Low-dose Radiotherapy Plus Chemotherapy With Gem-based Doublets and Stereotactic Radiotherapy for Advanced Pancreatic Cancer

NCT ID: NCT02416609

Last Updated: 2022-12-12

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

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

44 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-01-31

Study Completion Date

2024-11-30

Brief Summary

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Aim of this study is to evaluate if low-dose radiotherapy (LDR) can intensify local effect of a chemotherapy regimen with Gem-based doublets administered sequentially with stereotactic body radiotherapy (SBRT) and to assess the safety and efficacy of this combined treatment on patients affected by locally advanced pancreatic adenocarcinoma (LAPC).

Detailed Description

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Conditions

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Pancreatic Cancer

Keywords

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Locally advanced pancreatic cancer Stereotactic Body Radiotherapy Chemopotentiator Low dose radiotherapy Hyper-Radiosensitivity

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Gem-based doublets with LDR & sequential SBRT

Four Gem-based doublets cycles will be administered concurrent with LDR. If no progression, three fractions of SBRT will be administered.

Group Type EXPERIMENTAL

LDR

Intervention Type RADIATION

LDR will be delivered during each cycle of Gem-based doublets

Gem-based doublets

Intervention Type DRUG

4 cycles of Gem-based doublets

SBRT

Intervention Type RADIATION

SBRT will be administered after the fourth Gem-based doblet cycle, if no progression; three fractions will be administered

Interventions

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LDR

LDR will be delivered during each cycle of Gem-based doublets

Intervention Type RADIATION

Gem-based doublets

4 cycles of Gem-based doublets

Intervention Type DRUG

SBRT

SBRT will be administered after the fourth Gem-based doblet cycle, if no progression; three fractions will be administered

Intervention Type RADIATION

Other Intervention Names

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Low dose radiotherapy Steretactic body radiotherapy

Eligibility Criteria

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Inclusion Criteria

* Pathologically confirmed adenocarcinoma of the pancreas
* Patients with unresectable disease based on institutional standardized criteria of unresectability or patients whose disease appeared potentially resectable on axial CT imaging but were found unresectable at surgery
* Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2. Age ≥ 18
* Patients with biliary or gastroduodenal obstruction must have drainage or surgical bypass prior to starting treatment
* Patients with radiographically assessable disease
* Adequate bone marrow, hepatic and renal function: -Hemoglobin \>10.0 g/dL, absolute neutrophil count \> 1.5 x 10\^9/L, platelet count \> 100 x 10\^9/L. -Aspartate transaminase (AST or SGOT) and alanine transaminase (ALT or SGPT) should be ≤ 3 x upper limit of normal (ULN). -Total bilirubin \< 2 mg/dL. Patients with elevated bilirubin due to obstruction should be stented and their bilirubin should decrease to \< 2 mg/dL prior to study entry. - Creatinine \< 3 mg/dL or Creatinine clearance \> 40 mL/min (calculated according to Cockroft and Gault)

Exclusion Criteria

* Evidence of metastatic disease in the major viscera or peritoneal seeding or ascites
* Gastric or duodenal obstruction
* Previous peripheral neuropathy
* Previous irradiation to the planned field; previous chemotherapy for pancreatic cancer
* Malignancy (within the past two years) except non-melanomatous skin cancer or carcinoma in situ of the cervix, uterus, or bladder
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Azienda Ospedaliero-Universitaria di Modena

OTHER

Sponsor Role lead

Responsible Party

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Bruno Meduri

Medical Doctor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Bruno Meduri, MD

Role: PRINCIPAL_INVESTIGATOR

Azienda Ospedaliero-Universitaria Policlinico di Modena

Locations

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Azienda Ospedaliero-Universitaria Policlinico di Modena

Modena, MO, Italy

Site Status RECRUITING

Countries

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Italy

Central Contacts

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Bruno Meduri, MD

Role: CONTACT

Phone: +393388878319

Email: [email protected]

Facility Contacts

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Bruno Meduri, MD

Role: primary

References

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Mantini G, Valentini V, Meduri B, Margaritora S, Balducci M, Micciche F, Nardone L, De Rose F, Cesario A, Larici AR, Maggi F, Calcagni ML, Granone P. Low-dose radiotherapy as a chemo-potentiator of a chemotherapy regimen with pemetrexed for recurrent non-small-cell lung cancer: a prospective phase II study. Radiother Oncol. 2012 Nov;105(2):161-6. doi: 10.1016/j.radonc.2012.09.006. Epub 2012 Oct 12.

Reference Type BACKGROUND
PMID: 23068709 (View on PubMed)

Regine WF, Hanna N, Garofalo MC, Doyle A, Arnold S, Kataria R, Sims J, Tan M, Mohiuddin M. Low-dose radiotherapy as a chemopotentiator of gemcitabine in tumors of the pancreas or small bowel: a phase I study exploring a new treatment paradigm. Int J Radiat Oncol Biol Phys. 2007 May 1;68(1):172-7. doi: 10.1016/j.ijrobp.2006.11.045. Epub 2007 Feb 2.

Reference Type BACKGROUND
PMID: 17276612 (View on PubMed)

Mahadevan A, Jain S, Goldstein M, Miksad R, Pleskow D, Sawhney M, Brennan D, Callery M, Vollmer C. Stereotactic body radiotherapy and gemcitabine for locally advanced pancreatic cancer. Int J Radiat Oncol Biol Phys. 2010 Nov 1;78(3):735-42. doi: 10.1016/j.ijrobp.2009.08.046. Epub 2010 Feb 18.

Reference Type BACKGROUND
PMID: 20171803 (View on PubMed)

Valentini V, Massaccesi M, Balducci M, Mantini G, Micciche F, Mattiucci GC, Dinapoli N, Meduri B, D'Agostino GR, Salvi G, Nardone L. Low-dose hyperradiosensitivity: is there a place for future investigation in clinical settings? Int J Radiat Oncol Biol Phys. 2010 Feb 1;76(2):535-9. doi: 10.1016/j.ijrobp.2009.02.075. Epub 2009 Jun 18.

Reference Type BACKGROUND
PMID: 19540061 (View on PubMed)

Other Identifiers

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BMed1

Identifier Type: -

Identifier Source: org_study_id