Phase 3 Study of FOLFIRINOX (mFFX) +/- SBRT in Locally Advanced Pancreatic Cancer

NCT ID: NCT01926197

Last Updated: 2022-10-28

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

27 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-08-14

Study Completion Date

2022-09-30

Brief Summary

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The goal of this study is to determine the safety and efficacy of a chemotherapy regimen known as Modified FOLFIRINOX (mFFX) alone or with the addition of Stereotactic Body Radiotherapy (SBRT). We hope to learn if this new treatment combination helps to control the disease and improve survival for patients with locally advanced pancreatic cancer.

Detailed Description

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Primary Objective:

To determine progression free survival for mFFX +/- SBRT.

Secondary Objectives:

* To determine metastasis free survival following mFFX chemotherapy alone or with SBRT.
* To determine the overall survival in pancreatic cancer patients treated with chemotherapy +/- SBRT.
* To determine local progression-free survival in pancreatic cancer patients after chemotherapy +/- SBRT.
* To evaluate acute (within 3 months of treatment) grade 2 or greater gastritis, fistula, enteritis, or ulcer and any other grade 3-4 gastrointestinal toxicity within 3 months of treatment.
* To evaluate the utility of FDG-PET for treatment planning and estimation of progression free survival.
* To identify new biomarkers in pancreatic cancer.
* To evaluate the quality of life of patients before and after either chemotherapy or chemotherapy and SBRT.

Conditions

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Pancreatic Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Modified FOLFIRINOX

Modified FOLFIRINOX (mFFX), a chemotherapeutic treatment regimen of 5FU, leucovorin, irinotecan, and oxaliplatin.

Group Type ACTIVE_COMPARATOR

Oxaliplatin

Intervention Type DRUG

Oxaliplatin 85 mg/m² IV over 2 hours on Day 1 of a 14-day cycle.

Irinotecan

Intervention Type DRUG

Irinotecan 180 mg/m² IV over 90 minutes on Day 1 of a 14-day cycle.

Leucovorin

Intervention Type DRUG

Leucovorin 400 mg/m² IV over 2 hours on Day 1 of a 14-day cycle.

5FU

Intervention Type DRUG

5FU 2,400 mg/m² IV over 46 to 48 hours starting on Day 1 of a 14-day cycle.

Modified FOLFIRINOX plus Stereotactic Body Radiotherapy

Modified FOLFIRINOX (mFFX), a chemotherapeutic treatment regimen of 5FU, leucovorin, irinotecan, and oxaliplatin, in combination with stereotactic body radiotherapy (SBRT)

Group Type EXPERIMENTAL

Oxaliplatin

Intervention Type DRUG

Oxaliplatin 85 mg/m² IV over 2 hours on Day 1 of a 14-day cycle.

Irinotecan

Intervention Type DRUG

Irinotecan 180 mg/m² IV over 90 minutes on Day 1 of a 14-day cycle.

Leucovorin

Intervention Type DRUG

Leucovorin 400 mg/m² IV over 2 hours on Day 1 of a 14-day cycle.

5FU

Intervention Type DRUG

5FU 2,400 mg/m² IV over 46 to 48 hours starting on Day 1 of a 14-day cycle.

Stereotactic Body Radiotherapy (SBRT)

Intervention Type RADIATION

Radiotherapy treatment starting about 8 weeks after modified FOLFIRINOX induction chemotherapy, administered as 5 fractions of 8 Grey (Gy) each, on 5 separate days.

Interventions

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Oxaliplatin

Oxaliplatin 85 mg/m² IV over 2 hours on Day 1 of a 14-day cycle.

Intervention Type DRUG

Irinotecan

Irinotecan 180 mg/m² IV over 90 minutes on Day 1 of a 14-day cycle.

Intervention Type DRUG

Leucovorin

Leucovorin 400 mg/m² IV over 2 hours on Day 1 of a 14-day cycle.

Intervention Type DRUG

5FU

5FU 2,400 mg/m² IV over 46 to 48 hours starting on Day 1 of a 14-day cycle.

Intervention Type DRUG

Stereotactic Body Radiotherapy (SBRT)

Radiotherapy treatment starting about 8 weeks after modified FOLFIRINOX induction chemotherapy, administered as 5 fractions of 8 Grey (Gy) each, on 5 separate days.

Intervention Type RADIATION

Other Intervention Names

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Eloxatin Camptosar Camptothecin-11 (CPT-11) Campto Onivyde Folinic acid Wellcovorin Citrovorum Factor 5-fluorouracil Tolak Fluoroplex Efudex Carac Adrucil

Eligibility Criteria

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Inclusion Criteria

* Histologically-confirmed adenocarcinoma of the pancreas
* Determined unresectable by a pancreatic cancer surgeon or a multi-disciplinary or gastrointestinal oncology Tumor Board.
* Stable or better disease on re-staging scans
* Typically, tumors \< 8.0 cm in greatest axial dimension but final determination of eligibility based upon radiation normal tissue constraints
* Eastern Cooperative Oncology Group (ECOG) Performance Status 0, 1, or 2
* Leukocytes (white blood cells, WBC) ≥ 3,000/mL
* Absolute neutrophil count (ANC) ≥ 1,500/mL
* Platelets ≥ 50,000/mL
* Total bilirubin ≤ 1.5 X institutional upper limit of normal (ULN)
* Aspartate aminotransferase (AST) / alanine aminotransferase (ALT) ≤ 2.5 X institutional ULN
* Creatinine within normal institutional limits
* Ability to understand and the willingness to sign an informed consent form
* Life expectancy \> 6 months

Exclusion Criteria

* Metastatic disease
* Prior radiotherapy to the upper abdomen/liver.
* Prior chemotherapy for pancreatic cancer, other than up to 4 cycles of modified FOLFIRINOX.
* Age \< 18 years
* Uncontrolled intercurrent illness including, but not limited to:

* Ongoing or active infection (or infections requiring systemic antibiotic treatment)
* Symptomatic congestive heart failure
* Unstable angina pectoris
* Cardiac arrhythmia
* Psychiatric illness/social situations that would limit compliance with study requirements.
* Any concurrent malignancy other than non-melanoma skin cancer, non-invasive bladder cancer, or carcinoma in situ of the cervix. Patients with a previous malignancy without evidence of disease for \> 5 years will be allowed to enter the trial.
* Pregnant or lactating
* Women of child-bearing potential who are unwilling or unable to use an acceptable method of birth control (hormonal or barrier method of birth control; abstinence) for duration of the study
* Women who are not post-menopausal (as defined in Appendix III) and have a positive urine or serum pregnancy test or refuse to take a pregnancy test
* Male subjects who are unwilling or unable to use effective contraception for duration of the study
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Stanford University

OTHER

Sponsor Role lead

Responsible Party

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Lucas Kas Vitzthum

Clinical Assistant Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Daniel T Chang

Role: PRINCIPAL_INVESTIGATOR

Stanford University

Locations

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UCLA

Los Angeles, California, United States

Site Status

UCSF

San Francisco, California, United States

Site Status

Stanford University, School of Medicine

Stanford, California, United States

Site Status

Loyola University

Maywood, Illinois, United States

Site Status

Medical University of South Carolina

Charleston, South Carolina, United States

Site Status

University of Texas Southwestern Medical Center

Dallas, Texas, United States

Site Status

Swedish Cancer Institute

Seattle, Washington, United States

Site Status

BC Cancer Agency

Vancouver, British Columbia, Canada

Site Status

Princess Margaret Cancer Centre

Toronto, Ontario, Canada

Site Status

Countries

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United States Canada

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Document Type: Informed Consent Form

View Document

Other Identifiers

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PANC0015

Identifier Type: OTHER

Identifier Source: secondary_id

NCI-2013-01658

Identifier Type: OTHER

Identifier Source: secondary_id

IRB-27492

Identifier Type: -

Identifier Source: org_study_id

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