Gemcitabine Hydrochloride, Dasatinib en Erlotinib Hydrochloride bij de behandeling van patiënten met pancreaskanker die uitgezaaid is of niet operatief kan worden verwijderd
Een fase 1-studie van gemcitabine, dasatinib en erlotinib bij patiënten met gevorderd pancreascarcinoom
This phase I trial studies the side effects and best dose of gemcitabine hydrochloride and dasatinib when given together with erlotinib hydrochloride in treating patients with pancreatic cancer that has spread to other places in the body or cannot be removed by surgery. Drugs used in chemotherapy, such as gemcitabine hydrochloride, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Dasatinib and erlotinib hydrochloride may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Giving gemcitabine hydrochloride and dasatinib together with erlotinib hydrochloride may kill more tumor cells.
Studie Overzicht
Toestand
Toestand
Conditie
Conditie
Interventie / Behandeling
Interventie / Behandeling
Gedetailleerde beschrijving
PRIMARY OBJECTIVES:
I. To determine the maximum tolerated dose (also phase II recommended dose) of the combination of gemcitabine (gemcitabine hydrochloride), erlotinib (erlotinib hydrochloride) and dasatinib in patients with advanced pancreatic adenocarcinoma.
SECONDARY OBJECTIVES:
I. To determine the safety profile of the combination of gemcitabine, erlotinib and dasatinib.
II. To evaluate the response rate and response duration of advanced pancreatic adenocarcinoma treated with dasatinib, erlotinib and gemcitabine.
III. To determine progression-free survival and overall survival for this group of patients.
IV. To determine the utility of advanced magnetic resonance imaging techniques to assess in vivo effects of therapy (changes in tumor vascularity, cellularity).
V. To assess the use of serum markers as predictors of response and outcome.
OUTLINE: This is a dose-escalation study of gemcitabine hydrochloride and dasatinib.
Patients receive gemcitabine hydrochloride intravenously (IV) over 30-60 minutes on days 1, 8, and 15, and dasatinib orally (PO) once daily (QD) and erlotinib hydrochloride PO QD on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed up for 30 days and then every 4 weeks thereafter.
Studietype
Studietype
Inschrijving (Werkelijk)
Inschrijving
Fase
Fase
- Fase 1
Contacten en locaties
Studie Locaties
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Tennessee
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Nashville, Tennessee, Verenigde Staten, 37232
- Vanderbilt University/Ingram Cancer Center
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Deelname Criteria
Geschiktheidscriteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
Inclusion Criteria:
- Cytologically or histologically confirmed pancreatic adenocarcinoma (excluding islet cell or ampullary tumors) that is metastatic or unresectable
- Measurable disease as defined by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1
- Patients may have received prior chemotherapy for advanced disease as long as it did not include gemcitabine; if patients received prior adjuvant therapy including gemcitabine, patients must be > 6 months from the last dose of gemcitabine; patients must have recovered from side effects of prior therapy to grade =< 1 as measured by National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version (v) 4.0
- Patients may have received prior radiation presuming > 4 weeks since last dose and measurable disease outside the radiation field
- Eastern Cooperative Oncology Group (ECOG) performance status =< 1
- Anticipated life expectancy of greater than 3 months
- Leukocytes >= 3,000/mcL
- Absolute neutrophil count >= 1,500/mcL
- Platelets >= 100,000/mcL
- Total bilirubin < 2.5 x institutional upper limit of normal (ULN)
- Aspartate aminotransferase (AST) (serum glutamic pyruvate transaminase [SGOT])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) =< 2.5 x institutional upper limit of normal OR =< 5 x institutional upper limit of normal when liver metastases are present
- Creatinine within normal institutional limits OR creatinine clearance >= 60 mL/min/1.73 m^2 for patients with creatinine levels above institutional normal
- Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation; should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately
- Ability to understand and the willingness to sign a written informed consent document
- Patients must be able to swallow pills
Exclusion Criteria:
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Patients who have had chemotherapy or radiotherapy within 4 weeks (6 weeks for nitrosoureas or mitomycin C) prior to entering the study or those who have not recovered from adverse events due to agents administered more than 4 weeks earlier (with the exception of alopecia and neuropathy); no radiation is allowed on study
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Patients who are receiving any other investigational agents
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Major surgical procedure within 4 weeks of treatment
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Patients with known brain metastases
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History of allergic reactions attributed to compounds of similar chemical or biologic composition to dasatinib, erlotinib or gemcitabine
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Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
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Pregnant women are excluded from this study, breastfeeding should be discontinued if the mother is treated with erlotinib or dasatinib
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Patients with immune deficiency are excluded
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Patients on potent cytochrome P450, family 3, subfamily A, polypeptide 4 (CYP3A4) inducers and inhibitors
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Malabsorption syndrome or other condition that would interfere with intestinal absorption
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Other active malignancy (with the exception of locally treated non-melanoma skin cancers)
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Human immunodeficiency virus (HIV) positive patients who are on combination antiretroviral therapy
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Patients may not have any clinically significant cardiovascular disease including the following:
- Myocardial infarction or ventricular tachyarrhythmia within 6 months
- Prolonged corrected QT (QTc) > 480 msec (Fridericia correction)
- Known ejection faction less than institutional normal
- Major conduction abnormality (unless a cardiac pacemaker is present)
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: NVT
- Interventioneel model: Opdracht voor een enkele groep
- Masker: Geen (open label)
Aantal wapens
Wapens en interventies
Deelnemersgroep / ArmDeelnemersgroep / Arm |
Interventie / BehandelingInterventie / Behandeling |
|---|---|
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Experimenteel: Treatment (gemcitabine, dasatinib, erlotinib)
Patients receive gemcitabine hydrochloride IV over 30-60 minutes on days 1, 8, and 15, and dasatinib PO QD and erlotinib hydrochloride PO QD on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. |
Given PO
Andere namen:
Given IV
Andere namen:
Given PO
Andere namen:
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Wat meet het onderzoek?
Primaire uitkomstmaten
Primaire uitkomstmaten
Uitkomstmaat |
Tijdsspanne |
|---|---|
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Maximaal getolereerde dosis gemcitabinehydrochloride en dasatinib samen gegeven met erlotinibhydrochloride, bepaald door de incidentie van dosisbeperkende toxiciteit ingedeeld volgens NCI CTCAE v 4.0
Tijdsspanne: Tot 4 weken na afronding van de studiebehandeling
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Tot 4 weken na afronding van de studiebehandeling
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Secundaire uitkomstmaten
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Overall survival (OS)
Tijdsspanne: The time from enrollment until the time of death due to any cause, assessed up to 6 years
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The OS curves will be estimated by the Kaplan-Meier method. Median OS and its 95% confidence intervals will be estimated. |
The time from enrollment until the time of death due to any cause, assessed up to 6 years
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Progression free survival (PFS)
Tijdsspanne: The time from enrollment until the first occurrence of radiographic or clinical evidence of disease progression or death due to any cause, assessed up to 6 years
|
The PFS curves will be estimated by the Kaplan-Meier method. Median PFS and its 95% confidence intervals will be estimated. |
The time from enrollment until the first occurrence of radiographic or clinical evidence of disease progression or death due to any cause, assessed up to 6 years
|
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Response rate, assessed according to RECIST
Tijdsspanne: Up to 6 years
|
The response rate and its 95% confidence interval will be calculated using the exact binominal method. |
Up to 6 years
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Response duration
Tijdsspanne: The time from when measurement criteria are met for complete response or partial response (whichever is first recorded) until the date that recurrent or progressive disease is objectively documented, assessed up to 6 years
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The response duration for the responders will be summarized using mean, median and standard deviation. |
The time from when measurement criteria are met for complete response or partial response (whichever is first recorded) until the date that recurrent or progressive disease is objectively documented, assessed up to 6 years
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Serious and other significant adverse events (AEs), graded according to NCI CTCAE v 4.0
Tijdsspanne: Up to 30 days after completion of study treatment
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The patient incidence of AEs will be summarized by preferred term, severity and relationship to study drug. Cross tabulations will be provided to summarize frequencies of abnormalities. |
Up to 30 days after completion of study treatment
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Medewerkers en onderzoekers
Sponsor
Sponsor
Onderzoekers
Onderzoekers
- Hoofdonderzoeker: Dana B Cardin, Vanderbilt University/Ingram Cancer Center
Studie record data
Bestudeer belangrijke data
Studie start (Werkelijk)
Studie start
Primaire voltooiing (Werkelijk)
Primaire voltooiing
Studie voltooiing (Geschat)
Studie voltooiing
Studieregistratiedata
Eerst ingediend
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Geschat)
Eerst geplaatst
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update geplaatst
Laatste update ingediend die voldeed aan QC-criteria
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
- Endocriene systeemziekten
- Neoplasmata per site
- Neoplasmata
- Neoplasmata van het spijsverteringsstelsel
- Ziekten van het spijsverteringsstelsel
- Endocriene klierneoplasmata
- Alvleesklier Ziekten
- Pancreasneoplasmata
- Zwavelverbindingen
- Organische chemicaliën
- Heterocyclische verbindingen, 1-ring
- Heterocyclische verbindingen
- Heterocyclische verbindingen, 2-ring
- Heterocyclische verbindingen, gefuseerd ring
- Thiazoles
- Azoles
- Deoxycytidine
- Cytidine
- Pyrimidine -nucleosiden
- Pyrimidines
- Chinazolines
- Erlotinibhydrochloride
- Dasatinib
- Gemcitabine
Andere studie-ID-nummers
Andere studie-ID-nummers
- NCI-2012-01290
- NCI-2012-01290 (Register-ID: CTRP (Clinical Trial Reporting Program))
- VICCGI1173
- GI 1173 (Andere identificatie: Vanderbilt University/Ingram Cancer Center)
- CDR0000738551
- 9043 (Andere identificatie: CTEP)
- P30CA068485 (Subsidie/contract van de Amerikaanse NIH)
- GI 1173
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