Implantation of iodine125-Seeds Combined With Chemotherapy in the Treatment of Metastatic Pancreatic Carcinoma
- Conditions
- Metastatic Pancreatic Cancer
- Interventions
- Procedure: Iodine125-Seeds implantationDrug: Gem/nab-P Chemotherapy
- Registration Number
- NCT05869474
- Lead Sponsor
- Changhai Hospital
- Brief Summary
The goal of this clinical trial is to evaluate the clinical efficacy and safety of endoscopic ultrasonography (EUS)-guided radioactive iodine 125 seeds in combination with AG regimen chemotherapy for the treatment of metastatic pancreatic cancer. The main questions it aims to answer are:
* whether the combination of minimally invasive endoscopy-guided local radiation therapy with chemotherapy may improve overall survival
* the adverse events of the combination therapy Participants will receive the implantation of radioactive seeds under EUS guide. 48h after implantation, chemotherapy with Gem/nab-P given on days 1 and 8 of each 21-day cycle will be conducted.
Researchers will compare the I125+AG group with the group that takes AG chemotherapy alone to see if the overall survival can be improved.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 206
(Before the trial, subjects must meet all of the requirements listed below in order to be enrolled)
- 18 to 80 years old;
- Stage IV pancreatic ductal adenocarcinoma with distant metastases confirmed by clinical, imaging, and pathology, and the primary and metastatic mass can be measured on imaging.
- No treatment history of chemotherapy, radiotherapy, or surgery
- Expected survival > 6 months
- ECGO score of 0-2
- Eligible for chemotherapy (white blood cell > 3.5×109/L, neutrophil value > 1.5×109/L, hemoglobin > 80g/L, platelets > 100×109/L, albumin > 25g/L, alanine aminotransferase or aspartate aminotransferase ≤ 3 times the upper limit of normal and total bilirubin level ≤ 34.2umol/L, creatinine < 176.8 umol/L, normal ECG)
- Signed written informed consent;
- Contraindication of EUS-guide procedure or technical infeasibility (e.g.,coagulation disorder, anatomical changes, large vessels along the puncture path)
- Pregnant or breastfeeding
- Presence of brain metastases
- Presence of deep vein thrombosis or pulmonary embolism
- Presence of HIV, HBV, HCV infection or other uncontrollable active infection
- Hypersensitivity to chemotherapy drugs
- History of other malignancies within 5 years
- Peripheral neuropathy or interstitial lung disease within 5 years
- Patient is enrolled in any other clinical protocol or investigational trial.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description I125-AG Iodine125-Seeds implantation Participants will receive the implantation of radioactive seeds under EUS guide. 48h after implantation, chemotherapy with Gemcitabine 1000mg/m2 plus albumin paclitaxel 125mg/m2 given on days 1 and 8 of each 21-day cycle will be conducted. I125-AG Gem/nab-P Chemotherapy Participants will receive the implantation of radioactive seeds under EUS guide. 48h after implantation, chemotherapy with Gemcitabine 1000mg/m2 plus albumin paclitaxel 125mg/m2 given on days 1 and 8 of each 21-day cycle will be conducted. AG Gem/nab-P Chemotherapy Participants receive chemotherapy alone. Gemcitabine 1000mg/m2 plus albumin paclitaxel 125mg/m2 given on days 1 and 8 of each 21-day cycle.
- Primary Outcome Measures
Name Time Method Overall survival (OS) 48 months OS is defined as the time from the date of randomization to the date of death (any cause). Patients who are alive will be censored at the last known time that the patient was alive.
- Secondary Outcome Measures
Name Time Method Metabolic response from baseline to the end of 2nd chemotherapy cycle Metabolic response is evaluated by PET/CT according to EORTC criteria.
Overall Response Rate (ORR) 48 months ORR is defined as the percentage of patients with an investigator-assessed complete (CR) or partial response (PR) according to RECIST v1.1.
CA19-9 response 48 months CA19-9 response is defined as a decrease of CA19-9 concentration by 50% from the prespecified baseline concentration of 74 U/mL or more.
Progression-free survival (PFS) 48 months PFS is defined as the time from the date of randomization to the date of objective disease progression according to RECIST 1.1 criteria or death (due to any cause),whichever occurs first.
Incidence and severity of Adverse events (AEs) 48 months AEs are graded and reported using The CTCAE version 5.0.
Visual analog scale (VAS) 48 months Pain is scored according to a VAS score, with a score of 0 indicating no pain and a score of 10 indicating the most intense degree of pain (unbearable pain).
Trial Locations
- Locations (1)
Changhai Hospital
🇨🇳Shanghai, Shanghai, China