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Study Combining Suicide Gene Therapy With Chemoradiotherapy in the Treatment of Non-Metastatic Pancreatic Adenocarcinoma

Primary Purpose

Pancreatic Cancer

Status
Terminated
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Ad5-yCD/mutTKSR39rep-ADP
Sponsored by
Henry Ford Health System
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pancreatic Cancer focused on measuring Pancreatic Cancer

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Age > = 18 and < = 80.
  • Non-metastatic, unresectable tumors
  • No evidence of peritoneal and/or hematogenous metastasis.
  • Histologically proven (biopsy or cytology) adenocarcinoma.
  • No evidence of peritoneal and/or hematogenous metastasis.
  • No prior chemotherapy, radiotherapy or biological therapy.
  • ECOG performance status 0 - 2.
  • Subjects must have adequate baseline organ function, as assessed by the following laboratory values, within 30 days before initiating the study therapy:
  • Adequate renal function with serum creatinine <=1.5 mg/dL or creatinine clearance >=50 mL/min/m2.
  • Absolute WBC > 4,000/μL.
  • Hemoglobin > 9.0 g/dL.
  • Platelet count > 100,000/μL.
  • Bilirubin < 1.5 mg/dL; SGOT and SGPT < 2.5 times upper limit of normal (ULN).
  • No history of malignancy within 5 years except for non-melanomatous skin cancer or carcinoma in situ of the cervix.
  • Men and women with conceptive potential must agree to follow a medically acceptable method of birth control.
  • Patients on oral warfarin anticoagulation therapy may be included in this study, but must have close monitoring of their coagulation parameters as altered parameters and/or bleeding have been reported in patients taking Xeloda® and such agents concomitantly.
  • The subject must possess the ability to give informed consent and express a willingness to meet all of the expected requirements of the protocol for the duration of the study.

Exclusion Criteria:

  • Pregnant and lactating women.
  • Serious non-malignant disease (e.g., congestive heart failure or uncontrolled infections), which, in the opinion of the investigator would compromise study objectives.
  • Major surgery within four weeks other than diagnostic procedures such as laparoscopy, endoscopic ultrasound and stenting or PEG/PEJ placement.
  • Islet cell tumor, benign cyst, peri-ampullary carcinoma or any non-adenocarcinomas.
  • Acute infection. Acute infection is defined by any viral, bacterial, or fungal infection that has required specific therapy within 72 hours of initiation of the study therapy (defined as Day 1).
  • Active HIV disease.
  • Previous history of liver disease including hepatitis.
  • Positive serologic test for Hepatitis B or C at baseline.
  • Immunosuppressive therapy including systemic corticosteroids. Use of inhaled and topical corticosteroids is permitted.
  • Serious medical or psychiatric illness or concomitant medication, which, in the judgment of the investigator, might interfere with the subject's ability to respond to or tolerate the treatment or complete the trial.
  • Impaired immunity or susceptibility to serious viral infections.
  • Allergy to any product used on the protocol including ciprofloxacin.
  • Clinical or laboratory evidence of pancreatitis

Sites / Locations

  • Henry Ford Health System

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Gene therapy

Arm Description

Adenovirus injection followed by 3 weeks of 5-FC + vGCV prodrug therapy and a 6 week course of capecitabine-based chemoradiation

Outcomes

Primary Outcome Measures

Toxicity

Secondary Outcome Measures

Tumor response
Time to progression
Survival
Gene expression in pancreas

Full Information

First Posted
December 21, 2006
Last Updated
June 21, 2011
Sponsor
Henry Ford Health System
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1. Study Identification

Unique Protocol Identification Number
NCT00415454
Brief Title
Study Combining Suicide Gene Therapy With Chemoradiotherapy in the Treatment of Non-Metastatic Pancreatic Adenocarcinoma
Official Title
Phase I Study Combining Replication-Competent Adenovirus-Mediated Suicide Gene Therapy With Chemoradiotherapy for the Treatment of Non-Metastatic Pancreatic Adenocarcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
June 2011
Overall Recruitment Status
Terminated
Why Stopped
Poor enrollment
Study Start Date
November 2006 (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Name of the Sponsor
Henry Ford Health System

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The primary purpose of this phase I study is to determine the safety of combining replication-competent adenovirus-mediated suicide gene therapy with chemoradiotherapy in patients with non-metastatic pancreatic cancer.
Detailed Description
The objectives of this study are: To determine the toxicity and maximum tolerated dose (MTD) of the Ad5-yCD/mutTKSR39rep-ADP adenovirus in combination with 5-fluorocytosine (5-FC) and valganciclovir (vGCV) prodrug therapy and standard chemoradiation. Fifteen to 30 subjects (5 cohorts of 3 - 6 subjects each) with non-metastatic, unresectable pancreatic cancer will receive a single intratumoral injection of the Ad5-yCD/mutTKSR39rep-ADP adenovirus at one of five dose levels (1 x 10e10 vp, 3 x 10e10 vp, 1 x 10e11 vp, 3 x 10e11 vp, 1 x 10e12 vp) under endoscopic ultrasound (EUS)-guidance. Beginning three days later, subjects will receive 3 weeks (15 days) of 5-FC and vGCV prodrug therapy concomitant with a 6 week (30 day) course of capecitabine chemotherapy and 54 Gy conformal radiotherapy. The primary endpoint is toxicity at 12 weeks. Secondary endpoints are: 1) tumor (radiological) response, 2) time to disease progression, 3) survival, 4) persistence of Ad5-yCD/mutTKSR39rep-ADP adenoviral DNA in blood, 5) infectious Ad5-yCD/mutTKSR39rep-ADP adenovirus in blood, and 6) HSV-1 TK gene expression in the pancreas.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pancreatic Cancer
Keywords
Pancreatic Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
8 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Gene therapy
Arm Type
Experimental
Arm Description
Adenovirus injection followed by 3 weeks of 5-FC + vGCV prodrug therapy and a 6 week course of capecitabine-based chemoradiation
Intervention Type
Genetic
Intervention Name(s)
Ad5-yCD/mutTKSR39rep-ADP
Intervention Description
Single injection on day 1 at one of five dose levels
Primary Outcome Measure Information:
Title
Toxicity
Time Frame
12 weeks post adenovirus injection
Secondary Outcome Measure Information:
Title
Tumor response
Time Frame
3 - 12 months
Title
Time to progression
Time Frame
3 - 12 months
Title
Survival
Time Frame
10 - 20 months
Title
Gene expression in pancreas
Time Frame
1 - 14 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age > = 18 and < = 80. Non-metastatic, unresectable tumors No evidence of peritoneal and/or hematogenous metastasis. Histologically proven (biopsy or cytology) adenocarcinoma. No evidence of peritoneal and/or hematogenous metastasis. No prior chemotherapy, radiotherapy or biological therapy. ECOG performance status 0 - 2. Subjects must have adequate baseline organ function, as assessed by the following laboratory values, within 30 days before initiating the study therapy: Adequate renal function with serum creatinine <=1.5 mg/dL or creatinine clearance >=50 mL/min/m2. Absolute WBC > 4,000/μL. Hemoglobin > 9.0 g/dL. Platelet count > 100,000/μL. Bilirubin < 1.5 mg/dL; SGOT and SGPT < 2.5 times upper limit of normal (ULN). No history of malignancy within 5 years except for non-melanomatous skin cancer or carcinoma in situ of the cervix. Men and women with conceptive potential must agree to follow a medically acceptable method of birth control. Patients on oral warfarin anticoagulation therapy may be included in this study, but must have close monitoring of their coagulation parameters as altered parameters and/or bleeding have been reported in patients taking Xeloda® and such agents concomitantly. The subject must possess the ability to give informed consent and express a willingness to meet all of the expected requirements of the protocol for the duration of the study. Exclusion Criteria: Pregnant and lactating women. Serious non-malignant disease (e.g., congestive heart failure or uncontrolled infections), which, in the opinion of the investigator would compromise study objectives. Major surgery within four weeks other than diagnostic procedures such as laparoscopy, endoscopic ultrasound and stenting or PEG/PEJ placement. Islet cell tumor, benign cyst, peri-ampullary carcinoma or any non-adenocarcinomas. Acute infection. Acute infection is defined by any viral, bacterial, or fungal infection that has required specific therapy within 72 hours of initiation of the study therapy (defined as Day 1). Active HIV disease. Previous history of liver disease including hepatitis. Positive serologic test for Hepatitis B or C at baseline. Immunosuppressive therapy including systemic corticosteroids. Use of inhaled and topical corticosteroids is permitted. Serious medical or psychiatric illness or concomitant medication, which, in the judgment of the investigator, might interfere with the subject's ability to respond to or tolerate the treatment or complete the trial. Impaired immunity or susceptibility to serious viral infections. Allergy to any product used on the protocol including ciprofloxacin. Clinical or laboratory evidence of pancreatitis
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Munther Ajlouni, M.D.
Organizational Affiliation
Henry Ford Health System
Official's Role
Principal Investigator
Facility Information:
Facility Name
Henry Ford Health System
City
Detroit
State/Province
Michigan
ZIP/Postal Code
48202
Country
United States

12. IPD Sharing Statement

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Study Combining Suicide Gene Therapy With Chemoradiotherapy in the Treatment of Non-Metastatic Pancreatic Adenocarcinoma

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