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临床试验/NCT02750657
NCT02750657已完成不适用

Comprehensive Molecular Characterization of Advanced Pancreatic Ductal Adenocarcinomas (PDAC) for Better Treatment Selection: A Prospective Study

University Health Network, Toronto4 个研究点 分布在 1 个国家目标入组 332 人开始时间: 2015年12月1日最近更新:
适应症

试验速览

阶段
不适用
状态
已完成
入组人数
332
试验地点
4
主要终点
The feasibility of prospectively identifying subgroups of patients with advanced PDAC who have distinct genomic characteristics for better treatment selection while undergoing 1st-line chemotherapy using next generation sequencing.

研究概览

简要总结

Researchers are looking for better ways of understanding and treating pancreatic cancer. The purpose of this study is to see how useful it is to look for changes and characteristics in your genes (molecules that contain instructions for the development and functioning of the cells) and the genes within the tumour. These characteristics may be useful in choosing treatments for patients in the future. Changes (mutations) in genes have been shown to be an important characteristic in cancers. Looking at differences in genes in patients with advanced pancreatic ductal adenocarcinomas and comparing this information with response to their initial chemotherapy treatment may help to learn which treatments may be better for certain patients after initial treatment.

研究设计

研究类型
Observational
观察模型
Cohort
时间视角
Prospective

入排标准

年龄范围
18 Years 至 —(Adult, Older Adult)
性别
All
接受健康志愿者

入选标准

  • Patients must have a histological or radiological diagnosis of locally advanced or metastatic pancreatic ductal adenocarcinoma. Patients with borderline resectable disease are not eligible.
  • Patient must have a tumor lesion that is amenable to a core needle biopsy.
  • Patients must have a measurable lesion by RECIST 1.1 in addition to the lesion that is going to be biopsied.
  • Patients must be fit enough to safely undergo a tumor biopsy.
  • Age 18 years or older.
  • Eastern Cooperative Group (ECOG) performance status of 1 or less.
  • Life expectancy of greater than 90 days.
  • Patients must have normal organ and marrow function
  • Patients must undergo systemic treatment with m-FOLFIRINOX or nab-paclitaxel as a first line standard systemic palliative treatment or combination treatment with m-FOLFIRINOX or nab-paclitaxel with or without other investigational agents within a clinical trial as a first line palliative treatment.
  • Ability to understand and willing to sign a written informed consent document.

排除标准

  • Patients with one or more contraindications to tumor biopsy.
  • Patients who have prior systemic treatment (chemotherapy or any other anti-cancer agent) in advanced setting.
  • Patients who are currently on anti-cancer treatment including chemotherapy.
  • Patients with known brain metastases.
  • Patients with advanced PDAC who are going to be treated with gemcitabine monotherapy in advanced setting.
  • Uncontrolled inter-current illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
  • Any other condition that would, in the Investigator's judgment, contraindicate the patient's participation in the clinical study due to safety concerns or compliance with clinical study procedures.

结局指标

主要结局

The feasibility of prospectively identifying subgroups of patients with advanced PDAC who have distinct genomic characteristics for better treatment selection while undergoing 1st-line chemotherapy using next generation sequencing.

时间窗: 8 weeks

次要结局

  • Disease control rate achieved by m-FOLFIRINOX(5 years)
  • Duration of response defined as the interval between the first date of complete response or partial response and the earliest date of disease progression or death due to any cause to m-FOLFIRINOX(5 years)
  • Duration of response defined as the interval between the first date of complete response or partial response and the earliest date of disease progression or death due to any cause to nab-paclitaxel.(5 years)
  • Progression free survival defined as the interval between the date of registration and the earliest date of disease progression or death due to any cause of patients treated with m-FOLFIRINOX.(5 years)
  • Disease control rate achieved by nab-paclitaxel(5 years)
  • Progression free survival defined as the interval between the date of registration and the earliest date of disease progression or death due to any cause of patients treated with nab-paclitaxel.(5 years)
  • Overall survival defined as the interval between the date of registration and the date of death of patients treated with nab-paclitaxel.(5 years)
  • Percentage of patients who might benefit from immunotherapy (patients with smoking genomic signatures, patients with a hypermutated phenotype, patients with mismatch repair deficiency and patients with tumor neo-antigen expression).(5 years)
  • Difference in disease control rate between patients with tumor smoking signature and those without.(5 years)
  • Difference in overall survival between patients with tumor smoking signature and those without.(5 years)
  • Correlation with tumor molecular characteristics and toxicities to treatment using next generation sequencing.(5 years)
  • Correlation between tumor genomic characteristics and nab-paclitaxel response using the next generation sequencing.(5 years)
  • Overall survival defined as the interval between the date of registration and the date of death of patients treated with m-FOLFIRINOX(5 years)
  • Correlation between tumor genomic characteristics and m-FOLFIRINOX response using next generation sequencing.(5 years)
  • Percentage of patients with germline BRCA, PALB2 and ATM mutations who might benefit from a personalized treatment strategy such as combination of cisplatin and a PARP inhibition.(5 years)
  • Percentage of patients with somatic DSBR deficiency who might benefit from a personalized treatment strategy such as combination of cisplatin and a PARP inhibitor.(5 years)
  • Percentage of patients with rare but targetable somatic mutations.(5 years)

研究者

申办方类型
Other
责任方
Sponsor

研究点 (4)

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