First Line Treatment of Patients With Metastatic Pancreatic Adenocarcinoma. (GABRINOX)
Primary Purpose
Metastatic Pancreatic Adenocarcinoma
Status
Completed
Phase
Phase 1
Locations
France
Study Type
Interventional
Intervention
GEMBRAX
FOLFIRINOX
Sponsored by

About this trial
This is an interventional treatment trial for Metastatic Pancreatic Adenocarcinoma
Eligibility Criteria
Inclusion Criteria:
- Histologically or cytologically confirmed metastatic adenocarcinoma of the pancreas. The definitive diagnosis of metastatic pancreatic adenocarcinoma will be made by integrating the histopathological data within the context of the radiologic data.
- Initial diagnosis of metastatic disease must have occurred ≤6 weeks prior to inclusion in the study.
- One or more metastatic tumors measurable metastatic lesions by CT scan of the abdomen, pelvis and chest, or hepatic MRI and CT scan (abdomen, pelvis and chest) without injection, if patient is allergic to CT contrast media).
- No previous radiotherapy, surgery, chemotherapy or investigational therapy for the treatment of metastatic disease.
- Prior treatment with 5 FU or gemcitabine administered as a radiation sensitizer in the adjuvant setting is allowed, provided that at least 6 months have relapsed since completion of the last dose and no lingering toxicities are present.
- Eastern Cooperative Oncology Group (ECOG) performance status of ≤ 1.
- Males or females aged 18 to 75 years at the time of signing the Informed Consent Form (ICF).
- Adequate blood function at baseline (obtained within 14 days before start of study treatment)
- Adequate liver and renal function at baseline (obtained within 14 days before start of study treatment)
- Patient has no clinical significant abnormalities in urinalysis results (obtained ≤ 14 days before start of study treatment)
- Patient has acceptable coagulation values (obtained ≤14 days prior to the first administration of study drug)
- Patient should be asymptomatic for jaundice prior to the first administration of study drug (Day1). Significant or symptomatic amounts of ascites should be drained prior to Day 1.
- Pain symptoms should be stable and should not require modifications in analgesic management prior to Day 1 of treatment.
- Life expectancy ≥ 2 months
- Non-pregnant and non-lactating female. If a female patient is of child-bearing potential, as evidenced by regular menstrual periods, she must have a negative serum pregnancy test (β-hCG) documented 72 hours prior to randomization.
- If sexually active, the patient must agree to use contraception considered adequate and appropriate by the Investigator during the period of administration of study drug. In addition, male and female patients must utilize contraception after the end of treatment as recommended in the product's Summary of Product Characteristics or Prescribing Information provided in the study manual.
- Informed consent signed prior to any study specific procedures.
- Affiliated to the French National social security
Exclusion Criteria:
- Known brain metastases.
- Patient has only locally advanced disease.
- History of other malignancy in the last 5 years. Patients with prior history of in situ cancer or basal or squamous cell skin cancer are eligible. Patients with other malignancies are eligible if they were cured by surgery alone or surgery plus radiotherapy and have been continuously disease-free for at least 5 years.
- Patients having received cytotoxic doses of any other chemotherapy (than 5FU and gemcitabine) in the adjuvant setting.
- Peripheral sensory neuropathy ≥ grade 2 at the time of signing the ICF.
- Active and uncontrolled bacterial, viral, or fungal infection(s) requiring systemic therapy.
- Known historical or active infection with HIV.
- Major surgery, other than diagnostic surgery (i.e. surgery done to obtain a biopsy for diagnosis without removal of an organ), within 4 weeks prior to Day 1 of treatment in this study.
- History of allergy or hypersensitivity to any of the study drugs or any of their excipients, or the patient exhibits any of the events outlined in the Contraindications or Special Warnings and Precautions sections of the SmPCs or Prescribing Information.
- History of connective tissue disorders (e.g., lupus, scleroderma, arteritis nodosa).
- Patients with high cardiovascular risk, including, but not limited to, coronary stenting or myocardial infarction in the past year.
- History of Peripheral Artery Disease (e.g. claudication, Leo Buerger's disease).
- Serious medical risk factors involving any of the major organ systems, or serious psychiatric disorders, which could compromise the patient's safety or the study data integrity.
- Enrollment in any other clinical protocol within 4 weeks of signing the ICF.
- Patient is unwilling or unable to comply with study procedures, or is planning to take vacation for 7 or more consecutive days during the course of the study.
- Legal incapacity or limited legal capacity. Medical or psychological conditions not allowing the subject to complete the study or sign the consent.
Sites / Locations
- Institut regional du Cancer - Val d Aurelle
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Gembrax followed by Folfirinox
Arm Description
Gembrax: Albumin-bound paclitaxel followed by Gemcitabine Day 1,8,15 followed by 2 weeks of rest Folfirinox: Oxaliplatin, irinotecan, leucovorin, 5FU bolus and continuous
Outcomes
Primary Outcome Measures
Determination of the MTD
Phase I: Identify the maximum tolerated dose and the recommended phase II dose of first line treatment combining gemcitabine plus nab-paclitaxel followed by folfirinox in metatstatic pancreatic adenocarcinoma.
Phase II: Objective response rate of patients treated with this new combination
Secondary Outcome Measures
Overall survival
evaluate the safety profile
Full Information
NCT ID
NCT01964287
First Posted
August 5, 2013
Last Updated
December 30, 2020
Sponsor
Institut du Cancer de Montpellier - Val d'Aurelle
1. Study Identification
Unique Protocol Identification Number
NCT01964287
Brief Title
First Line Treatment of Patients With Metastatic Pancreatic Adenocarcinoma.
Acronym
GABRINOX
Official Title
Phase I-II Trial of Gemcitabine Plus Nab-paclitaxel (GemBrax) Followed by Folfirinox as First Line Treatment of Patients With Metastatic Pancreatic Adenocarcinoma.
Study Type
Interventional
2. Study Status
Record Verification Date
December 2020
Overall Recruitment Status
Completed
Study Start Date
September 24, 2013 (Actual)
Primary Completion Date
December 22, 2016 (Actual)
Study Completion Date
December 30, 2020 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Institut du Cancer de Montpellier - Val d'Aurelle
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
Based on conventional chemotherapy approach, data have indicated that the Folfirinox regimen is more effective and tolerate than the treatment by Gemcitabine alone in patients with metastatic pancreatic adenocarcinoma. A recent study combining gemcitabine and nab paclitaxel improve the objective response rate.
Primary objective of this study is to identify the maximun tolerated dose and the recommended phase II dose of first line treatment combining gemcitabine plus nab-paclitaxel followed by folfirinox in metastatic pancreatic adenocarcinoma.
Detailed Description
Estimated enrollment:
Phase I: 60 Phase II: 53
Study start Date: August 2013 Estimated study completion date: March 2016
Treatment:
Gembrax: albumin-bound paclitaxel over 30 minutes IV followed by Gemcitabine 10mg/m²/min IV on day 1, 8 and 15 followed by 2 weeks of rest Folfirinox: Oxaliplatin IV associated with LeucovorinIV. After the end of leucovorin administration, bolus injection of 5FU and subsequent continuous 5FU 46-hour infusion at day 29 and 43.
Day 1=Day 57
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metastatic Pancreatic Adenocarcinoma
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
78 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Gembrax followed by Folfirinox
Arm Type
Experimental
Arm Description
Gembrax:
Albumin-bound paclitaxel followed by Gemcitabine Day 1,8,15 followed by 2 weeks of rest
Folfirinox:
Oxaliplatin, irinotecan, leucovorin, 5FU bolus and continuous
Intervention Type
Drug
Intervention Name(s)
GEMBRAX
Other Intervention Name(s)
Albumin bound paclitaxel 125 mg/m², Gemcitabine 1000 mg/m²
Intervention Type
Drug
Intervention Name(s)
FOLFIRINOX
Other Intervention Name(s)
Oxaliplatin 85 mg/m², Irinotecan 180 mg/m², Leucovorin 200 mg/m², 5FU bolus 400mg/m², 5FU continuous 2400 mg/m²
Primary Outcome Measure Information:
Title
Determination of the MTD
Description
Phase I: Identify the maximum tolerated dose and the recommended phase II dose of first line treatment combining gemcitabine plus nab-paclitaxel followed by folfirinox in metatstatic pancreatic adenocarcinoma.
Phase II: Objective response rate of patients treated with this new combination
Time Frame
18 months
Secondary Outcome Measure Information:
Title
Overall survival
Description
evaluate the safety profile
Time Frame
12 months
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:
Histologically or cytologically confirmed metastatic adenocarcinoma of the pancreas. The definitive diagnosis of metastatic pancreatic adenocarcinoma will be made by integrating the histopathological data within the context of the radiologic data.
Initial diagnosis of metastatic disease must have occurred ≤6 weeks prior to inclusion in the study.
One or more metastatic tumors measurable metastatic lesions by CT scan of the abdomen, pelvis and chest, or hepatic MRI and CT scan (abdomen, pelvis and chest) without injection, if patient is allergic to CT contrast media).
No previous radiotherapy, surgery, chemotherapy or investigational therapy for the treatment of metastatic disease.
Prior treatment with 5 FU or gemcitabine administered as a radiation sensitizer in the adjuvant setting is allowed, provided that at least 6 months have relapsed since completion of the last dose and no lingering toxicities are present.
Eastern Cooperative Oncology Group (ECOG) performance status of ≤ 1.
Males or females aged 18 to 75 years at the time of signing the Informed Consent Form (ICF).
Adequate blood function at baseline (obtained within 14 days before start of study treatment)
Adequate liver and renal function at baseline (obtained within 14 days before start of study treatment)
Patient has no clinical significant abnormalities in urinalysis results (obtained ≤ 14 days before start of study treatment)
Patient has acceptable coagulation values (obtained ≤14 days prior to the first administration of study drug)
Patient should be asymptomatic for jaundice prior to the first administration of study drug (Day1). Significant or symptomatic amounts of ascites should be drained prior to Day 1.
Pain symptoms should be stable and should not require modifications in analgesic management prior to Day 1 of treatment.
Life expectancy ≥ 2 months
Non-pregnant and non-lactating female. If a female patient is of child-bearing potential, as evidenced by regular menstrual periods, she must have a negative serum pregnancy test (β-hCG) documented 72 hours prior to randomization.
If sexually active, the patient must agree to use contraception considered adequate and appropriate by the Investigator during the period of administration of study drug. In addition, male and female patients must utilize contraception after the end of treatment as recommended in the product's Summary of Product Characteristics or Prescribing Information provided in the study manual.
Informed consent signed prior to any study specific procedures.
Affiliated to the French National social security
Exclusion Criteria:
Known brain metastases.
Patient has only locally advanced disease.
History of other malignancy in the last 5 years. Patients with prior history of in situ cancer or basal or squamous cell skin cancer are eligible. Patients with other malignancies are eligible if they were cured by surgery alone or surgery plus radiotherapy and have been continuously disease-free for at least 5 years.
Patients having received cytotoxic doses of any other chemotherapy (than 5FU and gemcitabine) in the adjuvant setting.
Peripheral sensory neuropathy ≥ grade 2 at the time of signing the ICF.
Active and uncontrolled bacterial, viral, or fungal infection(s) requiring systemic therapy.
Known historical or active infection with HIV.
Major surgery, other than diagnostic surgery (i.e. surgery done to obtain a biopsy for diagnosis without removal of an organ), within 4 weeks prior to Day 1 of treatment in this study.
History of allergy or hypersensitivity to any of the study drugs or any of their excipients, or the patient exhibits any of the events outlined in the Contraindications or Special Warnings and Precautions sections of the SmPCs or Prescribing Information.
History of connective tissue disorders (e.g., lupus, scleroderma, arteritis nodosa).
Patients with high cardiovascular risk, including, but not limited to, coronary stenting or myocardial infarction in the past year.
History of Peripheral Artery Disease (e.g. claudication, Leo Buerger's disease).
Serious medical risk factors involving any of the major organ systems, or serious psychiatric disorders, which could compromise the patient's safety or the study data integrity.
Enrollment in any other clinical protocol within 4 weeks of signing the ICF.
Patient is unwilling or unable to comply with study procedures, or is planning to take vacation for 7 or more consecutive days during the course of the study.
Legal incapacity or limited legal capacity. Medical or psychological conditions not allowing the subject to complete the study or sign the consent.
Facility Information:
Facility Name
Institut regional du Cancer - Val d Aurelle
City
Montpellier
ZIP/Postal Code
34298
Country
France
12. IPD Sharing Statement
Learn more about this trial
First Line Treatment of Patients With Metastatic Pancreatic Adenocarcinoma.
We'll reach out to this number within 24 hrs