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Capecitabine as Second-Line Therapy in Treating Patients With Stage IV Pancreatic Cancer Who Have the Thymidylate Synthase Gene

Primary Purpose

Pancreatic Cancer

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
capecitabine
Sponsored by
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pancreatic Cancer focused on measuring recurrent pancreatic cancer, stage IV pancreatic cancer

Eligibility Criteria

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

DISEASE CHARACTERISTICS: Histologically confirmed pancreatic cancer Stage IV disease Measurable disease (≥ 1 cm or > 10 mm lesion(s) by spiral CT scan) Disease progression after ≥ 1 gemcitabine-based treatment regimen for advanced/metastatic disease Patient carries the double tandem repeat (S/S) variant of the thymidylate synthase gene enhancer region (TSER) No active CNS metastases (indicated by clinical symptoms, cerebral edema, steroid requirement, or progressive growth) PATIENT CHARACTERISTICS: ECOG performance status 0-2 Absolute neutrophil count ≥ 1,500/mm^3 Platelet count ≥ 100,000/mm^3 AST/ALT ≤ 2.5 times upper limit of normal (ULN) (5 times ULN if attributable to liver metastases) Total bilirubin ≤ 1.5 times ULN Creatinine normal OR creatinine clearance > 50 mL/min Fertile patients must use effective contraception during and for 30 days after completion of study treatment Not pregnant or nursing Negative pregnancy test Asymptomatic HIV infection allowed No recent or ongoing clinically significant gastrointestinal disorder (e.g., malabsorption, bleeding, inflammation, emesis, or diarrhea > grade 1) Able to swallow capecitabine tablets No known hypersensitivity to fluorouracil No dihydropyrimidine dehydrogenase (DPD) deficiency No clinically significant cardiac disease (e.g., congestive heart failure, symptomatic coronary artery disease, or cardiac arrhythmias not well controlled with medication) No myocardial infarction within the past 6 months No serious, uncontrolled, concurrent infection(s) No prior unanticipated severe reaction to fluoropyrimidine therapy No other malignancy within the past 5 years except cured nonmelanoma skin cancer or treated carcinoma in situ of the cervix PRIOR CONCURRENT THERAPY: See Disease Characteristics At least 3 weeks since prior chemotherapy No prior capecitabine except in the adjuvant setting At least 3 weeks since prior radiotherapy or major surgery At least 4 weeks since prior participation in any investigational drug study At least 4 weeks since prior sorivudine or brivudine No concurrent sorivudine or brivudine No concurrent cimetidine or azidothymidine (AZT) Concurrent radiotherapy for bone pain allowed to a limited field provided ≥ 1 indicator lesion remains outside of the field No other concurrent chemotherapy or immunotherapy

Sites / Locations

  • Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
  • Hospital Universitario 12 de Octubre

Outcomes

Primary Outcome Measures

Survival at 6-months
Toxicity

Secondary Outcome Measures

Association between capecitabine exposure at steady-state, allelic variants in candidate genes, and drug response
Relationship between expression of TS, TP and DPD in tumor tissues and response
Response rate

Full Information

First Posted
March 15, 2006
Last Updated
March 18, 2010
Sponsor
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00303927
Brief Title
Capecitabine as Second-Line Therapy in Treating Patients With Stage IV Pancreatic Cancer Who Have the Thymidylate Synthase Gene
Official Title
Thymidylate Synthase (TS) Genotype-Directed Phase II Trial of Oral Capecitabine for 2-Line Treatment of Advanced Pancreatic Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
March 2010
Overall Recruitment Status
Completed
Study Start Date
December 2005 (undefined)
Primary Completion Date
September 2007 (Actual)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Name of the Sponsor
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Collaborators
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
RATIONALE: Drugs used in chemotherapy, such as capecitabine, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. PURPOSE: This phase II trial is studying how well capecitabine works as second-line therapy in treating patients with stage IV pancreatic cancer who have the thymidylate synthase gene.
Detailed Description
OBJECTIVES: Primary Characterize the 6-month survival of patients with stage IV pancreatic cancer (progressing after at least 1 prior gemcitabine-containing chemotherapy regimen) who carry the double tandem repeat (S/S) variant of the thymidylate synthase (TS) gene enhancer region (TSER) treated with capecitabine. Characterize toxicity of capecitabine in patients with stage IV pancreatic cancer who carry the S/S variant of the TSER. Secondary Explore the association between capecitabine exposure at steady-state, allelic variants in candidate genes (carboxylesterase 1, carboxylesterase 2, cytidine deaminase, thymidine phosphorylase [TP], dihydropyrimidine dehydrogenase [DPD], methylenetetrahydrofolate reductase) and drug response (toxicity and efficacy) in this patient population. Determine the relationship between expression of TS, TP, and DPD in tumor tissues and the response to capecitabine in this patient population. Analyze response rate to capecitabine, based on the presence of homozygous S/S variant of the TSER. OUTLINE: This is an open-label, multicenter study. Patients receive oral capecitabine twice daily on days 1-14. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. PROJECTED ACCRUAL: A total of 65 patients will be accrued for this study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pancreatic Cancer
Keywords
recurrent pancreatic cancer, stage IV pancreatic cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Masking
None (Open Label)
Enrollment
65 (Anticipated)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
capecitabine
Primary Outcome Measure Information:
Title
Survival at 6-months
Title
Toxicity
Secondary Outcome Measure Information:
Title
Association between capecitabine exposure at steady-state, allelic variants in candidate genes, and drug response
Title
Relationship between expression of TS, TP and DPD in tumor tissues and response
Title
Response rate

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically confirmed pancreatic cancer Stage IV disease Measurable disease (≥ 1 cm or > 10 mm lesion(s) by spiral CT scan) Disease progression after ≥ 1 gemcitabine-based treatment regimen for advanced/metastatic disease Patient carries the double tandem repeat (S/S) variant of the thymidylate synthase gene enhancer region (TSER) No active CNS metastases (indicated by clinical symptoms, cerebral edema, steroid requirement, or progressive growth) PATIENT CHARACTERISTICS: ECOG performance status 0-2 Absolute neutrophil count ≥ 1,500/mm^3 Platelet count ≥ 100,000/mm^3 AST/ALT ≤ 2.5 times upper limit of normal (ULN) (5 times ULN if attributable to liver metastases) Total bilirubin ≤ 1.5 times ULN Creatinine normal OR creatinine clearance > 50 mL/min Fertile patients must use effective contraception during and for 30 days after completion of study treatment Not pregnant or nursing Negative pregnancy test Asymptomatic HIV infection allowed No recent or ongoing clinically significant gastrointestinal disorder (e.g., malabsorption, bleeding, inflammation, emesis, or diarrhea > grade 1) Able to swallow capecitabine tablets No known hypersensitivity to fluorouracil No dihydropyrimidine dehydrogenase (DPD) deficiency No clinically significant cardiac disease (e.g., congestive heart failure, symptomatic coronary artery disease, or cardiac arrhythmias not well controlled with medication) No myocardial infarction within the past 6 months No serious, uncontrolled, concurrent infection(s) No prior unanticipated severe reaction to fluoropyrimidine therapy No other malignancy within the past 5 years except cured nonmelanoma skin cancer or treated carcinoma in situ of the cervix PRIOR CONCURRENT THERAPY: See Disease Characteristics At least 3 weeks since prior chemotherapy No prior capecitabine except in the adjuvant setting At least 3 weeks since prior radiotherapy or major surgery At least 4 weeks since prior participation in any investigational drug study At least 4 weeks since prior sorivudine or brivudine No concurrent sorivudine or brivudine No concurrent cimetidine or azidothymidine (AZT) Concurrent radiotherapy for bone pain allowed to a limited field provided ≥ 1 indicator lesion remains outside of the field No other concurrent chemotherapy or immunotherapy
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Wells Messersmith, MD
Organizational Affiliation
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Official's Role
Study Chair
Facility Information:
Facility Name
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21231-2410
Country
United States
Facility Name
Hospital Universitario 12 de Octubre
City
Madrid
ZIP/Postal Code
28041
Country
Spain

12. IPD Sharing Statement

Learn more about this trial

Capecitabine as Second-Line Therapy in Treating Patients With Stage IV Pancreatic Cancer Who Have the Thymidylate Synthase Gene

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