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PhI Study of Erbitux & Gemcitabine w/Radiation Therapy for Locally Adv. Pancreas Ca

16. maj 2012 opdateret af: Nipun Merchant, MD, Vanderbilt-Ingram Cancer Center

A Phase I Study of Erbitux and Gemcitabine With Radiation Therapy for Locally Advanced Pancreas Cancer

RATIONALE: Drugs used in chemotherapy, such as gemcitabine, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Monoclonal antibodies, such as cetuximab, can block tumor growth in different ways. Some find tumor cells and help kill them or carry tumor-killing substances to them. Others interfere with the ability of tumor cells to grow and spread. Cetuximab may also stop the growth of tumor cells by blocking blood flow to the tumor. Radiation therapy uses high-energy x-rays to kill tumor cells. Gemcitabine and cetuximab may make tumor cells more sensitive to radiation therapy. Giving gemcitabine together with cetuximab and radiation therapy may kill more tumor cells.

PURPOSE: This phase I trial is studying the side effects and best dose of gemcitabine when given together with cetuximab and radiation therapy in treating patients with locally advanced pancreatic cancer that cannot be removed by surgery.

Studieoversigt

Detaljeret beskrivelse

OBJECTIVES:

  • Determine the maximum tolerated dose of gemcitabine hydrochloride when administered with cetuximab and radiotherapy in patients with unresectable locally advanced pancreatic or periampullary region cancer.
  • Determine the toxicity of this regimen in these patients.

OUTLINE: This is a dose-escalation study of gemcitabine hydrochloride.

Patients receive cetuximab IV over 1-2 hours once weekly in weeks 1-7 and gemcitabine hydrochloride IV over 15-40 minutes once weekly in weeks 2-7. Patients also undergo radiotherapy 5 days a week in weeks 2-7. Treatment continues in the absence of disease progression or unacceptable toxicity.

Cohorts of 3-6 patients receive escalating doses of gemcitabine hydrochloride until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity.

After completion of study treatment, patients are followed for 30 days and then every 3 months thereafter.

PROJECTED ACCRUAL: A total of 12-30 patients will be accrued for this study.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

9

Fase

  • Fase 1

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

    • Tennessee
      • Nashville, Tennessee, Forenede Stater, 37232-6838
        • Vanderbilt-Ingram Cancer Center

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Histologically confirmed adenocarcinoma of the pancreas (head, body, or tail) or periampullary region, meeting both of the following criteria:

    • Unresectable disease
    • Locally advanced disease
  • Measurable or evaluable disease by CT scan or MRI
  • No evidence of metastatic disease outside of the planned irradiation field
  • ECOG performance status 0-2
  • WBC ≥ 3,000/mm³
  • ANC ≥ 1,500/mm³
  • Platelet count ≥ 100,000/mm³
  • Hemoglobin ≥ 8.5 g/dL
  • AST and ALT ≤ 5 times upper limit of normal
  • Bilirubin ≤ 2.0 mg/dL
  • Creatinine ≤ 2.0 mg/dL
  • No clinical indication of compromised function of nonirradiated kidney
  • No secondary malignancies within the past 5 years except for resected nonmelanoma skin cancer or carcinoma in situ of the cervix
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception

Exclusion Criteria:

  • No acute hepatitis
  • No known HIV infection
  • No other active or uncontrolled infection
  • No significant history of uncontrolled cardiac disease, including any of the following:

    • Hypertension
    • Unstable angina
    • Myocardial infarction within the past 6 months
    • Congestive heart failure
    • Cardiomyopathy with decreased ejection fraction
  • No prior severe infusion reaction to a monoclonal antibody

PRIOR CONCURRENT THERAPY:

  • No prior radiotherapy to planned field of treatment
  • No prior therapy that specifically and directly targets EGFR pathway
  • At least 14 days since prior surgery or biopsy
  • At least 28 days since prior bypass procedures
  • More than 5 years since prior and no other concurrent chemotherapy
  • No other concurrent investigational agent

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: N/A
  • Interventionel model: Enkelt gruppeopgave
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Terapeutisk intervention
400mg/m2 initial dose week 1; followed by 250mg/m2/weekly starting week 2 with gemcitabine at fixed dose rate (10 mg/m2/min) + XRT. Cetuximab will start 1 week prior to all other treatment.
Andre navne:
  • Erbitux

Dose Level Gemcitabine dose Gemcitabine infusion

-1 150mg/m2 15 Minutes 0 200mg/m2 20 minutes

  1. 300mg/m2 30 minutes
  2. 400mg/m2 40 minutes
Andre navne:
  • Gemzar

50.4 Gy, 28 fractions, 5.5 weeks (1.8 Gy/day). A cone down after 45 Gy will be performed to encompass gross disease with a margin of 1-1.5 cm.

The prescription point will be designated at the intersection of the multiple beams.

There are no planned interruptions > 3 days.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Tidsramme
Maximum Tolerated Dose
Tidsramme: Weekly and 4 weeks after last dose of radiation
Weekly and 4 weeks after last dose of radiation

Sekundære resultatmål

Resultatmål
Tidsramme
Dose-limiting toxicity
Tidsramme: Weekly and 4 weeks after last dose of radiation
Weekly and 4 weeks after last dose of radiation
Toxicity
Tidsramme: Weekly and 4 weeks after last dose of radiation
Weekly and 4 weeks after last dose of radiation
Tumor response rate
Tidsramme: 4 weeks after last dose of radiation and every 3 months
4 weeks after last dose of radiation and every 3 months

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Samarbejdspartnere

Efterforskere

  • Ledende efterforsker: Nipun B. Merchant, Vanderbilt-Ingram Cancer Center

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. oktober 2005

Primær færdiggørelse (Faktiske)

1. august 2007

Studieafslutning (Faktiske)

1. oktober 2007

Datoer for studieregistrering

Først indsendt

25. april 2007

Først indsendt, der opfyldte QC-kriterier

25. april 2007

Først opslået (Skøn)

27. april 2007

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Skøn)

18. maj 2012

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

16. maj 2012

Sidst verificeret

1. maj 2012

Mere information

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

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