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Gemcitabine, Bevacizumab, and Abdominal Radiation Therapy in Treating Patients With Localized Pancreatic Cancer

Phase 2
Completed
Conditions
Pancreatic Cancer
Interventions
Biological: bevacizumab
Procedure: conventional surgery
Radiation: radiation therapy
Registration Number
NCT00460174
Lead Sponsor
Northwestern University
Brief Summary

RATIONALE: Drugs used in chemotherapy, such as gemcitabine, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Monoclonal antibodies, such as bevacizumab, can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Bevacizumab may also stop the tumor growth by blocking blood flow to the tumor. Radiation therapy uses high-energy x-rays to kill tumor cells. Gemcitabine and bevacizumab may make tumor cells more sensitive to radiation therapy. Giving gemcitabine together with bevacizumab and radiation therapy may kill more tumor cells.

PURPOSE: This phase II trial is studying how well giving gemcitabine together with bevacizumab and abdominal radiation therapy works in treating patients with localized pancreatic cancer.

Detailed Description

OBJECTIVES:

Primary

* Determine the objective response rate in patients treated with concurrent bevacizumab, gemcitabine hydrochloride, and abdominal radiotherapy.

Secondary

* Determine the quantitative toxicity associated with the delivery of this regimen in these patients.

* Determine the 1-year and median survival of patients treated with this regimen.

* Determine the time to progression in patients treated with this regimen.

* Determine the patterns of recurrence in the entire population of patients treated with this regimen and in the subgroup that is resected for cure.

* Determine the safety of this regimen in these patients.

* Evaluate the surgical experience of patients who undergo surgical resection after completion of protocol-directed therapy.

* Evaluate the toxicity associated with surgical resection in these patients.

OUTLINE: Patients receive gemcitabine hydrochloride IV over 30 minutes on days 1 and 8 of courses 1 and 3 and on days 1, 8, and 15 of course 2. Patients also receive bevacizumab IV over 30-90 minutes on days 1 and 15 of course 1, on days 8 and 22 of course 2, and on day 8 of course 3. Treatment repeats every 3-4 weeks for up to 3 courses in the absence of disease progression or unacceptable toxicity. Beginning on day 1 of the second course of chemotherapy, patients undergo concurrent abdominal radiotherapy once daily, five days a week, for 3 weeks.

Patients are evaluated at week 10. Patients whose disease deemed resectable after study treatment undergo standard pancreatic resection at least 6 weeks after completion of bevacizumab. Patients who remain unresectable and have not progressed after completion of chemoradiotherapy may begin maintenance therapy comprising gemcitabine hydrochloride IV over 30 minutes on days 1, 8, and 15 and bevacizumab IV over 30-90 minutes on days 1 and 15. Treatment with gemcitabine hydrochloride and bevacizumab repeats every 4 weeks in the absence of disease progression or unacceptable toxicity.

After completion of study therapy, patients are followed periodically for up to 10 years.

PROJECTED ACCRUAL: A total of 30 patients will be accrued for this study.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
31
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Treatment ArmbevacizumabConcurrent gemcitabine, bevacizumab, and radiation therapy
Treatment Armconventional surgeryConcurrent gemcitabine, bevacizumab, and radiation therapy
Treatment Armradiation therapyConcurrent gemcitabine, bevacizumab, and radiation therapy
Treatment ArmgemcitabineConcurrent gemcitabine, bevacizumab, and radiation therapy
Primary Outcome Measures
NameTimeMethod
Response rateAfter 10 weeks of concurrent therapy

Response will be measured by CT scans using Recist and defined as Complete Response, Partial Response, Stable disease/no response, Progressive Disease.

Secondary Outcome Measures
NameTimeMethod
Toxicity profile of bevacizumab and gemcitabine with radiation therapyAfter every cycle of therapy (cycle = 3-4 weeks), then every 3 months for 2 years, then every 6 months for 3 years, then yearly up to 10 years or until disease progression.

Toxicities will be measured using National Cancer Institute's Common Toxicity Criteria for adverse events version 3.0 (CTCAE v3.0). Adverse events (AE)are graded:

Grade 1 Mild AE Grade 2 Moderate AE Grade 3 Severe AE Grade 4 Life-threatening or disabling AE Grade 5 Death related to AE

Trial Locations

Locations (1)

Northwestern University

🇺🇸

Chicago, Illinois, United States

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