- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01903083
Chemoimmunotherapy and Radiation in Pancreatic Cancer (CRIT)
January 31, 2018 updated by: Providence Health & Services
Phase I Trial of Chemoimmunotherapy and Hypofractionated Radiation Therapy for Borderline Resectable and Locally Advanced Pancreatic Adenocarcinoma.
The goal of this study is to evaluate the safety of combination treatment that includes chemotherapy, radiation therapy, and immunotherapy in patients with pancreatic cancer.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
This study is for borderline resectable and advanced pancreatic cancer patients.
Patients will receive chemotherapy with gemcitabine and immunotherapy with daily tadalafil during the first 21 days of treatment.
On study day 22, patients will receive the first of three planned doses of radiation therapy and continue daily tadalafil.
Patients are then evaluated to determine if they are candidates for pancreaticoduodenectomy. Patients who are not candidates will continue daily tadalafil and receive gemcitabine chemotherapy.
Patients who have surgery will resume daily tadalafil and gemcitabine chemotherapy following recovery from surgery.
Patients will receive up to four cycles of gemcitabine.
Study Type
Interventional
Enrollment (Actual)
10
Phase
- Phase 1
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
Oregon
-
Portland, Oregon, United States, 97213
- Portland Providence Medical Center
-
-
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 and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Pancreatic adenocarcinoma
- Locally advanced unresectable disease, or borderline resectable disease
- ECOG (Eastern Cooperative Oncology Group)Performance Status 0 or 1
- Ability to provide consent and comply with study protocol
- Women of child-bearing potential must have a negative pregnancy test and avoid pregnancy during the study
Exclusion Criteria:
- Age < 18
- History of other malignancy in previous 2 years except carcinoma in situ of the cervix or bladder, or non-melanoma skin cancer
- Previous chemotherapy or radiation therapy for pancreatic cancer or previous radiation to the target field
- Clinically active autoimmune disease or active infection
- History of heart attack within 90 days or stroke within 6 months, hypertension requiring change in blood pressure medications in the last 4 weeks, hypotension, uncontrolled arrhythmias, heart failure (NYHA >= Class 2 in last 6 months), unstable angina, or angina during sexual activity
- Use of nitrates or nitroglycerin
- History of hereditary degenerative retinal disorders including retinitis pigmentosa
- Chronic systemic corticosteroid use at supra-physiologic doses
- Use of recreational drugs called 'poppers' like amyl nitrite and butyl nitrite
- Blood test results (neutrophils < 1000 /uL (microliter); hemoglobin < 9 gm /dL; platelet count < 1000 cells / uL; significant coagulopathy; significant liver or renal dysfunction
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: Immunochemoradiotherapy
Immunotherapy with oral tadalafil daily; three doses of chemotherapy with IV Gemcitabine in 21-day cycles for up to 4 cycles; three fractions of external beam radiation to the pancreas and and regional lymph nodes; pancreaticoduodenectomy (surgical resection) for eligible patients.
|
One 2.5 mg tablet is self-administered orally by the study participant on a once daily basis.
Other Names:
Three doses of gemcitabine (1000 mg / m^2)are given over a 21-day cycle.
Patients may receive up to 4 cycles.
Other Names:
Patients will receive 3 doses of radiation (8-10 Gy per fraction).
Surgical resection.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Safety
Time Frame: 135 Days
|
Patients will return be seen in the clinic 8 times over the first 50 days for an evaluation of adverse events and toxicities before being evaluated for surgery.
Patients who are not candidates for surgery will be seen in clinic 10 more times over the next 85 days for safety evaluations, and patients who have surgery will be seen 10 times over the 85 days following recovery from surgery for safety evaluations.
|
135 Days
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Immune Infiltration in pancreaticoduodenectomy tissue
Time Frame: 50 Days
|
For surgery patients, formalin fixed and paraffin-embedded tumor tissue obtained during surgery will be sectioned and immunohistology performed to determine the tumor inflammatory micro-environment and the degree of macrophage and T cell inflammation.
|
50 Days
|
Quantification of T cells in peripheral blood pre- and post-treatment
Time Frame: 135 Days
|
Patients will provide a pre-treatment blood sample and 4 blood samples over 135 days to evaluate the influence of the study treatment on immune parameters.
For patients who have surgery, the time period will be longer depending on their recovery time.
Post-treatment long term follow up will occur every 12 weeks (+/- 2 weeks) beyond post-recovery date (PRD) 85 for 6 visits.
Blood will be collected for immune monitoring at each visit.
|
135 Days
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Investigators
- Principal Investigator: Todd Crocenzi, MD, Providence Health & Services
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.
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
July 1, 2013
Primary Completion (Actual)
December 1, 2017
Study Completion (Actual)
December 1, 2017
Study Registration Dates
First Submitted
July 2, 2013
First Submitted That Met QC Criteria
July 16, 2013
First Posted (Estimate)
July 19, 2013
Study Record Updates
Last Update Posted (Actual)
February 1, 2018
Last Update Submitted That Met QC Criteria
January 31, 2018
Last Verified
January 1, 2018
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Neoplasms
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Vasodilator Agents
- Anti-Infective Agents
- Urological Agents
- Antiviral Agents
- Enzyme Inhibitors
- Antimetabolites, Antineoplastic
- Antimetabolites
- Antineoplastic Agents
- Immunosuppressive Agents
- Immunologic Factors
- Phosphodiesterase Inhibitors
- Phosphodiesterase 5 Inhibitors
- Gemcitabine
- Tadalafil
Other Study ID Numbers
- 13-026A
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Locally Advanced Malignant Neoplasm
-
ECOG-ACRIN Cancer Research GroupNational Cancer Institute (NCI)CompletedAdvanced Malignant Neoplasm | Locally Advanced Malignant NeoplasmUnited States
-
University of California, San FranciscoCompletedIntegrative Palliative Care/Psycho-Oncology Telehealth Intervention in Patients With Advanced CancerAdvanced Malignant Solid Neoplasm | Locally Advanced Malignant Solid Neoplasm | Metastatic Malignant Solid NeoplasmUnited States
-
M.D. Anderson Cancer CenterNational Cancer Institute (NCI)RecruitingLocally Advanced Malignant Solid Neoplasm | Metastatic Malignant Solid NeoplasmUnited States
-
M.D. Anderson Cancer CenterNational Cancer Institute (NCI)Active, not recruitingLocally Advanced Malignant Solid NeoplasmUnited States
-
M.D. Anderson Cancer CenterNational Cancer Institute (NCI)Active, not recruitingMetastatic Malignant Neoplasm | Caregiver | Advanced Malignant Neoplasm | Locally Advanced Malignant NeoplasmUnited States
-
M.D. Anderson Cancer CenterTerminatedLocally Advanced Malignant Solid Neoplasm | Unresectable Malignant Solid Neoplasm | Metastatic Malignant Solid NeoplasmUnited States
-
National Cancer Institute (NCI)RecruitingLocally Advanced Malignant Solid Neoplasm | Unresectable Malignant Solid Neoplasm | Metastatic Malignant Solid NeoplasmUnited States
-
M.D. Anderson Cancer CenterNational Cancer Institute (NCI)Active, not recruitingMalignant Neoplasm | Metastatic Malignant Neoplasm | Advanced Malignant Neoplasm | Recurrent Malignant Neoplasm | Locally Advanced Malignant NeoplasmUnited States
-
M.D. Anderson Cancer CenterNational Cancer Institute (NCI)Active, not recruitingMetastatic Malignant Neoplasm | Advanced Malignant Neoplasm | Recurrent Malignant Neoplasm | Refractory Malignant Neoplasm | Locally Advanced Malignant NeoplasmUnited States
-
M.D. Anderson Cancer CenterNot yet recruitingHematopoietic and Lymphoid Cell Neoplasm | Advanced Malignant Solid Neoplasm | Locally Advanced Malignant Solid Neoplasm | Recurrent Malignant Solid Neoplasm | Metastatic Malignant Solid NeoplasmUnited States
Clinical Trials on Tadalafil
-
Institute for the Study of Urological Diseases,...RecruitingErectile DysfunctionGreece
-
Eli Lilly and CompanyCompleted
-
Eli Lilly and CompanyCompletedBenign Prostatic HyperplasiaJapan
-
Centro Universitario de Ciencias de la Salud, MexicoUnknownObesity and Erectile DysfuntionMexico
-
Futura Medical Developments Ltd.CompletedErectile DysfunctionUnited States, Bulgaria, Georgia, Poland
-
Saint Petersburg State University, RussiaRecruitingErectile DysfunctionRussian Federation
-
Cairo UniversityUnknownErectile DysfunctionEgypt
-
Cedars-Sinai Medical CenterCompleted
-
University of PernambucoUnknown
-
Mark FeinglosEli Lilly and Company; Duke UniversityWithdrawnNausea | Vomiting | Gastroparesis | Diabetic GastroparesisUnited States