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Molecularly Target Therapy With GEMOX in Advanced or Recurrent Extrahepatic Cholangiocarcinoma and Gallbladder Carcinoma

Primary Purpose

Cholangiocarcinoma of the Extrahepatic Bile Duct, Gallbladder Cancer

Status
Unknown status
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
biological test
GEMOX
Cetuximab
Trastuzumab
Gefitinib
Lapatinib
Everolimus
Sorafenib
Crizotinib
Sponsored by
Shanghai Jiao Tong University School of Medicine
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Cholangiocarcinoma of the Extrahepatic Bile Duct

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Chinese;
  • Stable vital signs, KPS≥60;
  • Patients have a diagnosis of advanced or recurrent metastatic extrahepatic cholangiocarcinoma or gallbladder carcinoma by histopathology or cytopathology, who are not suitable for radical surgery or have progressed R1 resection or palliative surgery;
  • Adequate fresh tumor tissue for genome sequencing and immuno-histochemistry test; harboring mutations or abnormal activation of erb-b2 receptor tyrosine kinase signal pathway components;
  • At least one measurable and evaluable site of disease according to the RECIST criteria version 1.1;
  • Life expectancy of more than 12 weeks;
  • Adequate hepatic, hematologic and renal functions(ALT≤10×upper limit of normal (ULN), AST≤10×ULN, the Child-Pugh classification for class A or B, white blood cells≥3×10^9/L, neutrophils≥1.5×10^9/L, platelets≥80×10^9/L , hemoglobin ≥ 90g/L, creatinine clearance rate≥60ml/min;
  • Volunteer for this study, have written informed consent and have good Patient compliance;
  • Female patients of childbearing potential and their mates agree to avoid pregnancy.

Exclusion Criteria:

  • Have received following treatment before this study:

    1. Anti-tumor molecular target therapy; anti-tumor chemotherapy in 6 months;
    2. lesions have been treated by irradiation;
    3. participate in other therapeutic or interventional clinical trials.
  • Have central nervous system metastasis;
  • History of other malignancies except carcinoma in-situ of uterine cervix, cured basal cell carcinoma of skin and other malignancies for more than 5 years;
  • Have symptomatic ascites and need for treatment;
  • Have serious concurrent illness including, but not limited to

    1. uncontrolled congestive heart failure(NYHA classification grade III or IV), unstable angina pectoris, unstable cardiac arrhythmias, uncontrolled moderate or serious hypertension(systolic blood pressure >21.3 Kpa or diastolic blood pressure >13.3 Kpa);
    2. ongoing or active serious infection;
    3. uncontrolled diabetes mellitus;
    4. psychiatric illness which potentially hamper the ability to willingly give written informed consent and compliance with the study protocol;
    5. HIV infection;
    6. other serious illness considered not suitable for this study by investigators.
  • be allergic or have contraindications to target medicines involved in this study, gemcitabine or oxaliplatin.

Sites / Locations

  • Xinhua HospitalRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Other

Arm Label

target therapy

GEMOX

Arm Description

The patients wil receive conventional chemotherapy(GEMOX) combined with target agents according to the result of genomic and proteomic profiling of tumor tissue.

The patients wil receive conventional chemotherapy(GEMOX).

Outcomes

Primary Outcome Measures

Progression Free Survival
From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 1 year. The progression is defined consistent with Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 criteria for solid tumors.

Secondary Outcome Measures

Overall survival
Objective Response Rate
Objective Response Rate is defined as the percentage of patients with a complete or partial response to treatment, consistent with RECIST version 1.1 criteria for solid tumors.
Disease Control Rate
Disease Control Rate is defined as the percentage of patients with a complete or partial response to treatment or stable disease, consistent with RECIST version 1.1 criteria for solid tumors.
percentage of patients with Clinical Benefit Response
Composite measure based on patient-reported pain (per Faces pain scale revised), patient-reported pain medication, Karnofsky performance status(KPS), and weight. Clinical benefit is indicated by either:(a) improvement in pain (less pain intensity with stable or decreased pain medication; or less pain medication with stable or decreased pain intensity) with stable or improved KPS; or (b) improvement in KPS with stable or improved pain.With stable for KPS and pain, clinical benefit may be indicated with an observation of positive weight change. Clinical benefit response (CBR) was classified weekly and a patient was considered a clinical benefit responder if clinical benefit was observed and maintained over a 4 week period.

Full Information

First Posted
July 13, 2016
Last Updated
May 4, 2018
Sponsor
Shanghai Jiao Tong University School of Medicine
Collaborators
Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Ruijin Hospital, RenJi Hospital, Eastern Hepatobiliary Surgery Hospital, Huashan Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT02836847
Brief Title
Molecularly Target Therapy With GEMOX in Advanced or Recurrent Extrahepatic Cholangiocarcinoma and Gallbladder Carcinoma
Official Title
A Multicentre, Open-label, Randomised, Controlled Study of Molecularly Precision Target Therapy Based on Tumor Molecular Profiling With GEMOX in Advanced or Recurrent Extrahepatic Cholangiocarcinoma and Gallbladder Carcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
May 2018
Overall Recruitment Status
Unknown status
Study Start Date
July 2016 (undefined)
Primary Completion Date
December 2019 (Anticipated)
Study Completion Date
December 2020 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Shanghai Jiao Tong University School of Medicine
Collaborators
Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Ruijin Hospital, RenJi Hospital, Eastern Hepatobiliary Surgery Hospital, Huashan Hospital

4. Oversight

5. Study Description

Brief Summary
The purpose of this study is to evaluate the feasibility, efficacy and safety of target therapy according to genomic and proteomic profiling combined with GEMOX in advanced or recurrent extrahepatic cholangiocarcinoma and gallbladder carcinoma.
Detailed Description
Genomic profiling studies the deoxyribonucleic acid (DNA) of a tumor to detect genetic changes or abnormalities. immuno-histochemistry tests reveal the abnormal activation status of signal pathways involved in study.These information will be used to recommend target therapy which may be more likely to result in a beneficial response.Patients will receive target anti-tumor agents according to the result of genomic and proteomic profiling.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cholangiocarcinoma of the Extrahepatic Bile Duct, Gallbladder Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
152 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
target therapy
Arm Type
Experimental
Arm Description
The patients wil receive conventional chemotherapy(GEMOX) combined with target agents according to the result of genomic and proteomic profiling of tumor tissue.
Arm Title
GEMOX
Arm Type
Other
Arm Description
The patients wil receive conventional chemotherapy(GEMOX).
Intervention Type
Procedure
Intervention Name(s)
biological test
Intervention Description
mutation and signal pathway activation status analysis
Intervention Type
Drug
Intervention Name(s)
GEMOX
Intervention Description
Conventional chemotherapy:gemcitabine and oxaliplatin
Intervention Type
Drug
Intervention Name(s)
Cetuximab
Intervention Type
Drug
Intervention Name(s)
Trastuzumab
Intervention Type
Drug
Intervention Name(s)
Gefitinib
Intervention Type
Drug
Intervention Name(s)
Lapatinib
Intervention Type
Drug
Intervention Name(s)
Everolimus
Intervention Type
Drug
Intervention Name(s)
Sorafenib
Intervention Type
Drug
Intervention Name(s)
Crizotinib
Primary Outcome Measure Information:
Title
Progression Free Survival
Description
From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 1 year. The progression is defined consistent with Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 criteria for solid tumors.
Time Frame
up to 1 year
Secondary Outcome Measure Information:
Title
Overall survival
Time Frame
up to 2 years
Title
Objective Response Rate
Description
Objective Response Rate is defined as the percentage of patients with a complete or partial response to treatment, consistent with RECIST version 1.1 criteria for solid tumors.
Time Frame
up to 1 year
Title
Disease Control Rate
Description
Disease Control Rate is defined as the percentage of patients with a complete or partial response to treatment or stable disease, consistent with RECIST version 1.1 criteria for solid tumors.
Time Frame
up to 1 year
Title
percentage of patients with Clinical Benefit Response
Description
Composite measure based on patient-reported pain (per Faces pain scale revised), patient-reported pain medication, Karnofsky performance status(KPS), and weight. Clinical benefit is indicated by either:(a) improvement in pain (less pain intensity with stable or decreased pain medication; or less pain medication with stable or decreased pain intensity) with stable or improved KPS; or (b) improvement in KPS with stable or improved pain.With stable for KPS and pain, clinical benefit may be indicated with an observation of positive weight change. Clinical benefit response (CBR) was classified weekly and a patient was considered a clinical benefit responder if clinical benefit was observed and maintained over a 4 week period.
Time Frame
up to 1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Chinese; Stable vital signs, KPS≥60; Patients have a diagnosis of advanced or recurrent metastatic extrahepatic cholangiocarcinoma or gallbladder carcinoma by histopathology or cytopathology, who are not suitable for radical surgery or have progressed R1 resection or palliative surgery; Adequate fresh tumor tissue for genome sequencing and immuno-histochemistry test; harboring mutations or abnormal activation of erb-b2 receptor tyrosine kinase signal pathway components; At least one measurable and evaluable site of disease according to the RECIST criteria version 1.1; Life expectancy of more than 12 weeks; Adequate hepatic, hematologic and renal functions(ALT≤10×upper limit of normal (ULN), AST≤10×ULN, the Child-Pugh classification for class A or B, white blood cells≥3×10^9/L, neutrophils≥1.5×10^9/L, platelets≥80×10^9/L , hemoglobin ≥ 90g/L, creatinine clearance rate≥60ml/min; Volunteer for this study, have written informed consent and have good Patient compliance; Female patients of childbearing potential and their mates agree to avoid pregnancy. Exclusion Criteria: Have received following treatment before this study: Anti-tumor molecular target therapy; anti-tumor chemotherapy in 6 months; lesions have been treated by irradiation; participate in other therapeutic or interventional clinical trials. Have central nervous system metastasis; History of other malignancies except carcinoma in-situ of uterine cervix, cured basal cell carcinoma of skin and other malignancies for more than 5 years; Have symptomatic ascites and need for treatment; Have serious concurrent illness including, but not limited to uncontrolled congestive heart failure(NYHA classification grade III or IV), unstable angina pectoris, unstable cardiac arrhythmias, uncontrolled moderate or serious hypertension(systolic blood pressure >21.3 Kpa or diastolic blood pressure >13.3 Kpa); ongoing or active serious infection; uncontrolled diabetes mellitus; psychiatric illness which potentially hamper the ability to willingly give written informed consent and compliance with the study protocol; HIV infection; other serious illness considered not suitable for this study by investigators. be allergic or have contraindications to target medicines involved in this study, gemcitabine or oxaliplatin.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
liu yingbin, PHD
Phone
+86 13918803900
Email
laoniulyb@163.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
liu yingbin, PHD
Organizational Affiliation
Xinhua Hospital, Shanghai Jiao Tong University School of Medicine
Official's Role
Principal Investigator
Facility Information:
Facility Name
Xinhua Hospital
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200092
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
yingbin liu
Phone
13918803900
Email
laoniulyb@163.com

12. IPD Sharing Statement

Plan to Share IPD
Undecided

Learn more about this trial

Molecularly Target Therapy With GEMOX in Advanced or Recurrent Extrahepatic Cholangiocarcinoma and Gallbladder Carcinoma

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