Gemcitabine and Radiation Therapy Compared With Gemcitabine Alone in Treating Patients Who Have Undergone Surgery for Pancreatic Cancer
Randomized Phase II/III Study Comparing Gemcitabine Followed by Gemcitabine Plus Concomitant Radiation (50.4 Gy) Versus Control After Curative Pancreaticoduodenectomy for Pancreatic Head Cancer
RATIONALE: Drugs used in chemotherapy such as gemcitabine use different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Radiation therapy uses high-energy x-rays to kill tumor cells. Giving these treatments after surgery may kill any tumor cells that remain after surgery. It is not yet known whether giving gemcitabine together with radiation therapy is more effective than gemcitabine alone following surgery in treating pancreatic cancer.
PURPOSE: This randomized phase II/III trial is studying how well giving gemcitabine together with radiation therapy works and compares it to gemcitabine alone in treating patients who have undergone surgery for pancreatic cancer.
調査の概要
詳細な説明
OBJECTIVES:
Phase II:
- Determine the feasibility of gemcitabine followed by chemoradiotherapy with gemcitabine vs gemcitabine alone after prior curative resection in patients with pancreatic head adenocarcinoma.
- Compare the tolerability of these regimens, in terms of acute and late toxicity, in these patients.
Phase III:
- Compare the disease-free and overall survival of patients treated with these regimens .
- Compare the quality of life of patients treated with these regimens.
- Compare the toxicity of these regimens in these patients.
- Determine the sites of recurrence in patients treated with these regimens.
OUTLINE: This is a randomized, multicenter study. Patients are stratified according to ECOG/WHO performance status (0-1 vs 2), participating center, and N stage (N0 vs N1 vs NX). Patients are randomized to 1 of 2 treatment arms.
- Arm I: Within 8 weeks after prior surgical resection, patients receive gemcitabine IV over 30 minutes on days 1, 8, and 15. Treatment repeats every 4 weeks for 2 courses.
Patients then receive additional gemcitabine IV over 30 minutes on days 57, 64, 71, 78, 85, and 92. Beginning on day 57, patients also undergo radiotherapy once daily, 5 days a week, for 6 weeks. Treatment continues in the absence of disease progression or unacceptable toxicity.
- Arm II: Patients receive gemcitabine IV over 30 minutes on days 1, 8, and 15. Treatment repeats every 4 weeks for 4 courses.
Quality of life (QOL) is assessed in both arms, according to the following schedules:
- Arm I: QOL is assessed at baseline; at 3 weeks after the beginning of chemoradiotherapy; after the completion of chemoradiotherapy; every 3 months for 2 years; and then every 6 months for 1 year.
- Arm II: QOL is assessed at baseline; at 12 weeks; at 16 weeks; every 3 months for 2 years; and then every 6 months for 1 year.
Patients are followed every 3 months for 2 years and then every 6 months thereafter.
PROJECTED ACCRUAL: A total of 538 patients (269 per treatment arm) will be accrued for this study within 3 years.
研究の種類
入学 (実際)
段階
- フェーズ2
- フェーズ 3
連絡先と場所
研究場所
-
-
-
Haifa、イスラエル、31096
- Rambam Medical Center
-
-
-
-
-
Amsterdam、オランダ、1105 AZ
- Academisch Medisch Centrum at University of Amsterdam
-
-
-
-
-
Geneva、スイス、CH-1211
- Hôpital Cantonal Universitaire de Genève
-
-
-
-
-
Berlin、ドイツ、D-10117
- Charité - Campus Charité Mitte
-
Berlin、ドイツ、D-13122
- Robert Roessle Comprehensive Cancer Center at University of Berlin - Charite Campus Buch
-
Duesseldorf、ドイツ、D-40225
- Universitaetsklinikum Duesseldorf
-
Mainz、ドイツ、D-55101
- Johannes Gutenberg University
-
Munich、ドイツ、D-80335
- Munich Oncologic Practice at Elisenhof
-
-
-
-
-
Abbeville、フランス、80101
- Centre Hospitalier d'Abbeville
-
Annecy、フランス、74011 Cedex
- Centre hospitalier d'Annecy
-
Avignon、フランス、84902
- Hopital Duffaut
-
Avignon、フランス、84082
- Institut Sainte Catherine
-
Beauvais、フランス、60021
- C.H.G. Beauvais
-
Blois、フランス、41016
- Centre Hospitalier de Blois
-
Bordeaux、フランス、F-33000
- Clinique Tivoli
-
Boucher、フランス、33300
- Polyclinique Bordeaux Nord Aquitaine
-
Boulogne Billancourt、フランス、F-92104
- Centre Hospitalier Universitaire Ambroise Pare - Boulogne
-
Boulogne Sur Mer、フランス、62200
- Centre Hospitalier Docteur Duchenne
-
Bourgoin-Jallieu、フランス、38300
- Centre hospitalier Pierre Oudot
-
Caen、フランス、14033
- CHU de Caen
-
Clermont-Ferrand、フランス、63003
- CHR Clermont Ferrand, Hotel Dieu
-
Clichy、フランス、92118
- Hopital Beaujon
-
Colombes Cedex、フランス、92701
- Louis Mourier Hospital
-
Creteil、フランス、94010
- Centre Hospitalier Universitaire Henri Mondor
-
Dax、フランス、40107
- Centre Hospitalier de Dax
-
Dijon、フランス、21034
- Hôpital du Bocage
-
Elbeuf、フランス、76503
- Centre Hospitalier Intercommunal St. Aubin les Elbeuf
-
Grenoble、フランス、38043
- CHU de Grenoble - Hopital de la Tronche
-
La Roche Sur Yon、フランス、F-85025
- Centre Hospitalier departemental
-
Le Mans、フランス、F-72000
- Clinique Victor Hugo
-
Libourne、フランス、33500
- Hôpital Robert Boulin
-
Limoges、フランス、87042
- Centre Hospital Regional Universitaire de Limoges
-
Lyon、フランス、69008
- Clinique Saint Jean
-
Lyon、フランス、69373
- Centre Léon Bérard
-
Marseille、フランス、13385
- CHU de la Timone
-
Mont-de-Marsan、フランス、40000
- Centre Hospitalier General de Mont de Marsan
-
Montpellier、フランス、34298
- Centre Regional de Lutte Contre le Cancer - Centre Val d'Aurelle
-
Mulhouse、フランス、68051
- Centre Hospitalier de Mulhouse
-
Nimes、フランス、30029
- C.H.U. de Nimes - Groupe Hospitals-Universitaire Caremeau
-
Paris、フランス、75015
- Hôpital Europeén Georges Pompidou
-
Paris、フランス、75018
- Hopital Bichat - Claude Bernard
-
Paris、フランス、75651
- CHU Pitié-Salpétrière
-
Paris、フランス、75674
- Hôpital Cochin
-
Paris、フランス、75970
- Hôpital Tenon
-
Paris、フランス、75571
- Hopital Saint Antoine
-
Pau、フランス、64000
- C.H.G. De Pau
-
Pierre Benite、フランス、69495
- Centre Hospitalier LYON SUD
-
Poitiers、フランス、86021
- CHU Poitiers
-
Rouen、フランス、76031
- Hôpital Charles Nicolle
-
Strasbourg、フランス、67098
- Hopital Universitaire Hautepierre
-
Strasbourg、フランス、67065
- Centre Paul Strauss
-
Tours、フランス、37044
- Centre Hospitalier Universitaire Bretonneau de Tours
-
Vandoeuvre-les-Nancy、フランス、54511
- Centre Alexis Vautrin
-
-
-
-
-
Brussels、ベルギー、1070
- Hopital Universitaire Erasme
-
Ghent、ベルギー、B-9000
- Universitair Ziekenhuis Gent
-
Haine Saint Paul、ベルギー、7100
- Hopital De Jolimont
-
Kortrijk、ベルギー、B-8500
- Cazk Groeninghe - Campus St-Niklaas
-
Liege、ベルギー、B-4000
- CHU Liege - Domaine Universitaire du Sart Tilman
-
Wilrijk、ベルギー、2610
- Algemeen Ziekenhuis Sint-Augustinus
-
-
参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
DISEASE CHARACTERISTICS:
- Histologically confirmed pancreatic head adenocarcinoma
Prior pancreaticoduodenectomy required
- Documented histological examination of surgical margins (R0), including retroperitoneal margin
- Performed within the past 8 weeks
- Any number of lymph nodes (less than 10 OR 10 or more) allowed
- No periampullary cancer
PATIENT CHARACTERISTICS:
Age
- 18 and over
Performance status
- ECOG 0-2 OR
- WHO 0-2
Life expectancy
- Not specified
Hematopoietic
- WBC greater than 3,500/mm^3
- Platelet count greater than 150,000/mm^3
- Hemoglobin greater than 9.0 g/dL
Hepatic
- Bilirubin less than 1.5 times normal
- AST and ALT less than 3.0 times normal
Renal
- Creatinine less than 1.2 mg/dL
Other
- Not pregnant or nursing
- Fertile patients must use effective contraception
- No other prior or concurrent malignancy except basal cell skin cancer or carcinoma in situ of the cervix
- No psychological, familial, sociological, or geographical condition that would preclude study compliance and follow-up
PRIOR CONCURRENT THERAPY:
Biologic therapy
- No concurrent immunotherapy
Chemotherapy
- No prior chemotherapy
- No other concurrent chemotherapy
Endocrine therapy
- Not specified
Radiotherapy
- No prior radiotherapy
Surgery
- See Disease Characteristics
- Recovered from prior surgery
Other
- No other concurrent anticancer agents
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
|---|
|
Feasibility of full completion of treatment as measured by the number of patients completing treatment 1 month after treatment in phase II
|
|
Tolerability in terms of acute toxicity as measured by NCI-CTC v2.0 1 month after completion of treatment in phase II
|
|
Tolerability in terms of late toxicity as measured by EORTC and RTOG 1 month after completion of treatment in phase II
|
|
Overall survival as measured by Logrank every 3 months in years 1-2, and every 6 months thereafter in phase III
|
二次結果の測定
結果測定 |
|---|
|
Disease-free survival as measured by Logrank every 3 months in years 1-2, and every 6 months thereafter
|
|
Acute toxicity as measured by NCI-CTC v2.0 every 3 months in years 1-2, and every 6 months thereafter
|
|
Late toxicity as measured by EORTC and RTOG every 3 months in years1-2, and every 6 months thereafter
|
|
Quality of life as measured by Quality of Life Questionnaire Core 30 (QLQ-C30) v3.0 and EORTC QLQ PAN-26 every 3 months in years 1-2 and every 6 months thereafter
|
協力者と研究者
捜査官
- スタディチェア:Volker G. Budach, MD, PhD、Charite University, Berlin, Germany
- スタディチェア:Pascal Hammel, MD, PhD、Hopital Beaujon
- スタディチェア:Jean-Luc Van Laethem, MD, PhD、Erasme University Hospital
出版物と役立つリンク
一般刊行物
- Van Laethem JL, Hammel P, Mornex F, Azria D, Van Tienhoven G, Vergauwe P, Peeters M, Polus M, Praet M, Mauer M, Collette L, Budach V, Lutz M, Van Cutsem E, Haustermans K. Adjuvant gemcitabine alone versus gemcitabine-based chemoradiotherapy after curative resection for pancreatic cancer: a randomized EORTC-40013-22012/FFCD-9203/GERCOR phase II study. J Clin Oncol. 2010 Oct 10;28(29):4450-6. doi: 10.1200/JCO.2010.30.3446. Epub 2010 Sep 13.
- Van Laethem J, Van Cutsem E, Hammel P, et al.: Adjuvant chemotherapy alone versus chemoradiation after curative resection for pancreatic cancer : feasibility results of a randomised EORTC/FFCD/GERCOR phase II/III study (40013/22012/0304). [Abstract] J Clin Oncol 26 (Suppl 15): A-4514, 2008.
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (見積もり)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。