Trial record 1 of 1 for:    ACOSOG Z5041
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Gemcitabine and Erlotinib Before and After Surgery in Treating Patients With Pancreatic Cancer That Can Be Removed by Surgery

This study is currently recruiting participants.
Verified February 2013 by National Cancer Institute (NCI)
Information provided by:
National Cancer Institute (NCI) Identifier:
First received: August 12, 2008
Last updated: February 13, 2013
Last verified: February 2013

RATIONALE: Drugs used in chemotherapy, such as gemcitabine, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Erlotinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Giving gemcitabine and erlotinib before surgery may make the tumor smaller and reduce the amount of normal tissue that needs to be removed. Giving these drugs after surgery may kill any tumor cells that remain after surgery.

PURPOSE: This phase II trial is studying how well gemcitabine and erlotinib work when given before and after surgery in treating patients with pancreatic cancer that can be removed by surgery.

Condition Intervention Phase
Pancreatic Cancer
Drug: erlotinib hydrochloride
Drug: gemcitabine hydrochloride
Genetic: RNA analysis
Genetic: gene expression analysis
Genetic: polymorphism analysis
Other: laboratory biomarker analysis
Procedure: adjuvant therapy
Procedure: neoadjuvant therapy
Procedure: therapeutic conventional surgery
Phase 2

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Phase II Study of Preoperative Gemcitabine and Erlotinib Plus Pancreatectomy and Postoperative Gemcitabine and Erlotinib for Patients With Operable Pancreatic Adenocarcinoma

Resource links provided by NLM:

Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Overall survival at 2 years [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Resection rate [ Designated as safety issue: No ]
  • Relapse/progression-free survival [ Designated as safety issue: No ]
  • Adverse event profile [ Designated as safety issue: Yes ]
  • Response rate [ Designated as safety issue: No ]
  • Molecular and genetic profiles [ Designated as safety issue: No ]

Estimated Enrollment: 123
Study Start Date: April 2009
Estimated Primary Completion Date: October 2013 (Final data collection date for primary outcome measure)
Detailed Description:



  • To estimate the proportion of patients with resectable adenocarcinoma of the pancreas alive at 2 years from the date of study registration after treatment with neoadjuvant and adjuvant gemcitabine hydrochloride and erlotinib hydrochloride plus pancreatectomy.


  • To determine the resection rate (defined as the fraction of patients who proceed to planned surgery with removal of primary tumor [R0/R1]) after neoadjuvant treatment with gemcitabine hydrochloride and erlotinib hydrochloride.
  • To estimate the time to disease progression/relapse in these patients.
  • To evaluate the rate of R0, R1, and R2 resections in these patients.
  • To evaluate the toxicity profile and feasibility of this regimen in these patients.
  • To evaluate response rates in patients treated with this regimen.
  • To identify molecular predictors of response to this regimen.
  • To identify genetic profiles of pancreatic adenocarcinoma that may be associated with response to neoadjuvant therapy.

OUTLINE: This is a multicenter study.

  • Neoadjuvant therapy:Patients receive gemcitabine hydrochloride IV over 30 minutes on days 1, 8, 15, 29, 36, and 43 and oral erlotinib hydrochloride once daily on days 1-43 in the absence of disease progression or unacceptable toxicity.
  • Surgery:At 3-6 weeks after completion of neoadjuvant therapy, patients undergo pancreaticoduodenectomy.
  • Adjuvant therapy:Beginning 5-10 weeks after surgery, patients receive gemcitabine hydrochloride and erlotinib hydrochloride as in neoadjuvant therapy.

Patients undergo blood and tumor tissue sample collection for correlative laboratory studies. Studies include assessment of epithelial-mesenchymal transition (EMT) markers, analysis of EGFR intron 1 polymorphism, and identification of genetic profiles by RNA analysis.

After completion of study treatment, patients are followed every 3 months for 2 years and then every 6 months for 2 years.


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


  • Histologically or cytologically confirmed adenocarcinoma of the pancreatic head or uncinate process

    • No tumors of the pancreatic neck, body, or tail
    • No evidence of neuroendocrine tumors, duodenal adenocarcinoma, or ampullary adenocarcinoma
  • Localized, potentially resectable* tumor by chest x-ray or CT scan and abdominal CT scan or MRI, as defined by the following:

    • No evidence of tumor extension to the celiac axis, hepatic artery, or superior mesenteric artery
    • No evidence of tumor encasement or occlusion of the superior mesenteric vein (SMV) or the SMV/portal vein confluence
    • No evidence of visceral or peritoneal metastases NOTE: *Patients with borderline resectable or marginally resectable pancreatic cancer are not eligible.


  • ECOG or Zubrod performance status 0-1
  • WBC ≥ 2,000/mm³
  • ANC ≥ 1,500/mm³
  • Platelet count ≥ 100,000/mm³
  • Total bilirubin ≤ 2.5 mg/dL
  • ALT and AST ≤ 2.5 times upper limit of normal
  • Albumin ≥ 3.2 g/dL
  • Serum creatinine ≤ 1.5 mg/dL OR creatinine clearance ≥ 50 mL/min
  • Baseline weight loss ≤ 15% of premorbid weight
  • No active infection requiring intravenous antibiotics
  • No other malignancy within the past 5 years except for nonmelanoma skin cancer or in situ cancer
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception


  • No prior EGFR-targeted therapy
  • No prior therapy for pancreatic cancer
  • No other concurrent investigational or commercial agents or therapies for pancreatic cancer
  Contacts and Locations
Please refer to this study by its identifier: NCT00733746

  Hide Study Locations
United States, California
Rebecca and John Moores UCSD Cancer Center Recruiting
La Jolla, California, United States, 92093-0658
Contact: Clinical Trials Office - Rebecca and John Moores UCSD Cancer    858-822-5354   
Kaiser Permanente Medical Center - Los Angeles Recruiting
Los Angeles, California, United States, 90027
Contact: L. Andrew DiFronzo    323-667-4011      
Chao Family Comprehensive Cancer Center at University of California Irvine Medical Center Recruiting
Orange, California, United States, 92868
Contact: Clinical Trials Office - Chao Family Comprehensive Cancer Cent    877-UC-STUDY   
United States, Connecticut
St. Vincent's Medical Center Recruiting
Bridgeport, Connecticut, United States, 06606
Contact: Stuart G. Marcus    203-576-6000      
United States, Florida
Lakeland Regional Cancer Center at Lakeland Regional Medical Center Recruiting
Lakeland, Florida, United States, 33805
Contact: Madhavi L. Venigalla, MD    508-368-3168      
United States, Indiana
St. Francis Hospital Cancer Care Services Recruiting
Indianapolis, Indiana, United States, 46237
Contact: Daniel P. McKellar, MD    937-832-9310      
United States, Maryland
Alvin and Lois Lapidus Cancer Institute at Sinai Hospital Recruiting
Baltimore, Maryland, United States, 21215
Contact: Mukund S. Didolkar, MD, MS    410-601-8317      
St. Agnes Hospital Cancer Center Recruiting
Baltimore, Maryland, United States, 21229
Contact: Carole Miller, MD    410-368-3414      
United States, Mississippi
University of Mississippi Cancer Clinic Recruiting
Jackson, Mississippi, United States, 39216
Contact: Thomas S. Helling    601-984-5590      
United States, Nebraska
Methodist Estabrook Cancer Center Recruiting
Omaha, Nebraska, United States, 68114
Contact: James A. Reilly, MD    402-354-8163      
United States, New York
NYU Cancer Institute at New York University Medical Center Recruiting
New York, New York, United States, 10016
Contact: Elliot Newman    212-263-6485      
United States, North Carolina
Lineberger Comprehensive Cancer Center at University of North Carolina - Chapel Hill Recruiting
Chapel Hill, North Carolina, United States, 27599-7295
Contact: Clinical Trials Office - Lineberger Comprehensive Cancer Cente    877-668-0683; 919-966-4432      
United States, Ohio
CCOP - Dayton Recruiting
Dayton, Ohio, United States, 45420
Contact: Daniel P. McKellar, MD    937-832-9310      
David L. Rike Cancer Center at Miami Valley Hospital Recruiting
Dayton, Ohio, United States, 45409
Contact: Clinical Trials Office - David L. Rike Cancer Center at Miami    937-208-2079      
Samaritan North Cancer Care Center Recruiting
Dayton, Ohio, United States, 45415
Contact: Daniel P. McKellar, MD    937-832-9310      
Charles F. Kettering Memorial Hospital Recruiting
Kettering, Ohio, United States, 45429
Contact: Clinical Trials Office - Charles F. Kettering Memorial Hospita    937-298-3399 ext. 57556      
UVMC Cancer Care Center at Upper Valley Medical Center Recruiting
Troy, Ohio, United States, 45373-1300
Contact: Clinical Trials Office - UVMC Cancer Care Center at Upper Vall    937-440-4842      
United States, Oklahoma
Natalie Warren Bryant Cancer Center at St. Francis Hospital Recruiting
Tulsa, Oklahoma, United States, 74136
Contact: James B. Lockhart, MD    918-481-4800      
United States, Oregon
Providence Cancer Center at Providence Portland Medical Center Recruiting
Portland, Oregon, United States, 97213-2967
Contact: Clinical Trials Office - Providence Cancer Center at Providenc    503-215-6412      
United States, South Carolina
Gibbs Regional Cancer Center at Spartanburg Regional Medical Center Recruiting
Spartanburg, South Carolina, United States, 29303
Contact: Clinical Trials Office - Gibbs Regional Cancer Center    800-486-5941      
United States, Virginia
Surgical Oncology Associates Recruiting
Newport News, Virginia, United States, 23606
Contact: Richard A Hoefer, Jr.    757-594-6770      
United States, West Virginia
Mary Babb Randolph Cancer Center at West Virginia University Hospitals Recruiting
Morgantown, West Virginia, United States, 26506
Contact: Ronald Matteotti    304-293-4500      
United States, Wisconsin
University of Wisconsin Paul P. Carbone Comprehensive Cancer Center Recruiting
Madison, Wisconsin, United States, 53792-6164
Contact: Clinical Trials Office - University of Wisconsin Paul P. Carbo    608-262-5223      
Canada, Ontario
Princess Margaret Hospital Recruiting
Toronto, Ontario, Canada, M5G 2M9
Contact: Malcolm J. Moore, MD    416-946-2263      
Sponsors and Collaborators
American College of Surgeons
Study Chair: Peter W.T. Pisters, MD M.D. Anderson Cancer Center
  More Information

Additional Information:
No publications provided

Responsible Party: David M. Ota, American College of Surgeons Oncology Group Identifier: NCT00733746     History of Changes
Other Study ID Numbers: CDR0000609871, ACOSOG-Z5041
Study First Received: August 12, 2008
Last Updated: February 13, 2013
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
adenocarcinoma of the pancreas
stage I pancreatic cancer
stage II pancreatic cancer

Additional relevant MeSH terms:
Pancreatic Neoplasms
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Digestive System Neoplasms
Neoplasms by Site
Endocrine Gland Neoplasms
Digestive System Diseases
Pancreatic Diseases
Endocrine System Diseases
Antimetabolites, Antineoplastic
Molecular Mechanisms of Pharmacological Action
Pharmacologic Actions
Antineoplastic Agents
Therapeutic Uses
Antiviral Agents
Anti-Infective Agents
Enzyme Inhibitors
Immunosuppressive Agents
Immunologic Factors
Physiological Effects of Drugs
Radiation-Sensitizing Agents
Protein Kinase Inhibitors processed this record on April 17, 2014