膵臓がん患者の血糖値のモニタリングと管理 (PEGASUS)
膵臓癌のグルコースの評価と調節に関する研究
この研究では、膵臓がん患者の血糖値を綿密に監視および管理することが実現可能かどうかを調査します。 また、グルコース管理が膵臓がんにどのような影響を与えるかについても調査します。
これは、膵臓がん患者約 50 人の血糖値を連続血糖モニター (CGM) を使用して監視するパイロット研究です。 参加者は、膵臓がんを治療するために最大4つの薬物を組み合わせた標準的な化学療法を受けます:オキサリプラチン、イリノテカン、5-フルオロウラシル、およびロイコボリン(FOLFIRINOX)。 高血糖値を治療するために、参加者はランダムに 2 つのグループのいずれかに割り当てられます。グループ 2 は、血糖値が標準治療である 15 mmol/L を超えている場合、抗高血糖治療を受けます。 グループ1と2の両方の参加者は、標準的な抗高血糖治療を受けます:メトホルミン、インスリン、グルカゴン様ペプチド-1(GLP-1)受容体アゴニスト、ナトリウムグルコース共輸送体(SGLT2)阻害剤、およびジペプチジルペプチダーゼ4(DPP- 4) 阻害剤。
FOLFIRINOX の 4 サイクル後、CGM は除去されますが、必要に応じて抗高血糖治療が継続されます。 参加者が FOLFIRINOX による治療を中止した場合、生存とその後の抗がん治療について引き続き追跡調査が行われ、内分泌専門医および/または腫瘍内科医の裁量により、グルコース関連の懸念について追跡調査が継続されます。
調査の概要
研究の種類
入学 (推定)
段階
- 適用できない
連絡先と場所
研究連絡先
- 名前:Daniel Renouf, MD, MPH
- 電話番号:800-663-3333
- メール:drenouf@bccancer.bc.ca
研究場所
-
-
British Columbia
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Vancouver、British Columbia、カナダ、V5Z 4E6
- 募集
- British Columbia Cancer
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主任研究者:
- Daniel Renouf, MD, MPH
-
コンタクト:
- Daniel Renouf, MD, MPH
- 電話番号:800-663-3333
- メール:drenouf@bccancer.bc.ca
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-
Ontario
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Toronto、Ontario、カナダ、M5G 2M9
- 募集
- Princess Margaret Cancer Centre
-
コンタクト:
- Erica Tsang, MD, MPH
- 電話番号:416-946-2000
- メール:erica.tsang@uhn.ca
-
コンタクト:
- Robert Grant, MD
- 電話番号:416-946-2000
- メール:robert.grant@uhn.ca
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-
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
説明
包含基準:
- 膵管腺癌(PDAC)の組織学的/細胞学的診断。
- FOLFIRINOXによる一次全身療法を受ける予定。
- 18 歳以上の年齢。
- 東部共同腫瘍学グループ (ECOG) のパフォーマンス ステータス 0-1。
-次の検査値によって定義される適切な骨髄および臓器機能:
- -絶対好中球数(ANC)が1.5 x 10 ^ 9 / L以上。
- -血小板数が75 x 10 ^ 9 / L以上。
- 9.0 g/dL 以上のヘモグロビン。
- -Cockroft-Gault方程式による推定糸球体濾過率(GFR)または24時間の尿収集が40ml /分以上。
- -Cockcroft-Gault式を使用したクレアチニンクリアランスが40mL/分以上。
- 正常範囲内のカリウム、またはサプリメントで補正。
- -国際正規化比率(INR)が1.5以下。
- -総血清ビリルビンが正常の上限(ULN)の2倍以下(ビリルビンの上昇は登録時に無症候性でなければなりません) 総ビリルビンが3倍以下の場合にのみ含まれる可能性がある、記録されたギルバート症候群の参加者を除く-ULNまたは1.5 x ULN以下の直接ビリルビン)。
- -アラニンアミノトランスフェラーゼ(ALT)およびアスパラギン酸アミノトランスフェラーゼ(AST)が2.5 x ULN以下(または肝転移が存在する場合は5 x ULN以下)。
- -インフォームドコンセントフォームを理解し、自発的に署名できる。
- -研究訪問スケジュールおよびその他のプロトコル要件を順守できる。
- 経口薬を飲み込むことができ、皮下インスリン注射の禁忌はありません。
- -ベースラインでの固形腫瘍の反応評価基準(RECIST)1.1による測定可能または評価可能な疾患。
- -研究担当医師が判断した90日以上の平均余命。
除外基準:
- 遠隔転移またはリンパ節転移がないこと。 境界切除可能または局所進行PDACの参加者は対象外です。
- -転移性PDACの治療のために以前に全身療法(化学療法またはその他の抗がん剤)を受けた。 -初期段階の疾患の外科的切除後に補助化学療法を受けた参加者は適格です。
- -現在、抗がん療法(化学療法またはその他の抗がん剤)を受けています。
- -研究担当医が判断した併用化学療法には適していません。
- 脳転移の存在。
- -厳密なグルコース制御と綿密な内分泌学のフォローアップがすでに示されているI型糖尿病の既知の診断。
- -II型糖尿病の既知の診断であり、すでに内分泌学者がフォローしています。
- -妊娠検査が陽性の女性参加者。
- -研究に含めるのが安全ではない参加者 何らかの医学的または非医学的理由で研究担当医師が判断した理由。
- 試験の評価およびフォローアップに応じることができない。
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:なし
- 介入モデル:単一グループの割り当て
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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実験的:Glucose Measurements via Blood Draws
Participants will have glucose levels measured using blood drawn prior to each cycle of systemic therapy.
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Blood glucose levels will be measured using blood drawn prior to each cycle of systemic therapy.
Anti-cancer treatment can follow standard care protocols or be given within another clinical trial.
Anti-hyperglycemic treatment will be administered when indicated by and following standard care protocols.
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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 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Proportion of participants who experience at least one episode of hyperglycemia
時間枠:From baseline (up to 2 weeks prior to first dose) until progression of disease, assessed up to 24 months.
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The proportion of participants who experience at least one episode of hyperglycemia.
Hyperglycemia is defined by standard non-fasting criteria: random plasma glucose greater than or equal to 11.1 mmol/L or hemoglobin A1c greater than or equal to 6.5%.
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From baseline (up to 2 weeks prior to first dose) until progression of disease, assessed up to 24 months.
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Percentage of glucose measurements above the target range
時間枠:From baseline (up to 2 weeks prior to first dose) until progression of disease, assessed up to 24 months.
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The percentage of random plasma glucose measurements that are greater than or equal to 11.1 mmol/L or hemoglobin A1c measurements that are greater than or equal to 6.5%.
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From baseline (up to 2 weeks prior to first dose) until progression of disease, assessed up to 24 months.
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Overall response rate (ORR) of the cohort, as defined by RECIST 1.1
時間枠:From the date of the screening scan (within 28 days of first dose) until the date of confirmed progression, assessed up to 24 months.
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The proportion of participants who have a complete response (CR) or partial response (PR) to first-line systemic therapy, as defined by RECIST 1.1.
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From the date of the screening scan (within 28 days of first dose) until the date of confirmed progression, assessed up to 24 months.
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Progression-free survival (PFS) of the cohort from the initiation of first-line systemic therapy
時間枠:From the date of first dose of first-line systemic therapy until the date of confirmed progression, assessed up to 24 months.
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The length of time from the first dose of first-line systemic therapy until the date of progressive disease (PD), as defined by RECIST 1.1.
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From the date of first dose of first-line systemic therapy until the date of confirmed progression, assessed up to 24 months.
|
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Overall survival (OS) of the cohort from the initiation of first-line systemic therapy
時間枠:From the date of first dose of first-line systemic therapy until the date of death or end of study, assessed up to 24 months.
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The length of time from the initiation of first-line systemic therapy that participants survive.
|
From the date of first dose of first-line systemic therapy until the date of death or end of study, assessed up to 24 months.
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その他の成果指標
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Overall response rate (ORR) of the cohort, as defined by RECIST 1.1 and stratified by prognostic and metabolic gene expression subtypes of PDAC
時間枠:From the date of the screening scan (within 28 days of first dose) until the date of confirmed progression, assessed up to 24 months.
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The proportion of participants stratified by prognostic and metabolic gene expression subtypes of PDAC who have a complete response (CR) or partial response (PR) to first-line systemic therapy, as defined by RECIST 1.1.
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From the date of the screening scan (within 28 days of first dose) until the date of confirmed progression, assessed up to 24 months.
|
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Progression-free survival (PFS) of the cohort stratified by prognostic and metabolic gene expression subtypes of PDAC from the initiation of first-line systemic therapy
時間枠:From the date of first dose of first-line systemic therapy until the date of confirmed progression, assessed up to 24 months.
|
The length of time from the first dose of first-line systemic therapy until the date of progressive disease (PD), as defined by RECIST 1.1, for participants stratified by prognostic and metabolic gene expression subtypes of PDAC.
|
From the date of first dose of first-line systemic therapy until the date of confirmed progression, assessed up to 24 months.
|
|
Overall survival (OS) of the cohort stratified by prognostic and metabolic gene expression subtypes of PDAC from the initiation of first-line systemic therapy
時間枠:From the date of first dose of first-line systemic therapy until the date of death or end of study, assessed up to 24 months.
|
The length of time from the initiation of first-line systemic therapy that participants survive stratified by prognostic and metabolic gene expression subtypes of PDAC.
|
From the date of first dose of first-line systemic therapy until the date of death or end of study, assessed up to 24 months.
|
|
Overall response rate (ORR) of the cohort, as defined by RECIST 1.1 and stratified by clinical features (i.e. type 2 diabetes), pathological profiles, and genomic profiles
時間枠:From the date of the screening scan (within 28 days of first dose) until the date of confirmed progression, assessed up to 24 months.
|
The proportion of participants stratified by clinical features (i.e.
type 2 diabetes), pathological profiles, and genomic profiles who have a complete response (CR) or partial response (PR) to first-line systemic therapy, as defined by RECIST 1.1.
|
From the date of the screening scan (within 28 days of first dose) until the date of confirmed progression, assessed up to 24 months.
|
|
Progression-free survival (PFS) of the cohort, stratified by clinical features (i.e. type 2 diabetes), pathological profiles, and genomic profiles from the initiation of first-line systemic therapy
時間枠:From the date of first dose of first-line systemic therapy until the date of confirmed progression, assessed up to 24 months.
|
The length of time from the first dose of first-line systemic therapy until the date of progressive disease (PD), as defined by RECIST 1.1, for participants stratified by clinical features (i.e.
type 2 diabetes), pathological profiles, and genomic profiles.
|
From the date of first dose of first-line systemic therapy until the date of confirmed progression, assessed up to 24 months.
|
|
Overall survival (OS) of the cohort stratified by clinical features (i.e. type 2 diabetes), pathological profiles, and genomic profiles from the initiation of first-line systemic therapy
時間枠:From the date of first dose of first-line systemic therapy until the date of death or end of study, assessed up to 24 months.
|
The length of time from the initiation of first-line systemic therapy that participants survive stratified by clinical features (i.e.
type 2 diabetes), pathological profiles, and genomic profiles.
|
From the date of first dose of first-line systemic therapy until the date of death or end of study, assessed up to 24 months.
|
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Amount of insulin, measured in molar, for participants from screening until the end of study visit
時間枠:From the date of screening blood sample collection until the date of the end of study blood sample collection (an average of 6 months).
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The quantity of insulin, measured in molar from immunoassays, from blood samples collected throughout the study.
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From the date of screening blood sample collection until the date of the end of study blood sample collection (an average of 6 months).
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Amount of proinsulin, measured in molar, for participants from screening until the end of study visit
時間枠:From the date of the screening blood sample collection until the date of the end of study blood sample collection (an average of 6 months).
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The quantity of proinsulin, measured in molar from immunoassays, from blood samples collected throughout the study.
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From the date of the screening blood sample collection until the date of the end of study blood sample collection (an average of 6 months).
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Amount of C-peptide, measured in molar, for participants from screening until the end of study visit
時間枠:From the date of the screening blood sample collection until the date of the end of study blood sample collection (an average of 6 months).
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The quantity of C-peptide, measured in molar from immunoassays, from blood samples collected throughout the study.
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From the date of the screening blood sample collection until the date of the end of study blood sample collection (an average of 6 months).
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Amount of circulating biomarkers, measured in molar, for participants from screening until the end of study visit
時間枠:From the date of the screening blood sample collection until the date of the end of study blood sample collection (an average of 6 months).
|
The quantity of circulating biomarkers, measured in molar from immunoassays, from blood samples collected throughout the study.
|
From the date of the screening blood sample collection until the date of the end of study blood sample collection (an average of 6 months).
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協力者と研究者
捜査官
- 主任研究者:Daniel Renouf, MD, MPH、BC Cancer
出版物と役立つリンク
一般刊行物
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研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (推定)
研究の完了 (推定)
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 (実際)
学習記録の更新
投稿された最後の更新 (実際)
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
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
- H21-03061
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
米国で製造され、米国から輸出された製品。
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。