Scheduling Nab-paclitaxel With Gemcitabine

NCT ID: NCT03529175

Last Updated: 2019-07-16

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE2
• Total Enrollment: 146 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2014-01-31
• Study Completion Date: 2016-06-30

Brief Summary

Metastatic pancreatic cancer is difficult to treat. Until recently, most patients would be offered treatment with a chemotherapy drug called gemcitabine. However, a large international trial showed that combining gemcitabine with a drug called nab-paclitaxel (or abraxane) was more effective compared with gemcitabine alone. The purpose of this study is to compare two different ways of combining gemcitabine with abraxane. Conventionally, both drugs are given on the same day via a drip into a vein in the arm but research suggests that giving abraxane 24 hours in advance of gemcitabine could possibly be more beneficial.

In this study, blood and tumour samples will be collected and analysed to try to confirm what has been seen in the laboratory studies. In addition, the investigators wish to find out whether certain tumour characteristics (called biomarkers) can be used to predict for response to chemotherapy.

Conditions

Pancreatic Adenocarcinoma Metastatic

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Concomitant

Intravenous Abraxane125 mg/m2 30-minute infusion followed immediately by intravenous Gemcitabine 1000 mg/m2 30-minute infusion will be administered on days 1, 8 and 15 of a 4-week cycle.

Group Type: ACTIVE_COMPARATOR

Abraxane (nab-paclitaxel)

Intervention Type: DRUG

Gemcitabine

Intervention Type: DRUG

Sequential

Intravenous Abraxane 125 mg/m2 30-minute infusion will be administered on days 1, 8 and 15 of a 4-week cycle. Intravenous Gemcitabine 1000 mg/m2 30-minute infusion will be administered on days 2, 9 and 16 of a 4-week cycle. Gemcitabine must be delivered 24 +/- 2 hours after commencing Abraxane infusion.

Group Type: ACTIVE_COMPARATOR

Abraxane (nab-paclitaxel)

Intervention Type: DRUG

Gemcitabine

Intervention Type: DRUG

Interventions

Abraxane (nab-paclitaxel)

Intervention Type: DRUG

Gemcitabine

Intervention Type: DRUG

Eligibility Criteria

Inclusion Criteria

• Aged ≥ 18 years old
• Signed informed consent and ability to comply with the protocol
• Histologically or cytologically confirmed metastatic PDAC
• Radiologically confirmed stage IV disease and measurable disease by Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1; baseline tumour assessments and measurements must be done within 28 days prior to randomisation
• Karnofsky performance status ≥70%
• Life expectancy >12 weeks from the date of screening assessment
• Adequate bone marrow function

• Absolute neutrophil count (ANC) ≥1.5 x 109 /L
• Haemoglobin (Hb) ≥ 100 g/L
• Platelets ≥100 x 109 /L
• White blood cell count (WBC) ≥ 3 x 109 /L
• Adequate liver function

• Aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT) ≤2.5 x upper limit of normal range (ULN)
• Total bilirubin <1.5 x ULN
• Adequate renal function defined as a serum creatinine ≤1.5 x ULN or calculated creatinine clearance by Cockcroft-Gault of ≥50 mL/min
• Received no prior systemic therapy for metastatic disease
• Prior adjuvant chemotherapy (with GEM or any other drug/s) is allowed if completed at least 6 months previously
• Prior radiotherapy is allowed as long as there is measurable disease which has not been irradiated
• Willingness and ability to comply with scheduled visits, treatment plans, laboratory tests, completion of QoL and HE questionnaires and other study procedures
• Confirmation of tumour tissue sample collected within 12 weeks prior to randomisation and blood to be taken prior to randomisation
• Women of child-bearing potential (WCBP), defined as a sexually mature woman not surgically sterilized or not post-menopausal for at least 24 consecutive months if age ≤55 years or 12 months if age >55 years, must have a negative serum or urine pregnancy test within 14 days prior to randomisation
• All WCBP and all sexually active male patients must agree to use effective contraception methods throughout the study and for 30 days after the final dose of study drug for WCBP and for up to 6 months after treatment for male patients

Exclusion Criteria

• Patients with operable or locally advanced PDAC
• Other invasive malignancies diagnosed within the last 5 years, except non-melanoma skin cancer and localized cured prostate cancer
• Significant acute or chronic medical or psychiatric condition, disease or laboratory abnormality which in the judgment of the investigator would place the patient at undue risk or interfere with the trial. Examples include, but are not limited to:

• Patients who have had a venous thromboembolic event who are not appropriately anticoagulated or have had a significant bleeding episode in the 3 weeks prior to randomisation
• Patients with symptoms of severe chronic obstructive airways disease or significant shortness of breath at rest AND have an FEV1<1.0 L within the last 6 months
• Patients with a history of interstitial lung disease, sarcoidosis, silicosis, idiopathic pulmonary fibrosis, pulmonary hypersensitivity pneumonitis, cystic fibrosis or bronchiectasis
• Patients with uncontrolled ischaemic heart or other cardiovascular event (myocardial infarction (MI), new angina, stroke transient ischaemic attack (TIA), or new congestive cardiac failure (CCF)) within the last 6 months
• Patients with stable but significant cardiovascular disease defined by heart failure (New York Heart Association Functional Classification (NYHF) III or IV, see Appendix 3) or frequent angina
• Presence of active infection
• Cirrhotic liver disease, known chronic active or acute hepatitis B, or hepatitis C
• Known allergy or hypersensitivity to GEM or ABX
• Women who are pregnant, plan to become pregnant or are lactating
• Routine use of any of the following will exclude patients:

• Oral anti-oxidant supplements: beta-carotene, selenium, lutein, zeaxanthin, lycopene, pycnogenol, fernblock, omega-3S, vitamin C, vitamin E, astaxanthin

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Celgene

INDUSTRY

Sponsor Role: collaborator

CCTU- Cancer Theme

OTHER

Sponsor Role: lead

Responsible Party

CCTU- Cancer Theme

CCTU-Cancer Theme

Responsibility Role: SPONSOR_INVESTIGATOR

Principal Investigators

Pippa Corrie

Role: PRINCIPAL_INVESTIGATOR

Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital

Locations

Cambridge University Hospitals NHS Foundation Trust

Cambridge, Cambridgeshire, United Kingdom

Peterborough City Hospital

Peterborough, Cambridgeshire, United Kingdom

Ysbyty Gwynedd

Bangor, , United Kingdom

Belfast City Hospital

Belfast, , United Kingdom

Queen Elizabeth Hospital

Birmingham, , United Kingdom

Bristol Haematology & Oncology Centre

Bristol, , United Kingdom

Velindre Cancer Centre

Cardiff, , United Kingdom

Colchester Hospital

Colchester, , United Kingdom

University Hospitals Coventry & Warwickshire

Coventry, , United Kingdom

Edinburgh Cancer Research Centre

Edinburgh, , United Kingdom

The Beatson Oncology Centre

Glasgow, , United Kingdom

The Royal Surrey County Hospital

Guildford, , United Kingdom

St James' Institute of Oncology

Leeds, , United Kingdom

Leicester Royal Infirmary

Leicester, , United Kingdom

Clatterbridge Cancer Centre

Liverpool, , United Kingdom

Barts Health NHS Trust

London, , United Kingdom

Hammersmith Hospital

London, , United Kingdom

The Royal Free Hospital

London, , United Kingdom

University College London Hospital

London, , United Kingdom

The Christie Hospital

Manchester, , United Kingdom

Churchill Hospital

Oxford, , United Kingdom

Weston Park Hospital

Sheffield, , United Kingdom

Royal Cornwall Hospital

Truro, , United Kingdom

Countries

United Kingdom

References

Dayimu A, Di Lisio L, Anand S, Roca-Carreras I, Qian W, Al-Mohammad A, Basu B, Valle JW, Jodrell D, Demiris N, Corrie P. Clinical and biological markers predictive of treatment response associated with metastatic pancreatic adenocarcinoma. Br J Cancer. 2023 May;128(9):1672-1680. doi: 10.1038/s41416-023-02170-9. Epub 2023 Feb 22.

Reference Type: DERIVED

PMID: 36813867 (View on PubMed)

Corrie PG, Qian W, Basu B, Valle JW, Falk S, Lwuji C, Wasan H, Palmer D, Scott-Brown M, Wadsley J, Arif S, Bridgewater J, Propper D, Gillmore R, Gopinathan A, Skells R, Bundi P, Brais R, Dalchau K, Bax L, Chhabra A, Machin A, Dayim A, McAdam K, Cummins S, Wall L, Ellis R, Anthoney A, Evans J, Ma YT, Isherwood C, Neesse A, Tuveson D, Jodrell DI. Scheduling nab-paclitaxel combined with gemcitabine as first-line treatment for metastatic pancreatic adenocarcinoma. Br J Cancer. 2020 Jun;122(12):1760-1768. doi: 10.1038/s41416-020-0846-2. Epub 2020 Apr 30.

Reference Type: DERIVED

PMID: 32350413 (View on PubMed)

Related Links

http://www.cambridge-pcc.org/trials.html

University of Cambridge Pancreatic Cancer Centre

Other Identifiers

SIEGE (AX-PANC-PI-0101)

Identifier Type: -

Identifier Source: org_study_id