around 1 in 5 people diagnosed with cancer in the UK take part in a clinical trial.
This trial compared chemotherapy and bevacizumab with chemotherapy on its own as a treatment both before and after surgery. It was open to people
with:
At some hospitals another part of the trial looked at lapatinib for people who had cancer that was . This part was a feasibility study.
Cancer Research UK supported this trial.
The standard treatment of chemotherapy and surgery for stomach cancer can lower the risk of the cancer coming back.
In the main part of the trial, the trial team compared having chemotherapy on its own with having chemotherapy and bevacizumab. Everyone had either:
Bevacizumab (Avastin) is a type of targeted cancer drug called a monoclonal antibody. It targets a protein on the cells called vascular endothelial growth factor (VEGF).
This protein helps cancers to grow blood vessels, so they can get food and oxygen from the blood. All cancers need a blood supply to be able to survive and grow.
Bevacizumab blocks this protein and stops the cancer from growing blood vessels, so it is starved and won’t be able to grow.
Researchers thought that having bevacizumab as well as chemotherapy may be better than chemotherapy on its own. But they weren’t sure.
All treatments have side effects, and it is important that people don’t have treatment they don’t need.
The aims of the main trial were to:
In the feasibility study, some people had lapatinib with their chemotherapy.
Some stomach cancer cells have large amounts of a protein called HER2.
Lapatinib is a type of targeted cancer drug. It is a cancer growth blocker. It stops signals that cancer cell use to divide and grow.
The aims of the feasibility study were to:
These results are for the main trial comparing chemotherapy on its own with chemotherapy and bevacizumab.
The trial team found that adding bevacizumab to chemotherapy wasn’t any better than chemotherapy on its own for:
The main trial was open to people to join between 2007 and 2014. These results were published in 2017.
The team are still looking at the results for the feasibility study of lapatinib. When these results are published we will update this summary.
About this trial
This main trial was a phase 2/3 trial. 1,063 people took part. They were put into 1 of 2 treatment groups at random.
Survival
After an overall average follow up of just over 3 years (38.4 months) the total number of people who had died was 508.
At 3 years follow up the team found there was little difference in the percentage of people who had survived in each group. It was:
How well treatment worked
To find out how well each treatment worked the team were able to look at the results of 875 people.
The number of people who didn’t have any sign of their cancer (complete response) was:
The number of people whose cancer stayed the same (stable disease) was:
Side effects
Side effects were similar in both groups. The most serious side effects included:
The number of people who had problems with how their wound healed after surgery was higher in the chemotherapy and bevacizumab group than those who had chemotherapy only.
Conclusion
The trial team concluded that adding bevacizumab to chemotherapy didn’t increase the amount of time people lived after having surgery to remove their stomach cancer or oesophageal cancer.
Bevacizumab might also be linked to poor wound healing after surgery.
This hasn’t changed the way these people are treated. But continuing to assess new drugs helps to improve the outcomes for people with these cancers.
Where this information comes from
We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists () and published in a medical journal. The figures we quote above were provided by the trial team who did the research. We have not analysed the data ourselves.
Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.
Professor David Cunningham
Cancer Research UK
Experimental Cancer Medicine Centre (ECMC)
GlaxoSmithKline (GSK)
Novartis
Medical Research Council (MRC)
NIHR Clinical Research Network: Cancer
Roche
This is Cancer Research UK trial number CRUK/06/025.
Freephone 0808 800 4040
Around 1 in 5 people diagnosed with cancer in the UK take part in a clinical trial.