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Combination Chemotherapy as First-Line Therapy in Treating Patients With Locally Advanced or Metastatic Neuroendocrine Tumors of the Duodenum or Pancreas That Cannot Be Removed By Surgery

Primary Purpose

Gastrointestinal Carcinoid Tumor, Islet Cell Tumor, Neoplastic Syndrome

Status
Completed
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
fluorouracil
irinotecan hydrochloride
leucovorin calcium
Sponsored by
Federation Francophone de Cancerologie Digestive
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Gastrointestinal Carcinoid Tumor focused on measuring metastatic gastrointestinal carcinoid tumor, recurrent gastrointestinal carcinoid tumor, regional gastrointestinal carcinoid tumor, gastrinoma, insulinoma, WDHA syndrome, glucagonoma, pancreatic polypeptide tumor, somatostatinoma, recurrent islet cell carcinoma

Eligibility Criteria

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

DISEASE CHARACTERISTICS:

  • Diagnosis of neuroendocrine tumor of the duodenum/pancreas by histology or bone scan
  • Functional or nonfunctional tumor

    • Tumor meets ≥ 1 of the following criteria:

      • Hepatic or extrahepatic metastases
      • Progressive locally advanced tumor (primary or adenopathies)
  • Unresectable disease
  • Tumor differentiated and meets the following criteria:

    • Ki 67 ≤ 15%
    • Less than 10 mitoses per 10 large fields
  • Measurable or evaluable disease

    • Target lesions must meet 1 of the following criteria within the past 6 months:

      • Increase of 20% in the longest diameter
      • New metastases detected
    • Minimum size of lesions must be 1 of the following:

      • More than 15 mm for metastases
      • More than 50 mm for primary tumor or local lymph nodes

PATIENT CHARACTERISTICS:

  • WHO performance status 0-2
  • Creatinine ≤ 1.5 mg/dL
  • Absolute neutrophil count ≥ 1,500/mm^3
  • Platelet count ≥ 100,000/mm^3
  • Bilirubin ≤ 1.8 mg/dL
  • No coronary insufficiency or symptomatic cardiac disease
  • No intestinal obstruction, enteropathy, or uncontrolled chronic diarrhea
  • No Gilbert's disease
  • No psychological, social, familial, or geographic condition that would preclude study treatment
  • Not pregnant or nursing
  • Fertile patients must use effective contraception during and for 6 months after completion of study therapy
  • No other condition that would preclude study therapy

PRIOR CONCURRENT THERAPY:

  • No prior adjuvant radiotherapy
  • At least 3 months since prior interferon
  • Prior somatostatin analogs or antisecretories allowed
  • No other prior treatment for this cancer
  • No concurrent radiotherapy to the target lesion

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    FOLFIRI

    Arm Description

    Outcomes

    Primary Outcome Measures

    Secondary Outcome Measures

    Full Information

    First Posted
    December 27, 2006
    Last Updated
    May 27, 2016
    Sponsor
    Federation Francophone de Cancerologie Digestive
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    1. Study Identification

    Unique Protocol Identification Number
    NCT00416767
    Brief Title
    Combination Chemotherapy as First-Line Therapy in Treating Patients With Locally Advanced or Metastatic Neuroendocrine Tumors of the Duodenum or Pancreas That Cannot Be Removed By Surgery
    Official Title
    Study of First-Line Therapy Comprising Leucovorin Calcium, Fluorouracil, and Irinotecan (FOLFIRI) in Patients With Progressive Locally Advanced or Metastatic Duodenal-Pancreatic Endocrine Tumors
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    May 2016
    Overall Recruitment Status
    Completed
    Study Start Date
    May 2004 (undefined)
    Primary Completion Date
    January 2006 (Actual)
    Study Completion Date
    July 2007 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Federation Francophone de Cancerologie Digestive

    4. Oversight

    5. Study Description

    Brief Summary
    RATIONALE: Drugs used in chemotherapy, such as fluorouracil, leucovorin, and irinotecan, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more tumor cells. PURPOSE: This phase II trial is studying how well combination chemotherapy works as first-line therapy in treating patients with locally advanced or metastatic neuroendocrine tumors of the duodenum or pancreas that cannot be removed by surgery.
    Detailed Description
    OBJECTIVES: Primary Determine the 6-month progression-free survival rate in patients with unresectable locally advanced or metastatic neuroendocrine tumors of the duodenum/pancreas treated with fluorouracil, leucovorin calcium, and irinotecan hydrochloride as first-line chemotherapy. Secondary Determine tumor and biologic response at 6, 12, 18, and 24 months in patients treated with this regimen. Determine the duration of response of the primary tumor in patients treated with this regimen. Determine the tolerability of this regimen in these patients. Determine the progression-free survival of patients treated with this regimen. Determine the overall survival of patients treated with this regimen. OUTLINE: This is a multicenter study. Patients receive irinotecan hydrochloride IV over 90 minutes and leucovorin calcium IV over 2 hours on day 1 and fluorouracil IV over 46 hours on days 1 and 2. Courses repeat every 14 days in the absence of disease progression or unacceptable toxicity. After completion of study therapy, patients are followed every 3 months for 1 year and then every 6 months thereafter. PROJECTED ACCRUAL: A total of 20 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
    Gastrointestinal Carcinoid Tumor, Islet Cell Tumor, Neoplastic Syndrome
    Keywords
    metastatic gastrointestinal carcinoid tumor, recurrent gastrointestinal carcinoid tumor, regional gastrointestinal carcinoid tumor, gastrinoma, insulinoma, WDHA syndrome, glucagonoma, pancreatic polypeptide tumor, somatostatinoma, recurrent islet cell carcinoma

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 2
    Interventional Study Model
    Single Group Assignment
    Masking
    None (Open Label)
    Allocation
    N/A
    Enrollment
    20 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    FOLFIRI
    Arm Type
    Experimental
    Intervention Type
    Drug
    Intervention Name(s)
    fluorouracil
    Intervention Type
    Drug
    Intervention Name(s)
    irinotecan hydrochloride
    Intervention Type
    Drug
    Intervention Name(s)
    leucovorin calcium

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    80 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    DISEASE CHARACTERISTICS: Diagnosis of neuroendocrine tumor of the duodenum/pancreas by histology or bone scan Functional or nonfunctional tumor Tumor meets ≥ 1 of the following criteria: Hepatic or extrahepatic metastases Progressive locally advanced tumor (primary or adenopathies) Unresectable disease Tumor differentiated and meets the following criteria: Ki 67 ≤ 15% Less than 10 mitoses per 10 large fields Measurable or evaluable disease Target lesions must meet 1 of the following criteria within the past 6 months: Increase of 20% in the longest diameter New metastases detected Minimum size of lesions must be 1 of the following: More than 15 mm for metastases More than 50 mm for primary tumor or local lymph nodes PATIENT CHARACTERISTICS: WHO performance status 0-2 Creatinine ≤ 1.5 mg/dL Absolute neutrophil count ≥ 1,500/mm^3 Platelet count ≥ 100,000/mm^3 Bilirubin ≤ 1.8 mg/dL No coronary insufficiency or symptomatic cardiac disease No intestinal obstruction, enteropathy, or uncontrolled chronic diarrhea No Gilbert's disease No psychological, social, familial, or geographic condition that would preclude study treatment Not pregnant or nursing Fertile patients must use effective contraception during and for 6 months after completion of study therapy No other condition that would preclude study therapy PRIOR CONCURRENT THERAPY: No prior adjuvant radiotherapy At least 3 months since prior interferon Prior somatostatin analogs or antisecretories allowed No other prior treatment for this cancer No concurrent radiotherapy to the target lesion
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Guillaume Cadiot
    Organizational Affiliation
    CHU - Robert Debre
    Official's Role
    Study Chair

    12. IPD Sharing Statement

    Citations:
    Citation
    Cadiot G, Bonnetain F, Landi B, et al.: Simplified LV5FU2-irinotecan (FOLFIRI) in the first-line therapy of well-differentiated endocrine carcinomas of the duodeno- pancreatic area: preliminary results of the FFCD 0302 phase II trial with GTE participation. [Abstract] J Clin Oncol 25 (Suppl 18): A-4620, 2007.
    Results Reference
    result
    PubMed Identifier
    21831734
    Citation
    Brixi-Benmansour H, Jouve JL, Mitry E, Bonnetain F, Landi B, Hentic O, Bedenne L, Cadiot G. Phase II study of first-line FOLFIRI for progressive metastatic well-differentiated pancreatic endocrine carcinoma. Dig Liver Dis. 2011 Nov;43(11):912-6. doi: 10.1016/j.dld.2011.07.001. Epub 2011 Aug 9.
    Results Reference
    result

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    Combination Chemotherapy as First-Line Therapy in Treating Patients With Locally Advanced or Metastatic Neuroendocrine Tumors of the Duodenum or Pancreas That Cannot Be Removed By Surgery

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