NCT02243007终止2 期
Phase II Study of Preoperative FOLFIRINOX Versus Gemcitabine/Nab-Paclitaxel in Patients With Resectable Pancreatic Cancer
适应症
干预措施
相关药物
试验速览
- 阶段
- 2 期
- 状态
- 终止
- 入组人数
- 7
- 试验地点
- 1
- 主要终点
- Survival Rate at 18 Month
研究概览
简要总结
This research study is a Phase II clinical trial, which evaluates a combination of drugs, FOLFIRINOX and Gemcitabine/Nab-Paclitaxel, in the management of participants with resectable pancreatic cancer prior to surgery.
详细描述
Patients who fulfill eligibility criteria will be randomized to Arm A or Arm B
- Treatment will be administered on an outpatient basis.
- Upon registration participants will be randomized to Arm A (FOLFIRINOX) or Arm B (Gemcitabine/nab-Paclitaxel).
- After completion of FOLFIRINOX or Gemcitabine/Nab-paclitaxel, all participants without progressive disease will proceed to radiation therapy with capecitabine .
- Between 2 and 4 weeks after radiation is complete, participants will proceed for surgical resection of pancreatic cancer
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
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Cytologic or histologic proof of pancreatic ductal carcinoma is required prior to study entry.
- •No evidence of metastatic disease as determined by chest CT scan, and abdominal CT scan (or MRI with gadolinium and/or manganese) and laparoscopy. All patients must be staged with a physical exam, chest CT, abdominal CT with intravenous contrast (or abdominal MRI with gadolinium and/or manganese). Only potentially resectable patients are eligible. Potentially resectable is defined as a) no extrapancreatic disease, b) no evidence (on CT) of involvement of the celiac axis or SMA, c) no evidence (CT or MRI) of occlusion of the SMV or SMPV confluence, and d) no evidence of gross peritoneal or distant metastases by laparoscopy.
- •Patients must be 18 years old or older. There will be no upper age restriction.
- •ECOG Performance Status of 0 or 1 are eligible.
- •Life expectancy of greater than 3 months.
- •Lab Values:
- •ANC ≥ 1500 cells/mm3
- •Platelet count at least 100,000 cells/mm
- •AST and ALT ≤2.5 x upper limit of normal
- •Total Bilirubin ≤ 5 x upper limit of normal if patient is s/p biliary stenting AND decreasing at least two time points after stenting.
- •Total Bilirubin ≤ 1.5 x upper limit of normal if no biliary stenting was done
- •Serum Creatinine ≤1.5mg/dl OR
- •Creatinine Clearance greater than or equal to 30ml/min (as estimated by Cockroft Gault Equation) (140 - age [yrs]) (body wt [kg])
- •Creatinine clearance for males = ------------ (72) (serum creatinine [mg/dL])
- •Creatinine clearance for females = 0.85 x male value
- •The effects of radiation on the developing human fetus are known to be teratogenic. Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study treatment plus 30 days from the last date of study drug administration. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately.
- •Ability to understand and the willingness to sign a written informed consent document.
排除标准
- •Patients who fulfill any of the following criteria will be excluded:
- •The presence of metastatic disease on imaging or laparoscopy.
- •Serious concomitant systemic disorders incompatible with the study (at the discretion of the investigator), such as significant cardiac or pulmonary morbidity e.g. congestive heart failure, symptomatic coronary artery disease and cardiac arrhythmias not well controlled with medication) or myocardial infarction within the last 12 months, ongoing infection as manifested by fever.
- •Pregnant or lactating women. Women of childbearing potential with either a positive or no pregnancy test (serum or urine) at baseline. (Postmenopausal woman must have been amenorrheic for at least 12 months to be considered of non-childbearing potential).
- •Any prior chemotherapy or radiation for treatment of the patient's pancreatic tumor.
- •Diagnosis for other invasive carcinomas (except basal cell carcinoma/squamous cell carcinoma of the skin) within the last five years. Carcinoma in-situ is allowed.
- •Other serious uncontrolled medical conditions that the investigator feels might compromise study participation.
- •Unwillingness to participate or inability to comply with the protocol for the duration of the study.
- •Participation in any investigational drug study within 4 weeks preceding the start of study treatment.
- •History of uncontrolled seizures, central nervous system disorders or psychiatric disability judged by the investigator to be clinically significant, precluding informed consent, or interfering with compliance or oral drug intake.
- •Major surgery, excluding laparoscopy, within 4 weeks of the start of study treatment, without complete recovery.
研究组 & 干预措施
Folfirinox-ARM A
Experimental
Upon registration patients will be randomized to Arm A (FOLFIRINOX) or Arm B (Gemcitabine/nab-Paclitaxel
- Treatment will be administered on an outpatient basis and will include intravenous administration of the FOLFIRINOX regimen on predetermined days.
- After completion of FOLFIRINOX all patients without progressive disease will proceed with radiation therapy with the standard dose of capecitabine.
- Between 2 and 4 weeks after radiation is complete, patients will proceed for surgical resection of pancreatic cancer
干预措施: FOLFIRINOX (Drug)
Folfirinox-ARM A
Experimental
Upon registration patients will be randomized to Arm A (FOLFIRINOX) or Arm B (Gemcitabine/nab-Paclitaxel
- Treatment will be administered on an outpatient basis and will include intravenous administration of the FOLFIRINOX regimen on predetermined days.
- After completion of FOLFIRINOX all patients without progressive disease will proceed with radiation therapy with the standard dose of capecitabine.
- Between 2 and 4 weeks after radiation is complete, patients will proceed for surgical resection of pancreatic cancer
干预措施: Radiation therapy (Radiation)
Folfirinox-ARM A
Experimental
Upon registration patients will be randomized to Arm A (FOLFIRINOX) or Arm B (Gemcitabine/nab-Paclitaxel
- Treatment will be administered on an outpatient basis and will include intravenous administration of the FOLFIRINOX regimen on predetermined days.
- After completion of FOLFIRINOX all patients without progressive disease will proceed with radiation therapy with the standard dose of capecitabine.
- Between 2 and 4 weeks after radiation is complete, patients will proceed for surgical resection of pancreatic cancer
干预措施: Capecitabine (Drug)
Gemcitabine/nab-Paclitaxel- Arm B
Experimental
- Treatment will be administered on an outpatient basis. Upon registration patients will be randomized to Arm A (FOLFIRINOX) or Arm B (Gemcitabine/nab-Paclitaxel).
- Intravenous administration of the Gemcitabine/Nab-paclitaxel regimen on predetermined days of each 28 day treatment cycle (unless a delay is mandated by toxicity criteria). A cycle of Gemcitabine/Nab-paclitaxel will constitute a 28 day treatment period.
- After Gemcitabine/Nab-paclitaxel, all patients without progressive disease will proceed to radiation therapy with the standard dose of capecitabine
- Between 2 and 4 weeks after radiation is complete, patients will proceed for surgical resection of pancreatic cancer
干预措施: Gemcitabine/nab-Paclitaxel (Drug)
Gemcitabine/nab-Paclitaxel- Arm B
Experimental
- Treatment will be administered on an outpatient basis. Upon registration patients will be randomized to Arm A (FOLFIRINOX) or Arm B (Gemcitabine/nab-Paclitaxel).
- Intravenous administration of the Gemcitabine/Nab-paclitaxel regimen on predetermined days of each 28 day treatment cycle (unless a delay is mandated by toxicity criteria). A cycle of Gemcitabine/Nab-paclitaxel will constitute a 28 day treatment period.
- After Gemcitabine/Nab-paclitaxel, all patients without progressive disease will proceed to radiation therapy with the standard dose of capecitabine
- Between 2 and 4 weeks after radiation is complete, patients will proceed for surgical resection of pancreatic cancer
干预措施: Radiation therapy (Radiation)
Gemcitabine/nab-Paclitaxel- Arm B
Experimental
- Treatment will be administered on an outpatient basis. Upon registration patients will be randomized to Arm A (FOLFIRINOX) or Arm B (Gemcitabine/nab-Paclitaxel).
- Intravenous administration of the Gemcitabine/Nab-paclitaxel regimen on predetermined days of each 28 day treatment cycle (unless a delay is mandated by toxicity criteria). A cycle of Gemcitabine/Nab-paclitaxel will constitute a 28 day treatment period.
- After Gemcitabine/Nab-paclitaxel, all patients without progressive disease will proceed to radiation therapy with the standard dose of capecitabine
- Between 2 and 4 weeks after radiation is complete, patients will proceed for surgical resection of pancreatic cancer
干预措施: Capecitabine (Drug)
结局指标
主要结局
Survival Rate at 18 Month
时间窗: 18 Month
Number of participants surviving after 18 months of study follow-up
次要结局
- 30-day Post-operative Mortality Rate(30 Days)
- Overall Survival Rate(Baseline, 5 Years)
- Number of Participants With Serious and Non-Serious Adverse Events(Baseline, 28 Days)
- Surgical Morbidity Rate(within 30 days of surgery)
- Correlation of Biomarkers With PFS(2 Years)
- Pathologic Complete Response Rate (pCR).(18 Months)
- Rate of Pathologic Downstaging(2 Years)
- Local Control Rate(2 Years)
研究者
David Patrick Ryan, MD
Principal Investigator
Massachusetts General Hospital
研究点 (1)
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