Two Chemotherapy Regimens Compared With Observation in Treating Patients With Completely Resected Pancreatic Cancer

NCT ID: NCT00058201

Last Updated: 2013-12-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

1030 participants

Study Classification

INTERVENTIONAL

Study Start Date

2001-07-31

Study Completion Date

2010-09-30

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. It is not yet known which chemotherapy regimen is more effective, or whether chemotherapy is more effective than observation, in treating pancreatic cancer after surgery.

PURPOSE: Phase III trial to compare the effectiveness of two chemotherapy regimens with no further therapy in treating patients who have completely resected pancreatic cancer.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

OBJECTIVES:

Primary

* Compare the efficacy of adjuvant gemcitabine vs fluorouracil and leucovorin calcium (vs observation only in patients with ampullary or other pancreatic malignancy), in terms of overall survival, in patients with completely resected pancreatic cancer.

Secondary

* Compare the toxicity of these regimens in these patients.
* Compare the quality of life and 5-year survival of patients treated with these regimens.

OUTLINE: This is a randomized, multicenter study. Patients are stratified according to histology (ductal adenocarcinoma vs ampullary or other pancreatic malignancy), resection margin status, and participating country. Patients are randomized to 1 of 2 treatment arms. Randomization for patients with ampullary or other pancreatic malignancy includes an observation arm.

* Arm I: Patients receive leucovorin calcium IV and fluorouracil IV on days 1-5.
* Arm II: Patients receive gemcitabine IV over 30 minutes on days 1, 8, and 15.
* Arm III (patients with ampullary or other pancreatic malignancy only): Patients undergo observation.

Treatment in arms I and II repeats every 28 days for 6 courses in the absence of disease progression or unacceptable toxicity.

Quality of life is assessed at baseline, 3, 6, and 12 months, and then annually for 5 years.

Patients are followed every 3 months.

PROJECTED ACCRUAL: A total of 1,030 patients with pancreatic adenocarcinoma (515 per arms I and II) will be accrued for this study.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Pancreatic Cancer

Keywords

Explore important study keywords that can help with search, categorization, and topic discovery.

acinar cell adenocarcinoma of the pancreas duct cell adenocarcinoma of the pancreas stage I pancreatic cancer stage II pancreatic cancer stage III pancreatic cancer stage IV pancreatic cancer

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Primary Study Purpose

TREATMENT

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Arm I

Patients receive leucovorin calcium IV and fluorouracil IV on days 1-5.

Group Type ACTIVE_COMPARATOR

fluorouracil

Intervention Type DRUG

Given IV

leucovorin calcium

Intervention Type DRUG

Given IV

Arm II

Patients receive gemcitabine IV over 30 minutes on days 1, 8, and 15.

Group Type EXPERIMENTAL

gemcitabine hydrochloride

Intervention Type DRUG

Given IV

Arm III

Patients undergo observation.

Group Type NO_INTERVENTION

clinical observation

Intervention Type OTHER

No intervention

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

fluorouracil

Given IV

Intervention Type DRUG

gemcitabine hydrochloride

Given IV

Intervention Type DRUG

leucovorin calcium

Given IV

Intervention Type DRUG

clinical observation

No intervention

Intervention Type OTHER

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

DISEASE CHARACTERISTICS:

* Histologically confirmed ductal adenocarcinoma of the pancreas OR
* Histologically confirmed diagnosis of 1 of the following types of cancer:

* Acinar cell carcinoma or cystadenocarcinoma of the pancreas
* Cancers of the periampullary region
* Cancers of the intrapancreatic part of the bile duct
* Periampullary cancers of uncertain origin
* Complete macroscopic resection (R0 or R1 resection)

* Histological examination of all resection margins required
* No stage IVB disease
* No evidence of malignant ascites
* No liver or peritoneal metastases
* No evidence of spread to other distant abdominal or extra-abdominal organs
* No pancreatic lymphoma

PATIENT CHARACTERISTICS:

Age

* 18 and over

Performance status

* WHO 0-2

Life expectancy

* More than 3 months

Hematopoietic

* Not specified

Hepatic

* Not specified

Renal

* Not specified

Other

* Not pregnant
* Able to participate in long-term follow-up
* No other prior or concurrent malignancy except curatively treated basal cell skin cancer or carcinoma in situ of the cervix
* No serious medical or psychological condition that would preclude study treatment

PRIOR CONCURRENT THERAPY:

Biologic therapy

* Not specified

Chemotherapy

* No neoadjuvant chemotherapy
* No other concurrent chemotherapy

Endocrine therapy

* Not specified

Radiotherapy

* Not specified

Surgery

* See Disease Characteristics
* Recovered from prior resection
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

NCIC Clinical Trials Group

NETWORK

Sponsor Role collaborator

Australasian Gastro-Intestinal Trials Group

NETWORK

Sponsor Role collaborator

Royal Liverpool University Hospital

OTHER_GOV

Sponsor Role lead

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

John P. Neoptolemos, MD

Role: STUDY_CHAIR

Royal Liverpool University Hospital

Malcolm J. Moore, MD

Role: STUDY_CHAIR

Princess Margaret Hospital, Canada

R. Padbury

Role:

Flinders Medical Centre

David Goldstein, MD

Role:

Institute of Oncology at Prince of Wales Hospital

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Institute of Oncology at Prince of Wales Hospital

Randwick, New South Wales, Australia

Site Status

Flinders Medical Centre

Bedford Park, South Australia, Australia

Site Status

Cross Cancer Institute at University of Alberta

Edmonton, Alberta, Canada

Site Status

British Columbia Cancer Agency - Centre for the Southern Interior

Kelowna, British Columbia, Canada

Site Status

British Columbia Cancer Agency - Vancouver Island Centre

Victoria, British Columbia, Canada

Site Status

CancerCare Manitoba

Winnipeg, Manitoba, Canada

Site Status

Nova Scotia Cancer Centre

Halifax, Nova Scotia, Canada

Site Status

Cancer Research Institute at Queen's University

Kingston, Ontario, Canada

Site Status

Cancer Centre of Southeastern Ontario at Kingston General Hospital

Kingston, Ontario, Canada

Site Status

London Regional Cancer Program at London Health Sciences Centre

London, Ontario, Canada

Site Status

Ottawa Hospital Regional Cancer Centre - General Campus

Ottawa, Ontario, Canada

Site Status

Edmond Odette Cancer Centre at Sunnybrook

Toronto, Ontario, Canada

Site Status

Princess Margaret Hospital

Toronto, Ontario, Canada

Site Status

St. Joseph's Health Centre - Toronto

Toronto, Ontario, Canada

Site Status

Hopital Charles Lemoyne

Greenfield Park, Quebec, Canada

Site Status

McGill Cancer Centre at McGill University

Montreal, Quebec, Canada

Site Status

Institute for Clinical and Experimental Medicine

Preha 4, , Czechia

Site Status

Tampere University Hospital

Tampere, , Finland

Site Status

Hopital Tenon

Paris, , France

Site Status

Universitaets-Kinderklinik Heidelberg

Heidelberg, , Germany

Site Status

Agia Olga Hospital

Athens, , Greece

Site Status

Petz Aladar County Hospital

Gydr, , Hungary

Site Status

Policlinico Borgo Roma

Verona, , Italy

Site Status

Kyoto University Hospital

Kyoto, Kyoto, Japan

Site Status

Uppsala University Hospital

Uppsala, , Sweden

Site Status

Inselspital Bern

Bern, , Switzerland

Site Status

Royal Liverpool University Hospital

Liverpool, England, United Kingdom

Site Status

Countries

Review the countries where the study has at least one active or historical site.

Australia Canada Czechia Finland France Germany Greece Hungary Italy Japan Sweden Switzerland United Kingdom

References

Explore related publications, articles, or registry entries linked to this study.

Neoptolemos JP, Moore MJ, Cox TF, Valle JW, Palmer DH, McDonald AC, Carter R, Tebbutt NC, Dervenis C, Smith D, Glimelius B, Charnley RM, Lacaine F, Scarfe AG, Middleton MR, Anthoney A, Ghaneh P, Halloran CM, Lerch MM, Olah A, Rawcliffe CL, Verbeke CS, Campbell F, Buchler MW; European Study Group for Pancreatic Cancer. Effect of adjuvant chemotherapy with fluorouracil plus folinic acid or gemcitabine vs observation on survival in patients with resected periampullary adenocarcinoma: the ESPAC-3 periampullary cancer randomized trial. JAMA. 2012 Jul 11;308(2):147-56. doi: 10.1001/jama.2012.7352.

Reference Type RESULT
PMID: 22782416 (View on PubMed)

Neoptolemos JP, Stocken DD, Bassi C, Ghaneh P, Cunningham D, Goldstein D, Padbury R, Moore MJ, Gallinger S, Mariette C, Wente MN, Izbicki JR, Friess H, Lerch MM, Dervenis C, Olah A, Butturini G, Doi R, Lind PA, Smith D, Valle JW, Palmer DH, Buckels JA, Thompson J, McKay CJ, Rawcliffe CL, Buchler MW; European Study Group for Pancreatic Cancer. Adjuvant chemotherapy with fluorouracil plus folinic acid vs gemcitabine following pancreatic cancer resection: a randomized controlled trial. JAMA. 2010 Sep 8;304(10):1073-81. doi: 10.1001/jama.2010.1275.

Reference Type RESULT
PMID: 20823433 (View on PubMed)

Jones RP, Psarelli EE, Jackson R, Ghaneh P, Halloran CM, Palmer DH, Campbell F, Valle JW, Faluyi O, O'Reilly DA, Cunningham D, Wadsley J, Darby S, Meyer T, Gillmore R, Anthoney A, Lind P, Glimelius B, Falk S, Izbicki JR, Middleton GW, Cummins S, Ross PJ, Wasan H, McDonald A, Crosby T, Ting Y, Patel K, Sherriff D, Soomal R, Borg D, Sothi S, Hammel P, Lerch MM, Mayerle J, Tjaden C, Strobel O, Hackert T, Buchler MW, Neoptolemos JP; European Study Group for Pancreatic Cancer. Patterns of Recurrence After Resection of Pancreatic Ductal Adenocarcinoma: A Secondary Analysis of the ESPAC-4 Randomized Adjuvant Chemotherapy Trial. JAMA Surg. 2019 Nov 1;154(11):1038-1048. doi: 10.1001/jamasurg.2019.3337.

Reference Type DERIVED
PMID: 31483448 (View on PubMed)

Ghaneh P, Kleeff J, Halloran CM, Raraty M, Jackson R, Melling J, Jones O, Palmer DH, Cox TF, Smith CJ, O'Reilly DA, Izbicki JR, Scarfe AG, Valle JW, McDonald AC, Carter R, Tebbutt NC, Goldstein D, Padbury R, Shannon J, Dervenis C, Glimelius B, Deakin M, Anthoney A, Lerch MM, Mayerle J, Olah A, Rawcliffe CL, Campbell F, Strobel O, Buchler MW, Neoptolemos JP; European Study Group for Pancreatic Cancer. The Impact of Positive Resection Margins on Survival and Recurrence Following Resection and Adjuvant Chemotherapy for Pancreatic Ductal Adenocarcinoma. Ann Surg. 2019 Mar;269(3):520-529. doi: 10.1097/SLA.0000000000002557.

Reference Type DERIVED
PMID: 29068800 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

RLUH-NCRI-ESPAC-3V2

Identifier Type: -

Identifier Source: secondary_id

EU-20043

Identifier Type: -

Identifier Source: secondary_id

CAN-NCIC-PA2

Identifier Type: -

Identifier Source: secondary_id

AGITG-ESPAC-3

Identifier Type: -

Identifier Source: secondary_id

CDR0000287023

Identifier Type: -

Identifier Source: org_study_id