Gemcitabine With or Without Capecitabine and/or Radiation Therapy or Gemcitabine With or Without Erlotinib in Treating Patients With Locally Advanced Pancreatic Cancer That Cannot Be Removed by Surgery

NCT ID: NCT00634725

Last Updated: 2015-12-11

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

820 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-02-29

Study Completion Date

2014-09-30

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, such as gemcitabine and capecitabine, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Erlotinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Radiation therapy uses high-energy x-rays to kill tumor cells. It is not yet known which regimen of chemotherapy with or without erlotinib and/or radiation therapy is most effective in treating pancreatic cancer.

PURPOSE: This randomized phase III trial is studying giving gemcitabine together with or without capecitabine and/or radiation therapy to see how well it works compared with giving gemcitabine together with or without erlotinib in treating patients with locally advanced pancreatic cancer that cannot be removed by surgery.

Detailed Description

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

OBJECTIVES:

Primary

* To assess whether administrating chemoradiotherapy in patients whose tumor is controlled after 4 months of induction chemotherapy (CT) increases survival compared with continuation of the same CT in patients with unresectable, locally advanced adenocarcinoma of the pancreas.

Secondary

* To assess whether erlotinib hydrochloride combined with gemcitabine hydrochloride and administered as maintenance treatment increases progression-free survival compared with gemcitabine hydrochloride alone and without maintenance treatment.
* To evaluate the response rate in the CT and chemoradiotherapy (CRT) arms.
* To evaluate tolerance to erlotinib hydrochloride as maintenance treatment after the end of CT or CRT.
* To study the predictive molecular factors (i.e., survivin, K-ras, EGFR, PTEN, or AKT) of survival.

OUTLINE: This is a multicenter study. Patients in the first randomization are stratified according to center and ECOG performance status (0-1 vs 2). Patients in the second randomization are stratified according to center and initial treatment arm (I vs II).

* First randomization: Patients are randomized to 1 of 2 treatment arms.

* Arm I: Patients receive gemcitabine hydrochloride IV over 30 minutes on days 1, 8, 15, 22, 29, 36, and 43. Following the first evaluation, patients continue to receive gemcitabine hydrochloride on days 57, 64, 71, 85, 92, and 99 for a total of 4 months.
* Arm II: Patients receive gemcitabine hydrochloride IV over 30 minutes on days 1, 8, 15, 22, 29, 36, and 43. Following the first evaluation, patients continue to receive gemcitabine hydrochloride on days 57, 64, 71, 85, 92, and 99. Patients also receive oral erlotinib hydrochloride once daily for 4 months.

After completion of treatment in the first randomization proceed to the second randomization.

* Second randomization: Patients are randomized to 1 of 4 treatment arms.

* Arm I: Patients continue gemcitabine hydrochloride as in arm I in the first randomization on days 113, 120, and 127 and on days 141, 148, and 155 for 2 months in the absence of disease progression.
* Arm II: Patients continue gemcitabine hydrochloride as in arm II in the first randomization on days 113, 120, and 127 and on days 141, 148, and 155 and oral erlotinib hydrochloride daily for 2 months followed by erlotinib hydrochloride alone as maintenance therapy in the absence of disease progression.
* Arm III: Patients receive oral capecitabine twice daily and undergo radiotherapy beginning on day 127, 5 days a week, for 6 weeks, in the absence of disease progression.
* Arm IV: Patients receive oral capecitabine twice daily and undergo radiotherapy beginning on day 127, 5 days a week, for 6 weeks. Beginning 15 days after completion of CRT, patients receive a reintroduction of oral erlotinib hydrochloride alone once daily in the absence of disease progression or unacceptable toxicity.

Tumor tissue will be analyzed for the relationship between biological markers and resistance to treatment.

After completion of study treatment, patients are followed every 2 months.

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.

adenocarcinoma of the pancreas stage III pancreatic cancer

Study Design

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

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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

Arm 1 (A1) - Gemcitabine

Gemcitabine 2 months, then stop until progression

Group Type ACTIVE_COMPARATOR

gemcitabine hydrochloride

Intervention Type DRUG

laboratory biomarker analysis

Intervention Type OTHER

Arm 2 (B1) Gemcitabine + Erlotinib

B1 Gemcitabine + Erlotinib (100mg/d) 2 months, then erlotinib maintenance (150 mg/d)until progression

Group Type EXPERIMENTAL

erlotinib hydrochloride

Intervention Type DRUG

gemcitabine hydrochloride

Intervention Type DRUG

laboratory biomarker analysis

Intervention Type OTHER

Arm 3 (A2) CRT

A2 CRT then stop until progression

Group Type EXPERIMENTAL

capecitabine

Intervention Type DRUG

laboratory biomarker analysis

Intervention Type OTHER

radiation therapy

Intervention Type RADIATION

Arm 4 (B2) CRT then erlotinib

B2 CRT then erlotinib maintenance (150mg/d) until progression

Group Type EXPERIMENTAL

capecitabine

Intervention Type DRUG

erlotinib hydrochloride

Intervention Type DRUG

laboratory biomarker analysis

Intervention Type OTHER

radiation therapy

Intervention Type RADIATION

Interventions

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

capecitabine

Intervention Type DRUG

erlotinib hydrochloride

Intervention Type DRUG

gemcitabine hydrochloride

Intervention Type DRUG

laboratory biomarker analysis

Intervention Type OTHER

radiation therapy

Intervention Type RADIATION

Eligibility Criteria

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

Inclusion Criteria

* ECOG performance status 0-2
* Life expectancy ≥ 12 weeks
* Polynuclear neutrophils ≥ 1.5 x 10\^9/L
* Platelets ≥ 100 x 10\^9/L
* Hemoglobin ≥ 9 g/dL
* Total bilirubin ≤ 1.5 times upper limit of normal (ULN)

* For patients who have had a recent biliary drain and whose bilirubin is descending, a value of ≤ 3 times ULN is acceptable
* Creatinine ≤ 2 mg/dL
* AST and ALT ≤ 2.5 times ULN
* Alkaline phosphatase ≤ 5 times ULN
* Albumin ≥ 25 g/L
* Not pregnant or nursing
* Negative pregnancy test
* Fertile patients must use effective contraception during and for 3 months after completion of therapy

Exclusion Criteria

* Diarrhea ≥ grade 2 and/or uncontrolled diarrhea
* Affiliated with a social security regime
* Unable to follow instructions for psychological, familial, or geographical reasons
* Allergic to one of the ingredients in erlotinib hydrochloride
* Cancer within the past 5 years, except for in situ cancer of the neck of the uterus or basal cell skin cancer
* Severe infection
* Ophthalmic disease (i.e., inflammation, keratopathy, or infection)
* Symptomatic coronary or cardiac insufficiency, myocardial infarction, or stroke within the last 6 months
* Unable to take oral treatments
* Gastrointestinal disorders that could be associated with absorption disorders
* Untreated gastric or duodenal ulcer

PRIOR CONCURRENT THERAPY:

* No prior radiotherapy (including abdominal radiotherapy) or chemotherapy for any reason
* No prior anti-epidermal growth factor-receptor therapy
Minimum Eligible Age

18 Years

Maximum Eligible Age

120 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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

GERCOR - Multidisciplinary Oncology Cooperative Group

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

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

Pascal Hammel, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Hopital Beaujon

Locations

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

Centre Radiotherapie Oncologie Moyenne Garonne

Agen, , France

Site Status

Centre Hospitalier d'Aix en Provence

Aix-en-Provence, , France

Site Status

Centre Paul Papin

Angers, , France

Site Status

Polyclinique Sainte Marguerite

Auxerre, , France

Site Status

Centre Hospitalier d'Auxerre

Auxerre, , France

Site Status

Institut Sainte Catherine

Avignon, , France

Site Status

Hopital Duffaut

Avignon, , France

Site Status

Centre Hospitalier de la Cote Basque

Bayonne, , France

Site Status

Centre Hospitalier de Beauvais

Beauvais, , France

Site Status

Centre Hospitalier Regional de Besancon - Hopital Jean Minjoz

Besançon, , France

Site Status

Hopital de Beziers

Béziers, , France

Site Status

Hopital Saint Andre

Bordeaux, , France

Site Status

Institut Bergonie

Bordeaux, , France

Site Status

Polyclinique Bordeaux Nord Aquitaine

Bordeaux, , France

Site Status

Clinique Tivoli

Bordeaux, , France

Site Status

Hopital Ambroise Pare

Boulogne-Billancourt, , France

Site Status

Centre Hospitalier Pierre Oudot

Bourgoin, , France

Site Status

CHU de Caen

Caen, , France

Site Status

Polyclinique Du Parc

Caen, , France

Site Status

Hopital Beaujon

Clichy, , France

Site Status

Hopital Louis Pasteur

Colmar, , France

Site Status

Centre Hospitalier Compiegne

Compiègne, , France

Site Status

Centre Hospitalier Universitaire Henri Mondor

Créteil, , France

Site Status

Centre Hospitalier de Dax

Dax, , France

Site Status

Centre Hospitalier de Digne les Bains

Digne-les-Bains, , France

Site Status

Hopital Du Bocage

Dijon, , France

Site Status

Centre de Lutte Contre le Cancer Georges-Francois Leclerc

Dijon, , France

Site Status

Centre Hospitalier Draguignan

Draguignan, , France

Site Status

CHU de Grenoble - Hopital de la Tronche

Grenoble, , France

Site Status

Centre Hospitalier Departemental

La Roche-sur-Yon, , France

Site Status

Centre Hospitalier de Lagny

Lagny-sur-Marne, , France

Site Status

Hopital Louis Pasteur - Le Coudray

Le Coudray, , France

Site Status

Centre Hospitalier Universitaire de Bicetre

Le Kremlin-Bicêtre, , France

Site Status

Clinique Victor Hugo

Le Mans, , France

Site Status

Hopital Robert Boulin

Libourne, , France

Site Status

Polyclinique Du Bois

Lille, , France

Site Status

Polyclinique des Quatre Pavillons

Lormont, , France

Site Status

Centre Hospitalier St. Joseph St. Luc

Lyon, , France

Site Status

Hopital Prive Jean Mermoz

Lyon, , France

Site Status

Hopital de la Croix Rousse

Lyon, , France

Site Status

Centre Leon Berard

Lyon, , France

Site Status

Hopital Edouard Herriot - Lyon

Lyon, , France

Site Status

Marseille Institute of Cancer - Institut J. Paoli and I. Calmettes

Marseille, , France

Site Status

CHU de la Timone

Marseille, , France

Site Status

Centre Gray

Maubeuge, , France

Site Status

Centre Hospitalier Chanaux

Mâcon, , France

Site Status

Centre Hospitalier de Meaux

Meaux, , France

Site Status

Centre Hospitalier General de Mont de Marsan

Mont-de-Marsan, , France

Site Status

Centre Hospitalier de Montelimar

Montélimar, , France

Site Status

C.H.U. de Nimes - Groupe Hospitals-Universitaire Caremeau

Nîmes, , France

Site Status

Clinique De Valdegour

Nîmes, , France

Site Status

CHR D'Orleans - Hopital de la Source

Orléans, , France

Site Status

Hopital Pitie-Salpetriere

Paris, , France

Site Status

Hopital Europeen Georges Pompidou

Paris, , France

Site Status

Hopital Bichat - Claude Bernard

Paris, , France

Site Status

Hopital Saint-Louis

Paris, , France

Site Status

Hopital Saint Antoine

Paris, , France

Site Status

Hopital Saint Joseph

Paris, , France

Site Status

Hopital Tenon

Paris, , France

Site Status

Centre Catalan d'Oncologie

Perpignan, , France

Site Status

Hopital Haut Leveque

Pessac, , France

Site Status

Centre Hospitalier Lyon Sud

Pierre-Bénite, , France

Site Status

CHU Poitiers

Poitiers, , France

Site Status

Hopital Rene Dubos

Pontoise, , France

Site Status

CHU - Robert Debre

Reims, , France

Site Status

Hopital Charles Nicolle

Rouen, , France

Site Status

Centre Hospitalier

Saint-Omer, , France

Site Status

Centre Hospitalier de Tarbes

Tarbes, , France

Site Status

Centre Hospitalier Regional Metz Thionville

Thionville, , France

Site Status

CHRU de Tours - Hopital Trousseau

Tours, , France

Site Status

Nouvelle Clinique Generale

Valence, , France

Site Status

Centre Hospitalier Bretagne Atlantique

Vannes, , France

Site Status

Countries

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

France

References

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

Hammel P, Huguet F, van Laethem JL, Goldstein D, Glimelius B, Artru P, Borbath I, Bouche O, Shannon J, Andre T, Mineur L, Chibaudel B, Bonnetain F, Louvet C; LAP07 Trial Group. Effect of Chemoradiotherapy vs Chemotherapy on Survival in Patients With Locally Advanced Pancreatic Cancer Controlled After 4 Months of Gemcitabine With or Without Erlotinib: The LAP07 Randomized Clinical Trial. JAMA. 2016 May 3;315(17):1844-53. doi: 10.1001/jama.2016.4324.

Reference Type DERIVED
PMID: 27139057 (View on PubMed)

Other Identifiers

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

GERCOR-LAP-07-D07-1

Identifier Type: -

Identifier Source: secondary_id

EU=20827

Identifier Type: -

Identifier Source: secondary_id

ROCHE-GERCOR-LAP-07-D07-1

Identifier Type: -

Identifier Source: secondary_id

EudraCT- 2007-001174-81

Identifier Type: -

Identifier Source: secondary_id

CDR0000589283

Identifier Type: -

Identifier Source: org_study_id