Biomarker Directed Adjuvant Chemotherapy for Resected Pancreas Cancer

NCT01411072 | Unknown

• 1 other identifier: Panc002/ethics 25823
• Study Type: interventional
• Target: 20
• Locations: 1 country
• Sites: 2

Brief Summary

Chemotherapy is given after curative surgery for pancreas cancer to try to improve cure rates. There are two choices of chemotherapy which are currently considered equal treatments: gemcitabine or 5-fluorouracil (5FU). This study is trying to determine if one of two standard chemotherapies is better than the other depending on whether patients have high or low human equilibrative nucleoside transporter 1 (hENT1). hENT1 is a protein that is found in varying amounts on pancreas cancers.

Conditions

Pancreas Cancer

Keywords

Biomarker directed adjuvant chemotherapy; resected pancreas cancer

Outcome Measures

Primary Outcomes (1)

• Overall Survival

  Post treatment, patients will be followed every 3 months via phone call and/or electronic health record

Study Arms (2)

Gemcitabine

EXPERIMENTAL

Drug: gemcitabine

5-fluorouracil

EXPERIMENTAL

Drug: 5-fluorouracil

Interventions

gemcitabine DRUG

Gem 1000 mg/m2 IV weekly for 3 weeks then one week off of each 28 day cycle

Also known as: hENT1 high group

Gemcitabine

5-fluorouracil DRUG

5-FU 425 mg/m2 and Leucovorin 20 mg/m2 IV day 1, 2, 3, 4, and 5 of each 28 day cycle

Also known as: hENT1 low group

5-fluorouracil

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Histologically documented pancreatic adenocarcinoma not previously treated with systemic therapy.
• Complete macroscopic and microscopic (R0) resection for ductal adenocarcinoma of the pancreas with no evidence of malignant ascites, peritoneal metastases or distant metastases. Lack of recurrent and/metastatic disease must be confirmed radiologically with CT chest, abdomen, and pelvis prior to enrolment.
• Adequate tissue available for IHC testing of hENT1. Histological/cytological confirmation of tissue to ensure sufficient material is available for hENT1 analysis by the Cross Cancer Institute (CCI) is required. Paraffin block sufficient for preparing ≥ 6 unstained slides for central storage and testing if required by oncologist.
• ECOG performance status of 0 - 2. (Appendix B)
• Age ≥ 18 years
• Life expectancy of at least 6 months based on discretion of treating
• Adequate hematologic function defined by the following laboratory parameters: Hemoglobin \> 100, Platelet count \> 100 and Absolute granulocyte count \> 1.5.
• Adequate hepatic and renal function defined by the following laboratory parameters: AST and ALT ≤ 2.5 X upper limit of institutional normal, bilirubin ≤ upper limit of institutional normal, and calculated creatinine clearance of ≥ 50 mL/min using the Cockcroft-Gault formula, if just below 50 mL/min based on this formula then GFR ≥ 50 mL/min as determined.
• Patients may have received prior curative radiotherapy for a different malignancy (unless radiation was curative therapy to ≥ 25% of bone marrow stores) and patients must have recovered from the toxic effects of this treatment.
• Patients must be started on protocol ≤ 10 weeks from the date of curative surgical resection, and patients must have recovered from the toxic effects of surgery.
• Patients must have the ability to read, understand, and sign an informed consent and must be willing to comply with study treatment and follow-up.

You may not qualify if:

• Patients who have received prior chemotherapy or radiation delivered as parts of initial curative therapy for pancreas cancer (i.e. neoadjuvant or adjuvant chemotherapy administered alone and/or concurrently delivered with radiation and/or surgery) are not permitted. Metastatic patients are not permitted.
• Prior treatment for a different malignancy with \> 6 cycles of traditional alkylating agent-based chemotherapy, \> 2 cycles of carboplatin-based chemotherapy, or concurrent treatment with other experimental drugs or anti-cancer therapy.
• Lack of physical integrity of the upper gastrointestinal tract, malabsorption syndrome, short gut syndrome, or history of bowel obstruction due to peritoneal metastases.
• Previous or concurrent malignancies, excluding curatively treated in situ carcinoma of the cervix or non-melanoma skin cancer, unless at least 5 years have elapsed since last treatment and the patient is considered cured.
• Any serious medical condition within 6 months prior to study entry such as myocardial infarction, uncontrolled congestive heart failure, unstable angina, active cardiomyopathy, unstable ventricular arrhythmia, cerebrovascular diseases, uncontrolled hypertension, uncontrolled diabetes, uncontrolled psychiatric disorder, serious infection, active peptic ulcer disease, or other medical condition that.
• Known dihydropyrimidine dehydrogenase (DPD) deficiency.
• Pregnant or lactating women; women of child bearing potential must have a negative serum pregnancy test within 7 days of trial registration. Women or men of child bearing potential must use effective contraception (defined by the treating physician) which must be documented in study CRFs.
• Any other reason the investigator considers the patient should not participate in the study

Sponsors & Collaborators

• AHS Cancer Control Alberta: lead

Study Sites (2)

Tom Baker Cancer Center

Calgary, Alberta, Canada

RECRUITING

Cross Cancer Institute

Edmonton, Alberta, Canada

RECRUITING

MeSH Terms

Conditions

Pancreatic Neoplasms

Interventions

Gemcitabine; Fluorouracil

Condition Hierarchy (Ancestors)

Digestive System Neoplasms; Neoplasms by Site; Neoplasms; Endocrine Gland Neoplasms; Digestive System Diseases; Pancreatic Diseases; Endocrine System Diseases

Intervention Hierarchy (Ancestors)

Heterocyclic Compounds; Deoxycytidine; Cytidine; Pyrimidine Nucleosides; Pyrimidines; Heterocyclic Compounds, 1-Ring; Uracil; Pyrimidinones

Study Officials

• Jennifer Spratlin, MD, FRCPC

  Cross Cancer Institute

  PRINCIPAL INVESTIGATOR

• Jennifer Spratlin, MD, FRCPC

  Cross Cancer Institute

  STUDY CHAIR

Central Study Contacts

Jennifer Spratlin, MD, FRCPC

CONTACT

780-700-0842; Jennifer.Spratlin@albertahealthservices.ca

Karen Mulder, MD, FRCPC

CONTACT

780-432-8248; Karen.Mulder@albertahealthservices.ca

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: August 4, 2011
• First Posted: August 8, 2011
• Study Start: September 1, 2011
• Primary Completion: September 1, 2015
• Study Completion: December 1, 2015
• Last Updated: October 3, 2014

Record last verified: 2014-10

Locations

CA (2)