Gemcitabine/Taxotere/Xeloda (GTX) With Cisplatin in Subjects With Metastatic Pancreatic Cancer
| Status: | Active, not recruiting |
|---|---|
| Conditions: | Cancer, Cancer, Pancreatic Cancer |
| Therapuetic Areas: | Oncology |
| Healthy: | No |
| Age Range: | 18 - 75 |
| Updated: | 1/25/2019 |
| Start Date: | November 2011 |
| End Date: | November 2019 |
Phase II Study of Gemcitabine/Taxotere/Xeloda (GTX) in Combination With Cisplatin in Subjects With Metastatic Pancreatic Cancer
Primary Objectives
To assess the efficacy of the combination of gemcitabine, taxotere, and xeloda (GTX) with
cisplatin in subjects with metastatic pancreatic cancer based on the progression-free
survival (PFS) rate at 6 month.
Secondary Objectives
- To assess safety and characterize toxicities of the combination of GTX with cisplatin in
subjects with metastatic pancreatic cancer.
- To estimate 3, 6, 9, 12, 15, and 18 month disease control rate (DCR), PFS, and overall
survival (OS).
Study Design
This study is a single arm phase II study to assess the efficacy of GTX with cisplatin in
subjects with metastatic pancreatic cancer. Approximately 38 evaluable subjects will be
enrolled, 28 in the initial cohort and 10 in the expansion cohort
The study will have a safety run-in phase consisting of 6 subjects. To ensure that the
combination is safe, the first six subjects will be treated at DL1 and observed for limiting
toxicity for the first 2 cycles before continuation with further accrual. After the safety
run-in, the study will be continuously monitored for adverse events.
The primary endpoint will be the PFS rate at 6 month, which is defined as the proportion of
subjects alive, free of disease progression at 6 months. The treatment regimen would be
considered of insufficient activity for further study in this population if PFS rate at 6
months is 50% or less, and the minimum required level of efficacy that would warrant further
study with the proposed regimen is a 75% PFS rate at 6 months. The study design includes
interim monitoring for futility using a predictive probability approach. We will stop the
study early if given the information at the interim analysis, it is unlikely that the PFS
rate at 6 months will be greater than 50% if the study continues to the end.
To assess the efficacy of the combination of gemcitabine, taxotere, and xeloda (GTX) with
cisplatin in subjects with metastatic pancreatic cancer based on the progression-free
survival (PFS) rate at 6 month.
Secondary Objectives
- To assess safety and characterize toxicities of the combination of GTX with cisplatin in
subjects with metastatic pancreatic cancer.
- To estimate 3, 6, 9, 12, 15, and 18 month disease control rate (DCR), PFS, and overall
survival (OS).
Study Design
This study is a single arm phase II study to assess the efficacy of GTX with cisplatin in
subjects with metastatic pancreatic cancer. Approximately 38 evaluable subjects will be
enrolled, 28 in the initial cohort and 10 in the expansion cohort
The study will have a safety run-in phase consisting of 6 subjects. To ensure that the
combination is safe, the first six subjects will be treated at DL1 and observed for limiting
toxicity for the first 2 cycles before continuation with further accrual. After the safety
run-in, the study will be continuously monitored for adverse events.
The primary endpoint will be the PFS rate at 6 month, which is defined as the proportion of
subjects alive, free of disease progression at 6 months. The treatment regimen would be
considered of insufficient activity for further study in this population if PFS rate at 6
months is 50% or less, and the minimum required level of efficacy that would warrant further
study with the proposed regimen is a 75% PFS rate at 6 months. The study design includes
interim monitoring for futility using a predictive probability approach. We will stop the
study early if given the information at the interim analysis, it is unlikely that the PFS
rate at 6 months will be greater than 50% if the study continues to the end.
Inclusion Criteria:
- Subjects must have histologically or cytologically confirmed metastatic pancreatic
adenocarcinoma. Subjects with islet cell neoplasms are excluded. Subjects with mixed
histology will be excluded.
- Subject has one or more tumors measurable by CT scan using RECIST 1.1 criteria. MRI is
acceptable if a CT scan is contraindicated.
- Patient must be chemotherapy naïve or must have completed chemotherapy greater than 5
years prior to enrollment.
- Male or non-pregnant and non-lactating female of age >18 years
- ECOG performance status <1. ECOG 0 indicates that the patient is fully active and able
to carry on all pre-disease activities without restriction; and, ECOG 1 indicates that
the patient is restricted in physically strenuous activity but is ambulatory and able
to carry out work of a light or sedentary nature
- Life expectancy of greater than 12 weeks.
- Subjects must have adequate organ and marrow function as defined below:
WBC ≥ 3,500/mcL Absolute Neutrophil Count ≥1,500/mcL Platelets ≥100 x 10^9/L Hemoglobin ≥ 9
g/d Total Bilirubin within normal institutional limits Alkaline phosphatase ≤ 2.5 x ULN (≤
5 X ULN for subjects with documented liver metastases) AST(SGOT)/ALT(SGPT) ≤ 2.5 x ULN (≤ 5
X ULN for subjects with documented liver metastases) Creatinine within normal institutional
limits OR Creatinine clearance ≥ 60 mL/min/1.73 m2 for subjects with creatinine levels
above institutional normal.
- Women of child-bearing potential and men must agree to use adequate contraception
(hormonal or barrier method of birth control; abstinence) prior to study entry and for
the duration of study participation. Should a woman become pregnant or suspect she is
pregnant while she or her partner is participating in this study, she should inform
her treating physician immediately.
- Willingness to undergo a tumor biopsy (implemented after the first 6 patients).
- Ability to understand and the willingness to sign a written informed consent document.
Exclusion Criteria:
- Subjects who have had any prior chemotherapy within 5 years of enrollment
- Subjects who have had radiotherapy for pancreatic cancer.
- Age ≥ 76 years
- Subjects who are receiving or have received any other investigational agents within 28
days prior to Day 1 of treatment in this study.
- Subject has undergone major surgery, other than diagnostic surgery (i.e.--surgery done
to obtain a biopsy for diagnosis or an aborted Whipple), within 28 days prior to Day 1
of treatment in this study.
- Subject has known brain metastases unless previously treated and well controlled for
at least 3 months (defined as stable clinically, no edema, no steroids).
- History of hypersensitivity or allergic reactions attributed to compounds of similar
chemical or biologic composition to gemcitabine, taxotere, xeloda, or cisplatin.
- Uncontrolled intercurrent illness including, but not limited to, ongoing or active
infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac
arrhythmia, or psychiatric illness/social situations that would limit compliance with
study requirements.
- Subject has serious medical risk factors involving any of the major organ systems such
that the Investigator considers it unsafe for the subject to receive an experimental
research drug.
- Subject has active, uncontrolled bacterial, viral, or fungal infection(s) requiring
systemic therapy.
- Subject has a known history of infection with HIV, hepatitis B, or hepatitis C.
- Subject is pregnant or breast feeding.
- Subject is unwilling or unable to comply with study procedures.
- Subject with an unhealed surgical wound or other clinically significant wound.
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