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Adjuvant Chemotherapy for Biliary Tract Cancer After Curative Resection (AdBTC-1)

Primary Purpose

Cholangiocarcinoma, Gall Bladder Carcinoma

Status
Recruiting
Phase
Phase 3
Locations
China
Study Type
Interventional
Intervention
Gemcitabine
Capecitabine
Sponsored by
Tianjin Medical University Cancer Institute and Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Cholangiocarcinoma focused on measuring adjuvant chemotherapy, cholangiocarcinoma, invasive gall bladder carcinoma, overall survival, disease free survival, Gemcitabine, Capecitabine

Eligibility Criteria

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

DISEASE CHARACTERISTICS:

  • Histologically confirmed biliary tract cancer (including intrahepatic, extrahepatic, hilar cholangiocarcinoma or muscle invasive gallbladder cancer or cancer of the distal bile duct)
  • Must have undergone a radical surgical approach which includes liver resection, pancreatic resection, or less commonly both
  • Patients with pathological evidence of microscopic involvement of the margins of the excised specimen are eligible as long as resection is macroscopically complete
  • Must be able to start treatment within 12 weeks of surgery
  • No pancreatic or periampullary cancer
  • No mucosal gallbladder cancer

PATIENT CHARACTERISTICS:

  • ECOG performance status 0-2
  • Urea < 1.5 times upper limit of normal (ULN)
  • Creatinine < 1.5 times ULN
  • Glomerular filtration rate ≥ 60 mL/min (if < 60 mL/min, adequate renal function for capecitabine must be confirmed by isotope EDTA)
  • Hemoglobin ≥ 10 g/dL
  • WBC ≥ 3,000/mm³
  • Absolute neutrophil count ≥ 1,500/mm³
  • Platelet count ≥ 100,000/mm³
  • Bilirubin ≤ 3 times ULN
  • ALT and AST ≤ 5 times ULN
  • Adequate surgical biliary drainage with no evidence of infection
  • Not pregnant or nursing
  • Negative pregnancy test for women of childbearing age and childbearing potential
  • Fertile patients must use effective contraception during study treatment and for at least 3 months after study treatment has ended
  • Must provide written informed consent
  • No history of other malignant diseases within the past 5 years
  • No serious coexisting medical condition likely to interfere with protocol treatment, including a potential serious infection
  • No evidence of significant clinical disorder or laboratory finding that makes it undesirable for the patient to participate in the trial
  • No psychological, familial, sociological, or geographical factors considered likely to preclude study compliance
  • No other serious uncontrolled medical conditions
  • No unresolved biliary tree obstruction

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • Completely recovered from prior surgery
  • No use of other investigational agents within 28 days prior to and during study treatment
  • No prior chemotherapy or radiotherapy for biliary tract cancer
  • No other concurrent anticancer chemotherapy, radiotherapy, or investigational agent

Sites / Locations

  • Tianjin Medical University Cancer Insititute and HospitalRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Gemcitabine plus Capecitabine

Capecitabine

Arm Description

Gemcitabine (1000 mg per square meter) on days 1 and 8 Capecitabine (1250 mg per square meter) twice a day on days 1-14. Treatment repeats every 3 weeks for 8 courses in the absence of disease progression or unacceptable toxicity.

Capecitabine (1250 mg per square meter) twice a day on days 1-14. Treatment repeats every 3 weeks for 8 courses in the absence of disease progression or unacceptable toxicity.

Outcomes

Primary Outcome Measures

Disease free survival (DFS) rate
DFS

Secondary Outcome Measures

Overall survival (OS) rate
OS
Disease free survival (DFS) rate
DFS
Overall survival (OS) rate
OS
The rate of patients with hepatic or locoregional recurrence

Full Information

First Posted
December 12, 2018
Last Updated
December 17, 2018
Sponsor
Tianjin Medical University Cancer Institute and Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT03779035
Brief Title
Adjuvant Chemotherapy for Biliary Tract Cancer After Curative Resection
Acronym
AdBTC-1
Official Title
Adjuvant Chemotherapy With Gemcitabine and Capecitabine Compared to Capecitabine for Biliary Tract Cancer After Curative Resection
Study Type
Interventional

2. Study Status

Record Verification Date
December 2018
Overall Recruitment Status
Recruiting
Study Start Date
December 15, 2018 (Anticipated)
Primary Completion Date
December 31, 2020 (Anticipated)
Study Completion Date
December 31, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Tianjin Medical University Cancer Institute and Hospital

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No

5. Study Description

Brief Summary
This prospective, open-Label, comparative, randomized, controlled phase III trial was designed to compare the clinical performance of gemcitabine with capecitabine vs. capecitabine alone for patients with biliary tract cancer (BTC) after curative resection.
Detailed Description
Currently, complete surgical resection represents the only potentially curative treatment option for cholangiocarcinoma (CCA, including intrahepatic, hilar and distal CCA) and gallbladder carcinoma (GBCA). Because of high rates of disease recurrence and poor survival rates following surgical resection, postoperative treatment have been considered to improve patient survival after resection of BTC. The systematic review showed a beneficial impact of adjuvant treatment in BTC, particularly in patients with involved lymph nodes or resection margins and distal or hilar CCA. However, in regard of the paucity of randomized data, current guidelines recommend inclusion in clinical trials. Previously, the data of the BILCAP trial showed an improvement in median overall survival for capecitabine compared to observation alone for BTC, indicating capecitabine as the new standard postoperative treatment after curative resection of BTC. Previous phase II studies for advanced BTC showed superiority of the combination gemcitabine/ capecitabine regimen vs. the capecitabine monotherapy, the median OS was 12.7-14 vs. 7.9 months. Based on these data, this AdBTC trial will was designed to compare the clinical performance of gemcitabine with capecitabine vs. capecitabine alone for patients with biliary tract cancer (BTC) after curative resection, aiming for superiority of the combination regimen vs. the oral monotherapy. This will be based on the BILCAP protocol, applying the similar dosing, assessments and dose modifications. The primary endpoint is DFS and secondary endpoints include recurrence free survival, OS, safety and tolerability of adjuvant CTx, quality of life, and patterns of disease recurrence.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cholangiocarcinoma, Gall Bladder Carcinoma
Keywords
adjuvant chemotherapy, cholangiocarcinoma, invasive gall bladder carcinoma, overall survival, disease free survival, Gemcitabine, Capecitabine

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
460 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Gemcitabine plus Capecitabine
Arm Type
Experimental
Arm Description
Gemcitabine (1000 mg per square meter) on days 1 and 8 Capecitabine (1250 mg per square meter) twice a day on days 1-14. Treatment repeats every 3 weeks for 8 courses in the absence of disease progression or unacceptable toxicity.
Arm Title
Capecitabine
Arm Type
Active Comparator
Arm Description
Capecitabine (1250 mg per square meter) twice a day on days 1-14. Treatment repeats every 3 weeks for 8 courses in the absence of disease progression or unacceptable toxicity.
Intervention Type
Drug
Intervention Name(s)
Gemcitabine
Intervention Description
1000mg/m2
Intervention Type
Drug
Intervention Name(s)
Capecitabine
Intervention Description
1250mg/m2
Primary Outcome Measure Information:
Title
Disease free survival (DFS) rate
Description
DFS
Time Frame
at 24 months
Secondary Outcome Measure Information:
Title
Overall survival (OS) rate
Description
OS
Time Frame
at 24 months
Title
Disease free survival (DFS) rate
Description
DFS
Time Frame
at 60 months
Title
Overall survival (OS) rate
Description
OS
Time Frame
at 60 months
Title
The rate of patients with hepatic or locoregional recurrence
Time Frame
24 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically confirmed biliary tract cancer (including intrahepatic, extrahepatic, hilar cholangiocarcinoma or muscle invasive gallbladder cancer or cancer of the distal bile duct) Must have undergone a radical surgical approach which includes liver resection, pancreatic resection, or less commonly both Patients with pathological evidence of microscopic involvement of the margins of the excised specimen are eligible as long as resection is macroscopically complete Must be able to start treatment within 12 weeks of surgery No pancreatic or periampullary cancer No mucosal gallbladder cancer PATIENT CHARACTERISTICS: ECOG performance status 0-2 Urea < 1.5 times upper limit of normal (ULN) Creatinine < 1.5 times ULN Glomerular filtration rate ≥ 60 mL/min (if < 60 mL/min, adequate renal function for capecitabine must be confirmed by isotope EDTA) Hemoglobin ≥ 10 g/dL WBC ≥ 3,000/mm³ Absolute neutrophil count ≥ 1,500/mm³ Platelet count ≥ 100,000/mm³ Bilirubin ≤ 3 times ULN ALT and AST ≤ 5 times ULN Adequate surgical biliary drainage with no evidence of infection Not pregnant or nursing Negative pregnancy test for women of childbearing age and childbearing potential Fertile patients must use effective contraception during study treatment and for at least 3 months after study treatment has ended Must provide written informed consent No history of other malignant diseases within the past 5 years No serious coexisting medical condition likely to interfere with protocol treatment, including a potential serious infection No evidence of significant clinical disorder or laboratory finding that makes it undesirable for the patient to participate in the trial No psychological, familial, sociological, or geographical factors considered likely to preclude study compliance No other serious uncontrolled medical conditions No unresolved biliary tree obstruction PRIOR CONCURRENT THERAPY: See Disease Characteristics Completely recovered from prior surgery No use of other investigational agents within 28 days prior to and during study treatment No prior chemotherapy or radiotherapy for biliary tract cancer No other concurrent anticancer chemotherapy, radiotherapy, or investigational agent
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Tianqiang Song, PH.D.
Phone
+86-022-23340123
Ext
3090
Email
tjchi@hotmail.com
Facility Information:
Facility Name
Tianjin Medical University Cancer Insititute and Hospital
City
Tianjin
State/Province
Tianjin
ZIP/Postal Code
300060
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Tianqiang Song, PH.D.
Email
tjchi@hotmail.com

12. IPD Sharing Statement

Learn more about this trial

Adjuvant Chemotherapy for Biliary Tract Cancer After Curative Resection

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