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Pulse-low-dose Rate (PLDR) Radiation in Pancreatic Cancer

Primary Purpose

Pancreatic Cancer

Status
Recruiting
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
PLDR
Sponsored by
Fox Chase Cancer Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pancreatic Cancer

Eligibility Criteria

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

Inclusion Criteria:

  • Patients must have histologically or cytologically-confirmed pancreatic adenocarcinoma.
  • Patients must have non-metastatic pancreatic cancer not appropriate for immediate surgical resection. This includes the following:

    • Any involvement (defined as loss of fat plane on contrast CT) of any of the following vessels*:

      • Common hepatic artery
      • Superior mesenteric artery
      • Celiac axis
      • Superior mesenteric vein
      • Portal vein
      • Aorta

        • These criteria will be judged by the operating surgeon in conjunction with a radiologist prior to enrollment.
    • Poor performance status not immediately conducive to radical surgery
    • Other clinical reasoning by the treating physicians that supports pre-operative chemoradiation
  • Patients must have evaluable disease as measured by RECIST 1.1 criteria.
  • Planned surgical resection at the time of enrollment (may be initially staged as resectable, borderline resectable, or locally-advanced/unresectable).
  • Eastern Cooperative Oncology Group, or ECOG, performance status 0-2.
  • Adequate bone marrow, hepatic, renal function.

    • ANC ³ 1,500/ml and PLT ³ 100,000/ml
    • Bilirubin less than 1.5 ULN
    • AST and ALT < 3X ULN
    • Serum Creatinine <1.5X ULN
  • Prior chemotherapy allowed, but not mandatory. Patients who have undergone chemotherapy prior to participating in this study must have had a 2 week washout period at the time of signing the consent form.
  • Women of childbearing potential must be non-pregnant (negative pregnancy test within 72 hours prior to registration. Postmenopausal woman must have been amenorrheic and nonlactating for at least 12 months to be considered of non-childbearing potential. Men and women of child bearing potential must be willing to exercise an effective form of birth control (abstinence/contraception) while on study and for 3 months after therapy is completed. Please refer to section 6.4 for additional detail.
  • Age > 18 years
  • Participants must sign a written informed consent and HIPAA consent prior to performance of study-specific procedures or assessments and must be willing to comply with treatment and follow up.

Exclusion Criteria:

  • Radiological or cytologically confirmed metastatic disease
  • Patients who have had any prior therapy for pancreatic cancer, except chemotherapy (see 6.1.7)
  • Concurrent non-study chemotherapy or biologic therapy
  • A history of ataxia telangiectasia or other documented history of radiation hypersensitivity
  • Scleroderma or active connective tissue disease
  • Active inflammatory bowel disease
  • Serious, active infections requiring treatment with IV antibiotics
  • Uncontrolled intercurrent illness including, but not limited to, psychiatric illness/social situations that would limit compliance with study requirements.

Sites / Locations

  • Fox Chase Cancer CenterRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

PLDR Chemoradiation

Arm Description

Patients will receive pulse-low-dose rate radiation, along with gemcitabine chemotherapy. 6 patients each will be accrued at two dose levels. PLDR radiation will be delivered as 10 fractions of 20 cGy, initiated once every 3 minutes. Dose levels will be selected as follows: Dose level 1: 56 Gy; Dose level 2: 66 Gy

Outcomes

Primary Outcome Measures

Acute grade 3+ gastrointestinal toxicity possibly, probably or definitely related to radiation.
Number of participants with Grade 3 toxicity related to the treatment

Secondary Outcome Measures

Full Information

First Posted
June 26, 2020
Last Updated
July 19, 2023
Sponsor
Fox Chase Cancer Center
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1. Study Identification

Unique Protocol Identification Number
NCT04452357
Brief Title
Pulse-low-dose Rate (PLDR) Radiation in Pancreatic Cancer
Official Title
RT-155: Utilizing Pulsed Low-dose-rate (PLDR) Radiation to Prevent de Novo Stromal Activation; a Neoadjuvant Pancreatic Adenocarcinoma Phase I Trial
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Recruiting
Study Start Date
January 13, 2020 (Actual)
Primary Completion Date
December 1, 2023 (Anticipated)
Study Completion Date
December 1, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Fox Chase Cancer Center

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Standard chemoradiation, followed by surgery are standard treatment plan for patients suffering from pancreatic adenocarcinoma. Due to damage to the surrounding healthy tissue caused by standard radiation, this study uses a new type of radiation plan- pulsed low-dose rate (PLDR) radiation , in combination with chemotherapeutic drug, gemcitabine, given weekly along with the radiation.
Detailed Description
Radiation, combined with radiosensitizing chemotherapies, is often used preoperatively for borderline resectable cases with the intent of facilitating a curative surgical intervention. This includes providing margin adjacent to un-resectable vessels and sterilizing regional lymph nodes. Unfortunately, due to the radiosensitivity of adjacent small bowel and stomach, the total dose of radiation used is modest due to the risk of toxicities associated with higher doses. Pulsed low-dose-rate (PLDR) radiation improves the safety of radiation through breaking it up into small pulses. This increases the repair of DNA damage in normal tissues while remaining effective in cancer cells. Multiple prior studies have shown PLDR to be safe in the setting of re-irradiation, where additional radiation with conventional techniques is associated with severe toxicity. PLDR radiation will be given in 2 doses to 6 patients at each dose level: Dose level 1: 56 Gy- given over 6 weeks Dose level 2: 66 Gy- given over 7 weeks Standard chemotherapeutic drug, gemcitabine, will be administered once a week for the duration of radiation. This treatment will be followed by standard surgery to remove the cancer after consultation with a surgeon.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pancreatic Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
12 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
PLDR Chemoradiation
Arm Type
Experimental
Arm Description
Patients will receive pulse-low-dose rate radiation, along with gemcitabine chemotherapy. 6 patients each will be accrued at two dose levels. PLDR radiation will be delivered as 10 fractions of 20 cGy, initiated once every 3 minutes. Dose levels will be selected as follows: Dose level 1: 56 Gy; Dose level 2: 66 Gy
Intervention Type
Radiation
Intervention Name(s)
PLDR
Intervention Description
PLDR radiation will be delivered as 10 fractions of 20 cGy, initiated once every 3 minutes. Dose levels will be selected as follows: Dose level 1: 56 Gy; Dose level 2: 66 Gy Drug: Gemcitabine
Primary Outcome Measure Information:
Title
Acute grade 3+ gastrointestinal toxicity possibly, probably or definitely related to radiation.
Description
Number of participants with Grade 3 toxicity related to the treatment
Time Frame
11 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients must have histologically or cytologically-confirmed pancreatic adenocarcinoma. Patients must have non-metastatic pancreatic cancer not appropriate for immediate surgical resection. This includes the following: Any involvement (defined as loss of fat plane on contrast CT) of any of the following vessels*: Common hepatic artery Superior mesenteric artery Celiac axis Superior mesenteric vein Portal vein Aorta These criteria will be judged by the operating surgeon in conjunction with a radiologist prior to enrollment. Poor performance status not immediately conducive to radical surgery Other clinical reasoning by the treating physicians that supports pre-operative chemoradiation Patients must have evaluable disease as measured by RECIST 1.1 criteria. Planned surgical resection at the time of enrollment (may be initially staged as resectable, borderline resectable, or locally-advanced/unresectable). Eastern Cooperative Oncology Group, or ECOG, performance status 0-2. Adequate bone marrow, hepatic, renal function. ANC ³ 1,500/ml and PLT ³ 100,000/ml Bilirubin less than 1.5 ULN AST and ALT < 3X ULN Serum Creatinine <1.5X ULN Prior chemotherapy allowed, but not mandatory. Patients who have undergone chemotherapy prior to participating in this study must have had a 2 week washout period at the time of signing the consent form. Women of childbearing potential must be non-pregnant (negative pregnancy test within 72 hours prior to registration. Postmenopausal woman must have been amenorrheic and nonlactating for at least 12 months to be considered of non-childbearing potential. Men and women of child bearing potential must be willing to exercise an effective form of birth control (abstinence/contraception) while on study and for 3 months after therapy is completed. Please refer to section 6.4 for additional detail. Age > 18 years Participants must sign a written informed consent and HIPAA consent prior to performance of study-specific procedures or assessments and must be willing to comply with treatment and follow up. Exclusion Criteria: Radiological or cytologically confirmed metastatic disease Patients who have had any prior therapy for pancreatic cancer, except chemotherapy (see 6.1.7) Concurrent non-study chemotherapy or biologic therapy A history of ataxia telangiectasia or other documented history of radiation hypersensitivity Scleroderma or active connective tissue disease Active inflammatory bowel disease Serious, active infections requiring treatment with IV antibiotics Uncontrolled intercurrent illness including, but not limited to, psychiatric illness/social situations that would limit compliance with study requirements.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Joshua Meyer, MD
Phone
215-728-2667
Email
Joshua.Meyer@fccc.edu
First Name & Middle Initial & Last Name or Official Title & Degree
Meghann Hainsworth
Phone
215-728-5506
Email
Meghann.Hainsworth@fccc.edu
Facility Information:
Facility Name
Fox Chase Cancer Center
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19111
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Joshua Meyer, MD
Phone
215-728-2667
Email
Joshua.Meyer@fccc.edu
First Name & Middle Initial & Last Name & Degree
Meghann Hainsworth
Phone
215-728-5506
Email
Meghann.Hainsworth@fccc.edu

12. IPD Sharing Statement

Learn more about this trial

Pulse-low-dose Rate (PLDR) Radiation in Pancreatic Cancer

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