Clinical trial

Feasibility Study of Neoadjuvant Gemcitabine/Nab-Paclitaxel and Hypofractionated Image-Guided Intensity Modulated Radiotherapy in Resectable and Borderline Resectable Pancreatic Cancer

Name
Pro00058865
Description
This research protocol will evaluate the feasibility of administering neoadjuvant gemcitabine and nab-paclitaxel with hypofractionated, image guided, intensity modulated radiotherapy (HIGRT) in resectable and borderline resectable pancreatic cancer
Trial arms
Trial start
2015-02-17
Estimated PCD
2018-11-07
Trial end
2022-11-14
Status
Completed
Treatment
Gemcitabine/nab-Paclitaxel
Prospective, single arm study ; eligible subjects will recieve 2 cycles of neoadjuvant Gemcitabine/nab-Paclitaxel. All chemotherapy administered to study subjects is standard of care. The chemotherapy combination, gemcitabine/nab-paclitaxel, is considered to be a standard-of-care, non-investigational chemotherapy combination; chemotherapy dosing and treatment schedule will be managed by the treating medical oncologist. Restaging will be completed post chemotherapy.
Arms:
Chemotherapy/radiation/surgery
Radiation therapy
5 fractions of hypofractionated IGRT or IMRT at 5Gy per fraction will be delivered before surgery. Restaging will be completed post radiation therapy.
Arms:
Chemotherapy/radiation/surgery
Sugical resection
Surgical resection of the pancreas post radiation therapy
Arms:
Chemotherapy/radiation/surgery
Adjuvant chemotheapy
Adjuvant chemotherapy may be given after surgery at the clinical discretion of the medical oncologist
Arms:
Chemotherapy/radiation/surgery
Size
40
Primary endpoint
Feasibility as Measured by Number of Participants Who Complete the Neoadjuvant Gemcitabine/Nab-paclitaxel and HIGRT Regimen
approximately 6 months
Eligibility criteria
Inclusion Criteria: 1. Patient has signed informed consent and is willing to comply with the protocol 2. Histologically or cytologically proven adenocarcinoma of the pancreas (within the last 90 days) 3. Either resectable or borderline resectable as determined on staging imaging (as defined by National Comprehensive Cancer Network \[NCCN\]) 4. Patient is 18 years or older 5. Karnofsky performance status 70 or greater 6. The ANC count ≥ 1500, the platelet count ≥ 100,000 and hemoglobin ≥ 9g/dL 7. Laboratory values meet the following constraints: Bilirubin less than or equal to 2 mg/dL; AST and ALT less than or equal to 3 x ULN (stenting to improve biliary obstruction is permitted) 8. No evidence of metastatic disease based on imaging of the chest, abdomen and pelvis. Exclusion Criteria: 1. Metastatic disease on pretreatment imaging 2. Prior systemic therapy 3. Prior abdominal radiation. Any prior radiation must be approved by the Radiation Oncology PI 4. Previous treatment for pancreatic cancer 5. Patients with any serious/poorly controlled medical or psychological conditions that would be exacerbated by treatment, would complicate protocol compliance 6. Pregnant or lactating. Adequate birth control must be used if of child bearing potential per institutional policy. Negative pregnancy test in female patients of child-bearing potential per institutional policy. Post-menopausal women must have had amenorrhea for at least 18 months to be considered non-child bearing 7. Clinically significant peripheral vascular disease 8. Presence of active or chronic infection 9. Clinically significant atherosclerotic cardiovascular disease including patients with New York Heart Class II/III/IV CHF, ventricular arrhythmias requiring medication, myocardial infarction, cerebrovascular accident, transient ischemic attack, coronary artery bypass grafting, angioplasty, cardiac or other vascular stenting within the past 6 months 10. History of abdominal fistula, gastrointestinal perforation, intra-abdominal abscess within six months prior to treatment start 11. History of collagen vascular disease or inflammatory bowel disease (Crohn's or ulcerative colitis) 12. Current grade 2 or higher peripheral neuropathy 13. Anticoagulation with warfarin 14. History of arterial thromboembolic events or symptomatic pulmonary embolism within the past 6 months 15. Active bleeding diathesis or history of major bleeding, CNS bleeding, or significant hemoptysis within the past 6 months
Protocol
{'studyType': 'INTERVENTIONAL', 'phases': ['NA'], 'designInfo': {'allocation': 'NA', 'interventionModel': 'SINGLE_GROUP', 'primaryPurpose': 'TREATMENT', 'maskingInfo': {'masking': 'NONE'}}, 'enrollmentInfo': {'count': 40, 'type': 'ACTUAL'}}
Updated at
2023-10-26

1 organization

2 products

1 indication

Organization
Duke University