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Phase II Study of Gemcitabine Versus S-1 Adjuvant Therapy After Hemihepatectomy for Biliary Tract Cancer

Phase 2
Completed
Conditions
Biliary Tract Cancer
Interventions
Registration Number
NCT01815307
Lead Sponsor
Kansai Hepatobiliary Oncology Group
Brief Summary

To compare efficacy and safety of Gemcitabine versus S-1 adjuvant therapy after hemihepatectomy.

Detailed Description

There is no standard adjuvant therapy after liver hemi-hepatectomy due to bile duct cancer, because of high surgical morbidity ratio and high adverse event ratio of adjuvant therapy. For example, our preliminary results showed that regular gemcitabine administration (1000mg/m2, day 1, 8, 15 every 4 weeks) after hemihepatectomy was too toxic and induced severe leukocytopenia and/or thrombocytopenia. Formerly, the investigators planned the study to decide more safety adjuvant protocol (recommend dose: RD) for Gemcitabine or S-1 after hemihepatectomy using Continuous Reassessment Method (CRM) analysis and decided the recommend doses. Note: In the former study, the investigators decided that tolerable ratio of Dose Limiting Toxicity (DLT) would be less than 10%.

Herein, the investigators planned the study to evaluate efficacy (recurrent free survival as primary outcome, and overall-survival as secondary outcome) and safety (as secondary outcome) in our recommended protocols, and to compare the efficacy as randomized control trial.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
70
Inclusion Criteria
  1. Biliary tract cancer (BTC) (>= Unio Internationalis Contra Cancrum (UICC) Stage IB), adenocarcinoma
  2. R0 or R1 resection
  3. no obvious recurrent lesion
  4. 20 years old or more
  5. Eastern Cooperative Oncology Group (ECOG) performance status must be 0 or 1
  6. The patient underwent no other treatment than surgery for BTC
  7. Neutrophil must be over 1500/μl, Hemoglobin must be over 9.0g/dL, platelet must be over 100,000/μl, Aspartate transaminase (AST) and Alanine aminotransferase (ALT) must be less than 150 IU/L, total bilirubin must be less than 1.5 mg/dL, Creatinine must be less than 1.2 mg/dl, and Creatinine clearance must be over 60 mL/min
  8. The patient can intake drugs per os.
  9. From 4 to 12 weeks after the surgery
  10. Written informed consent
Exclusion Criteria
  1. Existence of active double cancer
  2. The patient suffered from severe drug allergy
  3. Sever complications (interstitial pneumonia, heart failure, renal failure, liver failure, ileus, incontrollable diabetes mellitus, and so on)
  4. Any active infections exist.
  5. Pregnancy
  6. Severe mental disorder
  7. Others

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Gemcitabine groupGemcitabine1000mg/m2, day 1 every 2 weeks
S-1 groupS-180mg/m2/day, day 1-28, every 6 weeks
Primary Outcome Measures
NameTimeMethod
1 year recurrent free survival rateOne year

Duration: From randomization to evidenced recurrence or death. Rate: Number of patients with evidenced recurrence or death / number of total patients.

1 year recurrent free survival rate: recurrent free survival rate at one-year from the randomization

Secondary Outcome Measures
NameTimeMethod
Two-year recurrent free survival rateTwo years
Two-year overall survival rateTwo years
Completion rate of the protocol treatment6 months
Dose intensity of anti-tumor drugs6 months
Rate and grade of adverse events or adverse drug reactions6 months
Duration of recurrent free survivalan expected average of 2 years
One-year overall survival rateOne year
Duration of overall survivalan expected average of 3 years

Trial Locations

Locations (1)

Osaka University, Graduate School of Medicine

🇯🇵

Osaka, Japan

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