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Biological Effect of Nab-paclitaxel Combined to Gemcitabine in Metastatic Pancreatic Cancer (MOAnab1)

Primary Purpose

Pancreatic Adenocarcinoma

Status
Completed
Phase
Phase 1
Locations
France
Study Type
Interventional
Intervention
Nab-paclitaxel + Gemcitabine
Sponsored by
Institut Paoli-Calmettes
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pancreatic Adenocarcinoma focused on measuring pancreatic adenocarcinoma, liver metastases

Eligibility Criteria

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

Inclusion Criteria:

  1. Age > 18 years
  2. Suspicion of pancreatic adenocarcinoma
  3. With liver measurable metastases
  4. Primary tumor non resected
  5. First line systemic treatment
  6. Correct haematological parameters
  7. Adequate Blood chemistry levels
  8. Life expectancy ≥ 2 months
  9. PS: 0 - 2
  10. Affiliation to French National social security or beneficiary
  11. Signed informed consent.
  12. Female patients must be surgically sterile, or be postmenopausal, or must commit to using reliable and appropriate methods of contraception during the study and during at least three months after the end of study treatment. All female patients with reproductive potential must have a negative pregnancy test (β HCG) within 72 hours prior to starting abraxane treatment. Breastfeeding is not allowed. Male patients must agree to use effective contraception in addition to having their partner use a contraceptive method as well during the trial and during at least six months after the end of the study treatment,

Exclusion Criteria:

  1. Previous radiotherapy of the tumor
  2. Patient has only locally advanced disease.
  3. Previous treatment with gemcitabine
  4. Active infection or severe concomitant disease
  5. Serious Peripheral neuropathy
  6. Known hypersensitivity or contraindication to any component of study drug formulation.
  7. Pregnant or breastfeeding women
  8. Other experimental treatment
  9. History of 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.
  10. Known brain metastases, unless previously treated and well-controlled for at least 3 months (defined as clinically stable, no edema, no steroids and stable in 2 scans at least 4 weeks apart).
  11. Patient has 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
  12. Patient with a history of interstitial lung disease, history of slowly progressive dyspnea and unproductive cough, sarcoidosis, silicosis, idiopathic pulmonary fibrosis, pulmonary, Hypersensitivity pneumonitis or multiple allergies
  13. Patient uses Coumadin
  14. 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 Paoli-Calmettes

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Nab-paclitaxel + Gemcitabine

Arm Description

Gemcitabine 1 g/m² IV infusion over 30 minutes at D1-D8-D15 every 28 days in combination with Nab-paclitaxel 125 mg/m² IV infusion over 30 minutes at D1-D8-D15 every 28 days The patients will receive 2 cycles of treatment every 28 days

Outcomes

Primary Outcome Measures

Vascularization parameters of pancreatic carcinoma
Vascularization parameters of pancreatic carcinoma: on the primary tumor assessed by contrast-enhanced harmonic endoscopic ultrasonography (EUS) and on liver metastases assessed by contrast enhanced ultrasonography (ceUS)

Secondary Outcome Measures

Stiffness
Stiffness will be assessed in the primary tumor using ratio-elastography
Density
Density will be assessed in liver metastases on CTscan using density measurement before injection of contrast agent and after injection during the portal phase (80 sec post IV)
Safety
Adverse events of the treatment will be evaluated according to the Common Toxicity Criteria for Adverse Events (CTCAE version 4.03)
Response rate
Response rate will be evaluated according to RECIST V1.1 and CHOI criteria

Full Information

First Posted
June 24, 2014
Last Updated
March 27, 2017
Sponsor
Institut Paoli-Calmettes
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1. Study Identification

Unique Protocol Identification Number
NCT02174887
Brief Title
Biological Effect of Nab-paclitaxel Combined to Gemcitabine in Metastatic Pancreatic Cancer
Acronym
MOAnab1
Official Title
A Unicentric, Open Label, Mechanism of Action Trial, on the Biological Effect of Nab-paclitaxel Combined to Gemcitabine, in Patients With Metastatic Pancreatic Adenocarcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
March 2017
Overall Recruitment Status
Completed
Study Start Date
September 2014 (Actual)
Primary Completion Date
October 2016 (Actual)
Study Completion Date
October 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Institut Paoli-Calmettes

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The prognostic of metastatic pancreatic adenocarcinoma is dismal and the treatment gold standard since the end of the 90s' is gemcitabine; unfortunately all trials testing combinations of gemcitabine with chemotherapeutic agents or targeted agents had failed to demonstrate any superiority over gemcitabine monotherapy. In a recently published phase I/II study of combination of gemcitabine plus nab-paclitaxel in patients with metastatic pancreatic adenocarcinoma (PAC), the combination gave an impressive response rate of 48% (Gemcitabine 1g/m² and nab-paclitaxel 125 mg/m² once a week for 3 weeks, every 4 weeks). The safety profile was correct (fatigue, sensory neuropathy, nausea, haematological side effects). This efficacy can be related to an improvement of gemcitabine delivery to the tumor bed, as shown on preclinical studies: the response rate in xenografts was better with the combination; this improvement was associated with an increase of intratumoral gemcitabine concentration in mice receiving the combination when compared to mice receiving gemcitabine alone. This might be associated to modifications of peritumoral stroma with reduction of stromal content and increase in dilated vessels. The aim of this study is to evaluate if the combination of nab-paclitaxel plus gemcitabine induces a modification in vascularization of pancreatic adenocarcinoma on the primary tumor and of liver metastases after 2 cycles of treatment by comparison to baseline.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pancreatic Adenocarcinoma
Keywords
pancreatic adenocarcinoma, liver metastases

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
19 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Nab-paclitaxel + Gemcitabine
Arm Type
Experimental
Arm Description
Gemcitabine 1 g/m² IV infusion over 30 minutes at D1-D8-D15 every 28 days in combination with Nab-paclitaxel 125 mg/m² IV infusion over 30 minutes at D1-D8-D15 every 28 days The patients will receive 2 cycles of treatment every 28 days
Intervention Type
Drug
Intervention Name(s)
Nab-paclitaxel + Gemcitabine
Intervention Description
Gemcitabine 1 g/m² IV infusion over 30 minutes at D1-D8-D15 every 28 days in combination with Nab-paclitaxel 125 mg/m² IV infusion over 30 minutes at D1-D8-D15 every 28 days The patients will receive 2 cycles of treatment every 28 days:
Primary Outcome Measure Information:
Title
Vascularization parameters of pancreatic carcinoma
Description
Vascularization parameters of pancreatic carcinoma: on the primary tumor assessed by contrast-enhanced harmonic endoscopic ultrasonography (EUS) and on liver metastases assessed by contrast enhanced ultrasonography (ceUS)
Time Frame
2 months
Secondary Outcome Measure Information:
Title
Stiffness
Description
Stiffness will be assessed in the primary tumor using ratio-elastography
Time Frame
2 months
Title
Density
Description
Density will be assessed in liver metastases on CTscan using density measurement before injection of contrast agent and after injection during the portal phase (80 sec post IV)
Time Frame
2 months
Title
Safety
Description
Adverse events of the treatment will be evaluated according to the Common Toxicity Criteria for Adverse Events (CTCAE version 4.03)
Time Frame
2 months
Title
Response rate
Description
Response rate will be evaluated according to RECIST V1.1 and CHOI criteria
Time Frame
2 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age > 18 years Suspicion of pancreatic adenocarcinoma With liver measurable metastases Primary tumor non resected First line systemic treatment Correct haematological parameters Adequate Blood chemistry levels Life expectancy ≥ 2 months PS: 0 - 2 Affiliation to French National social security or beneficiary Signed informed consent. Female patients must be surgically sterile, or be postmenopausal, or must commit to using reliable and appropriate methods of contraception during the study and during at least three months after the end of study treatment. All female patients with reproductive potential must have a negative pregnancy test (β HCG) within 72 hours prior to starting abraxane treatment. Breastfeeding is not allowed. Male patients must agree to use effective contraception in addition to having their partner use a contraceptive method as well during the trial and during at least six months after the end of the study treatment, Exclusion Criteria: Previous radiotherapy of the tumor Patient has only locally advanced disease. Previous treatment with gemcitabine Active infection or severe concomitant disease Serious Peripheral neuropathy Known hypersensitivity or contraindication to any component of study drug formulation. Pregnant or breastfeeding women Other experimental treatment History of 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. Known brain metastases, unless previously treated and well-controlled for at least 3 months (defined as clinically stable, no edema, no steroids and stable in 2 scans at least 4 weeks apart). Patient has 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 Patient with a history of interstitial lung disease, history of slowly progressive dyspnea and unproductive cough, sarcoidosis, silicosis, idiopathic pulmonary fibrosis, pulmonary, Hypersensitivity pneumonitis or multiple allergies Patient uses Coumadin Legal incapacity or limited legal capacity. Medical or psychological conditions not allowing the subject to complete the study or sign the consent.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jean-Luc RAOUL, MD
Organizational Affiliation
Institut Paoli-Calmettes
Official's Role
Principal Investigator
Facility Information:
Facility Name
Institut Paoli-Calmettes
City
Marseille
ZIP/Postal Code
13009
Country
France

12. IPD Sharing Statement

Links:
URL
http://www.institutpaolicalmettes.fr/
Description
official web site of the sponsor

Learn more about this trial

Biological Effect of Nab-paclitaxel Combined to Gemcitabine in Metastatic Pancreatic Cancer

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