Accelerating the Actionability of Treatment in Resected and Locally Advanced Pancreatic Cancer
Overview
- Phase
- Not Applicable
- Intervention
- Genetic testing
- Conditions
- Pancreatic Ductal Adenocarcinoma
- Sponsor
- British Columbia Cancer Agency
- Enrollment
- 200
- Locations
- 1
- Primary Endpoint
- Frequency of comprehensive genomic results returned within 8 weeks of sample collection.
- Status
- Recruiting
- Last Updated
- 3 months ago
Overview
Brief Summary
The goal of this study is to learn if the genetic information and proteins from tumours can help treat pancreatic ductal adenocarcinoma (PDAC). The main questions it aims to answer are:
- Is it feasible to obtain genetic test results within a timeframe that can help inform treatment decisions for individuals with PDAC?
- Can the genetic test results provide information about how a tumour will respond to or resist treatment?
Participants will:
- Receive standard chemotherapy to treat their cancer.
- Provide samples of their blood, tissue, and fluid for genetic testing.
- Visit the clinic every 4 weeks for check-ups and tests.
- Complete questionnaires every 12 weeks.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Participants must meet all of the following criteria prior to Pre-Baseline registration:
- •Age 18 years or older.
- •Histological or radiological diagnosis of resectable, borderline resectable, or locally advanced PDAC.
- •Medically fit and planned to undergo laparoscopic procedure as part of standard of care.
- •Able to give informed consent for the study-related procedures performed during laparoscopy.
- •Participants must meet all of the following criteria to be eligible for enrollment in the Main Study:
- •Age 18 years or older.
- •Enrolled in the Personalized Oncogenomics (POG) Program at BC Cancer.
- •Histological and/or radiological diagnosis of resectable, borderline resectable, or locally advanced PDAC. Participants without a histological diagnosis of PDAC must undergo confirmatory histological diagnosis prior to treatment start date.
- •Medically fit to undergo surgical resection of the primary lesion(s) as judged by the investigator (Resectable and Borderline Resectable Cohorts only).
Exclusion Criteria
- •Presence of distant or lymph node metastases. Individuals with metastatic PDAC are not eligible.
- •Currently receiving adjuvant (Resectable and Borderline Resectable Cohorts) or systemic (Locally Advanced Cohort) anti-cancer therapy (chemotherapy or any other anti-cancer agent) with one exception: pre-operative therapy is permitted.
- •Not fit for chemotherapy as judged by the investigator.
- •Presence of brain metastases.
- •Positive pregnancy test.
- •Unable to comply with the study assessments and procedures defined in this protocol.
- •Individuals who are otherwise judged by the investigator to be unfit to proceed with this protocol.
Arms & Interventions
Resectable Cohort
Participants with resectable PDAC. Participants will provide tumour, fluid, and blood samples for genetic testing and other analyses. Tumour samples will be collected from standard resection surgery and optional biopsies. Fluid samples will be collected from a standard laparoscopy procedure. Blood samples will be collected at several timepoints throughout the study. Participants will receive standard chemotherapy (folinic acid (leucovorin), fluorouracil, irinotecan, and oxaliplatin (FOLFIRINOX) or gemcitabine-based) regimens.
Intervention: Genetic testing
Resectable Cohort
Participants with resectable PDAC. Participants will provide tumour, fluid, and blood samples for genetic testing and other analyses. Tumour samples will be collected from standard resection surgery and optional biopsies. Fluid samples will be collected from a standard laparoscopy procedure. Blood samples will be collected at several timepoints throughout the study. Participants will receive standard chemotherapy (folinic acid (leucovorin), fluorouracil, irinotecan, and oxaliplatin (FOLFIRINOX) or gemcitabine-based) regimens.
Intervention: Optional biopsy
Resectable Cohort
Participants with resectable PDAC. Participants will provide tumour, fluid, and blood samples for genetic testing and other analyses. Tumour samples will be collected from standard resection surgery and optional biopsies. Fluid samples will be collected from a standard laparoscopy procedure. Blood samples will be collected at several timepoints throughout the study. Participants will receive standard chemotherapy (folinic acid (leucovorin), fluorouracil, irinotecan, and oxaliplatin (FOLFIRINOX) or gemcitabine-based) regimens.
Intervention: Tissue collection
Borderline Resectable Cohort
Participants with borderline resectable PDAC. Participants will provide tumour, fluid, and blood samples for genetic testing and other analyses. Tumour samples will be collected from standard resection surgery and optional biopsies. Fluid samples will be collected from a standard laparoscopy procedure. Blood samples will be collected at several timepoints throughout the study. Participants will receive standard chemotherapy (FOLFIRINOX or gemcitabine-based) regimens.
Intervention: Genetic testing
Borderline Resectable Cohort
Participants with borderline resectable PDAC. Participants will provide tumour, fluid, and blood samples for genetic testing and other analyses. Tumour samples will be collected from standard resection surgery and optional biopsies. Fluid samples will be collected from a standard laparoscopy procedure. Blood samples will be collected at several timepoints throughout the study. Participants will receive standard chemotherapy (FOLFIRINOX or gemcitabine-based) regimens.
Intervention: Optional biopsy
Borderline Resectable Cohort
Participants with borderline resectable PDAC. Participants will provide tumour, fluid, and blood samples for genetic testing and other analyses. Tumour samples will be collected from standard resection surgery and optional biopsies. Fluid samples will be collected from a standard laparoscopy procedure. Blood samples will be collected at several timepoints throughout the study. Participants will receive standard chemotherapy (FOLFIRINOX or gemcitabine-based) regimens.
Intervention: Tissue collection
Locally Advanced Cohort
Participants with locally advanced PDAC. Participants will provide fluid and blood samples for genetic testing and other analyses. Fluid samples will be collected from a standard laparoscopy procedure. Blood samples will be collected at several timepoints throughout the study. Tumour samples may also be collected, if participants agree to optional biopsies. Participants will receive standard chemotherapy (FOLFIRINOX or gemcitabine-based) regimens.
Intervention: Genetic testing
Locally Advanced Cohort
Participants with locally advanced PDAC. Participants will provide fluid and blood samples for genetic testing and other analyses. Fluid samples will be collected from a standard laparoscopy procedure. Blood samples will be collected at several timepoints throughout the study. Tumour samples may also be collected, if participants agree to optional biopsies. Participants will receive standard chemotherapy (FOLFIRINOX or gemcitabine-based) regimens.
Intervention: Optional biopsy
Locally Advanced Cohort
Participants with locally advanced PDAC. Participants will provide fluid and blood samples for genetic testing and other analyses. Fluid samples will be collected from a standard laparoscopy procedure. Blood samples will be collected at several timepoints throughout the study. Tumour samples may also be collected, if participants agree to optional biopsies. Participants will receive standard chemotherapy (FOLFIRINOX or gemcitabine-based) regimens.
Intervention: Tissue collection
Outcomes
Primary Outcomes
Frequency of comprehensive genomic results returned within 8 weeks of sample collection.
Time Frame: From the date of resection surgery or baseline ctDNA collection until genomic results are available (typically 8 weeks).
The percentage of participants with comprehensive genomic results for their baseline tumour tissue and/or circulating tumour deoxyribonucleic acid (ctDNA) within 8 weeks of their collection.
Secondary Outcomes
- Overall response rate (ORR) in each study arm, as defined by Response Evaluation Criteria in Solid Tumours (RECIST) 1.1(From the date of the baseline scan (within 28 days of first dose) until the date of confirmed progression, withdrawal, date of death, or end of study, whichever comes first, assessed up to 72 months.)
- Progression-free survival (PFS) in each study arm from the initiation of chemotherapy(From the date of first dose of chemotherapy until the date of confirmed progression, withdrawal, date of death, or end of study, whichever comes first, assessed up to 72 months.)
- Disease control rate in each study arm, as defined by RECIST 1.1(From the date of the baseline scan (within 28 days of first dose) until the date of confirmed progression, withdrawal, date of death, or end of study, whichever comes first, assessed up to 72 months.)
- Duration of response (DoR) in each study arm, as defined by RECIST 1.1(From the first date of CR or PR until the first date of confirmed progression, withdrawal, date of death, or end of study, whichever comes first, assessed up to 72 months.)
- Overall survival (OS) in each study arm from the initiation of chemotherapy(From the date of first dose of chemotherapy until the date of death or end of study, whichever comes first, assessed up to 72 months.])