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Neoadjuvant FDR GX in Locally Advanced Pancreatic Cancer

Primary Purpose

Pancreatic Cancer

Status
Completed
Phase
Phase 2
Locations
Korea, Republic of
Study Type
Interventional
Intervention
Gemcitabine plus Capecitabine
Sponsored by
Asan Medical Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pancreatic Cancer focused on measuring pancreatic cancer, neoadjuvant chemotherapy, gemcitabine, capecitabine

Eligibility Criteria

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

Inclusion Criteria:

  • Histologically or cytologically documented pancreatic adenocarcinoma
  • Clinical T3 or T4 tumor according to AJCC staging system
  • Tumors considered as borderline resectable or unresectable disease assessed by multidisciplinary team including pancreatic surgeon, gastroenterologist specializing in pancreas, medical oncologist, and radiation oncologist
  • Age 18 years or older
  • ECOG performance status 2 or less
  • Adequate organ function

    • Adequate bone marrow function (WBCs> 3,500/µL, absolute neutrophil count [ANC]> 1,500/µL, hemoglobin > 9.0 g/dL, and platelets > 100,000/µL)
    • Adequate kidney function (creatinine < 1.5 mg/dL)
    • Adequate liver function (bilirubin < 1.5 mg/dL [<2.5 mg/dL for patients with obstructive jaundice due to pancreatic cancer with adequate decompression], transaminases levels < 3 times the upper normal limit)
  • Patients must not have psychological, familial, sociological or geographical conditions which do not permit medical follow-up and compliance with this study
  • Women of childbearing potential must have a negative pregnancy test on admission. Post-menopausal women must have been amenorrheic for at least 12 months to be considered of non-childbearing potential. Men and women of reproductive potential must have agreed to use an effective method of contraception while on treatment and for 6 months after study treatment
  • The patient must be able to understand the study and has given written informed consent to participate in the study

Exclusion Criteria:

  • Other tumor type than adenocarcinoma
  • Evidence of gastrointestinal bleeding or obstruction
  • Presence of the clinically relevant ascites or distant metastases
  • Past or concurrent history of malignant neoplasm, except for curatively treated non-melanoma skin cancer or in situ carcinoma of the cervix uteri
  • Pregnant or lactating women, women of childbearing potential not employing adequate contraception
  • Hypersensitivity to any of the study drugs or ingredients
  • Other serious illness or medical conditions

    • Unstable cardiac disease despite treatment, myocardial infarction within 6 months prior to study entry
    • History of significant neurologic or psychiatric disorders including dementia or seizures
    • Active uncontrolled infection
    • Pre-existing clinically significant diarrhea
    • Active peptic ulcer
    • Severe hypercalcemia of 12 mg/dL uncontrolled with bisphosphonates
    • Active disseminated intravascular coagulation
    • Other serious underlying medical conditions which could impair the ability of the patient to participate in the study
  • Concomitant or administration of any other experimental drug under investigation within 3 weeks before the study
  • Concomitant chemotherapy, hormonal therapy, or immunotherapy

Sites / Locations

  • Asan Medical Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

FDR_GX

Arm Description

Fixed dose rate gemcitabine plus capecitabine every 3 weeks for 3-9 cycles

Outcomes

Primary Outcome Measures

R0 resection rate
Microscopic complete resection rate after neoadjuvant chemotherapy

Secondary Outcome Measures

Adverse events associated with neoadjuvant chemotherapy
NCI CTCAE v.3.0 based AEs
Overall survival
Overall survival after enrollment

Full Information

First Posted
December 29, 2010
Last Updated
December 5, 2011
Sponsor
Asan Medical Center
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1. Study Identification

Unique Protocol Identification Number
NCT01268384
Brief Title
Neoadjuvant FDR GX in Locally Advanced Pancreatic Cancer
Official Title
Phase II Study of Fixed Dose Rate Gemcitabine Plus Capecitabine in Locally Advanced Pancreatic Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
December 2011
Overall Recruitment Status
Completed
Study Start Date
April 2006 (undefined)
Primary Completion Date
July 2010 (Actual)
Study Completion Date
August 2011 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Asan Medical Center

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The rationale for phase II trial of neoadjuvant fixed dose rate gemcitabine plus capecitabine for patients with LAPC includes the following: First, obtaining a sufficient tumor down-staging to procure R0/R1 resection, reported to be one of the most significant prognostic factors for survival; second, providing an observation period to exclude from surgery those patients with rapidly progressive disease there by to help select patients for surgery who have the greatest likelihood of a favorable postoperative outcome; third, eliminating micrometastatic disease, that is likely present in most patients, earlier than adjuvant setting and preventing post-surgical growth spurts; fourth, adjuvant therapy given in the neoadjuvant setting is better tolerated, as the patient has not recently undergone a major operation; and the last, the lack of widely accepted optimal preoperative or palliative approach in patients with LAPC, the majority of whom may not be operated on. The primary goal is to determine the R0 resection rate of the neoadjuvant fixed dose rate (FDR) gemcitabine-capecitabine combination chemotherapy in patients with borderline resectable or unresectable locally advanced pancreatic adenocarcinoma. The secondary goals are to assess progression-free survival (PFS) and OS (overall survival) in these patients and to assess adverse events of these neoadjuvant treatments.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pancreatic Cancer
Keywords
pancreatic cancer, neoadjuvant chemotherapy, gemcitabine, capecitabine

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
FDR_GX
Arm Type
Experimental
Arm Description
Fixed dose rate gemcitabine plus capecitabine every 3 weeks for 3-9 cycles
Intervention Type
Drug
Intervention Name(s)
Gemcitabine plus Capecitabine
Other Intervention Name(s)
Neoadjuvant chemotherapy, GemCap
Intervention Description
Gemcitabine 1,250 mg/m2 mixed with 0.9% saline 500 ml i.v. for 10 mg/m2/min on D1 and D8 Capecitabine 950 mg/m2 b.i.d. po from D1 to D14 every 21 days
Primary Outcome Measure Information:
Title
R0 resection rate
Description
Microscopic complete resection rate after neoadjuvant chemotherapy
Time Frame
6 months
Secondary Outcome Measure Information:
Title
Adverse events associated with neoadjuvant chemotherapy
Description
NCI CTCAE v.3.0 based AEs
Time Frame
6 months
Title
Overall survival
Description
Overall survival after enrollment
Time Frame
2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically or cytologically documented pancreatic adenocarcinoma Clinical T3 or T4 tumor according to AJCC staging system Tumors considered as borderline resectable or unresectable disease assessed by multidisciplinary team including pancreatic surgeon, gastroenterologist specializing in pancreas, medical oncologist, and radiation oncologist Age 18 years or older ECOG performance status 2 or less Adequate organ function Adequate bone marrow function (WBCs> 3,500/µL, absolute neutrophil count [ANC]> 1,500/µL, hemoglobin > 9.0 g/dL, and platelets > 100,000/µL) Adequate kidney function (creatinine < 1.5 mg/dL) Adequate liver function (bilirubin < 1.5 mg/dL [<2.5 mg/dL for patients with obstructive jaundice due to pancreatic cancer with adequate decompression], transaminases levels < 3 times the upper normal limit) Patients must not have psychological, familial, sociological or geographical conditions which do not permit medical follow-up and compliance with this study Women of childbearing potential must have a negative pregnancy test on admission. Post-menopausal women must have been amenorrheic for at least 12 months to be considered of non-childbearing potential. Men and women of reproductive potential must have agreed to use an effective method of contraception while on treatment and for 6 months after study treatment The patient must be able to understand the study and has given written informed consent to participate in the study Exclusion Criteria: Other tumor type than adenocarcinoma Evidence of gastrointestinal bleeding or obstruction Presence of the clinically relevant ascites or distant metastases Past or concurrent history of malignant neoplasm, except for curatively treated non-melanoma skin cancer or in situ carcinoma of the cervix uteri Pregnant or lactating women, women of childbearing potential not employing adequate contraception Hypersensitivity to any of the study drugs or ingredients Other serious illness or medical conditions Unstable cardiac disease despite treatment, myocardial infarction within 6 months prior to study entry History of significant neurologic or psychiatric disorders including dementia or seizures Active uncontrolled infection Pre-existing clinically significant diarrhea Active peptic ulcer Severe hypercalcemia of 12 mg/dL uncontrolled with bisphosphonates Active disseminated intravascular coagulation Other serious underlying medical conditions which could impair the ability of the patient to participate in the study Concomitant or administration of any other experimental drug under investigation within 3 weeks before the study Concomitant chemotherapy, hormonal therapy, or immunotherapy
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jae-Lyun Lee, MD, PhD
Organizational Affiliation
Asan Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Asan Medical Center
City
Seoul
ZIP/Postal Code
138-736
Country
Korea, Republic of

12. IPD Sharing Statement

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Neoadjuvant FDR GX in Locally Advanced Pancreatic Cancer

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