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A Dose Escalation Safety Study of Locally-Delivered Gemcitabine in Pancreatic Cancer

Primary Purpose

Pancreatic Cancer

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Gemcitabine, local delivery
Sponsored by
RenovoRx
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Pancreatic Cancer focused on measuring pancreatic cancer, unresectable, gemcitabine, device, local delivery, chemoembolization

Eligibility Criteria

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

Inclusion Criteria:

Subjects will be eligible to participate in the study if all of the following criteria are met:

  1. Males and female subjects 18 years of age and older.
  2. Subjects with locally advanced unresectable adenocarcinoma (cytological or histologic proof required) of the pancreas.. Patients with islet cell tumors are not eligible.
  3. No clinical evidence of distant metastases, excluding single liver metastasis and local lymph node involvement. Patients with more than a single liver metastasis and/or other metastases who have already failed systemic chemotherapy and/or are on a break from systemic chemotherapy who are not surgical candidates can also qualify for this study.
  4. Karnofsky Performance Status (KPS) >60.
  5. Adequate renal, and bone marrow function described as:

    1. Leukocytes ≥ 3,000/uL
    2. Absolute neutrophil count ≥ 1,500/uL
    3. Platelets ≥100,000/uL
    4. Serum creatinine ≥2.0 mg/dL. Creatinine less than or equal to 1.5 mg/dL or creatinine clearance greater than 40 mL/min/1.73 m2 for patients with creatinine levels above institutional normal, as calculated by the Cockcroft Gault formula.
    5. Hemoglobin ≥8.5 g/dL (may be receiving supportive therapy)
    6. PT/PTT (WNL)
  6. Adequate Hepatic function (endoscopic or percutaneous drainage as needed) described as:

    1. Total bilirubin ≤3 times UNL (less than or equal to 2 mg/dL)
    2. AST (SGOT)/ALT (SGPT) ≤ 5 times ULN or ≤5 times ULN in the setting of liver metastases.
    3. Lipase and Amylase within normal limits.
  7. Capable of understanding the purpose and risks of the study and willing to provide written informed consent and to comply with the procedures

Exclusion Criteria:

Subjects will be excluded from participation in the study if any of the following criteria are met:

  1. Have a known sensitivity to gemcitabine.
  2. Identification of metastatic disease, with the exception of single liver metastases or local lymph node involvement. Patients with more than a single liver metastasis and/or other metastases who have already failed systemic chemotherapy and/or are on a break from systemic chemotherapy who are not surgical candidates can also qualify for this study.
  3. Evidence of coagulopathy.
  4. Inability or unwillingness to comply with study procedures and/or follow-up procedures.
  5. Evidence of infection or other coexisting medical condition, which in the opinion of the investigator would preclude administration of gemcitabine.
  6. Patients with uncontrolled congestive heart failure, unstable angina and myocardial infarction within 3 months.
  7. Female patient who is pregnant, nursing or planning on becoming pregnant.
  8. Current enrollment and participation in another clinical study or prior exposure to an investigational agent within 12 weeks or 5 half-lives (whichever is longer) of anticipated dosing on Day 1 of this study.
  9. Have known brain metastases.
  10. Have had any major surgery within four weeks of enrollment.
  11. Have any clinically detectable ascites.
  12. Have uncontrolled concomitant illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, or cardiac arrhythmia.
  13. Have serious medical or psychiatric illness that could, in the Investigator's opinion, potentially interfere with the completion of treatment according to this protocol.
  14. Other invasive malignancies within the past 3 years (with the exception of non-melanoma skin cancers, non-invasive bladder cancer or prostate cancer) not approved by the Medical Monitor (contact MM in event of prior diagnosis with malignancy to discuss enrollment status).
  15. Have had any chemotherapy or systemic corticosteroids within 2 weeks of study entry.
  16. Have acquired, hereditary or congenital immunodeficiency's including cellular immunodeficiencies, hypogammaglobulinemia and dysgammaglobulinemia or hepatitis.
  17. Have a prior history of a documented hemolytic event.
  18. Is HIV-positive or Hepatitis positive.

Sites / Locations

  • El Camino Hospital, Oncology
  • Florida Hospital

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Other

Other

Other

Other

Arm Label

Gemcitabine, Local Delivery (Dose 1)

Gemcitabine, Local Delivery (Dose 2)

Gemcitabine, Local Delivery (Dose 3)

Gemcitabine, Local Delivery (Dose 4)

Arm Description

Gemcitabine; 1 cycle, two doses per cycle; 250mg/m2 dose

Gemcitabine; 1 cycle, two doses per cycle; 500mg/m2 dose

Gemcitabine; 1 cycle, two doses per cycle; 750mg/m2 dose

Gemcitabine; 1 cycle, two doses per cycle; 1000mg/m2 dose

Outcomes

Primary Outcome Measures

Determine the Maximum Tolerated Dose of Gemcitabine to be Delivered Locally to the Pancreas
Maximum Tolerated Dose (MTD) of gemcitabine administered intra-arterially to the pancreatic tumor(s) using the RenovoCath™ RC120 catheter. One week post treatment, toxicities will be assessed to determine if there is a pre-defined Dose Limiting Toxicity necessitating dose stopping or holding.

Secondary Outcome Measures

CA19-9 Tumor Reduction
Measurements of CA19-9 tumor marker are measured pre-treatment and at various time points (starting with one week) post treatment.

Full Information

First Posted
September 8, 2014
Last Updated
April 14, 2021
Sponsor
RenovoRx
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1. Study Identification

Unique Protocol Identification Number
NCT02237157
Brief Title
A Dose Escalation Safety Study of Locally-Delivered Gemcitabine in Pancreatic Cancer
Official Title
A Dose Escalation Safety Study of Locally-Delivered (Intra-Arterial) Gemcitabine in Unresectable Adenocarcinoma of the Pancreas
Study Type
Interventional

2. Study Status

Record Verification Date
April 2021
Overall Recruitment Status
Completed
Study Start Date
March 2015 (undefined)
Primary Completion Date
September 2016 (Actual)
Study Completion Date
September 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
RenovoRx

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
A dose escalation, safety study of local (intra-arterially) delivered gemcitabine to the pancreas using the RenovoCath R120 catheter to determine the maximum tolerated dose.
Detailed Description
Patients diagnosed with unresectable pancreatic cancer who may or may not have had prior chemotherapy or radiation therapy may be eligible to enroll in this dose escalation study to determine the maximum tolerated dose of gemcitabine to be delivered locally to the pancreatic tumors using the RenovoCath R120 catheter. Patients enrolled may receive up to 8 catheterizations for delivering gemcitabine directly to the pancreatic tumors starting at a reduced dose( 1/4 of standard i.v. gemcitabine dose), then every two doses, increase the dose by 25% if there are no toxicities up to a maximum dose of 1000 mg/m2. There are four cycles, with two doses per cycle. Imaging studies will be conducted as well as assessment for standard, myelosuppresive and gastric toxicities will be assessed. Pain will also be measured throughout the study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pancreatic Cancer
Keywords
pancreatic cancer, unresectable, gemcitabine, device, local delivery, chemoembolization

7. Study Design

Primary Purpose
Other
Study Phase
Phase 1
Interventional Study Model
Sequential Assignment
Model Description
Subjects receive a gradual increase of drug dose, until the full systemic dose is administered. Cycle 1: 250mg/m2. Cycle 2: 500mg/m2. Cycle 3: 750mg/m2. Cycle 4: 1000mg/m2.
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
20 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Gemcitabine, Local Delivery (Dose 1)
Arm Type
Other
Arm Description
Gemcitabine; 1 cycle, two doses per cycle; 250mg/m2 dose
Arm Title
Gemcitabine, Local Delivery (Dose 2)
Arm Type
Other
Arm Description
Gemcitabine; 1 cycle, two doses per cycle; 500mg/m2 dose
Arm Title
Gemcitabine, Local Delivery (Dose 3)
Arm Type
Other
Arm Description
Gemcitabine; 1 cycle, two doses per cycle; 750mg/m2 dose
Arm Title
Gemcitabine, Local Delivery (Dose 4)
Arm Type
Other
Arm Description
Gemcitabine; 1 cycle, two doses per cycle; 1000mg/m2 dose
Intervention Type
Drug
Intervention Name(s)
Gemcitabine, local delivery
Other Intervention Name(s)
Gemzar
Intervention Description
Intra-arterial targeted drug delivery
Primary Outcome Measure Information:
Title
Determine the Maximum Tolerated Dose of Gemcitabine to be Delivered Locally to the Pancreas
Description
Maximum Tolerated Dose (MTD) of gemcitabine administered intra-arterially to the pancreatic tumor(s) using the RenovoCath™ RC120 catheter. One week post treatment, toxicities will be assessed to determine if there is a pre-defined Dose Limiting Toxicity necessitating dose stopping or holding.
Time Frame
1 week post treatment
Secondary Outcome Measure Information:
Title
CA19-9 Tumor Reduction
Description
Measurements of CA19-9 tumor marker are measured pre-treatment and at various time points (starting with one week) post treatment.
Time Frame
1 week after treatment

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects will be eligible to participate in the study if all of the following criteria are met: Males and female subjects 18 years of age and older. Subjects with locally advanced unresectable adenocarcinoma (cytological or histologic proof required) of the pancreas.. Patients with islet cell tumors are not eligible. No clinical evidence of distant metastases, excluding single liver metastasis and local lymph node involvement. Patients with more than a single liver metastasis and/or other metastases who have already failed systemic chemotherapy and/or are on a break from systemic chemotherapy who are not surgical candidates can also qualify for this study. Karnofsky Performance Status (KPS) >60. Adequate renal, and bone marrow function described as: Leukocytes ≥ 3,000/uL Absolute neutrophil count ≥ 1,500/uL Platelets ≥100,000/uL Serum creatinine ≥2.0 mg/dL. Creatinine less than or equal to 1.5 mg/dL or creatinine clearance greater than 40 mL/min/1.73 m2 for patients with creatinine levels above institutional normal, as calculated by the Cockcroft Gault formula. Hemoglobin ≥8.5 g/dL (may be receiving supportive therapy) PT/PTT (WNL) Adequate Hepatic function (endoscopic or percutaneous drainage as needed) described as: Total bilirubin ≤3 times UNL (less than or equal to 2 mg/dL) AST (SGOT)/ALT (SGPT) ≤ 5 times ULN or ≤5 times ULN in the setting of liver metastases. Lipase and Amylase within normal limits. Capable of understanding the purpose and risks of the study and willing to provide written informed consent and to comply with the procedures Exclusion Criteria: Subjects will be excluded from participation in the study if any of the following criteria are met: Have a known sensitivity to gemcitabine. Identification of metastatic disease, with the exception of single liver metastases or local lymph node involvement. Patients with more than a single liver metastasis and/or other metastases who have already failed systemic chemotherapy and/or are on a break from systemic chemotherapy who are not surgical candidates can also qualify for this study. Evidence of coagulopathy. Inability or unwillingness to comply with study procedures and/or follow-up procedures. Evidence of infection or other coexisting medical condition, which in the opinion of the investigator would preclude administration of gemcitabine. Patients with uncontrolled congestive heart failure, unstable angina and myocardial infarction within 3 months. Female patient who is pregnant, nursing or planning on becoming pregnant. Current enrollment and participation in another clinical study or prior exposure to an investigational agent within 12 weeks or 5 half-lives (whichever is longer) of anticipated dosing on Day 1 of this study. Have known brain metastases. Have had any major surgery within four weeks of enrollment. Have any clinically detectable ascites. Have uncontrolled concomitant illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, or cardiac arrhythmia. Have serious medical or psychiatric illness that could, in the Investigator's opinion, potentially interfere with the completion of treatment according to this protocol. Other invasive malignancies within the past 3 years (with the exception of non-melanoma skin cancers, non-invasive bladder cancer or prostate cancer) not approved by the Medical Monitor (contact MM in event of prior diagnosis with malignancy to discuss enrollment status). Have had any chemotherapy or systemic corticosteroids within 2 weeks of study entry. Have acquired, hereditary or congenital immunodeficiency's including cellular immunodeficiencies, hypogammaglobulinemia and dysgammaglobulinemia or hepatitis. Have a prior history of a documented hemolytic event. Is HIV-positive or Hepatitis positive.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jiali Li, MD
Organizational Affiliation
El Camino Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
El Camino Hospital, Oncology
City
Mountain View
State/Province
California
ZIP/Postal Code
94040
Country
United States
Facility Name
Florida Hospital
City
Tampa
State/Province
Florida
ZIP/Postal Code
33613
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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A Dose Escalation Safety Study of Locally-Delivered Gemcitabine in Pancreatic Cancer

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