Split-course SBRT for Borderline Resectable and Locally Advanced Pancreatic Cancer

February 14, 2023 updated by: Benhua Xu, Fujian Medical University Union Hospital

Chemotherapy-based Split Stereotactic Body Radiation Therapy for Borderline Resectable and Locally Advanced Pancreatic Cancer: Study Protocol of a Prospective, Single-arm Phase II Trial

Exploratory assessment of the efficacy and safety of gemcitabine-albumin-based paclitaxel chemotherapy combined with SBRT in the treatment of newly diagnosed borderline resectable and locally advanced unresectable pancreatic cancer patients with sequential investigator selection (IC).

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

The question of how to administer adequate chemotherapy to synchronize SBRT treatment strategy to maximize the benefits of neoadjuvant therapy for improved prognosis of patients with borderline resectable (BRPC) and locally advanced (LAPC) pancreatic cancer is a challenging and debatable issue. No studies have yet evaluated the efficacy of split-course SBRT as the neoadjuvant chemoradiotherapy regimen. The investigators aimed to study whether neoadjuvant chemotherapy plus split-course SBRT results in better outcomes in BRPC and LAPC patients.

Study Type

Interventional

Enrollment (Anticipated)

27

Phase

  • Phase 2

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

    • Fujian
      • Fuzhou, Fujian, China, 350000
        • Recruiting
        • Fujian Medical University Union Hospital
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 70 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Age ≥ 18 years old and ≤ 70 years old.
  • Histologically or cytologically confirmed adenocarcinoma of the pancreas.
  • Borderline resectable or locally advanced pancreatic cancer proven by imaging examinations via multidisciplinary approaches according to NCCN guidelines
  • No prior chemotherapy or radiotherapy
  • ECOG performance status of 0 or 1.
  • Without distant metastasis
  • The maximum diameter of the tumor must not exceed 5 cm
  • Acceptable hematology parameters: a. Absolute neutrophil count (ANC) ≥1500 cell/mm3 b. Platelet count ≥100,000/mm3 c. Hemoglobin (Hgb)≥9 g/dL
  • Acceptable blood chemistry levels: a. AST/SGOT and ALT/SGPT≤2.5× upper limit of normal range (ULN) b. Total bilirubin≤1.5 ULN c. Alkaline phosphatase≤2.5× ULN d. Serum albumin>3 g/dL e. Serum creatinine≤1.5 ULN
  • Understand and voluntarily sign an informed consent document prior to any study related assessments/procedures are conducted.

Exclusion Criteria:

  • Age < 18 years old and > 70 years old. Prior anticancer therapy for pancreatic carcinoma.
  • Presence of or history of metastatic pancreatic adenocarcinoma.
  • Patients who had surgeries, chemotherapy, or other treatments before inclusion.
  • Any other malignancy within 5 years prior to enrollment
  • History of allergy or hypersensitivity to nab-paclitaxel or gemcitabine or any of their excipients.
  • Peripheral sensory neuropathy Grade > 1
  • Serious medical risk factors involving any of the major organ systems, or serious psychiatric disorders.
  • Pregnant or breast feeding.
  • Patients enrolled in other clinical trials or incompliant with regular follow-up
  • Unwillingness or inability to comply with study procedures.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: SBRT with concurrent chemotherapy
SBRT with nab-Paclitaxel plus Gemcitabine (nab-P+Gem) chemotherapy
Drug: nab-Paclitaxel 125 mg/m2 IV over approximately 30-45 min on Days 1 and 15, followed by gemcitabine 1000 mg/m2 IV infusion over approximately 30 min on Days 1 and 15 of each 28-day cycle for 6 cycles.
Radiation: During the first 1 and 2 cycles of chemotherapy, SBRT was given as a single irradiation of 10 Gy ⅹ 4 times (Days 2 and 16 of each 28-day cycle).

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Kaplan-Meier Estimate of Progression-Free Survival (PFS)
Time Frame: From enrollment to 2 years after the end of treatment
Progression-free Survival (PFS) was defined as the time from the date of the first dose to the date of disease progression or death (by any cause), whichever is earlier. The analysis day was calculated from enrollment date for one participant who was not treated. Participants who have no disease progression or have not died were censored to last tumor assessment date with progression-free.
From enrollment to 2 years after the end of treatment

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Kaplan-Meier Estimates for Time to Treatment Failure (TTF)
Time Frame: From enrollment to 2 years after the end of treatment
TTF was defined as the time after the first dose of study therapy to discontinuation of study therapy due to disease progression, death by any cause, or the start of a new non-protocol-defined anticancer therapy/surgery.
From enrollment to 2 years after the end of treatment
Disease Control Rate (DCR)
Time Frame: From enrollment to 2 years after the end of treatment
DCR was defined as the percentage of participants with a CR or PR or SD from of date of first treatment to 16 weeks. Tumor assessments after start of non-protocol-defined anticancer therapy were excluded.
From enrollment to 2 years after the end of treatment
Overall Response Rate (ORR)
Time Frame: From enrollment to 2 years after the end of treatment
ORR was defined as the percentage of participants that achieved a combined incidence of complete (CR) and partial response (PR) using RECIST 1.1 guidelines as assessed by the investigator.
From enrollment to 2 years after the end of treatment
Kaplan-Meier Estimates for Overall Survival (OS)
Time Frame: From enrollment to 2 years after the end of treatment
Overall survival was defined as the time from the date of first dose of study therapy to the date of death (by any cause).
From enrollment to 2 years after the end of treatment
Participants With Treatment Emergent Adverse Events (TEAEs)
Time Frame: From enrollment to 2 years after the end of treatment
TEAEs are defined as any adverse event (AE) that begin or worsen on or after the start of study drug or procedure of the study period through the maximum duration of the period plus 28 days.
From enrollment to 2 years after the end of treatment

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Principal Investigator: Benhua Xu, PHD, Fujian Medical University Union Hospital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

May 9, 2020

Primary Completion (Anticipated)

May 9, 2024

Study Completion (Anticipated)

May 9, 2025

Study Registration Dates

First Submitted

February 20, 2020

First Submitted That Met QC Criteria

February 26, 2020

First Posted (Actual)

February 28, 2020

Study Record Updates

Last Update Posted (Estimate)

February 16, 2023

Last Update Submitted That Met QC Criteria

February 14, 2023

Last Verified

February 1, 2023

More Information

Terms related to this study

Other Study ID Numbers

  • splitPC

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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