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Clinical Trial to Investigate the Efficacy of Treatment With Gemcitabine/Pazopanib in Patients With Biliary Tree Cancer

Primary Purpose

Cholangiocarcinoma, Gallbladder Carcinoma, Biliary Carcinoma

Status
Terminated
Phase
Phase 2
Locations
Greece
Study Type
Interventional
Intervention
Gemcitabine-Pazopanib
Sponsored by
Hellenic Cooperative Oncology Group
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Cholangiocarcinoma

Eligibility Criteria

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

Inclusion Criteria:

  • Subjects must provide written informed consent prior to performance of study-specific procedures or assessments,and must be willing to comply with treatment and follow up.
  • Age ≥18 years
  • Histologically confirmed diagnosis of inoperable,locally advanced or metastatic cholangiocarcinoma (adenocarcinoma of intrahepatic,proximal extrahepatic,distal extrahepatic,gallbladder adenocarcinoma and periampullary bile duct adenocarcinoma).
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
  • Measurable disease criteria per RECIST v1.1.
  • No prior chemotherapy or treatment with targeted therapy
  • Formalin-fixed paraffin-embedded tumour and whole blood/plasma samples at diagnosis/study enrollment for biomarker studies.
  • Adequate organ system function as specified in the protocol
  • Female patients are allowed to participate provided they consent to avoid pregnancy throughout the course of the trial and 1 month after the last administration of the drug, if they are surgically sterilized or menopausal.

Exclusion Criteria:

  • Prior malignancy.Subjects with a history of completely resected non-melanomatous skin carcinoma or successfully treated in situ carcinoma or indolent prostate cancer are eligible (even if they are receiving antihormonal therapy).
  • Central nervous system (CNS) metastases at baseline, with the exception of those subjects who have previously-treated CNS metastases are asymptomatic and have no requirement for steroids or enzyme-inducing anticonvulsants in the past 6 months.
  • Clinically significant gastrointestinal abnormalities that may increase the risk for gastrointestinal, 28 days prior to study treatment initiation.
  • Clinically significant gastrointestinal abnormalities that may affect absorption of investigational product including malabsorption syndrome, major resection of the stomach
  • Corrected QT interval (QTc) >480 milliseconds using Bazett's formula
  • History of myocardial infarction, unstable angina, symptomatic peripheral vascular disease or Class II,III or IV congestive heart failure, as defined by the New York Heart Association (NYHA) or cardiac angioplasty or stenting within the past 6 months
  • Newly-diagnosed hypertension or history of poorly controlled hypertension [defined as systolic blood pressure (SBP) of ≥140 millimeters of mercury (mmHg)or diastolic blood pressure (DBP) of ≥90mmHg].
  • History of cerebrovascular accident including transient ischemic attack(TIA),pulmonary embolism or untreated deep venous thrombosis(DVT) within the past 6 months.Subjects with recent DVT who have been treated with therapeutic anti-coagulating agents for at least 6 weeks are eligible
  • Major surgery or trauma within 28 days prior to first dose of study drug and/or presence of any non-healing wound, fracture,or ulcer (procedures such as catheter placement not considered to be major).
  • Evidence of active bleeding or bleeding diathesis.
  • Known endobronchial lesions and/or lesions infiltrating major pulmonary vessels that increase the risk of pulmonary hemorrhage
  • Recent hemoptysis (≥ ½ teaspoon of red blood within 8 weeks of first dose of study drug).
  • Any serious and/or unstable pre-existing medical,psychiatric, or other condition that could interfere with subject's safety,provision of informed consent,or compliance to study procedures.
  • Unable or unwilling to discontinue use of prohibited medications for at least 14 days or five half-lives of a drug(whichever is longer) prior to the first dose of study drug and for the duration of the study
  • Radiation therapy,surgery or tumor embolization within 14 days prior to the first dose of pazopanib
  • Administration of any non-oncologic investigational study drug within 30 days or 5 half lives whichever is longer prior to receiving the first dose of study treatment.
  • Any ongoing toxicity from prior anti-cancer therapy that is >Grade 1 and/or that is progressing in severity, except alopecia.
  • Pregnancy or lactation.

Sites / Locations

  • 2nd Dept of Internal Medicine, Agios Savvas Cancer Hospital
  • Dept of Medical Oncology, 251 General Air Force Hospital
  • 2nd Dept of Internal Medicine, General Hospital of Athens "Hippokratio"
  • Oncology Dept, 2nd Surgyc Clinic, Aretaieio Hospital
  • Oncology Section, Dept of Clinical Therapeutics, General Hospital of Athens "Alexandra"
  • Division of Oncology, 2nd Dept of Internal Medicine, Propaedeutic, University Hospital "Attikon"
  • 2nd Dept of Medical Oncology, Agii Anargiri Cancer Hospital
  • 3rd Dept of Medical Oncology, Agii Anargiri Cancer Hospital
  • 3rd Dept of Medical Oncology, Hygeia Hospital
  • 1st Dept of Medical Oncology, Metropolitan Hospital
  • 2nd Dept of Medical Oncology, Metropolitan Hospital
  • Dept of Medical Oncology, University Hospital of Heraklion
  • Dept of Medical Oncology, Ioannina University Hospital
  • Division of Oncology, Dept of Internal Medicine, University Hospital of Patras
  • Dept of Medical Oncology, Papageorgiou General Hospital
  • Dept of Medical Oncology, Thermi Clinic S.A
  • 2nd Dept of Medical Oncology, EUROMEDICA General Clinic of Thessaloniki

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Gemcitabine-Pazopanib

Arm Description

Gemcitabine 1000 mg/m2 administered intravenously on days 1 and 8 and Pazopanib 800 mg administered per os on days 1 to 21 every 21 days. Treatment with gemcitabine/pazopanib combination will continue until disease progression, appearance of significant toxicity, completion of 8 cycles or informed consent withdrawal. Upon completion of 8 treatment cycles with the combination, and in the absence of disease progression, administration of pazopanib monotherapy as maintenance treatment will be continued until disease progression, appearance of significant toxicity or informed consent withdrawal.

Outcomes

Primary Outcome Measures

Objective Response Rate (ORR) according to Response Evaluation Criteria in Solid Tumors (RECIST 1.1)
Imaging evaluation for the determination of response to treatment will be performed every 8 weeks

Secondary Outcome Measures

Evaluation of Progression-Free Survival (PFS)
Evaluation of 6-month Progression-Free Survival rate (6-month PFS rate)
The aim is to determine the rate of PFS in patients, at 6 months of treatment
Evaluation of Overall Survival (OS)
Assessment of safety and tolerability
Distribution of Adverse Events (AEs) according to severity grade. Evaluation of AEs will be performed every 21 days (per treatment cycle) throughout the course of treatment
Evaluation of Quality of Life (QoL)
Quality of Life Questionnaires will be filled out before treatment initiation, every 8 weeks and at the end of treatment
Evaluation of potential prognostic and/or predictive biomarkers in tissue and blood samples
The following biomarkers will be analyzed: In bioptic material: Stem Cell Factor (KIT) Vascular Endothelial Growth Factor Receptor-2 (VEGF-2) Vascular Endothelial Growth Factor Receptor-3 (VEGF-3) In peripheral blood/plasma: Interleukin 8 Interleukin 12 Hepatocyte growth factor There may be additions to the biomarkers to be analyzed, dependent on the clinical and bibliographical data

Full Information

First Posted
May 14, 2013
Last Updated
November 6, 2018
Sponsor
Hellenic Cooperative Oncology Group
Collaborators
GlaxoSmithKline
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1. Study Identification

Unique Protocol Identification Number
NCT01855724
Brief Title
Clinical Trial to Investigate the Efficacy of Treatment With Gemcitabine/Pazopanib in Patients With Biliary Tree Cancer
Official Title
Phase II Single-arm Study of First Line Treatment With Gemcitabine and Pazopanib in Patients With Inoperable Locally Advanced or Metastatic Biliary Tree Cancer (Cholangiocarcinoma or Gallbladder Carcinoma)
Study Type
Interventional

2. Study Status

Record Verification Date
September 2017
Overall Recruitment Status
Terminated
Study Start Date
June 28, 2013 (Actual)
Primary Completion Date
September 15, 2018 (Actual)
Study Completion Date
September 28, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Hellenic Cooperative Oncology Group
Collaborators
GlaxoSmithKline

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to determine whether gemcitabine and pazopanib are effective in the treatment of inoperable, locally advanced or metastatic biliary tree cancer (cholangiocarcinoma or gallbladder carcinoma).
Detailed Description
This is an open label, uncontrolled, multicenter, phase II study to evaluate the efficacy and safety of Gemcitabine/Pazopanib combination as 1st line treatment in patients with unresectable, locally advanced or metastatic biliary tree adenocarcinoma. A total of 46 patients will be included in the study. The patients will receive open label Gemcitabine 1000 mg/m2 intravenously on days 1 and 8 and Pazopanib 800 mg per os on days 1 to 21 every 21 days. Treatment with gemcitabine/pazopanib combination will continue until disease progression, appearance of significant toxicity, completion of 8 cycles or informed consent withdrawal. Upon completion of 8 treatment cycles with the combination, and in the absence of disease progression, administration of pazopanib monotherapy as maintenance treatment will be continued until disease progression, appearance of significant toxicity or informed consent withdrawal. Imaging assessments will be performed every 8 weeks

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cholangiocarcinoma, Gallbladder Carcinoma, Biliary Carcinoma

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Gemcitabine-Pazopanib
Arm Type
Experimental
Arm Description
Gemcitabine 1000 mg/m2 administered intravenously on days 1 and 8 and Pazopanib 800 mg administered per os on days 1 to 21 every 21 days. Treatment with gemcitabine/pazopanib combination will continue until disease progression, appearance of significant toxicity, completion of 8 cycles or informed consent withdrawal. Upon completion of 8 treatment cycles with the combination, and in the absence of disease progression, administration of pazopanib monotherapy as maintenance treatment will be continued until disease progression, appearance of significant toxicity or informed consent withdrawal.
Intervention Type
Drug
Intervention Name(s)
Gemcitabine-Pazopanib
Other Intervention Name(s)
Gemzar, Votrient
Primary Outcome Measure Information:
Title
Objective Response Rate (ORR) according to Response Evaluation Criteria in Solid Tumors (RECIST 1.1)
Description
Imaging evaluation for the determination of response to treatment will be performed every 8 weeks
Time Frame
At an average of 6 months for each patient
Secondary Outcome Measure Information:
Title
Evaluation of Progression-Free Survival (PFS)
Time Frame
PFS will be calculated from the date of treatment initiation to the date of disease progression or date of death, assessed up to 48 months
Title
Evaluation of 6-month Progression-Free Survival rate (6-month PFS rate)
Description
The aim is to determine the rate of PFS in patients, at 6 months of treatment
Time Frame
Assessed up to 6 months
Title
Evaluation of Overall Survival (OS)
Time Frame
OS will be calculated from the date of treatment initiation to the date of death from any cause, assessed up to 48 months.
Title
Assessment of safety and tolerability
Description
Distribution of Adverse Events (AEs) according to severity grade. Evaluation of AEs will be performed every 21 days (per treatment cycle) throughout the course of treatment
Time Frame
Assessed up to 48 months
Title
Evaluation of Quality of Life (QoL)
Description
Quality of Life Questionnaires will be filled out before treatment initiation, every 8 weeks and at the end of treatment
Time Frame
Assessed up to 9 months
Title
Evaluation of potential prognostic and/or predictive biomarkers in tissue and blood samples
Description
The following biomarkers will be analyzed: In bioptic material: Stem Cell Factor (KIT) Vascular Endothelial Growth Factor Receptor-2 (VEGF-2) Vascular Endothelial Growth Factor Receptor-3 (VEGF-3) In peripheral blood/plasma: Interleukin 8 Interleukin 12 Hepatocyte growth factor There may be additions to the biomarkers to be analyzed, dependent on the clinical and bibliographical data
Time Frame
Tumor blocks and blood samples will be collected at baseline

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects must provide written informed consent prior to performance of study-specific procedures or assessments,and must be willing to comply with treatment and follow up. Age ≥18 years Histologically confirmed diagnosis of inoperable,locally advanced or metastatic cholangiocarcinoma (adenocarcinoma of intrahepatic,proximal extrahepatic,distal extrahepatic,gallbladder adenocarcinoma and periampullary bile duct adenocarcinoma). Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1. Measurable disease criteria per RECIST v1.1. No prior chemotherapy or treatment with targeted therapy Formalin-fixed paraffin-embedded tumour and whole blood/plasma samples at diagnosis/study enrollment for biomarker studies. Adequate organ system function as specified in the protocol Female patients are allowed to participate provided they consent to avoid pregnancy throughout the course of the trial and 1 month after the last administration of the drug, if they are surgically sterilized or menopausal. Exclusion Criteria: Prior malignancy.Subjects with a history of completely resected non-melanomatous skin carcinoma or successfully treated in situ carcinoma or indolent prostate cancer are eligible (even if they are receiving antihormonal therapy). Central nervous system (CNS) metastases at baseline, with the exception of those subjects who have previously-treated CNS metastases are asymptomatic and have no requirement for steroids or enzyme-inducing anticonvulsants in the past 6 months. Clinically significant gastrointestinal abnormalities that may increase the risk for gastrointestinal, 28 days prior to study treatment initiation. Clinically significant gastrointestinal abnormalities that may affect absorption of investigational product including malabsorption syndrome, major resection of the stomach Corrected QT interval (QTc) >480 milliseconds using Bazett's formula History of myocardial infarction, unstable angina, symptomatic peripheral vascular disease or Class II,III or IV congestive heart failure, as defined by the New York Heart Association (NYHA) or cardiac angioplasty or stenting within the past 6 months Newly-diagnosed hypertension or history of poorly controlled hypertension [defined as systolic blood pressure (SBP) of ≥140 millimeters of mercury (mmHg)or diastolic blood pressure (DBP) of ≥90mmHg]. History of cerebrovascular accident including transient ischemic attack(TIA),pulmonary embolism or untreated deep venous thrombosis(DVT) within the past 6 months.Subjects with recent DVT who have been treated with therapeutic anti-coagulating agents for at least 6 weeks are eligible Major surgery or trauma within 28 days prior to first dose of study drug and/or presence of any non-healing wound, fracture,or ulcer (procedures such as catheter placement not considered to be major). Evidence of active bleeding or bleeding diathesis. Known endobronchial lesions and/or lesions infiltrating major pulmonary vessels that increase the risk of pulmonary hemorrhage Recent hemoptysis (≥ ½ teaspoon of red blood within 8 weeks of first dose of study drug). Any serious and/or unstable pre-existing medical,psychiatric, or other condition that could interfere with subject's safety,provision of informed consent,or compliance to study procedures. Unable or unwilling to discontinue use of prohibited medications for at least 14 days or five half-lives of a drug(whichever is longer) prior to the first dose of study drug and for the duration of the study Radiation therapy,surgery or tumor embolization within 14 days prior to the first dose of pazopanib Administration of any non-oncologic investigational study drug within 30 days or 5 half lives whichever is longer prior to receiving the first dose of study treatment. Any ongoing toxicity from prior anti-cancer therapy that is >Grade 1 and/or that is progressing in severity, except alopecia. Pregnancy or lactation.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Joseph Sgouros, MD
Organizational Affiliation
3rd Dept of Medical Oncology, Agii Anargiri Cancer Hospital
Official's Role
Study Chair
Facility Information:
Facility Name
2nd Dept of Internal Medicine, Agios Savvas Cancer Hospital
City
Athens
ZIP/Postal Code
11522
Country
Greece
Facility Name
Dept of Medical Oncology, 251 General Air Force Hospital
City
Athens
ZIP/Postal Code
11525
Country
Greece
Facility Name
2nd Dept of Internal Medicine, General Hospital of Athens "Hippokratio"
City
Athens
ZIP/Postal Code
11527
Country
Greece
Facility Name
Oncology Dept, 2nd Surgyc Clinic, Aretaieio Hospital
City
Athens
ZIP/Postal Code
11528
Country
Greece
Facility Name
Oncology Section, Dept of Clinical Therapeutics, General Hospital of Athens "Alexandra"
City
Athens
ZIP/Postal Code
11528
Country
Greece
Facility Name
Division of Oncology, 2nd Dept of Internal Medicine, Propaedeutic, University Hospital "Attikon"
City
Athens
ZIP/Postal Code
12462
Country
Greece
Facility Name
2nd Dept of Medical Oncology, Agii Anargiri Cancer Hospital
City
Athens
ZIP/Postal Code
14564
Country
Greece
Facility Name
3rd Dept of Medical Oncology, Agii Anargiri Cancer Hospital
City
Athens
ZIP/Postal Code
14564
Country
Greece
Facility Name
3rd Dept of Medical Oncology, Hygeia Hospital
City
Athens
ZIP/Postal Code
15123
Country
Greece
Facility Name
1st Dept of Medical Oncology, Metropolitan Hospital
City
Athens
ZIP/Postal Code
18547
Country
Greece
Facility Name
2nd Dept of Medical Oncology, Metropolitan Hospital
City
Athens
ZIP/Postal Code
18547
Country
Greece
Facility Name
Dept of Medical Oncology, University Hospital of Heraklion
City
Heraklion
ZIP/Postal Code
71110
Country
Greece
Facility Name
Dept of Medical Oncology, Ioannina University Hospital
City
Ioannina
ZIP/Postal Code
45500
Country
Greece
Facility Name
Division of Oncology, Dept of Internal Medicine, University Hospital of Patras
City
Patras
ZIP/Postal Code
26504
Country
Greece
Facility Name
Dept of Medical Oncology, Papageorgiou General Hospital
City
Thessaloniki
ZIP/Postal Code
56429
Country
Greece
Facility Name
Dept of Medical Oncology, Thermi Clinic S.A
City
Thessaloniki
ZIP/Postal Code
57001
Country
Greece
Facility Name
2nd Dept of Medical Oncology, EUROMEDICA General Clinic of Thessaloniki
City
Thessaloníki
ZIP/Postal Code
54645
Country
Greece

12. IPD Sharing Statement

Learn more about this trial

Clinical Trial to Investigate the Efficacy of Treatment With Gemcitabine/Pazopanib in Patients With Biliary Tree Cancer

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