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临床试验/NCT00088894
NCT00088894已完成3 期

A Randomized Phase III Trial Of Gemcitabine Plus Bevacizumab (NSC#704865 IND#7621) Versus Gemcitabine Plus Placebo In Patients With Advanced Pancreatic Cancer

National Cancer Institute (NCI)1 个研究点 分布在 1 个国家目标入组 590 人开始时间: 2004年6月最近更新:
适应症
干预措施
相关药物

试验速览

阶段
3 期
状态
已完成
入组人数
590
试验地点
1
主要终点
Overall survival (OS)

研究概览

简要总结

This randomized phase III trial is studying gemcitabine and bevacizumab to see how well they work compared to gemcitabine alone in treating patients with locally advanced or metastatic pancreatic cancer. Drugs used in chemotherapy, such as gemcitabine, work in different ways to stop tumor cells from dividing so they stop growing or die. Monoclonal antibodies such as bevacizumab can locate tumor cells and either kill them or deliver tumor-killing substances to them without harming normal cells. Bevacizumab may also stop the growth of tumor cells by stopping blood flow to the tumor. Combining gemcitabine with bevacizumab may kill more tumor cells. It is not yet known whether gemcitabine is more effective with or without bevacizumab in treating pancreatic cancer.

详细描述

PRIMARY OBJECTIVES:

I. To determine if combination chemotherapy with gemcitabine and bevacizumab achieves superior survival compared to gemcitabine and placebo in patients with previously untreated advanced pancreatic cancer.

SECONDARY OBJECTIVES:

I. To compare the objective response rates, duration of response, progression free survival, and toxicity of these two regimens in patients with advanced pancreatic cancer.

II. To measure baseline levels of VEGF and correlate with treatment outcome. III. To measure baseline and on treatment levels of additional growth factors that may be co- or counter- regulated with VEGF and correlate with response to treatment.

研究设计

研究类型
Interventional
分配方式
Randomized
干预模型
Parallel
主要目的
Treatment
盲法
Double (Participant, Investigator)

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

  • Histologic or cytologic documentation of adenocarcinoma of the pancreas; documentation of disease extent by CT scan is required; radiologically measurable disease is not required; patients with documented invasion of adjacent organs (e.g., duodenum, stomach) by CT scan are not eligible
  • No prior chemotherapy for metastatic disease
  • If the patient received adjuvant therapy, it must have been completed at least 4 weeks prior to enrollment on this study; the patient must have recovered from all treatment related toxicities and must have evidence of disease progression following adjuvant treatment
  • Prior radiation therapy, with or without a radiosensitizing dose of fluoropyrimidines, is allowed provided the patient has disease outside of the radiation port; at least 4 weeks must have elapsed from completion of the radiation therapy and all signs of toxicity must have resolved
  • No prior treatment with gemcitabine or bevacizumab in the adjuvant or metastatic setting
  • No current or recent (within 1 month) use of a thrombolytic agent
  • Patients may not have had prior therapy with other VEGF inhibitors
  • No recent invasive surgical procedures; this includes:
  • Major surgical procedure (e.g. exploratory laparotomy or laparoscopy), open biopsy, or significant traumatic injury within 28 days prior to registration
  • Fine needle aspirations or venous access device within 7 days prior to registration
  • Anticipation of need for major surgical procedures during the course of the study
  • No clinically significant cardiovascular disease; this includes:
  • Uncontrolled hypertension (blood pressure > 150/90 on medication)
  • New York Heart Association grade II or greater congestive heart failure
  • Serious cardiac arrhythmia requiring medication
  • No recent (within 6 months) arterial thrombotic events, including transient ischemic attack (TIA), cerebrovascular accident (CVA), unstable angina, or myocardial infarction (MI); patients with clinically significant peripheral artery disease (i.e., claudication on less than one block) are also ineligible
  • No evidence of CNS disease, including primary brain tumor, or any brain metastasis
  • No serious or non-healing wound, ulcer or bone fracture
  • No serious active infection (viral, fungal bacterial); no infection requiring parenteral antibiotics at time of registration
  • Patients with known hypersensitivity of Chinese hamster ovary cell products or other recombinant human antibodies are not eligible
  • Patients with a "currently active" second malignancy other than non-melanoma skin cancers are not to be registered; patients are not considered to have a "currently active" malignancy if they have completed therapy and considered by their physician to be at less than 30% risk of relapse
  • Women must be non-pregnant and non-breast feeding
  • ECOG Performance status of 0, 1 or 2
  • Granulocytes ≥ 1,500/μl
  • Platelet count ≥ 100,000/μl
  • Creatinine ≤ 1.5 mg/dL or creatinine clearance ≥ 60 mL/min
  • Total bilirubin ≤ 1 x upper limit of normal
  • SGOT(AST) ≤ 2.5 x upper limit of normal
  • PT INR =< 1.5, unless patient is on full dose warfarin
  • Urine protein; for ≥ 1+ proteinuria, 24 hour urine collection must demonstrate < 1 gm of protein/24 hours
  • Required diagnostic procedures:
  • CT of the abdomen
  • Chest x-ray

排除标准

  • 未提供

研究组 & 干预措施

Arm I (gemcitabine hydrochloride, bevacizumab)

Experimental

Patients receive gemcitabine IV over 30 minutes on days 1, 8, and 15 and bevacizumab IV over 30-90 minutes on days 1 and 15.

干预措施: gemcitabine hydrochloride (Drug)

Arm I (gemcitabine hydrochloride, bevacizumab)

Experimental

Patients receive gemcitabine IV over 30 minutes on days 1, 8, and 15 and bevacizumab IV over 30-90 minutes on days 1 and 15.

干预措施: bevacizumab (Biological)

Arm I (gemcitabine hydrochloride, bevacizumab)

Experimental

Patients receive gemcitabine IV over 30 minutes on days 1, 8, and 15 and bevacizumab IV over 30-90 minutes on days 1 and 15.

干预措施: laboratory biomarker analysis (Other)

Arm I (gemcitabine hydrochloride, bevacizumab)

Experimental

Patients receive gemcitabine IV over 30 minutes on days 1, 8, and 15 and bevacizumab IV over 30-90 minutes on days 1 and 15.

干预措施: pharmacogenomic studies (Other)

Arm I (gemcitabine hydrochloride, bevacizumab)

Experimental

Patients receive gemcitabine IV over 30 minutes on days 1, 8, and 15 and bevacizumab IV over 30-90 minutes on days 1 and 15.

干预措施: pharmacological study (Other)

Arm II (gemcitabine hydrochloride, placebo)

Active Comparator

Patients receive gemcitabine IV as in arm I and placebo IV over 30-90 minutes on days 1 and 15.

干预措施: gemcitabine hydrochloride (Drug)

Arm II (gemcitabine hydrochloride, placebo)

Active Comparator

Patients receive gemcitabine IV as in arm I and placebo IV over 30-90 minutes on days 1 and 15.

干预措施: placebo (Other)

Arm II (gemcitabine hydrochloride, placebo)

Active Comparator

Patients receive gemcitabine IV as in arm I and placebo IV over 30-90 minutes on days 1 and 15.

干预措施: laboratory biomarker analysis (Other)

Arm II (gemcitabine hydrochloride, placebo)

Active Comparator

Patients receive gemcitabine IV as in arm I and placebo IV over 30-90 minutes on days 1 and 15.

干预措施: pharmacogenomic studies (Other)

Arm II (gemcitabine hydrochloride, placebo)

Active Comparator

Patients receive gemcitabine IV as in arm I and placebo IV over 30-90 minutes on days 1 and 15.

干预措施: pharmacological study (Other)

结局指标

主要结局

Overall survival (OS)

时间窗: From trial entry until death, assessed up to 7 years

Based on the stratified logrank test.

Discrepancies in the response rate between the two genotypic groups (CT/TT or CC) (Pharmacogenetics portion)

时间窗: Up to 7 years

This analysis will be done in the context of a two-way multiplicative logistic model with genotype and treatment as the two factors.

Grade 3-4 neutropenia in terms of specific single-nucleotide polymorphisms (SNPs) and/or copy number variations that are associated with the prevalence of these events (Clinical endpoint)

时间窗: Up to 7 years

次要结局

  • Objective response (complete or partial [CR/PR])(Up to 7 years)
  • Duration of response(Time from the first tumor assessment that supports the patient's response to the time of disease progression or death from any cause, assessed up to 7 years)
  • Progression-free survival (PFS)(From study entry until documented progression of disease or death from any cause, assessed up to 7 years)
  • Toxicity graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) v3.0(Up to 7 years)
  • Quantitative interaction between the genotypes (group 1 or 2) and the treatment arm (gemcitabine or gemcitabine + bevacizumab) in modeling response (Pharmacogenetics portion)(Up to 7 years)
  • Objective response (PR/CR versus stable disease [SD]/progressive disease [PD]) (Clinical endpoint)(Up to 7 years)
  • Disease-control (PR/CR/SD versus PD) (Clinical endpoint)(Up to 7 years)
  • OS (Clinical endpoint)(Up to 7 years)

研究者

申办方类型
Nih
责任方
Sponsor

研究点 (1)

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