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Efficacy and Safety of a Neoadjuvant Treatment in Pancreatic Cancer (GEMCAD1003)

Primary Purpose

Pancreatic Adenocarcinoma

Status
Completed
Phase
Phase 2
Locations
Spain
Study Type
Interventional
Intervention
Gemcitabine and Erlotinib
Sponsored by
Grupo Espanol Multidisciplinario del Cancer Digestivo
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pancreatic Adenocarcinoma focused on measuring Resectable pancreatic adenocarcinoma, Gemcitabine, Erlotinib, Radiotherapy, Neoadjuvant treatment

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Able to sign the inform consent form
  • Age between 18-75 years
  • Subject has not undergone any chemotherapy or radiotherapy previously
  • Functional status o-1 (ECOG scale)
  • Satisfy all radiological inclusion criteria (MSCT performed 28 days before the treatment starts and a centralized evaluation)
  • Patients with a cytologically confirmed diagnosis of pancreatic adenocarcinoma(preferably by EUS)
  • Appropriate analytical as inclusion criteria (7 days before the treatment starts):
  • bone marrow status: neutrophils ≥ 1,500x10^9/L; platelets ≥ 100x10^9/L; hemoglobin ≥ 9g/dL.
  • INR ≤ 1.5 and PTT ≤ 1.5 x upper range of normal.
  • Bilirubin ≤ 5 mg/dL
  • Albumin> 34 g/L
  • Renal function: creatinine ≤ 1.5 mg/dL and creatinine clearance> 50ml/min

Exclusion Criteria:

  • patients treated with any of the study's drugs
  • patients who has develop other primary tumors in 5 years prior to the inclusion at the clinical trial, except for cervix carcinoma in situ or basal cell skin cancer which have been treated properly.
  • significant clinical cardiovascular disease: stroke (≤ 6 months before the study inclusion), heart attack (≤ 6 months before inclusion), unstable ango pectoris, congestive heart failure second grade or higher of the New York Heart Association (NYHA) or serious cardiac arrhythmia requiring medication, uncontrolled hypertension
  • Total o partial bowel obstruction
  • Chronic diarrhea
  • Current treatment with another investigational drug or participation in another clinical trial within 30 days prior to inclusion.
  • Known hypersensitivity to any of the study drugs or their components
  • Currently o recent therapeutic treatment (opposite to prophylactic) with oral or parenteral anticoagulants (full dose) or thrombolytic agents. Patients who receive (or are candidates to receive) anticoagulants for prophylaxis of cardiovascular risk, should continue (or begin) treatment at baseline
  • Thromboembolic event history or bleeding in the 6 months prior to treatment.
  • Evidence of bleeding diathesis or coagulopathy.
  • Serious problems in wounds healing, ulcers or bone fractures.
  • Major surgery, open biopsy or significant traumatic injury 28 days before treatment.
  • Any other disease, metabolic disorder, physical examination findings or clinical laboratory that provides reasonable evidence for suspecting a disease or condition for which it is contraindicated or patient an experimental drug at high risk of experiencing complications related to treatment .
  • Patients undergoing with organ allografts requiring immunosuppressive treatment.
  • Pregnant or breastfeeding woman. It requires a negative pregnancy test (serum or urine) within 7 days before previous to treatment.
  • Men and women of childbearing potential (including women who have had their last menstrual period in less than 2 years) not using effective contraception precautions
  • Positive HIV status
  • Addiction to alcohol or other drugs
  • Known liver cirrhosis

Sites / Locations

  • Clínica Universitaria de Navarra
  • Hospital del Mar
  • Institut Català d'Oncologia (ICO) de L'Hospitalet
  • Hospital Vall d'Hebron
  • Hospital Clínic de Barcelona
  • Hospital Santa Creu y Sant Pau, Hospital Sant Pau
  • Instituto Catalán de Oncología
  • Hospital Virgen de la Arrixaca
  • Hospital la Fe de Valencia
  • Clínico Universitario de Valencia

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Gemcitabine, Erlotinib and radiotherapy

Arm Description

Gemcitabine + Erlotinib follow by Gemcitabine + Erlotinib + radiotherapy

Outcomes

Primary Outcome Measures

Percentage of ancients undergoing with neoadjuvant chemoradiotherapy and R0 resection

Secondary Outcome Measures

To describe the safety of the treatment
Based in safety population, all safety parameters will be analyzed and they will be recorded in lists and spread sheets. Most extreme intensity will be used for the notification of adverse events. Safety population will include all subjects that have taken at least one study medication dose.
Evaluate the response rate using RECIST criteria
Evaluate the percentage of resectability
Evaluate the percentage of lymphatic nodes removed
Evaluate the percentage of lymphatic nodes involved
Evaluate the pathological regression stage (primary tumor and lymphatic nodes)
Relate RECIST criteria with the pathological regress stage
Measure the progression free survival (time from the inclusion date to the progression of the disease or death)
Evaluate the overall survival time

Full Information

First Posted
July 1, 2011
Last Updated
May 15, 2018
Sponsor
Grupo Espanol Multidisciplinario del Cancer Digestivo
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1. Study Identification

Unique Protocol Identification Number
NCT01389440
Brief Title
Efficacy and Safety of a Neoadjuvant Treatment in Pancreatic Cancer
Acronym
GEMCAD1003
Official Title
Phase II Study Open, Not Randomized to Evaluate the Efficacy and Safety of Neoadjuvant Treatment With Gemcitabine and Erlotinib Followed by Gemcitabine, Erlotinib and Radiotherapy in Patients With Resectable Pancreatic Adenocarcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
August 2017
Overall Recruitment Status
Completed
Study Start Date
May 2011 (undefined)
Primary Completion Date
November 2016 (Actual)
Study Completion Date
January 22, 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Grupo Espanol Multidisciplinario del Cancer Digestivo

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a Phase II open study, not randomized with a neoadjuvant therapy,combination of Gemcitabine (1,000 mg/m2/week) with Erlotinib (100mg/day) (3 cycles of 4 weeks), followed by gemcitabine (300 mg/m2/week) combined with Erlotinib (100mg/day) and radiotherapy (45 Gy / day fr180 cGy) (5 cycles of 1 week) in patients with resectable pancreatic adenocarcinoma to assess the percentage of R0 resections. They have planned a total of 21 visits.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pancreatic Adenocarcinoma
Keywords
Resectable pancreatic adenocarcinoma, Gemcitabine, Erlotinib, Radiotherapy, Neoadjuvant treatment

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Gemcitabine, Erlotinib and radiotherapy
Arm Type
Experimental
Arm Description
Gemcitabine + Erlotinib follow by Gemcitabine + Erlotinib + radiotherapy
Intervention Type
Drug
Intervention Name(s)
Gemcitabine and Erlotinib
Other Intervention Name(s)
Gemcitabine and Tarceva
Intervention Description
Administration of gemcitabine (300mg/m2/weekly)with Erlotinib (100 mg/daily) and radiotherapy (45 Gy/daily) after a period of infusion with a full dose of Gemcitabine (1.000mg/m2/weekly) and Erlotinib (100 mg/daily)
Primary Outcome Measure Information:
Title
Percentage of ancients undergoing with neoadjuvant chemoradiotherapy and R0 resection
Time Frame
3 years
Secondary Outcome Measure Information:
Title
To describe the safety of the treatment
Description
Based in safety population, all safety parameters will be analyzed and they will be recorded in lists and spread sheets. Most extreme intensity will be used for the notification of adverse events. Safety population will include all subjects that have taken at least one study medication dose.
Time Frame
3 years
Title
Evaluate the response rate using RECIST criteria
Time Frame
3 years
Title
Evaluate the percentage of resectability
Time Frame
3 years
Title
Evaluate the percentage of lymphatic nodes removed
Time Frame
3 years
Title
Evaluate the percentage of lymphatic nodes involved
Time Frame
3 years
Title
Evaluate the pathological regression stage (primary tumor and lymphatic nodes)
Time Frame
3 years
Title
Relate RECIST criteria with the pathological regress stage
Time Frame
3 years
Title
Measure the progression free survival (time from the inclusion date to the progression of the disease or death)
Time Frame
3 years
Title
Evaluate the overall survival time
Time Frame
3 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Able to sign the inform consent form Age between 18-75 years Subject has not undergone any chemotherapy or radiotherapy previously Functional status o-1 (ECOG scale) Satisfy all radiological inclusion criteria (MSCT performed 28 days before the treatment starts and a centralized evaluation) Patients with a cytologically confirmed diagnosis of pancreatic adenocarcinoma(preferably by EUS) Appropriate analytical as inclusion criteria (7 days before the treatment starts): bone marrow status: neutrophils ≥ 1,500x10^9/L; platelets ≥ 100x10^9/L; hemoglobin ≥ 9g/dL. INR ≤ 1.5 and PTT ≤ 1.5 x upper range of normal. Bilirubin ≤ 5 mg/dL Albumin> 34 g/L Renal function: creatinine ≤ 1.5 mg/dL and creatinine clearance> 50ml/min Exclusion Criteria: patients treated with any of the study's drugs patients who has develop other primary tumors in 5 years prior to the inclusion at the clinical trial, except for cervix carcinoma in situ or basal cell skin cancer which have been treated properly. significant clinical cardiovascular disease: stroke (≤ 6 months before the study inclusion), heart attack (≤ 6 months before inclusion), unstable ango pectoris, congestive heart failure second grade or higher of the New York Heart Association (NYHA) or serious cardiac arrhythmia requiring medication, uncontrolled hypertension Total o partial bowel obstruction Chronic diarrhea Current treatment with another investigational drug or participation in another clinical trial within 30 days prior to inclusion. Known hypersensitivity to any of the study drugs or their components Currently o recent therapeutic treatment (opposite to prophylactic) with oral or parenteral anticoagulants (full dose) or thrombolytic agents. Patients who receive (or are candidates to receive) anticoagulants for prophylaxis of cardiovascular risk, should continue (or begin) treatment at baseline Thromboembolic event history or bleeding in the 6 months prior to treatment. Evidence of bleeding diathesis or coagulopathy. Serious problems in wounds healing, ulcers or bone fractures. Major surgery, open biopsy or significant traumatic injury 28 days before treatment. Any other disease, metabolic disorder, physical examination findings or clinical laboratory that provides reasonable evidence for suspecting a disease or condition for which it is contraindicated or patient an experimental drug at high risk of experiencing complications related to treatment . Patients undergoing with organ allografts requiring immunosuppressive treatment. Pregnant or breastfeeding woman. It requires a negative pregnancy test (serum or urine) within 7 days before previous to treatment. Men and women of childbearing potential (including women who have had their last menstrual period in less than 2 years) not using effective contraception precautions Positive HIV status Addiction to alcohol or other drugs Known liver cirrhosis
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Joan Maurel, MD
Organizational Affiliation
Hospital Clinic of Barcelona
Official's Role
Principal Investigator
Facility Information:
Facility Name
Clínica Universitaria de Navarra
City
Pamplona
State/Province
Navarra
ZIP/Postal Code
31008
Country
Spain
Facility Name
Hospital del Mar
City
Barcelona
ZIP/Postal Code
08003
Country
Spain
Facility Name
Institut Català d'Oncologia (ICO) de L'Hospitalet
City
Barcelona
ZIP/Postal Code
08007
Country
Spain
Facility Name
Hospital Vall d'Hebron
City
Barcelona
ZIP/Postal Code
08035
Country
Spain
Facility Name
Hospital Clínic de Barcelona
City
Barcelona
ZIP/Postal Code
08036
Country
Spain
Facility Name
Hospital Santa Creu y Sant Pau, Hospital Sant Pau
City
Barcelona
ZIP/Postal Code
08041
Country
Spain
Facility Name
Instituto Catalán de Oncología
City
Girona
ZIP/Postal Code
17007
Country
Spain
Facility Name
Hospital Virgen de la Arrixaca
City
Murcia
ZIP/Postal Code
30120
Country
Spain
Facility Name
Hospital la Fe de Valencia
City
Valencia
ZIP/Postal Code
46009
Country
Spain
Facility Name
Clínico Universitario de Valencia
City
Valencia
ZIP/Postal Code
46010
Country
Spain

12. IPD Sharing Statement

Citations:
PubMed Identifier
30225601
Citation
Maurel J, Sanchez-Cabus S, Laquente B, Gaba L, Visa L, Fabregat J, Poves I, Rosello S, Diaz-Beveridge R, Martin-Richard M, Rodriguez J, Sabater L, Conill C, Cambray M, Reig A, Ayuso JR, Valls C, Ferrandez A, Bombi JA, Gines A, Garcia-Albeniz X, Fernandez-Cruz L. Outcomes after neoadjuvant treatment with gemcitabine and erlotinib followed by gemcitabine-erlotinib and radiotherapy for resectable pancreatic cancer (GEMCAD 10-03 trial). Cancer Chemother Pharmacol. 2018 Dec;82(6):935-943. doi: 10.1007/s00280-018-3682-9. Epub 2018 Sep 17.
Results Reference
derived

Learn more about this trial

Efficacy and Safety of a Neoadjuvant Treatment in Pancreatic Cancer

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