A Phase II Study of S-1 in Combination With Gemcitabine and Erlotinib in Patients With Advanced or Metastatic Pancreatic Cancer
试验速览
- 阶段
- 2 期
- 状态
- 已完成
- 入组人数
- 37
- 试验地点
- 1
- 主要终点
- Objective response rate
研究概览
简要总结
This study will conduct a phase II study of gemcitabine, erlotinib, and S-1 as first-line chemotherapy in patients with advanced pancreatic cancer and evaluate the EGFR expression, KRAS mutation, and BRAF mutation as predictive or prognostic markers
详细描述
Pancreatic ductal adenocarcinoma, also known as pancreatic cancer, is an eighth cause of cancer-related deaths in the world. The estimated worldwide incidence of pancreatic cancer was 277,000 cases and an estimated 266,000 patients died from the disease in 20081.
Pancreatic cancer is more common in elderly persons than in younger persons, and characterised by early locoregional spread and distant metastasis. As a result, less than 20% of patients are diagnosed with localized, potentially curable disease, and the median survival is no longer than 3-4 months without effective treatment2.
Single-agent chemotherapy with gemcitabine was considered as standard of care for patients with advanced pancreatic cancer, since Burris et al. demonstrated superiority of gemcitabine over 5-fluorouracil (5-FU) in respect of a survival benefit as well as an improvement in disease related symptoms in a randomized study3.
Nevertheless, the activity of gemcitabine monotherapy in pancreatic cancer was modest, and there was a clear need to improve its efficacy by combining it with other anticancer drugs.
Multiple agents such as 5-FU4, capecitabine5,6, cisplatin7,8, oxaliplatin9, pemetrexed10, irinotecan11, cetuximab12, and bevacizumab13, in combination with gemcitabine have been tested in clinical trials, however, they have failed to improve the outcome.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 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
- •Pathologically confirmed locally advanced unresectable, recurrent or metastatic adenocarcinoma of pancreas (Stage III-IV ; TNM staging system)
- •Measurable or evaluable disease by RECIST criteria 1.1
- •Minimum age of 18 years
- •ECOG Performance status 0-1
- •Prior adjuvant chemotherapy without gemcitabine, erlotinib or S-1 is allowed if more than 4 weeks elapsed since completion of chemotherapy.
- •More than 4 weeks since completion of prior radiotherapy (measurable or evaluable lesions should be outside the radiation field)
- •Adequate organ functions
- •Patients must sign an informed consent indicating that they are aware of the investigational nature of the study in keeping with the policy of the hospital.
排除标准
- •Patients treated previously with gemcitabine, erlotinib, or S-1 as adjuvant chemotherapy.
- •Patients with CNS metastases
- •Patients with active infection, severe heart disease, uncontrollable hypertension or diabetes mellitus, myocardial infarction during the preceding 6 months, pregnancy, or breast feeding
- •Any previous or concurrent malignancy other than non-melanoma skin cancer or in situ cancer of uterine cervix
- •Known history of cerebral or leptomeningeal metastases or neurologic disease
研究组 & 干预措施
GES (Gemcitabine, Erlotinib, S-1)
Treatment will be delivered as a 3-week cycle.
- Gemcitabine 1000 mg/m² IV on day 1, 8
- Erlotinib 100 mg/day PO on day 1
- S-1 60 mg/m²/day PO on day 1-14
干预措施: GES (Gemcitabine, Erlotinib, S-1) (Drug)
结局指标
主要结局
Objective response rate
时间窗: 1.5 years
Objective response rate will be measured from the rate of complete response (disappearance of disease) and partial response (decrease at least 30% in the sum of the longest diameters of target lesions) by RECIST (response evaluation criteria in solid tumors) guidelines.
次要结局
- Progression free survival(1.5 years)
- Overall survival(1.5 years)
- Disease control rate(1.5 years)
- Toxicity profiles(1.5 years)