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Metastatic Advanced Pancreas Sorafenib (MAPS)

Primary Purpose

Locally Advanced Pancreatic Cancer

Status
Unknown status
Phase
Phase 2
Locations
Italy
Study Type
Interventional
Intervention
Sorafenib 400 mg po bid, continuously
Gemcitabina, Cisplatino
Sponsored by
Gruppo Italiano per lo studio dei Carcinomi dell'Apparato Digerente
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Locally Advanced Pancreatic Cancer focused on measuring pancreatic cancer, advanced or metastatic, sorafenib

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Signed written informed consent prior to beginning protocol specific procedures
  • Male or female 18 to 75 years of age
  • Diagnosis of histologically confirmed adenocarcinoma of the pancreas
  • Locally advanced (non-resectable) or metastatic pancreatic cancer
  • Presence of at least one uni-dimensional indicator lesion measurable by CT scan or MRI in not an irradiated area (RECIST criteria)
  • Karnofsky performance status of ≥ 70 at study entry
  • Neutrophils ≥ 1.5 x 109/L, platelets ≥ 100 x 109/L, and hemoglobin ≥ 9 g/dL
  • Bilirubin level either normal or < 1.5 x ULN
  • ASAT and ALAT ≤ 2.5 X ULN (≤ 5 x ULN if liver metastasis are present)
  • Serum creatinine < 1.5 x ULN
  • Amylase and lipase ≤ 1.5 x the upper limit of normal
  • PT or INR and PTT < 1.5 x upper limit of normal (subjects who receive anti-coagulation treatment with an agent such as warfarin or heparin will be allowed to participate provided that no evidence of underlying abnormality in these parameters exists).
  • Effective contraception for both male and female patients if the risk of conception exists

Exclusion Criteria:

  • Brain metastases
  • Previous chemotherapy for locally advanced or metastatic pancreatic cancer.
  • Adjuvant therapy if documented recurrence is within 6 months after the end of adjuvant treatment)
  • Radiotherapy within 4 weeks prior to study entry
  • Major surgery within 4 weeks of first dose of study drug
  • Concurrent chronic systemic immune therapy
  • Any investigational agent(s) 4 weeks prior to entry
  • Clinically relevant coronary artery disease or a history of a myocardial infarction within the last 6 months
  • Thrombotic or embolic events such as cerebrovascular accident including transient ischemic attacks within the past 6 months
  • Acute or subacute intestinal occlusion or history of inflammatory bowel disease
  • Known grade 3 or 4 allergic reaction to any of the components of the treatment
  • Known drug abuse/ alcohol abuse
  • Legal incapacity or limited legal capacity
  • Medical or psychological condition which in the opinion of the investigator would not permit the patient to complete the study or sign meaningful informed consent
  • Women who are pregnant or breastfeeding
  • Acute or subacute intestinal occlusion
  • Any concurrent malignancy other than non-melanoma skin cancer, or carcinoma in situ of the cervix. (Patients with a previous malignancy but without evidence of disease for ≥ 5 years will be allowed to enter the trial).

Sites / Locations

  • A.O. Treviglio-Caravaggio, P.le Ospedale n1Recruiting
  • Ospedale S.Orsola Fatebenefratelli
  • A.O. Ospedale S.MartinoRecruiting
  • A.O. san PaoloRecruiting
  • Casa di Cura Igea
  • Ospedale S.Carlo Borromeo
  • A.O. S.GerardoRecruiting
  • A.O. Universitaria Ospedali Riuniti Umberto IRecruiting
  • Ospedali Riuniti, Largo Barozzi, 1Recruiting
  • A.O.Policlinico S.Orsola Malpighi
  • A.O. Careggi-Università, Viale Pieraccini, 17Recruiting
  • Ospedale Galliera
  • A.O. Carlo Poma - Via Albertoni, 1Recruiting
  • A.O. Cà Granda, Piazza Ospedale Maggiore, 3Recruiting
  • Policlinico di modena
  • Università Campus Biomedico, Via Emilio Longoni, 83
  • A.O. S.Giovanni Calabita Fatebenefratelli

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

A

B

Arm Description

Sorafenib 400 mg po bid, continuously Gemcitabine 1000 mg/m2, Cisplatin 25 mg/m2 day 1, and 8 every 21 days.

Gemcitabine 1000 mg/m2, Cisplatin 25 mg/m2 day 1, and 8 every 21 days

Outcomes

Primary Outcome Measures

Progression Free Survival

Secondary Outcome Measures

- overall Response Rate (RECIST Criteria) - duration of response - overall survival time

Full Information

First Posted
September 22, 2008
Last Updated
October 9, 2008
Sponsor
Gruppo Italiano per lo studio dei Carcinomi dell'Apparato Digerente
Collaborators
Mario Negri Institute for Pharmacological Research
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1. Study Identification

Unique Protocol Identification Number
NCT00758381
Brief Title
Metastatic Advanced Pancreas Sorafenib
Acronym
MAPS
Official Title
A Randomized Phase II Study of Gemcitabine/Cisplatin With or Without Sorafenib to Evaluate the Efficacy and Safety in Patients With Locally Advanced or Metastatic Pancreatic Cancer. MAPS Trial
Study Type
Interventional

2. Study Status

Record Verification Date
October 2008
Overall Recruitment Status
Unknown status
Study Start Date
August 2007 (undefined)
Primary Completion Date
August 2008 (Anticipated)
Study Completion Date
August 2009 (Anticipated)

3. Sponsor/Collaborators

Name of the Sponsor
Gruppo Italiano per lo studio dei Carcinomi dell'Apparato Digerente
Collaborators
Mario Negri Institute for Pharmacological Research

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This is multicentre, open-label, randomized, phase II trial in patients with locally advanced or metastatic pancreatic cancer. Subjects will be randomized in a 1:1 ratio to receive gemcitabine/cisplatin in combination with Sorafenib (arm A) or gemcitabine/cisplatin alone (arm B), as first-line chemotherapy.
Detailed Description
Up to date no standard treatment is available for pancreatic cancer. Although gemcitabine is commonly used in patients with pancreatic cancer with the purpose of symptom palliation, there is no clear evidence of efficacy in terms of survival increase or progression control. Furthermore, attempts at improving results by combining gemcitabine with other cytotoxic drugs failed to obtain any advantage. Recently, an EGFR inhibitor (erlotinib) showed a small survival advantage when combined with gemcitabine. results obtained with a combination of gemcitabine and oxaliplatin seem more promising. A meta-analysis of randomised trials comparing gemcitabine versus gemcitabine and platinum analogues showed a statistical significant survival advantage for the combination. Sorafenib is an inhibitor of the RAS/RAF signalling pathway. Furthermore, sorafenib is able to inhibit both VEGFR and PDGFR. Since RAS and RAF mutations are quite common in pancreatic cancer, Sorafenib could be useful in the management of these tumours. Furthermore, it may be combined with gemcitabine and cisplatin without any pharmacokinetic interaction or enhanced toxicity.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Locally Advanced Pancreatic Cancer
Keywords
pancreatic cancer, advanced or metastatic, sorafenib

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
114 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
A
Arm Type
Experimental
Arm Description
Sorafenib 400 mg po bid, continuously Gemcitabine 1000 mg/m2, Cisplatin 25 mg/m2 day 1, and 8 every 21 days.
Arm Title
B
Arm Type
Active Comparator
Arm Description
Gemcitabine 1000 mg/m2, Cisplatin 25 mg/m2 day 1, and 8 every 21 days
Intervention Type
Drug
Intervention Name(s)
Sorafenib 400 mg po bid, continuously
Other Intervention Name(s)
L01XE05 V, Sostanza attiva o descrizione del livello ATC selezionato, SORAFENIB TOSILATO
Intervention Description
NEXAVAR*112CPR RIV 200MG Titolare AIC: BAYER SpA Numero di AIC dell'IMP: 037154010
Intervention Type
Drug
Intervention Name(s)
Gemcitabina, Cisplatino
Other Intervention Name(s)
GEMZAR*INFUS 1FL 1G POLV, Titolare AIC:, ELI LILLY ITALIA SpA, Numero di AIC dell'IMP:, 029452012, CISPLATINO TEVA*EV 50MG 100ML, TEVA PHARMA ITALIA Srl, 026543025
Intervention Description
Gemcitabina 1000 mg/mq, Cisplatino 25 mg/mq day 1 and 8 every 21 days
Primary Outcome Measure Information:
Title
Progression Free Survival
Time Frame
time from randomization date to date of local or regional relapse
Secondary Outcome Measure Information:
Title
- overall Response Rate (RECIST Criteria) - duration of response - overall survival time
Time Frame
time from the day of randomization to the date of death from any cause

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Signed written informed consent prior to beginning protocol specific procedures Male or female 18 to 75 years of age Diagnosis of histologically confirmed adenocarcinoma of the pancreas Locally advanced (non-resectable) or metastatic pancreatic cancer Presence of at least one uni-dimensional indicator lesion measurable by CT scan or MRI in not an irradiated area (RECIST criteria) Karnofsky performance status of ≥ 70 at study entry Neutrophils ≥ 1.5 x 109/L, platelets ≥ 100 x 109/L, and hemoglobin ≥ 9 g/dL Bilirubin level either normal or < 1.5 x ULN ASAT and ALAT ≤ 2.5 X ULN (≤ 5 x ULN if liver metastasis are present) Serum creatinine < 1.5 x ULN Amylase and lipase ≤ 1.5 x the upper limit of normal PT or INR and PTT < 1.5 x upper limit of normal (subjects who receive anti-coagulation treatment with an agent such as warfarin or heparin will be allowed to participate provided that no evidence of underlying abnormality in these parameters exists). Effective contraception for both male and female patients if the risk of conception exists Exclusion Criteria: Brain metastases Previous chemotherapy for locally advanced or metastatic pancreatic cancer. Adjuvant therapy if documented recurrence is within 6 months after the end of adjuvant treatment) Radiotherapy within 4 weeks prior to study entry Major surgery within 4 weeks of first dose of study drug Concurrent chronic systemic immune therapy Any investigational agent(s) 4 weeks prior to entry Clinically relevant coronary artery disease or a history of a myocardial infarction within the last 6 months Thrombotic or embolic events such as cerebrovascular accident including transient ischemic attacks within the past 6 months Acute or subacute intestinal occlusion or history of inflammatory bowel disease Known grade 3 or 4 allergic reaction to any of the components of the treatment Known drug abuse/ alcohol abuse Legal incapacity or limited legal capacity Medical or psychological condition which in the opinion of the investigator would not permit the patient to complete the study or sign meaningful informed consent Women who are pregnant or breastfeeding Acute or subacute intestinal occlusion Any concurrent malignancy other than non-melanoma skin cancer, or carcinoma in situ of the cervix. (Patients with a previous malignancy but without evidence of disease for ≥ 5 years will be allowed to enter the trial).
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Stefano Cascinu, MProfessor
Phone
+39 071 5964
Ext
171
Email
cascinu@yahoo.com
First Name & Middle Initial & Last Name or Official Title & Degree
Silvia Rota, Data Manager
Phone
+39 0331 490052
Email
centrotrialgiscad@yahoo.it
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Stefano Cascinu, M.Professor
Organizational Affiliation
GISCAD Foundation
Official's Role
Study Chair
Facility Information:
Facility Name
A.O. Treviglio-Caravaggio, P.le Ospedale n1
City
Treviglio
State/Province
Bergamo
ZIP/Postal Code
24047
Country
Italy
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
sandro Barni, MD
Facility Name
Ospedale S.Orsola Fatebenefratelli
City
Brescia
State/Province
BS
ZIP/Postal Code
15100
Country
Italy
Individual Site Status
Active, not recruiting
Facility Name
A.O. Ospedale S.Martino
City
Genova
State/Province
GE
ZIP/Postal Code
16132
Country
Italy
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Alberto Sobrero, MD
Facility Name
A.O. san Paolo
City
Milano
State/Province
MI
ZIP/Postal Code
20100
Country
Italy
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Paolo Foa, MD
Facility Name
Casa di Cura Igea
City
Milano
State/Province
MI
ZIP/Postal Code
20100
Country
Italy
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Gianfranco Pancera, MD
Facility Name
Ospedale S.Carlo Borromeo
City
Milano
State/Province
MI
ZIP/Postal Code
20123
Country
Italy
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Donata Tabiadon, MD
Facility Name
A.O. S.Gerardo
City
Monza
State/Province
MI
ZIP/Postal Code
20052
Country
Italy
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Paolo Bidoli, MD
Facility Name
A.O. Universitaria Ospedali Riuniti Umberto I
City
Ancona
ZIP/Postal Code
60020
Country
Italy
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Stefano Cascinu, M.Pr
Facility Name
Ospedali Riuniti, Largo Barozzi, 1
City
Bergamo
ZIP/Postal Code
24128
Country
Italy
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Roberto Labianca, MD
Facility Name
A.O.Policlinico S.Orsola Malpighi
City
Bologna
ZIP/Postal Code
40138
Country
Italy
Individual Site Status
Active, not recruiting
Facility Name
A.O. Careggi-Università, Viale Pieraccini, 17
City
Firenze
ZIP/Postal Code
50139
Country
Italy
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Francesco Di Costanzo, MD
Facility Name
Ospedale Galliera
City
Genova
ZIP/Postal Code
16132
Country
Italy
Individual Site Status
Active, not recruiting
Facility Name
A.O. Carlo Poma - Via Albertoni, 1
City
Mantova
ZIP/Postal Code
46100
Country
Italy
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Enrico Aitini, MD
Facility Name
A.O. Cà Granda, Piazza Ospedale Maggiore, 3
City
Milano
ZIP/Postal Code
20162
Country
Italy
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Salvatore Siena, MPr
Facility Name
Policlinico di modena
City
Modena
ZIP/Postal Code
41100
Country
Italy
Individual Site Status
Active, not recruiting
Facility Name
Università Campus Biomedico, Via Emilio Longoni, 83
City
Roma
ZIP/Postal Code
00155
Country
Italy
Individual Site Status
Active, not recruiting
Facility Name
A.O. S.Giovanni Calabita Fatebenefratelli
City
Roma
ZIP/Postal Code
00186
Country
Italy
Individual Site Status
Active, not recruiting

12. IPD Sharing Statement

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Metastatic Advanced Pancreas Sorafenib

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