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S0205 Gemcitabine w/ or w/o Cetuximab as First-Line Therapy in Locally Advanced Pancreas Cancer

Phase 3
Completed
Conditions
Pancreatic Cancer
Interventions
Biological: cetuximab
Registration Number
NCT00075686
Lead Sponsor
SWOG Cancer Research Network
Brief Summary

RATIONALE: Drugs used in chemotherapy, such as gemcitabine, work in different ways to stop tumor cells from dividing so they stop growing or die. Monoclonal antibodies, such as cetuximab, can locate tumor cells and either kill them or deliver tumor-killing substances to them without harming normal cells. It is not yet known whether gemcitabine is more effective with or without cetuximab in treating pancreatic cancer.

PURPOSE: This randomized phase III trial is studying giving gemcitabine together with cetuximab to see how well it works compared to giving gemcitabine alone as first-line therapy in treating patients with locally advanced unresectable or metastatic adenocarcinoma of the pancreas.

Detailed Description

OBJECTIVES:

* Compare the overall survival of patients with locally advanced unresectable or metastatic adenocarcinoma of the pancreas treated with gemcitabine and cetuximab vs gemcitabine alone.

* Compare the time to treatment failure in patients treated with these regimens.

* Estimate the percentage of patients with epidermal growth factor receptor (EGFR) tumor expression in patients treated with these regimens.

* Compare the overall survival of patients in the EGFR-positive subset treated with these regimens.

* Compare the toxicity of these regimens in these patients.

* Compare the total response rate (confirmed and unconfirmed complete and partial response) in patients with measurable disease treated with these regimens.

* Compare the patient report of pain and quality of life of patients treated with these regimens.

OUTLINE: This is an open-label, randomized, multicenter study. Patients are stratified according to disease status (locally advanced unresectable vs metastatic), Zubrod performance status (0 or 1 vs 2), and prior pancreatectomy (yes vs no). Patients are randomized to 1 of 2 treatment arms.

* Arm I: Patients receive cetuximab IV over 1-2 hours on days 1, 8, 15, and 22 and gemcitabine IV over 30 minutes on days 1, 8, 15, and 22 for course 1 and days 1, 8, and 15 for all subsequent courses.

* Arm II: Patients receive gemcitabine as in arm I. In both arms, courses repeat every 4 weeks in the absence of disease progression or unacceptable toxicity.

Quality of life is assessed at baseline, before each course, and at the end of study therapy.

Patients are followed every 6 months for 2 years and then annually for 1 year.

PROJECTED ACCRUAL: A total of 704 patients (352 per treatment arm) will be accrued for this study within 5 years.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
766
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
gemcitabine hydrochloride + IMC-C225gemcitabine hydrochlorideLoading dose: gemcitabine hydrochloride 1000mg/m2, IV on Day 1; Cetuxiumab 400mg/m2, IV on Day 1 (cycle 1 only) Weekly maintenance: Cetuximab 250mg/m2, IV on Days 8,15,22 of cycle 1 \& days 1,8,15,22 of all subsequent cycles; gemcitabine hydrochloride 1000mg/m2, IV on Days 8,15,22 of cycle 1 and Days 1,8,15 of all subsequent cycles.
gemcitabine hydrochloride alonegemcitabine hydrochloridegemcitabine hydrochloride 1000mg/m2, IV on Days 1,8,15,22 of cycle 1 and Days 1,8,15 of all subsequent cycles.
gemcitabine hydrochloride + IMC-C225cetuximabLoading dose: gemcitabine hydrochloride 1000mg/m2, IV on Day 1; Cetuxiumab 400mg/m2, IV on Day 1 (cycle 1 only) Weekly maintenance: Cetuximab 250mg/m2, IV on Days 8,15,22 of cycle 1 \& days 1,8,15,22 of all subsequent cycles; gemcitabine hydrochloride 1000mg/m2, IV on Days 8,15,22 of cycle 1 and Days 1,8,15 of all subsequent cycles.
Primary Outcome Measures
NameTimeMethod
Overall survival comparison between treatment groupsevery 4 weeks for 3 years
Secondary Outcome Measures
NameTimeMethod
Toxicity profile comparison of patients treated with 2 regimens and measured until 30 days after completion of study treatmentevery 4 weeks while on treatment
Total response rate comparison between treatment groups in the subset of patients with measurable disease by RECIST at every other courseevery 9 weeks until progression
Pain and quality of life comparison between treatment groups as measured by patient questionnaire at baseline, before each course, and then completion of study treatmentevery 4 weeks while on treatment
Response rate comparison between treatment groups as measured by RECIST and radiological evaluation at every other courseevery 9 weeks until progression
Time to treatment failure comparison between groups from registration to first observation of progressive disease, symptomatic deterioration, or deathevery 4 weeks while on treatment
Percentage of patients with EGFR tumor expression and compare overall survival of patients in the EGFR subsetevery 4 weeks for 3 years

Trial Locations

Locations (387)

Mobile Infirmary Medical Center

🇺🇸

Mobile, Alabama, United States

East Alabama Medical Center

🇺🇸

Opelika, Alabama, United States

Alaska Regional Hospital Cancer Center

🇺🇸

Anchorage, Alaska, United States

Cancer Center at Providence Alaska Medical Center

🇺🇸

Anchorage, Alaska, United States

Banner Thunderbird Medical Center

🇺🇸

Glendale, Arizona, United States

Banner Good Samaritan Medical Center

🇺🇸

Phoenix, Arizona, United States

CCOP - Western Regional, Arizona

🇺🇸

Phoenix, Arizona, United States

Hembree Mercy Cancer Center at St. Edward Mercy Medical Center

🇺🇸

Ft. Smith, Arkansas, United States

Highlands Oncology Group - Springdale

🇺🇸

Springdale, Arkansas, United States

Alta Bates Comprehensive Cancer Center

🇺🇸

Berkeley, California, United States

Scroll for more (377 remaining)
Mobile Infirmary Medical Center
🇺🇸Mobile, Alabama, United States

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