Metastatic Pancreatic Cancer
Conditions
Keywords
Circulating tumor cells, Nab-paclitaxel, Metastatic pancreatic cancer, Gemcitabine
Brief summary
The majority patients diagnosed with pancreatic cancer have metastatic disease at the time of diagnosis. The prognosis is extremely poor with a 5-year survival rate of less than 5%. Treatment with chemotherapy can improve efficacy, but still the median progression-free survival in patients receiving nab-paclitaxel and gemcitabine is only 5,5 months and median overall survival is less than one year. There is a urgent need for tools for predicting the efficacy of the treatment. The current trial aims at investigating the biomarker potential of circulating tumor cells (CTCs) in metastatic pancreatic cancer patients treated by gemcitabine and nab-paclitaxel.
Interventions
Patients will receive gemcitabine/nab-paclitaxel combination chemotherapy
Sponsors
Helse Stavanger HF
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Male or female \> 18 years up to 80 years * Histologically or cytologically proven adenocarcinoma of the pancreas before start of treatment. Also patients for whom there is a strong suspicion of unresectable pancreatic cancer will before the diagnosis is confirmed be asked for consent to take 2 additional biopsies at the time of diagnostic biopsy retrieval, in case the histological analysis confirms that they can be included. * Locally advanced (primarily unresectable) and/or metastatic disease. * Presence of at least one measurable lesion according to the RECIST criteria, not restricted to previously irradiated area or limited to bone, pleural effusion or ascites. * ECOG/WHO performance status ≤2 * Absolute neutrophil count (ANC) \>1.5 x 109 /L and platelet count \>100 x 109/L * Total bilirubin \< 1.5 times the upper limit of the normal range at the institution (ULN) or AST or ALT \< 2 x ULN. If liver metastases are present, patients can be included if total bilirubin \< 5× ULN or AST/ALT \<10× ULN. Dose reductions of paclitaxel will be performed when bilirubin \>2xULN, depending on increase of the bilirubin level according to the recommendations of the Summary of Product Characteristics. * Serum creatinin \< 1,5 ULN / calculated creatine clearance \> 60 ml/min. * Written informed consent
Exclusion criteria
* Current infection, bowel obstruction or subobstruction, or other uncontrolled intercurrent illness. * Prior medical treatment for advanced pancreatic cancer * Confirmed brain metastasis. * Concurrent or past history of another malignancy except curatively treated non-melanoma skin cancer or in situ carcinoma of the cervix. * Treatment with any other investigational drug more than 30 days prior to study entry. * Allergy to anyone of the included drugs. * Female patient breast feeding or pregnancy * Not able/ or not willing to use adequate contraception (defined below). A pregnancy test will be included in the baseline visit for women of childbearing potential.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Change in levels of circulating tumor cells (CTCs) during treatment | Baseline and 9 months |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Post-baseline over-all survival | Baseline and 9 months | — |
| Post-baseline disease-specific survival | Baseline and 9 months | — |
| Post-baseline time to progression | Baseline and 9 months | — |
| Clinical response to treatment by RECIST 1.1 | Baseline and 9 months | Radiologic, clinical and biochemical assessment |
| Changes in quality of life during treatment | Baseline and 9 months | Quality of Life is assessed every 4 weeks during treatment and then every 8th weeks. |
Countries
Norway
Outcome results
None listed