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A Research Trial of High Dose Vitamin C and Chemotherapy for Metastatic Pancreatic Cancer

Primary Purpose

Pancreatic Neoplasms

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Gemcitabine with escalating ascorbic acid
Sponsored by
Joseph J. Cullen
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pancreatic Neoplasms focused on measuring Ascorbic Acid, Gemcitabine

Eligibility Criteria

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

Inclusion Criteria:

  • Normal G6PD status
  • Histologically or cytologically diagnosed pancreatic adenocarcinoma.
  • Disease extent documented by CT scan (radiologically measurable disease is not required)
  • Ambulatory patient without evidence of spinal cord compression
  • No prior chemotherapy for metastatic disease
  • Failed curative therapy or patient ineligible for definitive curative therapy
  • Completed adjuvant therapy at least 4 weeks prior and recovered from any/all toxicities related to that treatment.
  • If post-therapy, must have disease progression since that treatment
  • If treated with prior radiation therapy, disease must be outside of the radiation fields
  • No currently active second malignancies unless it is a non-melanoma skin cancer
  • Women must be non-pregnant and non-lactating
  • ECOG performance of 0, 1, or 2
  • Granulocytes at least 1,500 / ul
  • Platelets at least 100,000 / ul
  • Creatinine less than 1.5 mg/dL or clearance of at least 60 mL / min
  • Total bilirubin less than 2 times the upper limit of normal
  • AST and ALT less than 3 times the upper limit of normal if liver metastases are not present. If liver metastases are present, AST and ALT less than 5 times the upper limit of normal
  • PT INR less than 1.5 (unless the patient is on full dose warfarin)
  • Patient must be at least 18 years of age
  • Patient must be able to understand consent process, the research study, and be able to sign the consent document

Exclusion Criteria:

  • A psychiatric disorder by history or examination that would prevent completion of the study
  • ECOG performance of 3 or 4
  • Co-morbid conditions that affect survival: end stage congestive heart failure, unstable angina, myocardial infarction (within the past 6 weeks), uncontrolled blood sugars of greater than 300 mg/dL, known chronic active hepatitis or cirrhosis.
  • Consumption of excess alcohol (more than 4 drinks per day) or use of illicit drugs
  • Continued sse of over-the-counter antioxidants (supplements like vitamin C and grape seeds)

Sites / Locations

  • The University of Iowa Hospitals & Clinics

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Ascorbate

Arm Description

Outcomes

Primary Outcome Measures

Blood cell counts (neutropenia, thrombocytopenia) and serum chemistries (liver function tests, creatinine)

Secondary Outcome Measures

Plasma ascorbate level (targeted to 350 to 400 mg/dL)
Survival

Full Information

First Posted
January 14, 2010
Last Updated
April 19, 2017
Sponsor
Joseph J. Cullen
Collaborators
University of Iowa, Holden Comprehensive Cancer Center
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1. Study Identification

Unique Protocol Identification Number
NCT01049880
Brief Title
A Research Trial of High Dose Vitamin C and Chemotherapy for Metastatic Pancreatic Cancer
Official Title
A Phase I Trial of Ascorbic Acid and Gemcitabine for the Treatment of Metastatic Pancreatic Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
April 2017
Overall Recruitment Status
Completed
Study Start Date
December 2009 (undefined)
Primary Completion Date
February 2013 (Actual)
Study Completion Date
March 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Joseph J. Cullen
Collaborators
University of Iowa, Holden Comprehensive Cancer Center

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study is designed to determine the maximum tolerated dose of vitamin C when given with a standard chemotherapy for people who have metastatic pancreatic cancer.
Detailed Description
This is a phase I, dose-escalating study of ascorbic acid (vitamin C) designed to determine the maximum tolerated dose of vitamin C or, if well tolerated, the dose required to obtain a desired ascorbic acid plasma concentration. Because this is a phase I study, prospective subjects should have advanced disease (i.e., metastasis) and have failed other curative therapies (or, are unable to receive curative therapies due to comorbidities or stage of disease).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pancreatic Neoplasms
Keywords
Ascorbic Acid, Gemcitabine

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Ascorbate
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Gemcitabine with escalating ascorbic acid
Other Intervention Name(s)
Gemzar, Ascor L 500
Intervention Description
Gemcitabine (1000 mg/m2) weekly for three weeks and then one week off. Ascorbic acid, given twice weekly, escalating doses weekly. Week 1: 15 grams ascorbic acid per infusion Week 2: 25 grams ascorbic acid per infusion Week 3: 50 grams ascorbic acid per infusion Week 4: 75 grams ascorbic acid per infusion Week 5: 100 grams ascorbic acid per infusion Ascorbic acid infusion dose is maintained at the level that provides a serum level of 350-400 mg/dL.
Primary Outcome Measure Information:
Title
Blood cell counts (neutropenia, thrombocytopenia) and serum chemistries (liver function tests, creatinine)
Time Frame
weekly
Secondary Outcome Measure Information:
Title
Plasma ascorbate level (targeted to 350 to 400 mg/dL)
Time Frame
Weekly
Title
Survival
Time Frame
Ongoing

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Normal G6PD status Histologically or cytologically diagnosed pancreatic adenocarcinoma. Disease extent documented by CT scan (radiologically measurable disease is not required) Ambulatory patient without evidence of spinal cord compression No prior chemotherapy for metastatic disease Failed curative therapy or patient ineligible for definitive curative therapy Completed adjuvant therapy at least 4 weeks prior and recovered from any/all toxicities related to that treatment. If post-therapy, must have disease progression since that treatment If treated with prior radiation therapy, disease must be outside of the radiation fields No currently active second malignancies unless it is a non-melanoma skin cancer Women must be non-pregnant and non-lactating ECOG performance of 0, 1, or 2 Granulocytes at least 1,500 / ul Platelets at least 100,000 / ul Creatinine less than 1.5 mg/dL or clearance of at least 60 mL / min Total bilirubin less than 2 times the upper limit of normal AST and ALT less than 3 times the upper limit of normal if liver metastases are not present. If liver metastases are present, AST and ALT less than 5 times the upper limit of normal PT INR less than 1.5 (unless the patient is on full dose warfarin) Patient must be at least 18 years of age Patient must be able to understand consent process, the research study, and be able to sign the consent document Exclusion Criteria: A psychiatric disorder by history or examination that would prevent completion of the study ECOG performance of 3 or 4 Co-morbid conditions that affect survival: end stage congestive heart failure, unstable angina, myocardial infarction (within the past 6 weeks), uncontrolled blood sugars of greater than 300 mg/dL, known chronic active hepatitis or cirrhosis. Consumption of excess alcohol (more than 4 drinks per day) or use of illicit drugs Continued sse of over-the-counter antioxidants (supplements like vitamin C and grape seeds)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Joseph J Cullen, M.D.
Organizational Affiliation
University of Iowa
Official's Role
Principal Investigator
Facility Information:
Facility Name
The University of Iowa Hospitals & Clinics
City
Iowa City
State/Province
Iowa
ZIP/Postal Code
52242
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
23381814
Citation
Welsh JL, Wagner BA, van't Erve TJ, Zehr PS, Berg DJ, Halfdanarson TR, Yee NS, Bodeker KL, Du J, Roberts LJ 2nd, Drisko J, Levine M, Buettner GR, Cullen JJ. Pharmacological ascorbate with gemcitabine for the control of metastatic and node-positive pancreatic cancer (PACMAN): results from a phase I clinical trial. Cancer Chemother Pharmacol. 2013 Mar;71(3):765-75. doi: 10.1007/s00280-013-2070-8. Epub 2013 Feb 5.
Results Reference
result
Links:
URL
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3587047/
Description
Study results, free article.

Learn more about this trial

A Research Trial of High Dose Vitamin C and Chemotherapy for Metastatic Pancreatic Cancer

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