Adjuvant Chemotherapy With Gemcitabine and Cisplatin Compared to Standard of Care After Curative Intent Resection of Biliary Tract Cancer

NCT ID: NCT02170090

Last Updated: 2025-03-30

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

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE3

Total Enrollment

789 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-04-30

Study Completion Date

2025-12-31

Brief Summary

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

This is a multicenter, prospective, randomized, controlled phase III trial designed to assess the clinical performance of gemcitabine with cisplatin and observation vs. standard of care (observation alone in stage 1 and capecitabine and observation in stage 2) in patients after curative intent resection of BTC.

Detailed Description

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

The ACTICCA-1 investigator initiated trial is funded by the Deutsche Krebshilfe (grant number 70110215, 70112047). With respect to data obtained in the ABC-02 trial, the combination of cisplatin and gemcitabine for 24 weeks as investigational treatment was selected. Based on adjuvant trials in pancreatic cancer (e.g. ESPAC IV) with a comparable postoperative recovery time, inclusion of patients within a maximum interval of 16 weeks between surgery and start of CTx was chosen. Gemcitabine and cisplatin has a relevantly higher cumulative dose of gemcitabine 18 vs. 12 applications and may thus be of increased efficacy compared to the gemcitabine/oxaliplatin regimen applied in the PRODIGE 12 trial.

Based on the data of the BILCAP trial showing an improvement in median overall survival for capecitabine compared to observation alone presented at the annual meeting of the American Society of Clinical Oncology on June 4th 2017 in Chicago by the British BILCAP trial group, capecitabine has evolved as the new standard of care after curative intent resection of biliary tract cancer.

Based on these data the comparative efficacy of gemcitabine/cisplatin and capecitabine had to be established.

Therefore, the ACTICCA trial was amended to compare gemcitabine and cisplatin to the newly established standard regimen in the adjuvant setting capecitabine, aiming for superiority of the combination regimen vs. the oral monotherapy This was based on the BILCAP protocol, applying the similar dosing, assessments and dose modifications as in BILCAP, including dose calculation and patient diary.

As data of recent trials like the French PRODIGE 12/ACCORD 18 trial have clearly shown that in terms of efficacy of an adjuvant chemotherapy there is no difference between cholangiocarcinoma and gall bladder carcinoma, these two subtypes are pooled and location was added as an stratification factor.

Randomization will be 1:1 with adjuvant CTx for 24 weeks and imaging every 12 weeks in the experimental arm and standard of care (capecitabine) and observation in the control arm.

The primary endpoint is DFS and secondary endpoints include recurrence free survival, OS, safety and tolerability of adjuvant CTx, quality of life, and patterns of disease recurrence.

Conditions

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

Cholangiocarcinoma Gall Bladder Carcinoma

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.

Gemcitabine plus Cisplatin

Chemotherapy will be administered on days 1 and 8 every 3 weeks, Cisplatin (25 mg per square meter of body-surface area) and Gemcitabine (1000 mg per square meter) for 24 weeks (8 cycles)

and Observation

Group Type EXPERIMENTAL

Gemcitabine

Intervention Type DRUG

Gemcitabine 1000mg/m2

Cisplatin

Intervention Type DRUG

Cisplatin 25mg/m2

Capecitabine

Capecitabine will be administered from day 1 to 14 every 3 weeks (1250 mg per square meter of body-surface area, twice daily) for 24 weeks (8 cycles)

and Observation

Group Type ACTIVE_COMPARATOR

Capecitabine

Intervention Type DRUG

Capecitabine 1250mg/m2

Interventions

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

Gemcitabine

Gemcitabine 1000mg/m2

Intervention Type DRUG

Cisplatin

Cisplatin 25mg/m2

Intervention Type DRUG

Capecitabine

Capecitabine 1250mg/m2

Intervention Type DRUG

Eligibility Criteria

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

Exclusion Criteria

* Macroscopically complete resection (R0/1) within 6 (-16) weeks before scheduled start of chemotherapy
* ECOG 0-1
* Age ≥18 years
* Adequate hematologic function
* Adequate liver function
* Adequate renal function
* No active uncontrolled infection, except chronic viral hepatitis under antiviral therapy
* No concurrent treatment with other experimental drugs or other anti-cancer therapy, treatment in a clinical trial within 30 days prior to randomization
* Negative serum pregnancy test within 7 days of starting study treatment in pre-menopausal women and women \<1 year after the onset of menopause (Note: a negative test has to be reconfirmed by a urine test, should the 7-day window be exceeded)

Criteria for initial study enrolment

* Written informed consent
* No prior chemotherapy for cholangiocarcinoma
* No previous malignancy within 3 years or concomitant malignancy, except: non-melanomatous skin cancer or adequately treated in situ cervical cancer
* No severe or uncontrolled cardiovascular disease (congestive heart failure NYHA III or IV, unstable angina pectoris, history of myocardial infarction in the last 3 months, significant arrhythmia)
* Absence of psychiatric disorder precluding understanding of information of trial related topics and giving informed consent
* No serious underlying medical conditions (judged by the investigator), that could impair the ability of the patient to participate in the trial
* Fertile women (\< 1 year after last menstruation) and procreative men willing and able to use effective means of contraception (oral contraceptives, intrauterine contraceptive device, barrier method of contraception in conjunction with spermicidal jelly or surgically sterile)
* No pregnancy or lactation
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.

Deutsche Krebshilfe e.V., Bonn (Germany)

OTHER

Sponsor Role collaborator

Cancer Research UK

OTHER

Sponsor Role collaborator

Australasian Gastro-Intestinal Trials Group

NETWORK

Sponsor Role collaborator

Dutch Cancer Society

OTHER

Sponsor Role collaborator

Universitätsklinikum Hamburg-Eppendorf

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.

Henning Wege

Role: PRINCIPAL_INVESTIGATOR

Universitätsklinikum Hamburg-Eppendorf

Locations

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

Bankstown Hospital

Bankstown, New South Wales, Australia

Site Status

Nepean Hospital Cancer Care

Kingswood, New South Wales, Australia

Site Status

St. George Hospital

Kogarah, New South Wales, Australia

Site Status

Prince of Wales Hospital

Randwick, New South Wales, Australia

Site Status

Calvary Mater Newcastle

Waratah, New South Wales, Australia

Site Status

Townsville Hospital

Douglas, Queensland, Australia

Site Status

Royal Brisbane and Women's Hospital

Herston, Queensland, Australia

Site Status

Princess Alexandra Hospital

Woolloongabba, Queensland, Australia

Site Status

Flinders Medical Centre

Bedford Park, South Australia, Australia

Site Status

Fiona Stanley Hospital Perth

Murdoch, Western Australia, Australia

Site Status

Sir Charles Gairdner Hospital

Nedlands, Western Australia, Australia

Site Status

St. John of God

Subiaco, Western Australia, Australia

Site Status

Kaiser-Franz-Josef Hospital

Vienna, , Austria

Site Status

Vejle Hospital

Vejle, , Denmark

Site Status

University Medical Center Hamburg-Eppendorf

Hamburg, City state of Hamburg, Germany

Site Status

University Medical Center Aachen

Aachen, , Germany

Site Status

Charite Berlin

Berlin, , Germany

Site Status

University Medical Center Carl Gustav Carus

Dresden, , Germany

Site Status

University Medical Center Essen

Essen, , Germany

Site Status

Klinikum Esslingen

Esslingen am Neckar, , Germany

Site Status

University of Frankfurt

Frankfurt, , Germany

Site Status

University Medical Center Freiburg

Freiburg im Breisgau, , Germany

Site Status

University of Hannover

Hanover, , Germany

Site Status

University of Heidelberg

Heidelberg, , Germany

Site Status

University of Saarland

Homburg, , Germany

Site Status

University Medical Center Jena

Jena, , Germany

Site Status

Johannes Gutenberg University of Mainz

Mainz, , Germany

Site Status

University of Mannheim

Mannheim, , Germany

Site Status

University of Munich Grosshadern

Munich, , Germany

Site Status

University of Regensburg

Regensburg, , Germany

Site Status

University Medical Center Tuebingen

Tübingen, , Germany

Site Status

University of Ulm

Ulm, , Germany

Site Status

University Medical Center

Würzburg, , Germany

Site Status

Istituto Oncologico Veneto IRCCS

Padua, Padova, Italy

Site Status

Azienda Ospedaliero Medica 2 Universitaria

Pisa, Pisa, Italy

Site Status

Fondazione Policlinico Gemelli, Roma

Rome, Rome, Italy

Site Status

Istituto Nazionale dei Tumori

Milan, , Italy

Site Status

Ospedale San Raffaele

Milan, , Italy

Site Status

Academic Medical Center

Amsterdam, , Netherlands

Site Status

University Medical Center

Maastricht, , Netherlands

Site Status

Erasmus Medisch Centrum

Rotterdam, , Netherlands

Site Status

Universitair Medisch Centrum Utrecht

Utrecht, , Netherlands

Site Status

Auckland Hospital

Auckland, , New Zealand

Site Status

Hampshire Hospitals NHS Foundation Trust

Basingstoke, , United Kingdom

Site Status

Queen Elizabeth Hospital Birmingham

Birmingham, , United Kingdom

Site Status

Royal Bournemouth Hospital

Bournemouth, , United Kingdom

Site Status

Bristol Haematology and Oncology Centre

Bristol, , United Kingdom

Site Status

Addenbrooke's Hospital Cambridge

Cambridge, , United Kingdom

Site Status

Velindre Hospital Cardiff

Cardiff, , United Kingdom

Site Status

Western General Hospital Edinburgh

Edinburgh, , United Kingdom

Site Status

Beatson West of Scotland Cancer Centre Glasgow

Glasgow, , United Kingdom

Site Status

James Paget University Hospitals

Great Yarmouth, , United Kingdom

Site Status

Royal Surrey County Hospital Guildford

Guildford, , United Kingdom

Site Status

Princess Alexandra Hospital

Harlow, , United Kingdom

Site Status

Huddersfield Royal Infirmary

Huddersfield, , United Kingdom

Site Status

Guy's and St Thomas's Hospital London

London, , United Kingdom

Site Status

Hammersmith Hospital London

London, , United Kingdom

Site Status

Royal Free Hospital London

London, , United Kingdom

Site Status

University College London Hospital

London, , United Kingdom

Site Status

Maidstone Hospital

Maidstone, , United Kingdom

Site Status

Christie Hospital Manchester

Manchester, , United Kingdom

Site Status

Clatterbridge Cancer Centre

Metropolitan Borough of Wirral, , United Kingdom

Site Status

Nottingham University Hospitals NHS Trust

Nottingham, , United Kingdom

Site Status

Churchill Hospital Oxford

Oxford, , United Kingdom

Site Status

Derriford Hospital Plymouth

Plymouth, , United Kingdom

Site Status

Weston Park Hospital Sheffield

Sheffield, , United Kingdom

Site Status

Southampton General Hospital

Southampton, , United Kingdom

Site Status

Countries

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

Australia Austria Denmark Germany Italy Netherlands New Zealand United Kingdom

References

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

Stein A, Arnold D, Bridgewater J, Goldstein D, Jensen LH, Klumpen HJ, Lohse AW, Nashan B, Primrose J, Schrum S, Shannon J, Vettorazzi E, Wege H. Adjuvant chemotherapy with gemcitabine and cisplatin compared to observation after curative intent resection of cholangiocarcinoma and muscle invasive gallbladder carcinoma (ACTICCA-1 trial) - a randomized, multidisciplinary, multinational phase III trial. BMC Cancer. 2015 Jul 31;15:564. doi: 10.1186/s12885-015-1498-0.

Reference Type DERIVED
PMID: 26228433 (View on PubMed)

Related Links

Access external resources that provide additional context or updates about the study.

http://ascopubs.org/doi/abs/10.1200/JCO.2017.35.4_suppl.225

Gemox versus surveillance following surgery of localized biliary tract cancer: Results of the PRODIGE 12-ACCORD 18 (UNICANCER GI) phase III trial. Edeline, Bonnetain et al.

http://ascopubs.org/doi/abs/10.1200/JCO.2017.35.15_suppl.4006

Adjuvant capecitabine for biliary tract cancer: The BILCAP randomized study. Primrose, Fox et al.

Other Identifiers

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

2024-517340-61-00

Identifier Type: CTIS

Identifier Source: secondary_id

ACTRN12615001283561

Identifier Type: REGISTRY

Identifier Source: secondary_id

ACTICCA-1

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.