MedPath

Geriatric Assessment Directed Trial to Evaluate Gemcitabine +/- Nab-paclitaxel in Elderly Pancreatic Cancer Patients

Phase 4
Completed
Conditions
Adenocarcinoma Pancreas
Interventions
Other: Best Supportive Care
Registration Number
NCT02812992
Lead Sponsor
AIO-Studien-gGmbH
Brief Summary

The GrantPax study is a multicenter phase 4 geriatric assessment directed trial to evaluate gemcitabine +/- nab-paclitaxel in elderly pancreatic cancer patients. The primary objective is that CGA-stratified patients do not decline in their CGA performance in response to chemotherapy measured as a loss of five points or less in the Barthel's ADL, (ADL1 vs. ADL2 during core CGA assessment).

Detailed Description

The hypothesis of the proposed study is that individualized assessment directed treatment algorithms identifies elderly patients, who benefit from combined nab-paclitaxel/gemcitabine therapy. The project uses a CGA, which includes various tests and scoring systems, to stratify patients as "GO-GO", "SLOW-GO" or "FRAIL" patients. Depending on test results patients receive chemotherapy (GO-GO group: nab-paclitaxel/gemcitabine; SLOW-GO group: gemcitabine monotherapy) or best supportive care (FRAIL group). After the first cycle of chemotherapy (4 weeks) a subsequent CGA and a safety assessment will be performed to assign patients to their definite treatment arm. The primary objective is that CGA-stratified patients do not decline in their CGA performance in response to chemotherapy measured as a loss of five points or less in the Barthel's ADL (ADL1 vs. ADL2 during core CGA assessment).

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
32
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
GO-GO armNab-paclitaxelNab-paclitaxel 125 mg/m\^2 i.v. over 30 minutes followed by gemcitabine infusion 1000 mg/m\^2 on days D1, D8, D15 of a 28-day cycle.
FRAIL armBest Supportive CareBest supportive care as determined by the investigator.
SLOW-GO armGemcitabineGemcitabine 1000 mg/m\^2 i.v. on days D1, D8, D15 of a 28-day cycle.
GO-GO armGemcitabineNab-paclitaxel 125 mg/m\^2 i.v. over 30 minutes followed by gemcitabine infusion 1000 mg/m\^2 on days D1, D8, D15 of a 28-day cycle.
Primary Outcome Measures
NameTimeMethod
Barthel's ADL [Barthel's scale in activities of daily living]4 weeks

Loss of five points or less in the Activity of Daily Living (Barthel's ADL; assessed during 2nd CGA) after first cycle of chemotherapy (or after 4 weeks in BSC group) compared to the initial ADL for each treatment groups.

Secondary Outcome Measures
NameTimeMethod
Discrepancy between CGA strata estimation by the investigator and true CGA assessment12 months
ADL (Barthel) [Activities of Daily Living]4 weeks

Scores before and after 1st treatment cycle (CGA1+2 further CGA scores 3+4 - if available) or after 28 days of BSC

IADL (Lawton/Browdy) [Instrumental Activities of Daily Living]4 weeks

Scores before and after 1st treatment cycle (CGA1+2 further CGA scores 3+4 - if available) or after 28 days of BSC

G8-Questionnaire4 weeks

Scores before and after 1st treatment cycle (CGA1+2 further CGA scores 3+4 - if available) or after 28 days of BSC

Percentage of patients receiving at least one chemotherapy in each treatment group12 months
Duration of treatment12 months
Cumulative dose12 months
QoL [Quality of Life]12 months

time to QoL deterioration \[loss of 10 points or more in QLQ-C30\]

ECOG [Eastern Cooperative Oncology Group]4 weeks

Scores before and after 1st treatment cycle (CGA1+2 further CGA scores 3+4 - if available) or after 28 days of BSC

AEs/SAEs [Adverse Events/Serious Adverse Events]12 months
PFS [Progression Free Survival]12 months
OS [Overall Survival]12 months
CR [Complete Response]12 months
DCR [Disease Control Rate]12 months
PR [Partial Response]12 months
ORR [Objective Response Rate]12 months
Percentage of patients escalating treatment12 months
CGA [Comprehensive Geriatric Assessment]4 weeks

Scores before and after 1st treatment cycle (CGA1+2 further CGA scores 3+4 - if available) or after 28 days of BSC

Trial Locations

Locations (1)

Universitätsklinikum Mannheim II. Medizinische Klinik

🇩🇪

Mannheim, Germany

© Copyright 2025. All Rights Reserved by MedPath