A Study of Gemcitabine/Nab-paclitaxel and Radiation Therapy Followed by Surgery in Patients With Advanced Pancreatic Cancer
Primary Purpose
Pancreatic Cancer
Status
Active
Phase
Phase 1
Locations
Canada
Study Type
Interventional
Intervention
Gemcitabine
Nab-paclitaxel
Radiation Therapy
Surgical Resection
Sponsored by
About this trial
This is an interventional treatment trial for Pancreatic Cancer focused on measuring Blood Vessels, Reconstructive Surgery
Eligibility Criteria
Inclusion Criteria:
Surgical:
- Medically fit for major pancreatic surgery
- No evidence of metastases
- No prior resection
- Arterial involvement limited to a single major vessel and is resectable
- Tumour-free margins could be achieved
- Acceptable length of vessel
- Mass considered otherwise resectable by current standards
General:
- Less than 70 years old
- Performance status <=2
- Has pancreatic adenocarcinoma
- Adequate bone marrow and organ function
- Therapeutic heparin is allowed
- Taking chronic erythropoietin are permitted
- Not pregnant
- Agree to use contraception
- Able to provide written consent
Exclusion Criteria:
Surgical:
- Aortic involvement
- Involvement of 2 major arterial trunks
- SMV/portal venous occlusion, cannot be reconstructed
- Extensive venous involvement, no arterial involvement
- Disease progression on neo-adjuvant treatme
General:
- Concurrent cancer diagnosis
- Other malignancies unless all therapy completed, no disease for >=3 years
- Prior radiotherapy or chemo within 1 year, to pancreas
- Bone marrow transplant/stem cell rescue
- Major surgery <4 wks prior
- Distant metastases
- Renal dysfunction
- Pulmonary insufficiency
- History of cardiac disease
- Active systemic infection(s) or any other related illnesses
- Known HIV, HBV, HCV
- History of solid organ transplant, cardiovascular disease, inflammatory bowel disease, or underlying neuropathy
- Conditions interfering with patient participation
- Known or suspected allergy to study drugs
- Pregnant or breast-feeding
- Therapeutic coumadin
- More than or equal to Grade 2 pre-exiting peripheral neuropathy
Sites / Locations
- Princess Margaret Cancer Centre
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Gemcitabine/Nab-paclitaxel, Radiation and Surgery
Arm Description
Gemcitabine (neoadjuvant and adjuvant), intravenously, at a dose of 1000 mg/m2 given over 30-40 minutes, on Day 1 of every 28 day cycle for 2 cycles. Nab-paclitaxel, intravenously, at a dose of 125 mg/m2 given over 30-40 minutes, on Days 1, 8, and 15 of every 28 day cycle for 2 cycles. Radiation Therapy: 50.4 Gy in 28 fractions (1.8 Gy/fraction) Surgery: Tumor resection and arterial resection/reconstruction
Outcomes
Primary Outcome Measures
Type and the severity of side effects
Secondary Outcome Measures
Number of surviving patients at 1 year after treatment
Number of patients who disease has not progressed
Number of patients that are able to receive surgery after chemoradiation
Average length of hospital stay per patient
Number of surviving patients at 30-days after surgery
Number of surviving patients at 90-days after surgery
Number of patients who need to be re-admitted to the hospital at 90-days after surgery
Time to Progression
Full Information
NCT ID
NCT02481635
First Posted
June 23, 2015
Last Updated
January 25, 2023
Sponsor
University Health Network, Toronto
1. Study Identification
Unique Protocol Identification Number
NCT02481635
Brief Title
A Study of Gemcitabine/Nab-paclitaxel and Radiation Therapy Followed by Surgery in Patients With Advanced Pancreatic Cancer
Official Title
A Phase I/II Study Evaluating the Feasibility and Safety of Neoadjuvant Gemcitabine/Nab-paclitaxel (GA) and Concurrent Gemcitabine and Radiation Therapy Followed By Pancreatic Resection and Major Arterial Resection for Adenocarcinoma of the Pancreas (ARCAP) in Patients With Advanced Disease
Study Type
Interventional
2. Study Status
Record Verification Date
December 2022
Overall Recruitment Status
Active, not recruiting
Study Start Date
July 2016 (undefined)
Primary Completion Date
December 2023 (Anticipated)
Study Completion Date
December 2023 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University Health Network, Toronto
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This is a phase 1 (the first phase in testing a new drug, to see how safe a new drug or new indication/population ) and phase 2 (the second phase in testing a new drug or new indication/population to see how effective the drug is) study of neoadjuvant (treatment before the main treatment) with gemcitabine and nab-paclitaxel (abraxane) and gemcitabine and radiation therapy before surgery and then gemcitabine and nab-paclitaxel after surgery in patients with pancreatic cancer that has grown to involve one of the major artery branches.
Detailed Description
Gemcitabine and nab-paclitaxel are chemotherapy drugs that are currently approved by Health Canada for use in combination for the treatment of pancreatic cancer. However, the combination of gemcitabine and nab-paclitaxel as a neoadjuvant treatment prior to gemcitabine and radiation is experimental. Surgery to remove or reconstruct the major artery is also experimental.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pancreatic Cancer
Keywords
Blood Vessels, Reconstructive Surgery
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
30 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Gemcitabine/Nab-paclitaxel, Radiation and Surgery
Arm Type
Experimental
Arm Description
Gemcitabine (neoadjuvant and adjuvant), intravenously, at a dose of 1000 mg/m2 given over 30-40 minutes, on Day 1 of every 28 day cycle for 2 cycles.
Nab-paclitaxel, intravenously, at a dose of 125 mg/m2 given over 30-40 minutes, on Days 1, 8, and 15 of every 28 day cycle for 2 cycles.
Radiation Therapy: 50.4 Gy in 28 fractions (1.8 Gy/fraction)
Surgery: Tumor resection and arterial resection/reconstruction
Intervention Type
Drug
Intervention Name(s)
Gemcitabine
Other Intervention Name(s)
Gemzar
Intervention Type
Drug
Intervention Name(s)
Nab-paclitaxel
Other Intervention Name(s)
Abraxane
Intervention Type
Radiation
Intervention Name(s)
Radiation Therapy
Intervention Type
Procedure
Intervention Name(s)
Surgical Resection
Primary Outcome Measure Information:
Title
Type and the severity of side effects
Time Frame
5 years
Secondary Outcome Measure Information:
Title
Number of surviving patients at 1 year after treatment
Time Frame
1 year
Title
Number of patients who disease has not progressed
Time Frame
2 years
Title
Number of patients that are able to receive surgery after chemoradiation
Time Frame
5 years
Title
Average length of hospital stay per patient
Time Frame
5 years
Title
Number of surviving patients at 30-days after surgery
Time Frame
30 days after surgery
Title
Number of surviving patients at 90-days after surgery
Time Frame
90 days after surgery
Title
Number of patients who need to be re-admitted to the hospital at 90-days after surgery
Time Frame
90 days after surgery
Title
Time to Progression
Time Frame
5 years
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Surgical:
Medically fit for major pancreatic surgery
No evidence of metastases
No prior resection
Arterial involvement limited to a single major vessel and is resectable
Tumour-free margins could be achieved
Acceptable length of vessel
Mass considered otherwise resectable by current standards
General:
Less than 70 years old
Performance status <=2
Has pancreatic adenocarcinoma
Adequate bone marrow and organ function
Therapeutic heparin is allowed
Taking chronic erythropoietin are permitted
Not pregnant
Agree to use contraception
Able to provide written consent
Exclusion Criteria:
Surgical:
Aortic involvement
Involvement of 2 major arterial trunks
SMV/portal venous occlusion, cannot be reconstructed
Extensive venous involvement, no arterial involvement
Disease progression on neo-adjuvant treatme
General:
Concurrent cancer diagnosis
Other malignancies unless all therapy completed, no disease for >=3 years
Prior radiotherapy or chemo within 1 year, to pancreas
Bone marrow transplant/stem cell rescue
Major surgery <4 wks prior
Distant metastases
Renal dysfunction
Pulmonary insufficiency
History of cardiac disease
Active systemic infection(s) or any other related illnesses
Known HIV, HBV, HCV
History of solid organ transplant, cardiovascular disease, inflammatory bowel disease, or underlying neuropathy
Conditions interfering with patient participation
Known or suspected allergy to study drugs
Pregnant or breast-feeding
Therapeutic coumadin
More than or equal to Grade 2 pre-exiting peripheral neuropathy
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Neesha Dhani, M.D.
Organizational Affiliation
Princess Margaret Cancer Centre
Official's Role
Principal Investigator
Facility Information:
Facility Name
Princess Margaret Cancer Centre
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5G 2M9
Country
Canada
12. IPD Sharing Statement
Learn more about this trial
A Study of Gemcitabine/Nab-paclitaxel and Radiation Therapy Followed by Surgery in Patients With Advanced Pancreatic Cancer
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