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

16. mai 2012 oppdatert av: 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.

Studieoversikt

Detaljert 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.

Studietype

Intervensjonell

Registrering (Faktiske)

9

Fase

  • Fase 1

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

    • Tennessee
      • Nashville, Tennessee, Forente stater, 37232-6838
        • Vanderbilt-Ingram Cancer Center

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år og eldre (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

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

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: N/A
  • Intervensjonsmodell: Enkeltgruppeoppdrag
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Terapeutisk intervensjon
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 navn:
  • 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 navn:
  • 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.

Hva måler studien?

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

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Samarbeidspartnere

Etterforskere

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

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart

1. oktober 2005

Primær fullføring (Faktiske)

1. august 2007

Studiet fullført (Faktiske)

1. oktober 2007

Datoer for studieregistrering

Først innsendt

25. april 2007

Først innsendt som oppfylte QC-kriteriene

25. april 2007

Først lagt ut (Anslag)

27. april 2007

Oppdateringer av studieposter

Sist oppdatering lagt ut (Anslag)

18. mai 2012

Siste oppdatering sendt inn som oppfylte QC-kriteriene

16. mai 2012

Sist bekreftet

1. mai 2012

Mer informasjon

Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .

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