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A Study of FOLFOX6 With Bevacizumab for Biliary System Carcinoma

Primary Purpose

Biliary Tract Cancer

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
"Bevacizumab" in combination with "modified FOLFOX6".
Sponsored by
Georgetown University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Biliary Tract Cancer focused on measuring Biliary, Oxaliplatin, Bevacizumab

Eligibility Criteria

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

Inclusion Criteria:

  • Histologically or cytologically confirmed diagnosis of non-resectable adenocarcinoma of the biliary tract, including carcinomas of the gallbladder, the intrahepatic or extrahepatic biliary tract, and ampullary cancer
  • Measurable or evaluable disease
  • Locally advanced disease that is inoperable ot patients who have had disease recurrence after curative surgical attempt
  • Ambulatory with an ECOG performance status of 0-1
  • Adequate organ and marrow function
  • Must agree to avoid pregnancy prior to study entry and throughout the duration of study participation
  • Ability to understand and the willingness to sign a written informed consent document

Exclusion Criteria:

  • Any prior chemotherapy
  • Patients who are receiving other investigational agents
  • Patients who have received radiotherapy to more than 25% of their bone marrow for any reason
  • Peripheral neuropathy >/= 2
  • Known brain metastases, uncontrolled seizure disorder, encephalitis
  • Prior history of hypertensive crisis or hypertensive encephalopathy, uncontrolled hypertension,unstable angina, congestive heart failure of New York Heart Association (NYHA) class 2 or greater, left ventricular ejection fraction less than 50%, clinically significant vascular disease, serious cardiac arrhythmia requiring medication, cardiomyopathy
  • History of myocardial infarction, unstable angina or stroke/transient ischemic attack (TIA) within 6 months
  • History of allergy to oxaliplatin, 5-fluoruracil (5-FU), Leucovorin, or Bevacizumab
  • History of intra-abdominal abscess within 4 weeks of study entry, abdominal fistula, gastrointestinal perforation, active peptic ulcer disease, or inflammatory bowel disease
  • Evidence of bleeding diathesis or coagulopathy
  • Serious non-healing wound, ulcer, or bone fracture
  • Major surgical procedure, open biopsy, or significant traumatic injury within 4 weeks of study entry or anticipation of need for major surgery during the course of the study
  • Minor surgical procedures such as core biopsies within 7 days before enrollment, chemotherapy port placement within 24 hours
  • Patients on full-dose anticoagulants who have out of range international normalized ratio (INR) or active bleeding
  • Concurrent malignancy unless the subject has been curatively treated and disease free for >/= 2 years or the cancer was non-melanoma skin cancer or early cervical cancer
  • Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection or psychiatric illness/social situations that would limit compliance with study requirements
  • Known HIV or Hepatitis B or C
  • Life expectancy less than 12 weeks
  • Pregnant or nursing women

Sites / Locations

  • Georgetown University Medical Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

"FOLFOX6" and "Bevacizumab"

Arm Description

Intervention = "bevacizumab" in combination with chemotherapy Treatment of biliary system carcinoma using "Bevacizumab" in combination with "modified FOLFOX6".

Outcomes

Primary Outcome Measures

Progression-free Survival
Progression-free Survival is defined as the time from randomization (or study initiation) until objective tumor progression or death.

Secondary Outcome Measures

Safety and Toxicity
The number of patients who underwent FOLFOX dose reductions as a result of Grade 3 toxicity.

Full Information

First Posted
April 13, 2009
Last Updated
October 16, 2014
Sponsor
Georgetown University
Collaborators
Sanofi
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1. Study Identification

Unique Protocol Identification Number
NCT00881504
Brief Title
A Study of FOLFOX6 With Bevacizumab for Biliary System Carcinoma
Official Title
A Single-Center, Open-Labeled, Phase II Trial of Modified FOLFOX6 With Bevacizumab in Patients With Advanced Biliary System Carcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
September 2014
Overall Recruitment Status
Terminated
Why Stopped
It was not possible to get insurance companies to cover bevacizumab.
Study Start Date
June 2009 (undefined)
Primary Completion Date
February 2011 (Actual)
Study Completion Date
December 2011 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Georgetown University
Collaborators
Sanofi

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study is for patients with biliary tract cancer that has spread and who are not candidates for surgical resection. The purpose of this research is to determine if bevacizumab can be safely administered with Modified FOLFOX 6 and find out what effects, good and/or bad, this type of treatment has on biliary cancer. In this study, a combination of chemotherapy, Modified FOLFOX6 and a biologic agent, bevacizumab will be tested. Subjects on this study will receive chemotherapy and bevacizumab every 2 weeks until their disease gets worse or they are unable to tolerate treatment.
Detailed Description
This is a single-center, open labeled, single-arm study in patients with previously untreated unresectable biliary tract cancer. This trial will follow a Simon's two-stage optimal design. For the first stage, 9 patients will be accrued. If none of the 9 patients have controlled disease with mFOLFOX6 in combination with bevacizumab, the combination will be rejected and the trial stopped. However, if at least 1 patient of the 9 (11%) respond to treatment in the first stage, then an additional 15 patients will be entered into the second stage, for a total of 24 patients in the phase II study. If 3 (13%) or more patients respond to therapy, then the combination will be considered for further investigation.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Biliary Tract Cancer
Keywords
Biliary, Oxaliplatin, Bevacizumab

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
9 (Actual)

8. Arms, Groups, and Interventions

Arm Title
"FOLFOX6" and "Bevacizumab"
Arm Type
Experimental
Arm Description
Intervention = "bevacizumab" in combination with chemotherapy Treatment of biliary system carcinoma using "Bevacizumab" in combination with "modified FOLFOX6".
Intervention Type
Drug
Intervention Name(s)
"Bevacizumab" in combination with "modified FOLFOX6".
Other Intervention Name(s)
Avastin, Eloxatin
Intervention Description
Oxaliplatin 85 mg/m2 IV on Day 1 5-FU: 400 mg/m2 IV bolus on Day 1, followed by 2400 mg/M2 over 46 hours Leucovorin: 400 mg IV Day 1 Bevacizumab: 10 mg/kg IV on Day 1 Repeat cycles every 2 weeks until death, disease progression, unacceptable toxicity, patient refusal, or treatment delay > 4 weeks
Primary Outcome Measure Information:
Title
Progression-free Survival
Description
Progression-free Survival is defined as the time from randomization (or study initiation) until objective tumor progression or death.
Time Frame
2 years
Secondary Outcome Measure Information:
Title
Safety and Toxicity
Description
The number of patients who underwent FOLFOX dose reductions as a result of Grade 3 toxicity.
Time Frame
8 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically or cytologically confirmed diagnosis of non-resectable adenocarcinoma of the biliary tract, including carcinomas of the gallbladder, the intrahepatic or extrahepatic biliary tract, and ampullary cancer Measurable or evaluable disease Locally advanced disease that is inoperable ot patients who have had disease recurrence after curative surgical attempt Ambulatory with an ECOG performance status of 0-1 Adequate organ and marrow function Must agree to avoid pregnancy prior to study entry and throughout the duration of study participation Ability to understand and the willingness to sign a written informed consent document Exclusion Criteria: Any prior chemotherapy Patients who are receiving other investigational agents Patients who have received radiotherapy to more than 25% of their bone marrow for any reason Peripheral neuropathy >/= 2 Known brain metastases, uncontrolled seizure disorder, encephalitis Prior history of hypertensive crisis or hypertensive encephalopathy, uncontrolled hypertension,unstable angina, congestive heart failure of New York Heart Association (NYHA) class 2 or greater, left ventricular ejection fraction less than 50%, clinically significant vascular disease, serious cardiac arrhythmia requiring medication, cardiomyopathy History of myocardial infarction, unstable angina or stroke/transient ischemic attack (TIA) within 6 months History of allergy to oxaliplatin, 5-fluoruracil (5-FU), Leucovorin, or Bevacizumab History of intra-abdominal abscess within 4 weeks of study entry, abdominal fistula, gastrointestinal perforation, active peptic ulcer disease, or inflammatory bowel disease Evidence of bleeding diathesis or coagulopathy Serious non-healing wound, ulcer, or bone fracture Major surgical procedure, open biopsy, or significant traumatic injury within 4 weeks of study entry or anticipation of need for major surgery during the course of the study Minor surgical procedures such as core biopsies within 7 days before enrollment, chemotherapy port placement within 24 hours Patients on full-dose anticoagulants who have out of range international normalized ratio (INR) or active bleeding Concurrent malignancy unless the subject has been curatively treated and disease free for >/= 2 years or the cancer was non-melanoma skin cancer or early cervical cancer Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection or psychiatric illness/social situations that would limit compliance with study requirements Known HIV or Hepatitis B or C Life expectancy less than 12 weeks Pregnant or nursing women
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
John L Marshall, MD
Organizational Affiliation
Georgetown University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Georgetown University Medical Center
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20007
Country
United States

12. IPD Sharing Statement

Learn more about this trial

A Study of FOLFOX6 With Bevacizumab for Biliary System Carcinoma

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