Fluorouracil and Oxaliplatin as First-line for Advanced Pancreatic Cancer

NCT ID: NCT02896803

Last Updated: 2020-11-10

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

PHASE2

Total Enrollment

37 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-08-31

Study Completion Date

2021-12-31

Brief Summary

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Patients with locally advanced or metastatic pancreatic adenocarcinoma not eligible for infusional fluorouracil, irinotecan and oxaliplatin (FOLFIRINOX) (PPS 2 or hyperbilirubinemia, among other causes) will be treated with mFLOX regimen (fluorouracil bolus and oxaliplatin). The primary endpoint is to assess the objective response rate according to RECIST criteria (version 1.1) and the secondary endpoints are time until clinical or radiological progression, overall survival, toxicity profile.

Detailed Description

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Currently, FOLFIRINOX is considered the standard treatment for PS 0 or 1 patients with advanced pancreatic carcinoma. However, due to excessive toxicity dose reductions and interruptions in the treatment toxicity are frequent. So, for those not eligible patients (PS 2 or 3, hyperbilirubinemia, among other causes), alternative schemes as gemcitabine alone are the standard approach .

This study aims to evaluate the efficacy and safety of the mFLOX regimen (fluorouracil bolus and oxaliplatin) as first-line regimen for advanced pancreatic adenocarcinoma not eligible for FOLFIRINOX.

The primary endpoint is to assess the objective response rate according to RECIST criteria (version 1.1) and the secondary endpoints are time until clinical or radiological progression, overall survival, toxicity profile.

It has been estimated an n=34 for a response rate of 20%, compared to the historical control of 7% with gemcitabine alone (Von Hoff et al.), with an alpha error of 5% and power of 80%. Considering a rate of 10% of dropout, our sample will be 37 patients.

Conditions

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Pancreatic Neoplasms

Keywords

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Pancreatic Cancer Chemotherapy

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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Experimental

mFLOX

Group Type EXPERIMENTAL

mFLOX

Intervention Type DRUG

5-fluorouracil 500 mg/m2 and folinic acid 20 mg/m2 infused both bolus weekly for 6 weeks (d1, 8,15, 22, 29 and 36) and oxaliplatin 85 mg / m2 infused over 2 hours at weeks 1,3 and 5 (d1,15 and 29). The scheme will be repeated every 8 weeks.

Interventions

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mFLOX

5-fluorouracil 500 mg/m2 and folinic acid 20 mg/m2 infused both bolus weekly for 6 weeks (d1, 8,15, 22, 29 and 36) and oxaliplatin 85 mg / m2 infused over 2 hours at weeks 1,3 and 5 (d1,15 and 29). The scheme will be repeated every 8 weeks.

Intervention Type DRUG

Other Intervention Names

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5-fluorouracil and oxaliplatin

Eligibility Criteria

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Inclusion Criteria

* Patients with pancreatic adenocarcinoma, confirmed by biopsy and histological material available for review
* Unresectable primary tumor considered by the team assistant or metastatic disease
* Aged between 18 and 75 at the time of study entry
* Naïve patients of palliative chemotherapy, admitted for treatment at the Institute of the São Paulo State Cancer (ICESP)
* Patients with performance status 0 or 1, not candidates to receive chemotherapy with FOLFIRINOX or performance status 2.
* No significant organ dysfunction defined as: Hb\> 9 g / dL, platelets\> 100,000 / microliter (mcL), neutrophils\> 1500 / mcL, clearance of creatinine (ClCr) \> 50 ml / min, total bilirubin \<5 mg/dl, serum alanine transaminase (ALT) and aspartate transaminase (AST) \<2.5 x upper limit of normal (ULN) (or \<5 x ULN if liver metastases present)
* Able to read and sign an informed consent form.

Exclusion Criteria

* Use of prior chemotherapy with other agents, except adjuvant chemotherapy with gemcitabine monotherapy since completed more than 6 months
* Absence of histological material available to local review (eg diagnostic fine needle aspiration (FNA) or cytology)
* Previous use of radiotherapy in the primary tumor or a metastasis site that will serve as target lesion to assess response to treatment
* Diagnosis of malignancy other activity except non-melanoma skin cancer
* Clinical evidence of metastasis in the central nervous system active meningeal carcinomatosis or severe chronic disease patients (cirrhosis, heart failure New York Heart Association Functional Classification (NYHA) III or IV, chronic obstructive pulmonary disease (COPD) oxygen-dependent or chronic kidney disease requiring dialysis)
* Pregnant or breastfeeding
* Patients with HIV / AIDS story on anti-retroviral therapy
* Patients with peripheral neuropathy grade\> 2 (CTCAE v4.03)
* Medium or large surgery in the last 4 weeks. For example, biliary derivation.
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Instituto do Cancer do Estado de São Paulo

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Tiago Castria, MD PhD

Role: PRINCIPAL_INVESTIGATOR

Instituto do Cancer do Estado de São Paulo

Locations

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Instituto do Câncer do Estado de São Paulo

São Paulo, , Brazil

Site Status RECRUITING

Countries

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Brazil

Central Contacts

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Tiago Castria, MD PhD

Role: CONTACT

Phone: +55113893-2000

Email: [email protected]

Facility Contacts

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Tiago Castria, MD PhD

Role: primary

Other Identifiers

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869/15

Identifier Type: -

Identifier Source: org_study_id