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Study of Gemcitabine and Abraxane to Treat Potentially Operable Pancreatic Cancer

Primary Purpose

Resectable Pancreatic Cancer

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Gemcitabine and Abraxane
Sponsored by
Pancreatic Cancer Research Team
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Resectable Pancreatic Cancer focused on measuring operable, pancreas, Abraxane, Gemcitabine, Preoperative, potentially, Pancreatic Cancer

Eligibility Criteria

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

Inclusion Criteria:

  1. Patient has histologically or cytologically confirmed potentially resectable adenocarcinoma of the pancreas. Patients with islet cell neoplasms are excluded.

    Definition of potentially operable disease

    1. Staging by high-quality, pancreatic protocol, helical abdominal computed tomography required (Endoscopic ultrasound is not required).
    2. No extension to superior mesenteric artery (SMA) and hepatic artery.
    3. Clear fat plane between the SMA and celiac axis.
    4. No extension to celiac axis and hepatic artery.
    5. Patent superior mesenteric vein and portal vein.
    6. No evidence of distant or extra-hepatic disease by CT scans.
    7. Pretreatment histological or cytological confirmation of an adenocarcinoma.
  2. Male or non-pregnant and non-lactating female, and ≥ 18 years of age.
  3. If a female patient is of child-bearing potential, she must have a negative serum pregnancy test (β hCG) documented within 72 hours of the first administration of study drug.
  4. If sexually active, the patient must agree to use contraception considered adequate and appropriate by the Investigator.
  5. Patient must have received no prior chemotherapy or radiation for pancreatic cancer and no exposure to gemcitabine and/or Abraxane
  6. Patient has the following blood counts at baseline:

    1. ANC ≥ 1.5 x 109/L (1500 /mm³);
    2. Platelets ≥ 100 x 109/L; (100,000/mm³);
    3. Hgb ≥ 10 g/dL.
  7. Patient has the following blood chemistry levels at baseline:

    1. AST (SGOT), ALT (SGPT) ≤ 2.5 x upper limit of normal (ULN);
    2. Alkaline phosphatase (AP) ≤ 2.5 X ULN;
    3. Total bilirubin ≤1.5 mg/dl;
    4. Serum creatinine ≤1.5mg/dl or calculated clearance ≥ 50 mL/min/1.73 m² for patients with serum creatinine levels >1.5 mg/dl.
  8. Patient has acceptable coagulation status as indicated by a PT within normal limits (±15%) and PTT within normal limits (± 15%).
  9. Patient has an ECOG performance status PS 0-1.
  10. Patient has been informed about the nature of the study, and has agreed to participate in the study, and signed the Informed Consent Form prior to participation in any study-related activities.

Exclusion Criteria:

  1. Patient has borderline resectable disease
  2. Patient uses therapeutic coumadin for a history of pulmonary emboli or DVT.
  3. Patient has active, uncontrolled bacterial, viral, or fungal infection(s) requiring systemic therapy.
  4. Patient has known infection with HIV, hepatitis B, or hepatitis C.
  5. Patient has undergone major surgery, other than diagnostic surgery (i.e.--surgery done to obtain a biopsy for diagnosis without removal of an organ), within 4 weeks prior to Day 1 of treatment in this study.
  6. Prior chemotherapy or radiation for pancreatic cancer. Prior exposure to gemcitabine and/or Abraxane.
  7. Patient has a history of allergy or hypersensitivity to the study drugs.
  8. Patient has serious medical risk factors involving any of the major organ systems such that the Investigator considers it unsafe for the patient to receive an experimental research drug.
  9. Patient is unwilling or unable to comply with study procedures.
  10. Patient is enrolled in any other therapeutic clinical protocol or investigational trial.
  11. Patient has metastatic disease on radiological staging.
  12. Patients aged ≥ 80 are not excluded. As two events of fatal sepsis have been seen in this group in other studies, candidates in this age group should be thoroughly evaluated before enrollment in the study, to ensure they are fit to receive chemotherapy. In addition to meeting all of the baseline patient selection criteria, clinical judgment on their susceptibility to infection and expected stability of their performance status as to receive repeat weekly chemotherapy cycles, should be paid special attention to. Patients should not be enrolled in the study should there be any hesitation on any of these considerations. Baseline criteria for all patients enrolled on the study must be carefully evaluated and all criteria followed appropriately.

Sites / Locations

  • TGen Clinical Research Services at Scottsdale Healthcare
  • St Mary's / Trinity Health Care
  • Virginia Piper Cancer Institute
  • University of Pittsburg Medical Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Gemcitabine & Abraxane Pancreatic Cancer

Arm Description

Outcomes

Primary Outcome Measures

Grade III/IV histological response in tumor specimen rate after induction therapy.

Secondary Outcome Measures

Number of participants with adverse events.
Tumor response rate to therapy.
Pre and post therapy radiological assessments of the primary tumor will be compared using RECIST criteria.
Change in CA 19-9
Baseline CA19-9 and subsequent levels will be compared.
Resection rate at surgery
The number of patients who have R0 and R1 surgery will be compiled.
Time to recurrence
SPARC protein expression in tumor
Overall Survival

Full Information

First Posted
February 14, 2011
Last Updated
June 15, 2015
Sponsor
Pancreatic Cancer Research Team
Collaborators
Celgene Corporation
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1. Study Identification

Unique Protocol Identification Number
NCT01298011
Brief Title
Study of Gemcitabine and Abraxane to Treat Potentially Operable Pancreatic Cancer
Official Title
A Pilot Phase II Multi Center Study of Gemcitabine and Nab-paclitaxel (Abraxane) as Preoperative Therapy for Potentially Operable Pancreatic Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
June 2015
Overall Recruitment Status
Completed
Study Start Date
May 2011 (undefined)
Primary Completion Date
December 2013 (Actual)
Study Completion Date
May 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Pancreatic Cancer Research Team
Collaborators
Celgene Corporation

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The main purpose of this research study is to evaluate whether Abraxane and gemcitabine are effective in treating patients with operable pancreatic cancer.
Detailed Description
The best outcome for a patient diagnosed with pancreatic cancer is surgery. However many patients have recurrence of the cancer after successful surgery. The investigators are evaluating chemotherapy before surgery, which is a new approach. In this study, Abraxane and gemcitabine will be tested as treatment for people with operable pancreatic cancer to see if surgery can be successfully performed and if treatment will reduce cancer cells in the tumor at surgery. Abraxane is approved by the US FDA for the treatment of metastatic breast cancer after failure of combination chemotherapy for metastatic disease or relapse within 6 months of adjuvant chemotherapy. Gemcitabine is approved by the FDA for first line treatment for patients with locally advanced or metastatic cancer of the pancreas.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Resectable Pancreatic Cancer
Keywords
operable, pancreas, Abraxane, Gemcitabine, Preoperative, potentially, Pancreatic Cancer

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Gemcitabine & Abraxane Pancreatic Cancer
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Gemcitabine and Abraxane
Other Intervention Name(s)
nab-paclitaxel, gemzar
Intervention Description
3 treatments for gemcitabine and abraxane every 28-days for 3 months, prior to surgery.
Primary Outcome Measure Information:
Title
Grade III/IV histological response in tumor specimen rate after induction therapy.
Time Frame
At time of surgery
Secondary Outcome Measure Information:
Title
Number of participants with adverse events.
Time Frame
From the initial dose of study drug up to 28 days after last dose of study drug.
Title
Tumor response rate to therapy.
Description
Pre and post therapy radiological assessments of the primary tumor will be compared using RECIST criteria.
Time Frame
Baseline and 16 weeks
Title
Change in CA 19-9
Description
Baseline CA19-9 and subsequent levels will be compared.
Time Frame
Baseline, Day 1 of each cycle, and end of therapy.
Title
Resection rate at surgery
Description
The number of patients who have R0 and R1 surgery will be compiled.
Time Frame
At time of surgery
Title
Time to recurrence
Time Frame
Time from first dose of study drug to date of first documented progression or date of death, whichever occurs first, assessed up to 60 months.
Title
SPARC protein expression in tumor
Time Frame
At time of surgery
Title
Overall Survival
Time Frame
Time from the first dose of study drug until date of death from any cause, up to 60 months.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patient has histologically or cytologically confirmed potentially resectable adenocarcinoma of the pancreas. Patients with islet cell neoplasms are excluded. Definition of potentially operable disease Staging by high-quality, pancreatic protocol, helical abdominal computed tomography required (Endoscopic ultrasound is not required). No extension to superior mesenteric artery (SMA) and hepatic artery. Clear fat plane between the SMA and celiac axis. No extension to celiac axis and hepatic artery. Patent superior mesenteric vein and portal vein. No evidence of distant or extra-hepatic disease by CT scans. Pretreatment histological or cytological confirmation of an adenocarcinoma. Male or non-pregnant and non-lactating female, and ≥ 18 years of age. If a female patient is of child-bearing potential, she must have a negative serum pregnancy test (β hCG) documented within 72 hours of the first administration of study drug. If sexually active, the patient must agree to use contraception considered adequate and appropriate by the Investigator. Patient must have received no prior chemotherapy or radiation for pancreatic cancer and no exposure to gemcitabine and/or Abraxane Patient has the following blood counts at baseline: ANC ≥ 1.5 x 109/L (1500 /mm³); Platelets ≥ 100 x 109/L; (100,000/mm³); Hgb ≥ 10 g/dL. Patient has the following blood chemistry levels at baseline: AST (SGOT), ALT (SGPT) ≤ 2.5 x upper limit of normal (ULN); Alkaline phosphatase (AP) ≤ 2.5 X ULN; Total bilirubin ≤1.5 mg/dl; Serum creatinine ≤1.5mg/dl or calculated clearance ≥ 50 mL/min/1.73 m² for patients with serum creatinine levels >1.5 mg/dl. Patient has acceptable coagulation status as indicated by a PT within normal limits (±15%) and PTT within normal limits (± 15%). Patient has an ECOG performance status PS 0-1. Patient has been informed about the nature of the study, and has agreed to participate in the study, and signed the Informed Consent Form prior to participation in any study-related activities. Exclusion Criteria: Patient has borderline resectable disease Patient uses therapeutic coumadin for a history of pulmonary emboli or DVT. Patient has active, uncontrolled bacterial, viral, or fungal infection(s) requiring systemic therapy. Patient has known infection with HIV, hepatitis B, or hepatitis C. Patient has undergone major surgery, other than diagnostic surgery (i.e.--surgery done to obtain a biopsy for diagnosis without removal of an organ), within 4 weeks prior to Day 1 of treatment in this study. Prior chemotherapy or radiation for pancreatic cancer. Prior exposure to gemcitabine and/or Abraxane. Patient has a history of allergy or hypersensitivity to the study drugs. Patient has serious medical risk factors involving any of the major organ systems such that the Investigator considers it unsafe for the patient to receive an experimental research drug. Patient is unwilling or unable to comply with study procedures. Patient is enrolled in any other therapeutic clinical protocol or investigational trial. Patient has metastatic disease on radiological staging. Patients aged ≥ 80 are not excluded. As two events of fatal sepsis have been seen in this group in other studies, candidates in this age group should be thoroughly evaluated before enrollment in the study, to ensure they are fit to receive chemotherapy. In addition to meeting all of the baseline patient selection criteria, clinical judgment on their susceptibility to infection and expected stability of their performance status as to receive repeat weekly chemotherapy cycles, should be paid special attention to. Patients should not be enrolled in the study should there be any hesitation on any of these considerations. Baseline criteria for all patients enrolled on the study must be carefully evaluated and all criteria followed appropriately.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ramesh K. Ramanathan, MD
Organizational Affiliation
TGen Drug Development
Official's Role
Principal Investigator
Facility Information:
Facility Name
TGen Clinical Research Services at Scottsdale Healthcare
City
Scottsdale
State/Province
Arizona
ZIP/Postal Code
85258
Country
United States
Facility Name
St Mary's / Trinity Health Care
City
Grand Rapids
State/Province
Michigan
ZIP/Postal Code
49505
Country
United States
Facility Name
Virginia Piper Cancer Institute
City
Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55408
Country
United States
Facility Name
University of Pittsburg Medical Center
City
Pittsburg
State/Province
Pennsylvania
ZIP/Postal Code
19047
Country
United States

12. IPD Sharing Statement

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Study of Gemcitabine and Abraxane to Treat Potentially Operable Pancreatic Cancer

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