Ta strona została przetłumaczona automatycznie i dokładność tłumaczenia nie jest gwarantowana. Proszę odnieść się do angielska wersja za tekst źródłowy.

Hipofrakcjonowana stereotaktyczna radioterapia ciała i fluorouracyl lub kapecytabina z kwasem zoledronowym lub bez kwasu zoledronowego w leczeniu pacjentów z miejscowo zaawansowanym rakiem trzustki

2 listopada 2026 zaktualizowane przez: University of Nebraska

Randomizowane badanie II fazy dotyczące skuteczności i bezpieczeństwa hipofrakcjonowanej radioterapii stereotaktycznej i 5FU lub kapecytabiny z lekiem Zometa i bez niego u pacjentów z miejscowo zaawansowanym gruczolakorakiem trzustki

Pancreatic cancer, most commonly adenocarcinoma, is the fourth leading cause of cancer death in the United States. The mainstay of management centers on surgical resection (if resectable) and although low (15% to 20%), resectability rates are associated with dismal survival. An estimated 80% to 85% of the patients recur after surgical resection, leading to a median survival of 20 to 24 months and potentially even less depending on lymph nodal involvement or positive margins. The rationale for utilizing neoadjuvant therapy, commonly fluoropyrimidine-based or gemcitabine based chemotherapy or Chemoradiotherapy (CRT), involves possibly down staging borderline resectable and unresectable patients, potentially making them resectable candidates.

This randomized phase II trial will study how well hypofractionated stereotactic body radiation therapy (SBRT) and fluorouracil or capecitabine with or without zoledronic acid work in treating participants with pancreatic cancer that has spread to nearby tissue or lymph nodes. Hypofractionated stereotactic body radiation therapy is a specialized radiation therapy that sends higher doses of x-rays over a shorter period of time directly to the tumor using smaller doses over several days which may cause less damage to normal tissue. Drugs used in chemotherapy, such as fluorouracil and capecitabine, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Zoledronic acid is used in cancer patients to reduce cancer symptoms and may make tumor cells more sensitive to radiation. Giving hypofractionated stereotactic body radiation therapy and fluorouracil or capecitabine with or without zoledronic acid may work better in treating pancreatic cancer.

Przegląd badań

Status

Aktywny, nie rekrutujący

Warunki

Interwencja / Leczenie

Szczegółowy opis

Pancreatic cancer, most commonly adenocarcinoma, is the fourth leading cause of cancer death in the United States. The mainstay of management centers on surgical resection (if resectable) and although low (15% to 20%), resectability rates are associated with dismal survival. An estimated 80% to 85% of the patients recur after surgical resection, leading to a median survival of 20 to 24 months and potentially even less depending on lymph nodal involvement or positive margins. The rationale for utilizing neoadjuvant therapy, commonly fluoropyrimidine-based or gemcitabine based chemotherapy or Chemoradiotherapy (CRT), involves possibly down staging borderline resectable and unresectable patients, potentially making them resectable candidates.

This randomized phase II trial will study how well hypofractionated stereotactic body radiation therapy (SBRT) and fluorouracil or capecitabine with or without zoledronic acid work in treating participants with pancreatic cancer that has spread to nearby tissue or lymph nodes. Hypofractionated stereotactic body radiation therapy is a specialized radiation therapy that sends higher doses of x-rays over a shorter period of time directly to the tumor using smaller doses over several days which may cause less damage to normal tissue. Drugs used in chemotherapy, such as fluorouracil and capecitabine, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Zoledronic acid is used in cancer patients to reduce cancer symptoms and may make tumor cells more sensitive to radiation. Giving hypofractionated stereotactic body radiation therapy and fluorouracil or capecitabine with or without zoledronic acid may work better in treating pancreatic cancer.

The primary study objective is to evaluate the efficacy of hypofractionated radiation therapy concurrently with zoledronic acid (Zometa) and fluorouracil or capecitabine. Other study objectives include examining the toxicity of Zometa when used concurrently with hypofractionated radiation therapy, evaluating local failure-free survival and overall survival, determining surgical resection and tumor response rates, measuring Zometa pharmacokinetics, evaluating tumor and organ motion and determining the effect those on the dosimetry, local control and survival. Post-treatment follow-up is for 30 days, then every 3 months for the first year, every 4 months for the second year, and every 6 months thereafter.

Typ studiów

Interwencyjne

Zapisy (Rzeczywisty)

46

Faza

  • Faza 2

Kontakty i lokalizacje

Ta sekcja zawiera dane kontaktowe osób prowadzących badanie oraz informacje o tym, gdzie badanie jest przeprowadzane.

Lokalizacje studiów

    • Nebraska
      • Omaha, Nebraska, Stany Zjednoczone, 68198
        • University of Nebraska Medical Center

Kryteria uczestnictwa

Badacze szukają osób, które pasują do określonego opisu, zwanego kryteriami kwalifikacyjnymi. Niektóre przykłady tych kryteriów to ogólny stan zdrowia danej osoby lub wcześniejsze leczenie.

Kryteria kwalifikacji

Wiek uprawniający do nauki

19 lat i starsze (Dorosły, Starszy dorosły)

Akceptuje zdrowych ochotników

Nie

Płeć kwalifikująca się do nauki

Wszystko

Opis

Inclusion Criteria:

  • Pathologically confirmed pancreatic adenocarcinoma, either initially diagnosed or recurrent locally advanced disease. The maximum dimension of the treatment target must be =<10 cm. Locally advanced disease defined as: T 1-2N+MO or T3-4 NxMo, or borderline resectable and unresectable adenocarcinoma without distant metastatic disease or resectable T3-4 NxMo disease or M1 with controlled distant disease
  • Inoperable conditions with resectable disease (T1-2NoMo)
  • Karnofsky performance status of 60% or better. Received recent chemotherapy for pancreatic cancer or completed chemotherapy > 5 years ago for malignancies other than pancreatic cancer with no evidence of the second malignancy at study entry
  • Radiation therapy completed > 5 years ago for malignancies other than pancreatic cancer and whose radiation therapy field is not overlapping with the 20% isodose line of current radiation field and no evidence of the second malignancy at study entry
  • All malignant disease must be able to be encompassed within a single irradiation field
  • Absolute neutrophil count (ANC) greater than or equal to 1500/uL
  • Radiographically assessable disease
  • Platelet count greater than or equal to 100,000/uL
  • Serum creatinine less than or equal to 2.0 mg/dL and total bilirubin less than or equal to 2.0 mg/dL in the absence of biliary obstruction. If biliary obstruction is present, biliary decompression will be required, either endoscopic placement of a biliary stent or percutaneous transhepatic. Once biliary drainage has been established, institution of protocol therapy may proceed when the total bilirubin falls to 4.0 mg/dL or lower
  • Calculated creatinine clearance of >= 35.
  • Awareness of the neoplastic nature of his/her disease and willingly provide written, informed consent after being informed of the procedure to be followed, the experimental nature of the therapy, alternatives, potential benefits, side-effects, risks, and discomforts

Exclusion Criteria:

  • Known allergy to Zometa or to anti-emetics appropriate in conjunction with protocol-directed therapy
  • Uncontrolled inter-current illness that might jeopardize the ability of the subject to receive the protocol therapy with reasonable safety. This may include, but not limited to, ongoing or active infection requiring intravenous antibiotics, symptomatic congestive heart failure, unstable angina pectoris, or serious, uncontrolled cardiac arrhythmia
  • Pregnant and nursing women
  • Prior malignancy except adequately treated basal cell or squamous cell skin cancer, adequately treated non-invasive carcinomas, or be disease-free for at least 5 years from other cancers
  • Active duodenal ulcer or bleeding or history of a gastrointestinal fistula or perforation or other significant bowel problems (severe nausea, vomiting, inflammatory bowel disease and significant bowel resection)
  • Known human immunodeficiency virus (HIV) infection, or hepatic insufficiency
  • Not currently receiving or have received Zometa within 3 weeks prior to study treatment with Zometa

Plan studiów

Ta sekcja zawiera szczegółowe informacje na temat planu badania, w tym sposób zaprojektowania badania i jego pomiary.

Jak projektuje się badanie?

Szczegóły projektu

  • Główny cel: Leczenie
  • Przydział: Randomizowane
  • Model interwencyjny: Przydział równoległy
  • Maskowanie: Brak (otwarta etykieta)

Broń i interwencje

Grupa uczestników / Arm
Interwencja / Leczenie
Aktywny komparator: Arm A (chemotherapy, radiation therapy)

Participants undergo hypofractionated stereotactic body radiation therapy in 5 fractions on days 1-5. Participants receive fluorouracil IV over 24 hours on day 1 weekly for 4 weeks or capecitabine by mouth every 12 hours starting the evening before day 1 of radiation therapy for 4 weeks as per standard of care. Participants then undergo surgery 6-8 weeks after completion of radiation therapy.

Correlative studies

Correlative studies

Given by mouth (PO)

Inne nazwy:
  • Xeloda
  • Ro 09-1978/000

Given Intravenously (IV)

Inne nazwy:
  • 5-FU
  • 5-fluracyl
  • Fluracyl
  • 5-Fluoro-2,4(1H, 3H)-pirymidynodion
  • 5-fluorouracyl
  • AccuSite
  • Carac
  • Fluorouracyl
  • Fluouracyl
  • Flurablastyna
  • Fluracedyl
  • Fluril
  • Fluroblastyna
  • Rybofluor
  • Rz 2-9757
  • Ro-2-9757

Undergo hypofractionated stereotactic radiotherapy

Inne nazwy:
  • SBRT
  • SABR
  • Stereotaktyczna ablacyjna radioterapia ciała
Eksperymentalny: Arm B (zoledronic acid, chemotherapy, radiation therapy)

Participants receive zoledronic acid IV over a minimum of 15 minutes 1 week prior to radiation therapy. Participants undergo hypofractionated stereotactic body radiation therapy and receive treatment with fluorouracil IV or capecitabine by mouth as in Arm A. Participants then undergo surgery 6-8 weeks after completion of radiation therapy.

Correlative studies

Correlative studies

Given by mouth (PO)

Inne nazwy:
  • Xeloda
  • Ro 09-1978/000

Given Intravenously (IV)

Inne nazwy:
  • 5-FU
  • 5-fluracyl
  • Fluracyl
  • 5-Fluoro-2,4(1H, 3H)-pirymidynodion
  • 5-fluorouracyl
  • AccuSite
  • Carac
  • Fluorouracyl
  • Fluouracyl
  • Flurablastyna
  • Fluracedyl
  • Fluril
  • Fluroblastyna
  • Rybofluor
  • Rz 2-9757
  • Ro-2-9757

Undergo hypofractionated stereotactic radiotherapy

Inne nazwy:
  • SBRT
  • SABR
  • Stereotaktyczna ablacyjna radioterapia ciała

Given IV

Inne nazwy:
  • Przekształć
  • Zometa
  • CGP 42446
  • CGP42446A
  • Kwas [1-hydroksy-2-(1H-imidazol-1-ilo)etylideno]bisfosfonowy
  • NDC-zoledronian
  • ZOL 446

Co mierzy badanie?

Podstawowe miary wyniku

Miara wyniku
Opis środka
Ramy czasowe
Local Control With and Without Zometa at Four Months in Follow-up
Ramy czasowe: At 4 months in follow-up

Local control will be assessed using three-dimensional (3D) computed tomography (CT). The primary tumor will be contoured using Varian planning software, and tumor volume will be measured at baseline and at 4 months post-treatment. Local control is defined as absence of disease progression, with progression defined as a ≥25% increase in tumor volume. Tumor response will also be assessed using RECIST-based criteria (≥20% increase in tumor diameter) as a supportive analysis.

At 4 months in follow-up
Local Control With and Without Zometa at Eight Months in Follow-up
Ramy czasowe: At 8 months in follow-up

Local control will be assessed using three-dimensional (3D) computed tomography (CT). The primary tumor will be contoured using Varian planning software, and tumor volume will be measured at baseline and at 8 months post-treatment. Local control is defined as absence of disease progression, with progression defined as a ≥25% increase in tumor volume. Tumor response will also be assessed using RECIST-based criteria (≥20% increase in tumor diameter) as a supportive analysis.

At 8 months in follow-up
Local Control With and Without Zometa at Twelve Months in Follow-up
Ramy czasowe: At 12 months in follow-up

Local control will be assessed using three-dimensional (3D) computed tomography (CT). The primary tumor will be contoured using Varian planning software, and tumor volume will be measured at baseline and at 12 months post-treatment. Local control is defined as absence of disease progression, with progression defined as a ≥25% increase in tumor volume. Tumor response will also be assessed using RECIST-based criteria (≥20% increase in tumor diameter) as a supportive analysis.

At 12 months in follow-up

Miary wyników drugorzędnych

Miara wyniku
Opis środka
Ramy czasowe
Grade 3 and Above Adverse Events With and Without Zoledronic Acid
Ramy czasowe: Up to 30 days after treatment

Grade 3 and above adverse events (AE) will be determined according to National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0.

Up to 30 days after treatment
Failure-free Survival With and Without Zometa
Ramy czasowe: From date of administration of study drug to the date of any failure, assessed up to 5 years

Time to any failure (disease progression or recurrence determined by imaging, or death) will be analyzed using Kaplan-Meier method between participants receiving Zometa and those who don't.

From date of administration of study drug to the date of any failure, assessed up to 5 years
Overall Survival With and Without Zometa
Ramy czasowe: From date of administration of study drug to the date of death, assessed up to 5 years

Time to death will be analyzed using Kaplan-Meier method between participants receiving Zometa and those who don't.

From date of administration of study drug to the date of death, assessed up to 5 years
Surgically Complete Resection Rate With and Without Zometa
Ramy czasowe: Immediately after surgery

The number and proportion of participants undergoing complete resection (negative margin) will be determined between participants receiving Zometa and those who don't.

Immediately after surgery
Pathologic Response After Resection With and Without Zometa
Ramy czasowe: Immediately after surgery

The pathologic response will be scored from 0-9 by a pathologist, 0 is no response and 9 is complete response between participants receiving Zometa and those who don't.

Immediately after surgery
All-Cause Mortality
Ramy czasowe: From date of administration of study drug to the date of death, assessed up to 10 years

All anticipated and unanticipated deaths due to any cause

From date of administration of study drug to the date of death, assessed up to 10 years

Współpracownicy i badacze

Tutaj znajdziesz osoby i organizacje zaangażowane w to badanie.

Sponsor

Współpracownicy

Śledczy

  • Główny śledczy: Chi Lin, MD, PhD, University of Nebraska

Daty zapisu na studia

Daty te śledzą postęp w przesyłaniu rekordów badań i podsumowań wyników do ClinicalTrials.gov. Zapisy badań i zgłoszone wyniki są przeglądane przez National Library of Medicine (NLM), aby upewnić się, że spełniają określone standardy kontroli jakości, zanim zostaną opublikowane na publicznej stronie internetowej.

Główne daty studiów

Rozpoczęcie studiów (Rzeczywisty)

23 marca 2017

Zakończenie podstawowe (Rzeczywisty)

12 grudnia 2023

Ukończenie studiów (Szacowany)

1 grudnia 2027

Daty rejestracji na studia

Pierwszy przesłany

28 lutego 2017

Pierwszy przesłany, który spełnia kryteria kontroli jakości

2 marca 2017

Pierwszy wysłany (Rzeczywisty)

8 marca 2017

Aktualizacje rekordów badań

Ostatnia wysłana aktualizacja (Rzeczywisty)

4 listopada 2026

Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości

2 listopada 2026

Ostatnia weryfikacja

1 września 2026

Więcej informacji

Terminy związane z tym badaniem

Inne numery identyfikacyjne badania

  • 0552-16-FB
  • P30CA036727 (Grant/umowa NIH USA)
  • NCI-2016-01360 (Identyfikator rejestru: CTRP (Clinical Trial Reporting Program))

Plan dla danych uczestnika indywidualnego (IPD)

Planujesz udostępniać dane poszczególnych uczestników (IPD)?

NIE

Informacje o lekach i urządzeniach, dokumenty badawcze

Bada produkt leczniczy regulowany przez amerykańską FDA

Tak

Bada produkt urządzenia regulowany przez amerykańską FDA

Nie

produkt wyprodukowany i wyeksportowany z USA

Nie

Te informacje zostały pobrane bezpośrednio ze strony internetowej clinicaltrials.gov bez żadnych zmian. Jeśli chcesz zmienić, usunąć lub zaktualizować dane swojego badania, skontaktuj się z register@clinicaltrials.gov. Gdy tylko zmiana zostanie wprowadzona na stronie clinicaltrials.gov, zostanie ona automatycznie zaktualizowana również na naszej stronie internetowej .