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Study of Neoadjuvant Treatment in Patients With Pancreatic Cancer That is Potentially Resectable

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01531712
Recruitment Status : Terminated (Due to a low recruitment rate since start of recruitment period.)
First Posted : February 13, 2012
Last Update Posted : August 29, 2017
Information provided by (Responsible Party):
Institut Català d'Oncologia

Brief Summary:
Phase II study of neoadjuvant treatment with Gemcitabine, Tarceva and Oxaliplatin followed by chemotherapy with Tarceva and Gemcitabine in patients with pancreatic adenocarcinoma with borderline resectability. The primary objective is to determine the resectability rate of patients with pancreas adenocarcinoma with borderline resectability determined radiologically, treated with Gemcitabine, Tarceva and Oxaliplatin followed by radiotherapy with Gemcitabine and Tarceva.

Condition or disease Intervention/treatment Phase
Pancreatic Cancer Drug: Gemcitabine Radiation: Radiotherapy Drug: Tarceva Drug: Oxaliplatin Phase 2

Detailed Description:

Patients with borderline resectable pancreatic adenocarcinoma are more likely to develop perioperative complications due to the complexity of surgery. In these patients there is also an increased risk of systemic relapse due to the advanced stage of the tumor as well as a higher possibility of having positive margins. Therefore, the treatment of these patients need to be decided based on a multidisciplinary strategy. Besides of that the use of systemic neoadjuvant chemotherapy as induction therapy, followed by sequential chemoradiotherapy is a very attractive therapeutic modality.

The neoadjuvant treatment offers the potential advantages of reducing the tumor stage, increasing resectability and decreasing postoperative complications.

The administration of chemotherapy and radiotherapy before surgery represent an strategy for early treatment of micrometastatic disease, present in most of these patients, and to identify patients with rapid progression of the disease.

For all the reasons above, the investigators consider it's of great interest to design new studies that combine systemic neoadjuvant chemotherapy followed by chemoradiotherapy with neoadjuvant intention in patients with pancreas cancer locally advanced.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 6 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Phase II Study of Neoadjuvant Treatment With Gemcitabine, Tarceva and Oxaliplatin Followed by Chemotherapy With Tarceva and Gemcitabine in Patients With Pancreas Adenocarcinoma With Borderline Resectability.
Study Start Date : February 10, 2011
Actual Primary Completion Date : December 2012
Actual Study Completion Date : December 2012

Arm Intervention/treatment
Experimental: QT + QRT

Chemotherapy (6 cycles x 14 days): Gemcitabine 1000 mg/m2 (day 1) + Oxaliplatin 100 mg/m2 (day 2) + Tarceva 100 mg/day.

Chemoradiotherapy (5,5 weeks): Gemcitabine 40 mg/m2 (2 days/week) + Tarceva 100 mg/day + Radiotherapy (1,8 Gy/day x 28 doses, total dose: 50,4 Gy).

Drug: Gemcitabine
1000mg/m2 / / 40mg/m2
Other Name: gemzar

Radiation: Radiotherapy
50.4 Gy

Drug: Tarceva
Other Name: Erlotinib

Drug: Oxaliplatin
100mg/m2 (only in QT)
Other Name: ELOXATIN

Primary Outcome Measures :
  1. Resectability rate after neoadjuvant treatment with chemotherapy plus chemoradiotherapy. [ Time Frame: Two years ]
    Determine the resectability rate of subjects with borderline resectable pancreatic cancer (radiologically measured) that were treated with Gemcitabine, Tarceva and Oxaliplatin followed by chemoradiotherapy with Gemcitabine and Tarceva.

Secondary Outcome Measures :
  1. Median overall survival. [ Time Frame: Two years ]
    To determine the overall survival (OS) and the tumor recurrence pattern (local versus distant).

  2. Rate of resections with engative margins and complete pathological response. [ Time Frame: Two years ]
    To determine the rate of negative margin resections and complete pathological response (cPR).

  3. Response rate to neoadjuvant treatment of tumor markers (CEA, CA19-9) [ Time Frame: Two years ]
    To determine the reponse rate to the neoadjuvant treatment of speficic tumor markers (CEA, Ca19-9).

  4. Ratio of objective responses (RECIST). [ Time Frame: Two years ]
    To determine the ratio of objective responses according to RECIST criteria.

  5. Prognosis accuracy of serum protein profiles [ Time Frame: Two years ]
    To determine the prognosis accuracy of serum protein profiles in these subjects.

  6. Viability of the collection of pre-treatment tumor samples [ Time Frame: Two years ]
    To determine the feasibility of the collection of pre-treatment (baseline) tumor samples and to set pathological correlations with the response after neoadyuvant treatment.

  7. Adverse events [ Time Frame: Two years ]
    To determine the safety, toxicity and feasibility of this therapeutical regimen as neoadyuvant treatment.

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 75 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Before the beginning of the specific protocol procedures must be obtained and documented a written consent form. Patients must have sufficient capacity to understand and sign the consent form.
  • Exocrine pancreatic potentially resectable carcinoma, histologically confirmed.
  • Aged 18-75 years.
  • OMS functional state (FE) from 0-2 and Karnofsky functional state 70%.
  • Radiologically or measurable disease, defined as borderline resectability disease.
  • Appropriate biological parameters: neutrophils > 1.500/mL; platelets > 100.000/mL; hemoglobin > 10 g/dl.Serum creatinine < 1,5 x upper limit of normal (LSN); alkaline phosphatase < 3 x LSN and bilirubin < 1,5 x LSN; AST and ALT 2,5 x LSN.
  • Controlled biliary obstruction in all the patients before their inclusion in the study.
  • Absence of peripheral neuropathy grade 2.
  • Life expectancy of at least 3 months.

Exclusion Criteria:

  • Previous administration of chemotherapy, radiotherapy or any investigational agents for pancreatic cancer treatment.
  • Administration of other experimental treatment during this study or in the previous 6 months.
  • Pregnancy, inappropriate or unsafe use of contraceptive methods or women who are breast-feeding.
  • Clinically significant heart disease(for example: congestive heart failure, symptomatic coronary artery disease and cardiac arrhythmias not properly controlled with medication or myocardial infarction in the last 12 months).
  • Presence of significant ophthalmologic anomaly, included: severe dry eye syndrome, Sjogren syndrome, dry keratoconjunctivitis, severe exposure keratopathy, conditions that might increase the risk of epithelium complications.
  • Patients with lack of physical integrity of the upper gastrointestinal tract or bad absorption syndromes or unable to ingest the tablets.
  • Other previous bad or concurrent diseases, with the exception of nonmelanoma skin cancer.
  • Medical or psychiatric pathologies that are severe or uncontrolled.
  • Distant metastases.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01531712

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Institut Català d'Oncologia
L'Hospitalet, Barcelona, Spain, 08907
Sponsors and Collaborators
Institut Català d'Oncologia
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Principal Investigator: Berta Laquente, MD ICO
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Responsible Party: Institut Català d'Oncologia Identifier: NCT01531712    
Other Study ID Numbers: ICO-20431
2010-021872-27 ( EudraCT Number )
GEMERLOXA ( Other Identifier: ICO )
First Posted: February 13, 2012    Key Record Dates
Last Update Posted: August 29, 2017
Last Verified: August 2017
Keywords provided by Institut Català d'Oncologia:
neoadjuvant treatment
borderline resectability
Additional relevant MeSH terms:
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Pancreatic Neoplasms
Digestive System Neoplasms
Neoplasms by Site
Endocrine Gland Neoplasms
Digestive System Diseases
Pancreatic Diseases
Endocrine System Diseases
Erlotinib Hydrochloride
Antimetabolites, Antineoplastic
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Antiviral Agents
Anti-Infective Agents
Enzyme Inhibitors
Immunosuppressive Agents
Immunologic Factors
Physiological Effects of Drugs
Protein Kinase Inhibitors