Status:
COMPLETED
Chemotherapy and Radiation Therapy Before Surgery Followed by Gemcitabine in Treating Patients with Pancreatic Cancer
Lead Sponsor:
Alliance for Clinical Trials in Oncology
Collaborating Sponsors:
National Cancer Institute (NCI)
Conditions:
Acinar Cell Adenocarcinoma of the Pancreas
Duct Cell Adenocarcinoma of the Pancreas
Eligibility:
All Genders
18+ years
Phase:
EARLY_PHASE1
Brief Summary
This pilot clinical trial studies combination chemotherapy and radiation therapy before surgery followed by gemcitabine hydrochloride in treating patients with pancreatic cancer. Drugs used in chemoth...
Detailed Description
The purpose of this study is to evaluate a new treatment program for patients with borderline resectable pancreas cancer in order to determine what effects, good and bad, chemotherapy and chemoradiati...
Eligibility Criteria
Inclusion
- Pre-Registration Eligibility Criteria
- Documentation of Disease and Radiographic Staging
- Cytologic or histologic proof of adenocarcinoma of the pancreatic head or uncinate process
- Objective radiographic staging with a) contrast-enhanced, helical thin-cut computed tomography (CT)/magnetic resonance imaging (MRI) scan of the abdomen and b) CT scan/MRI of the chest
- Note: echoendoscopic staging will be permitted as an adjunctive modality, but all stage definitions below will be determined using CT/MRI as outlined below. In the event echoendoscopic stage and CT/MRI stage are discordant, the CT/MRI stage will be used. Significant discordance should be discussed with the study principal investigator (PI) prior to enrollment
- Borderline resectable primary tumor, defined by the presence of any one or more of the following on CT/MRI, and confirmed by central radiographic review:
- An interface between the primary tumor and the superior mesenteric vein or portal vein (SMV-PV) measuring ≥ 180 degrees of the circumference of the vessel wall
- Short-segment occlusion of the SMV-PV with normal vein above and below the level of obstruction that is amenable to resection and venous reconstruction
- Short segment interface (of any degree) between tumor and hepatic artery with normal artery proximal and distal to the interface that is amenable to resection and reconstruction
- An interface between the tumor and superior mesenteric artery (SMA) measuring \< 180 degrees of the circumference of the vessel wall
- No potentially resectable disease defined as primary tumors with all of the following:
- An interface between the primary tumor and the superior mesenteric vein or portal vein (SMV-PV) measuring \< 180 degrees of the circumference of the vessel wall
- No radiographic interface between the tumor and the (superior mesenteric artery) SMA, hepatic artery or celiac axis
- No radiographic evidence of metastatic disease
- No metastatic disease defined as any one or more of the following:
- Suspicious lymphadenopathy outside the standard surgical field (i.e., aortocaval nodes, distant abdominal nodes)
- Radiographic evidence for metastatic disease in distant organs, such as masses in distant organs or ascites
- No locally advanced and/or unresectable disease clearly defined by any one or more of the following by CT/MRI:
- An interface between the tumor and the SMA measuring ≥ 180 degrees of the circumference of the vessel wall
- No interface between the tumor and the aorta
- Occlusion of the SMV or portal vein without a sufficient cuff of normal vein above and below the level of obstruction with which to perform venous reconstruction
- Long-segment interface (of any degree) between the tumor and the common hepatic artery or its major tributaries with insufficient artery proximal and distal to the interface to perform reconstruction
- No prior chemotherapy or chemoradiation for pancreatic cancer
- No patients with a "currently active" second malignancy other than non-melanoma skin cancers. Patients are not considered to have a "currently active" malignancy if they have completed therapy and are free of disease for ≥ 3 years
- Baseline peripheral sensory neuropathy must be grade \< 2
- No patients with known Gilbert's Syndrome or homozygosity for UGT1A1\*28 polymorphism
- No history of pulmonary embolism in the past 6 months
- Age ≥ 18 years of age
- Eastern Cooperative Oncology Group (ECOG)/Zubrod performance status 0-1
- Pregnancy/Nursing Status: Non-pregnant and non-breast-feeding. Female participants of child-bearing potential must have a negative urine or serum pregnancy test prior to registration. Perimenopausal participants must be amenorrheic \> 12 months to be considered not of childbearing potential.
- Required Pre-Registration Laboratory Values:
- Granulocytes ≥ 2,000/ul
- Hemoglobin \> 9 g/dL
- Platelets ≥ 100,000/ul
- Albumin \> 3.0 g/dL
- Creatinine ≤1.5 x upper limit of normal (ULN)
- Registration Eligibility Criteria
- Confirmation of pre-registration eligibility criteria as described under "Documentation of Disease and Radiographic Staging" by the Alliance Central Radiographic Review
- Required Registration Laboratory Values:
- Bilirubin ≤2 mg/dl
- AST (SGOT) \& ALT (SGPT) ≤ 2.5 x ULN
Exclusion
Key Trial Info
Start Date :
May 29 2013
Trial Type :
INTERVENTIONAL
Allocation :
ACTUAL
End Date :
June 15 2018
Estimated Enrollment :
23 Patients enrolled
Trial Details
Trial ID
NCT01821612
Start Date
May 29 2013
End Date
June 15 2018
Last Update
January 13 2025
Active Locations (14)
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1
UC San Diego Moores Cancer Center
La Jolla, California, United States, 92093
2
University of Chicago Comprehensive Cancer Center
Chicago, Illinois, United States, 60637
3
NorthShore University HealthSystem-Evanston Hospital
Evanston, Illinois, United States, 60201
4
The James Graham Brown Cancer Center at University of Louisville
Louisville, Kentucky, United States, 40202