Phase II Study of Gemcitabine and TS-1 in Biliary Trat Cancer (GetBil)

This study has been terminated.
(The objective response rate by more than two people are confirmed.)
Sponsor:
Information provided by (Responsible Party):
Samsung Medical Center
ClinicalTrials.gov Identifier:
NCT01171755
First received: July 27, 2010
Last updated: May 20, 2014
Last verified: January 2012
  Purpose

In current study, we evaluate the efficacy of gemcitabine and TS-1 combination chemotherapy in advanced BTC.


Condition Intervention Phase
Biliary Tract Cancer
Drug: Gemcitabine TS-1
Phase 2

Study Type: Interventional
Study Design: Endpoint Classification: Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Phase II Study of Gemcitabine and TS-1 in Patients With Previously Untreated Metastatic or Recurrent Biliary Tract Cancer

Resource links provided by NLM:


Further study details as provided by Samsung Medical Center:

Primary Outcome Measures:
  • Response rate [ Time Frame: 1year 6months ] [ Designated as safety issue: Yes ]

Enrollment: 19
Study Start Date: February 2008
Study Completion Date: December 2009
Primary Completion Date: December 2009 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Gemcitabine, Ts-1
Gemcitabine : 1000/m2 will be administered on days 1 and 8 at every 3 weeks . TS-1 will be administered orally according to body surface area (BSA) as follows : BSA<1.25 M2, 80 mg/day; 1.25 M2≤BSA<1.5 M2, 100 mg/day; 1.5 M2≤BSA, 120 mg/day for 14 consecutive days followed by a 7-day rest.
Drug: Gemcitabine TS-1
Gemcitabine (1,000mg/m2) will be administered on days 1 and 8 at every 3 weeks TS-1 will be administered orally according to body surface area (BSA) as follows : BSA<1.25 M2, 80 mg/day; 1.25 M2≤BSA<1.5 M2, 100 mg/day; 1.5 M2≤BSA, 120 mg/day for 14 consecutive days followed by a 7-day rest.
Other Name: Gemcitabine (Gemza)TS-1 (TS-1)

Detailed Description:

At present, surgery is the only curative treatment option for biliary tract cancer (BTC). However, less than 25% of patients are resectable at presentation with high relapse rates after surgery. Because of the low incidence and heterogeneity of BTC, clinical trials are difficult to conduct in these patients, hampering the evaluation of optimal chemotherapy regimens. Owing to the lack of randomized phase III studies, there is no standard regimen for palliative chemotherapy of GBC and CC. But the exploration of an optimal regimen for standard first-line chemotherapy for BTC is imperative in order to improve survival in these patients.

Gemcitabine has demonstrated antitumor activity as monotherapy in phase II trials in BTC patients with response rates ranging from 22 to 36% (2001 Proc Am Soc Clin Oncol 20:A626, 2001 J Clin Oncol 19(20):4089-4091, 2001 Ann Oncol 12(2):183-186).

As with most gastrointestinal tumors, 5-fluorouracil (5-FU) is the most studied drug as a single agent or a combination in different dosages and schedules with response rates of 10-20% and with median survival of 7-9 months in BTC (2005 Cancer 103:111-118, 2001 Clin Cancer Res 7:3375-3380).

The combination of gemcitabine and fluoropyrimidine in biliary cancers is worthy of further evaluation. The toxicity profiles of these agents are known to be non-overlapping, and combinations have been well tolerated. Oral fluoropyrimidines are considered to be an alternative to conventional protracted 5-FU infusion as far as they provide comparable efficacy and compliance.

S-1 is oral fluoropyrimidine preparation developed by Taiho Pharmaceutical Co., Ltd. (Tokyo, Japan) that combines tegafur with two 5-FU modulators, 5-chloro-2, 4-dihydroxypyridine (CDHP) and potassium oxonate (Oxo), in a molar ratio of 1:0.4:1. Tegafur, a prodrug of 5-FU, is converted to 5-FU mainly in liver and tumor cells. CDHP, a reversible inhibitor of dihydropyrimidine dehydrogenase, suppresses the degradation of 5-FU, thereby maintaining high concentrations of 5-FU in plasma and tumor cells. CDHP also decreases cardiotoxic and neurotoxic effects by reducing the production of F-b-alanine (FBAL), the main catabolite of 5-FU. Several phase II trials showed that TS-1 monotherapy or combination with CDDP, paclitaxel or irinotecan was effective palliative treatment option for advanced gastric cancer and colorectal cancer.

In current study, we evaluate the efficacy of gemcitabine and TS-1 combination chemotherapy in advanced BTC.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • 1. Pathologically proven, measurable, unresectable, locally advanced or metastatic adenocarcinoma arising from the intra- and extrahepatic biliary ducts or gallbladder or papilla of Vater 2. No prior chemotherapy for advanced disease was allowed 3. No concurrent radiotherapy 4. At least one measurable lesion according to the Response Evaluation Criteria in Solid Tumors (RECIST) 5. At least 18 years old 6. ECOG performance status of ≤ 2 7. Adequate organ function as evidenced by the following; Absolute neutophil count > 1.5 x 109/L; platelets > 100 x 109/L; hemoglobin > 10g/dL; INR ≤ 1.4; total bilirubin ≤1.5 UNL; AST and/or ALT < 5 UNL; albumin > 3g/dL or > 30µmol/L; creatinine clearance ≥ 50mL/minInformed consent signed 8. Subject able to comply with the scheduled follow-up and the management of toxicities

Exclusion Criteria:

  • 1. Impairment of gastrointestinal function or gastrointestinal disease that may significantly alter the absorption of TS-1 (e.g., ulcerative disease, uncontrolled nausea, vomiting, diarrhea, malabsorption syndrome or small bowel resection) 2. Subject with reproductive potential (male or female) not using adequate contraceptive measures 3. Pregnancy and breast-feeding 4. Other serious illness or medical condition, notably heart or lung failure, active uncontrolled infection (infection requiring antibiotics) 5. History of significant cardiac disease, arrhythmias and angina pectoris 6. Past or concurrent history of other neoplasm, except curatively treated basal cell skin cancer or adequately treated in-situ carcinoma of the cervix 7. Other concomitant anticancer agent 8. Subjects who cannot be regularly followed up for psychological, social, familial or geographic reasons 9. Patients who are using other investigational agents or who had received investigational drugs ≤ 4 weeks prior to first study treatment
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01171755

Sponsors and Collaborators
Samsung Medical Center
Investigators
Principal Investigator: Yeong Lim Lim, Professor Samsung Medical Center
  More Information

No publications provided

Responsible Party: Samsung Medical Center
ClinicalTrials.gov Identifier: NCT01171755     History of Changes
Other Study ID Numbers: 2007-11-008, 82-02-3410-0914
Study First Received: July 27, 2010
Last Updated: May 20, 2014
Health Authority: Korea: Food and Drug Administration

Additional relevant MeSH terms:
Biliary Tract Neoplasms
Biliary Tract Diseases
Digestive System Diseases
Digestive System Neoplasms
Neoplasms
Neoplasms by Site
Gemcitabine
Anti-Infective Agents
Antimetabolites
Antimetabolites, Antineoplastic
Antineoplastic Agents
Antiviral Agents
Enzyme Inhibitors
Immunologic Factors
Immunosuppressive Agents
Molecular Mechanisms of Pharmacological Action
Pharmacologic Actions
Physiological Effects of Drugs
Radiation-Sensitizing Agents
Therapeutic Uses

ClinicalTrials.gov processed this record on October 23, 2014