Metastatic Pancreatic Cancer
Conditions
Brief summary
It will be investigated whether it is possible to predict the effect or lack of effect of first-line treatment by analysing cancer cells from the individual patient receiving standard first line treatment. Also, the feasibility of selecting second-line therapy based on pre-treatment biopsies will be investigated. Cells from pancreatic cancer will be grown in the laboratory to form small, circulating tumors and adjacent tissue, so called tumoroids. The tumoroids will then be exposed to different pre-specified anticancer drugs to hopefully reveal sensitivity or lack of sensitivity in the specific patient.
Interventions
DIAGNOSTIC_TESTInditreat
Tumoroid formation and drug sensitivity analysis
DRUGExperimental drug
Second line treatment based on drug sensitivity analysis
Sponsors
Vejle Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Non-resectable pancreatic cancer * Biopsy proven adenocarcinoma compatible with pancreatic origin (primary tumor or metastasis) * If only biopsy from metastasis can be obtained, the patient must have a previously resected or image proven tumor of the pancreas * Deemed non-resectable at a multidisciplinary conference * Candidate to standard systemic therapy, defined as one of * Gemcitabine monotherapy, * Gemcitabine and nab-paclitaxel combination, * Gemcitabine and capecitabine combination, * 5-fluorouracil, oxaliplatin and irinotecan combination (FOLFIRINOX), or * New standard treatments approved by the multidisciplinary cancer group 'Danish Pancreatic Cancer Group' in the inclusion period. * Measurable disease according to RECIST 1.1 * ECOG performance status 0-2 * Age at least 18 years * Adequate bone marrow, liver and renal function allowing systemic chemotherapy * Absolute neutrophil count ≥1.5x10\^9/l and thrombocytes ≥ 100x10\^9/l * Bilirubin ≤ 3 x upper normal value and alanine aminotransferase ≤ 5 x upper normal value * Calculated or measured renal glomerular filtration rate at least 30 mL/min * Contraception for fertile women and for male patients with a fertile partner. Intrauterine device, vasectomy of a female subject's male partner or hormonal contraceptive are acceptable * Written and orally informed consent
Exclusion criteria
* Potentially resectable disease * Incapacity, frailty, disability, or comorbidity to a degree that according to the investigator is not compatible with participation in the protocol * Other active malignant disease requiring therapy * Other systemic anti-cancer therapy (palliative radiotherapy is allowed) * Pregnant (positive pregnancy test) or breast feeding women
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Predictive value of in-vitro testing | 2 months | Predictive value is defined as the ability to correctly predict response or resistance to first-line chemotherapy |
Secondary
| Measure | Time frame |
|---|---|
| Feasibility of selecting second-line therapy based on pre-treatment biopsies as measured by treatment response (RESIST 1.1 criteria) | Every 2 months during treatment up to 180 days |
| Feasibility of selecting second-line therapy based on pre-treatment biopsies as measured by progression free survival (PFS) | Every 2 months up to 12 months |
Countries
Denmark
Outcome results
None listed