Advanced Pancreatic Cancer
Conditions
Keywords
Organoid, Drug Sensitivity Test, Chemotherapy, Advanced Pancreatic Cancer
Brief summary
The purpose of this study is to explore whether chemotherapy regimens guided by organoid drug sensitivity test can improve the outcomes of advanced pancreatic cancer. At the same time, this study will evaluate the successful stablishment rate of organoid from biopsy tissue , and explore the concordance between drug sensitivity test results and patients' treatment response.
Detailed description
The poor prognosis of pancreatic cancer is not just because of the high malignancy of the tumor itself, but also its poor response to chemotherapy. At present, patient's drug-sensitivity is assessed by progression time after treatment. Therefore, it is difficult to judge a patient's sensitivity to a drug before chemotherapy. Organoid is a new tumor model, which has the potential to test the drug sensitivity before chemotherapy. Our center's previous experience has shown that the success rate of pancreatic cancer organoid culture is 77.6%. The previous research has confirmed that pancreatic cancer organoid was highly consistent with the original tissue in terms of genomics and histomorphology. More importantly, the investigators have tested the five first-line drug-sensitivity in 39 pancreatic cancer organoids, and compared the test results with the clinical treatment response of these patients, confirming that organoid can accurately evaluate the chemotherapy drug-sensitivity. This is a single-center, prospective, open-label, randomized, controlled clinical trial, designed to explore whether chemotherapy regimens guided by organoid drug sensitivity test can improve outcomes in advanced pancreatic cancer patients. At the same time, the consistency between the drug sensitivity test results and the treatment response of patients will be analyzed. Also, the radiosensitivity of organoids will be tested, and be compared with the patients' response to radiotherapy.
Interventions
OTHERChemotherapy guided by organoid drug sensitivity test
Chemotherapy guided by organoid will be given to advanced pancreatic cancer patients.
Sponsors
Changhai Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Age≥18 years old and ≤80 years old. * Histologically or cytologically confirmed local advanced/metastatic pancreas adenocarcinoma. * Eligible histologic variants include adenocarcinoma or variants to include mucinous adenocarcinoma or adenosquamous carcinoma. * Patient must have a tumor lesion that is amenable to a core needle biopsy. * Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1. * Life expectancy of greater than 90 days, as judged by the investigator. * Routine blood test: absolute neutrophil count\>1500/mm3, platelet\>100000/mm3. * Normal liver function: serum total bilirubin≤2.0mg/dl, alanine aminotransferase (ALT) and aspertate aminotransferase (AST) \<2.5 times of the upper limit of normal value. * Normal kidney function: serum creatinine\<1.5 times of the upper limit of normal value or creatinine clearance rate\>45ml/min. * The pancreatic cancer organoid were cultured successfully. * No severe comorbidities.
Exclusion criteria
* Patients with poor condition can not tolerate chemotherapy and targeted therapy. * Impaired organ functions: heart failure (New York Heart Association III-IV), coronary heart disease, myocardial infarction within 6 months, severe cardiac arrhythmia and respiratory failure. * Patients diagnosed with other cancer within 5 years. * Patients who are pregnant or breastfeeding. * Patients enrolled in other clinical trials or incompliant of regular follow up. * Patients who did not provide an informed consent.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| 6-month disease control rate | 6 months | Percentage of patient's measurable disease who have achieved either complete response (CR) , partial response (PR) or stable disease (SD) according to RECIST 1.1. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Progression free time | 1-2 years | Time from the date of randomization to progression based on the radiology assessment of response using RECIST v1.1, or death, whichever is earlier. |
| Overall survival time | 1-2 years | The time from the date of randomization to the date of death for any cause. Patients will be followed until their date of death or until final database closure. Patients who are lost-to-follow-up or are alive at the time of analysis will be censored at the time they were last known to be alive or at the date of event cut-off for Overall survival (OS) analysis. |
| The successful establishment rate of organoids | 1-2 years | The rate of organoid successfully cultured in all the samples collected. |
| Concordance between drug sensitivity test results and patients' treatment response (descriptive statistics). | 1-2 years | To assess the accuracy of drug sensitivity test in both group. The number of patients with correct prediction of treatment response by organoid drug-sensitivity test divided by the number of patients underwent chemotherapy |
| Concordance between radiosensitivity test results and patients' treatment response (descriptive statistics). | 1-2 years | To assess the accuracy of radiosensitivity test in both group. The number of patients with correct prediction of treatment response by organoid radiosensitivity test divided by the number of patients underwent radiotherapy |
Countries
China
Contacts
Primary ContactShiwei Guo, M.D.
Backup ContactHuan Wang, Master
Outcome results
None listed