Safety & Efficacy Study of Gemcitabine...With High Dose IV Vit. C (HDIVC)

NCT01654861 | Terminated Phase 1 Results

• 1 other identifier: ERMC 11-11
• Study Type: interventional
• Target: 3
• Locations: 1 country
• Sites: 1

Brief Summary

• The combination of gemcitabine and HDIVC is safe and may favorably change the clinical course for an individual patient.
• The combination of gemcitabine and HDIVC is synergistic in anti-tumor effect as seen in preclinical models, where HDIVC creates a pro-oxidative effect that adds to the anti-tumor effect of gemcitabine.
• The combination of gemcitabine and HDIVC may improve Progression Free Survival (PFS).
• The dosage schema of 1.2 g /kg bolus infusion followed by lower dose of 0.3 g / kg infusion may create sustained elevation in Vitamin C plasma levels for increased cytotoxic effect.
• The addition of HDIVC \& oral supplementation of Vitamin C to standard treatment with gemcitabine may improve quality of life for patients with comparison to prior to treatment start of this protocol.
• CA 19-9 and inflammatory markers may show trends for patients in this trial.

Conditions

Metastatic Adenocarcinoma of the Pancreas

Outcome Measures

Primary Outcomes (1)

• Adverse Events as a Measure of Safety and Tolerability

  Adverse events, whether volunteered by the study subject, discovered by the investigators during questioning, or detected by physical examination, laboratory tests, or other means will be collected and recorded at each visit. Events will be recorded from the time the consent is signed until 4 weeks after the study protocol is discontinued. Subjects experiencing Grade 4 neutropenia, Grade ≥3 thrombocytopenia, or Grade 2 peripheral neuropathy who do not recover will have treatment protocol discontinued.

  Weekly for up to 6 months.

Secondary Outcomes (1)

• Anti-Tumor Response

  Every 2 months for up to 6 months.

Study Arms (1)

HDIVC

EXPERIMENTAL

Gemcitabine (Gemzar), Intravenous and oral Ascorbic Acid (Vitamin C).

Drug: Gemcitabine, Intravenous and oral Ascorbic Acid (Vitamin C)

Interventions

Gemcitabine, Intravenous and oral Ascorbic Acid (Vitamin C) DRUG

Weeks 1,2,3: IV Gemcitabine 1000 mg / m² over 30 minutes followed by HDIVC 1.2 g / kg: 1.2 g/kg over 90 minutes for a dose ≤90 g and over 120 minutes for a dose \>90g followed by 0.3 g / kg over 120 minutes; Week 4: no treatment.

HDIVC

Eligibility Criteria

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

You may qualify if:

• Patient ≥ 18 years of age
• Biopsy proven adenocarcinoma of the pancreas
• Evidence of metastatic disease
• Received at least 1 prior chemotherapy treatment regimen with disease progression
• May have had any prior chemotherapy regimen including any gemcitabine based regimen or FOLFIRINOX
• May have participated in a prior study protocol
• May have had prior treatment with HDIVC
• Anticipated survival of at least 3 months
• Eastern Cooperative Oncology Group (ECOG) performance status = 0,1, or 2
• The patient must have screening laboratory: ANC ≥ 1,500/mm3, Hemoglobin \> 8g/dL, Platelets ≥ 100,000/mm3, Total Bilirubin \< 1.5mg/dL, Creatinine ≤ 1.5mg/dL, Transaminases \< 2.5 x upper limit of normal, Urine Uric Acid \< 1.000 mg/d, Urine pH \< 6, Urine microscopic negative for oxalates (if positive, reflex urinary oxalates \< 60mg/d), PT INR ≤ 1.5, unless patient is on full dose warfarin
• Glucose-6-phosphate dehydrogenase deficiency (G6PD) normal status via blood test The fluorescent spot test is the simplest, most reliable, and most sensitive of the G6PD screening tests
• Willingness to undergo central line placement and able to manage care of the entry site safely
• Willingness to adhere to supplemental oral dose regimen of ascorbic acid 500mg taken twice daily
• All other nutritional supplements would be discontinued for the duration of the trial except for pancreatic enzymes and probiotics
• Patients must be able to take food orally or have a peg tube for feeding

You may not qualify if:

• Glucose-6-phosphate dehydrogenase deficiency (G6PD)
• Renal insufficiency : serum creatinine of \> 1.5 mg /dl or evidence of oxalosis by urinalysis prior to enrollment and prior to each HDIVC infusion
• Documentation or report of history of kidney stones or urinary oxalosis.
• Co-morbid condition that would affect survival: congestive heart failure, unstable angina, myocardial infarction within 6 weeks of study, uncontrolled blood sugars of \> 300 mg / dl, patients with known chronic active hepatitis or cirrhosis
• Currently active second malignancy
• Chronic hemodialysis
• Iron overload/ Hemochromatosis: Ferritin \> 500 ng / ml
• Wilson's disease
• Pregnant or lactating female (pre- menopausal females will undergo pregnancy test prior to administration of protocol drugs throughout treatment cycles during this study)
• Aspirin use exceeding 81 mg per day
• Acetaminophen use exceeding 2 g per day
• Known brain metastasis
• Active tobacco smokers
• Treatment with the combination of HDIVC and gemcitabine previously

Sponsors & Collaborators

• Eastern Regional Medical Center: lead

Study Sites (1)

Eastern Regional Medical Center

Philadelphia, Pennsylvania, 19124, United States

Location

MeSH Terms

Interventions

Gemcitabine; Ascorbic Acid

Intervention Hierarchy (Ancestors)

Heterocyclic Compounds; Deoxycytidine; Cytidine; Pyrimidine Nucleosides; Pyrimidines; Heterocyclic Compounds, 1-Ring; Sugar Acids; Acids, Acyclic; Carboxylic Acids; Organic Chemicals; Hydroxy Acids; Carbohydrates

Results Point of Contact

• Title: Eiko Klimant, MD
• Organization: Eastern Regional Medical Center

eiko.klimant@ctca-hope.com

215-537-7400

Study Officials

• Eiko Klimant, MD, FACP

  Eastern Regional Medical Center

  PRINCIPAL INVESTIGATOR

• Heather Wright, ND, FABNO

  Eastern Regional Medical Center

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: Yes

Study Design

• Study Type: interventional
• Phase: phase 1
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 13, 2012
• First Posted: August 1, 2012
• Study Start: June 1, 2012
• Primary Completion: June 1, 2014
• Study Completion: June 1, 2014
• Last Updated: July 26, 2018
• Results First Posted: December 1, 2014

Record last verified: 2018-01

Locations

US (1)