PAXG Out in the Country

NCT ID: NCT04480268

Last Updated: 2021-02-10

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

RECRUITING

Clinical Phase

PHASE4

Total Enrollment

175 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-07-08

Study Completion Date

2026-01-01

Brief Summary

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The objective of this study is to assess the reproducibility of PAXG regimen as first-line/primary chemotherapy in daily clinical practice in Pancreatic Ductal Adenocarcinoma (PDAC) borderline resectable, locally advanced or metastatic patients out of a large volume center.

Detailed Description

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Pancreatic Ductal Adenocarcinoma (PDAC) is one of the most lethal malignancies, with a 5-year overall survival (OS) rate for all stages combined lower than 10%, decreasing to 3% in advanced disease. Additionally, PDAC is expected to become the 2nd leading cause for cancer-related death by 2030. Chemotherapy still represents the only therapeutic option in most cases, since 70% of PDAC patients exhibit metastatic or locally advanced disease at diagnosis. Concerning metastatic PDAC patients, combination chemotherapy has resulted in improved survival compared with single-agent treatment. Based on promising phase I/II studies, the PAXG regimen (cisplatin, nab-paclitaxel, capecitabine and gemcitabine) has been recommended for first-line treatment of metastatic PDAC patients in the 2019 edition of Associazione Italiana Oncologia Medica (AIOM) guidelines. Also, this regimen was approved by the Agenzia Italiana del Farmaco (AIFA) as first therapy of borderline-resectable, locally advanced and metastatic PDAC patients with good performance status (ECOG 0-1) and age 18-75 years.

Description of the intervention (schedule of visits):

All PDAC patients who are treated with PAXG regimen as first-line/primary chemotherapy at the participating institutions from January 1st 2020 to December 31st 2020 according to inclusion and exclusion criteria will be included in the present study.

Power size calculation:

The sample size will be as large as possible with a competitive enrollment. All patients treated by the PAXG regimen during 2020 in the participating institutions will be included into the trial. The investigators hypothesize that at least 175 patients (60% metastatic and 40% non-metastatic) from about 30 Italian centers will be enrolled by the end of the year. Such a sample size, or a larger one, will allow to compute in both groups a 95% confident interval of the 1-year OS with at least 10% margin of error, assuming to observe a (target) 1-year OS of 60% for metastatic patients and of 80% for non-metastatic. The trial will be considered successful if the target 1-year OS will fall into the corresponding computed 95% CI.

Conditions

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Pancreatic Ductal Adenocarcinoma

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Interventions

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PAXG regimen (cisplatin, nab-paclitaxel, capecitabine, gemcitabine) chemotherapy

The PAXG regimen includes:

* nab-paclitaxel 150 mg/m2 on day 1 and 15 of each cycle;
* cisplatin 30 mg/m2 on day 1 and 15 of each cycle;
* capecitabine 1250 mg/m2 on 1 day to 28 of each cycle;
* gemcitabine 800 mg/m2 on day 1 and 15 of each cycle. Each cycle lasts 28 days. Patients are treated until maximal response, disease progression or unacceptable toxicity.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* cyto/histological diagnosis of pancreatic adenocarcinoma;
* locally advanced and metastatic disease corresponding to clinical stage III-IV according to TNM 8th Ed. 2017 and borderline resectable disease as anatomically defined according to NCCN Guidelines Version 1.2020 - Pancreatic Adenocarcinoma and biologically defined according to the International consensus on definition and criteria of borderline resectable pancreatic ductal adenocarcinoma 2017 (CA 19.9 \> 500 IU/ml);
* ECOG Performance Status ≤1;
* adequate bone marrow function (GB ≥ 3500/mm3, neutrophils ≥1500/mm3, platelets ≥ 100000/mm3, Hb ≥10 g/dl), kidney function (serum creatinine \< 1.5 mg/dL) and liver function (ALT and AST \< 3 ULN and Serum total bilirubin ≤ 1.5 ULN);
* Patient of child-bearing potential must agree to use two medically acceptable methods of contraception (one for the patient and one for the partner) during the study and for 4 months after the last study treatment intake for women and 6 months for men;
* patients must have received at least 1 cycle (28 days) of the PAXG treatment for the disease within the timeframe starting from January 1 2020 to December 31st 2020 ;
* patient information and signed written informed consent.

Exclusion Criteria

* previous chemotherapy treatment for recurrent disease;
* concurrent treatment with experimental drugs;
* presence of symptomatic brain metastases;
* heart failure, arrhythmia and/or acute myocardial infarction within 6 months prior to the beginning of PAXG treatment;
* women on pregnancy or lactation;
* history of interstitial lung disease;
* history of connective tissue diseases (systemic lupus erythematosus, systemic sclerosis, etc. ).
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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IRCCS San Raffaele

OTHER

Sponsor Role lead

Responsible Party

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Michele Reni

MD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Michele Reni, MD

Role: PRINCIPAL_INVESTIGATOR

IRCCS Ospedale San Raffaele

Locations

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IRCCS Centro di Riferimento Oncologico (CRO)

Aviano, , Italy

Site Status NOT_YET_RECRUITING

Istituto dei tumori Giovanni Paolo II

Bari, , Italy

Site Status NOT_YET_RECRUITING

AULSS 1 di Belluno

Belluno, , Italy

Site Status NOT_YET_RECRUITING

ASST Papa Giovanni XXIII

Bergamo, , Italy

Site Status NOT_YET_RECRUITING

Azienda Ospedaliera Policlinico Sant'Orsola-Malpighi

Bologna, , Italy

Site Status NOT_YET_RECRUITING

Azienda Ospedaliera AOU di Cagliari

Cagliari, , Italy

Site Status NOT_YET_RECRUITING

Ospedale di Carpi

Carpi, , Italy

Site Status NOT_YET_RECRUITING

USL Toscana Nord Ovest

Carrara, , Italy

Site Status NOT_YET_RECRUITING

Fondazione Istituto Giglio

Cefalù, , Italy

Site Status NOT_YET_RECRUITING

Ospedaliera Sant' Anna di Como Asst Lariana

Como, , Italy

Site Status NOT_YET_RECRUITING

Azienda Ospedaliera Universitaria Ospedali Riuniti di Foggia

Foggia, , Italy

Site Status NOT_YET_RECRUITING

ASST Rhodense

Garbagnate, , Italy

Site Status NOT_YET_RECRUITING

Ospedale Moriggia Pelascini

Gravedona, , Italy

Site Status NOT_YET_RECRUITING

Ospedale Generale Provinciale di Macerata

Macerata, , Italy

Site Status NOT_YET_RECRUITING

Irccs Irst

Meldola, , Italy

Site Status NOT_YET_RECRUITING

ASST Melegnano e Della Martesana

Melegnano, , Italy

Site Status NOT_YET_RECRUITING

IRCCS San Raffaele Medical Oncology Unit

Milan, , Italy

Site Status RECRUITING

Istituto Oncologico Veneto IRCCS

Padua, , Italy

Site Status NOT_YET_RECRUITING

Ospedale Civico di Palermo

Palermo, , Italy

Site Status NOT_YET_RECRUITING

Azienda Ospedaliera di Parma

Parma, , Italy

Site Status NOT_YET_RECRUITING

Azienda Ospedaliera di Piacenza

Piacenza, , Italy

Site Status NOT_YET_RECRUITING

Giovanni Paolo II-Maria Paternò

Ragusa, , Italy

Site Status NOT_YET_RECRUITING

Azienda Ospedaliera Universitaria San Giovanni di Dio e Ruggi D'Aragona

Salerno, , Italy

Site Status NOT_YET_RECRUITING

AULSS 4 Veneto Orientale

San Donà di Piave, , Italy

Site Status NOT_YET_RECRUITING

IRCCS Casa Sollievo della Sofferenza

San Giovanni Rotondo, , Italy

Site Status NOT_YET_RECRUITING

Azienda Ospedaliera Ordine Mauriziano

Torino, , Italy

Site Status NOT_YET_RECRUITING

Presidio Ospedaliero Molinette

Torino, , Italy

Site Status NOT_YET_RECRUITING

Azienda Sanitaria Universitaria Integrata

Udine, , Italy

Site Status NOT_YET_RECRUITING

ASST Sette Laghi

Varese, , Italy

Site Status NOT_YET_RECRUITING

Ospedale San Bortolo Azienda ULSS8 Berica-Distretto Est

Vicenza, , Italy

Site Status NOT_YET_RECRUITING

Countries

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Italy

Central Contacts

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Giulia Orsi, MD

Role: CONTACT

+390226436620

Maria Maddalena Valente, PhD

Role: CONTACT

+390226437623

Facility Contacts

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Angela Buonadonna, MD

Role: primary

Nicola Silvestris, MD

Role: primary

Fable Zustovich, MD

Role: primary

Barbara Merelli, MD

Role: primary

Maria Cristina Di Marco, MD, PhD

Role: primary

Mario Scartozzi, MD

Role: primary

Ilaria Bernardini, MD

Role: primary

Andrea Mambrini, MD

Role: primary

Massimiliano Spada, MD

Role: primary

Monica Giordano, MD

Role: primary

Matteo Landriscina, MD, PhD

Role: primary

Silvia Della Torre, MD

Role: primary

Giuseppe Valmadre, MD

Role: primary

Luca Faloppi, MD, PhD

Role: primary

Giovanni Luca Frassineti, MD

Role: primary

Andrea De Monte, MD

Role: primary

Giulia Orsi, MD

Role: primary

+39 02 26437602

Maria Maddalena Valente, PhD

Role: backup

+39 02 26437623

Sara Lonardi, MD

Role: primary

Livio Blasi, MD

Role: primary

Ingrid Garajova, MD, PhD

Role: primary

Luigi Cavanna, MD

Role: primary

Stefano Cordio, MD

Role: primary

Clementina Savastano, MD

Role: primary

Silvia Zanon, MD

Role: primary

Evaristo Maiello, MD

Role: primary

Massimo Di Maio, MD

Role: primary

Maria Antonietta Satolli, MD, PhD

Role: primary

Giovanni Gerardo Cardellino, MD

Role: primary

Stefania Gobba, MD

Role: primary

Giuseppe Aprile, MD

Role: primary

References

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Reni M, Cereda S, Rognone A, Belli C, Ghidini M, Longoni S, Fugazza C, Rezzonico S, Passoni P, Slim N, Balzano G, Nicoletti R, Cappio S, Doglioni C, Villa E. A randomized phase II trial of two different 4-drug combinations in advanced pancreatic adenocarcinoma: cisplatin, capecitabine, gemcitabine plus either epirubicin or docetaxel (PEXG or PDXG regimen). Cancer Chemother Pharmacol. 2012 Jan;69(1):115-23. doi: 10.1007/s00280-011-1680-2. Epub 2011 May 28.

Reference Type BACKGROUND
PMID: 21626049 (View on PubMed)

Reni M, Balzano G, Zanon S, Passoni P, Nicoletti R, Arcidiacono PG, Pepe G, Doglioni C, Fugazza C, Ceraulo D, Falconi M, Gianni L. Phase 1B trial of Nab-paclitaxel plus gemcitabine, capecitabine, and cisplatin (PAXG regimen) in patients with unresectable or borderline resectable pancreatic adenocarcinoma. Br J Cancer. 2016 Jul 26;115(3):290-6. doi: 10.1038/bjc.2016.209. Epub 2016 Jul 12.

Reference Type BACKGROUND
PMID: 27404453 (View on PubMed)

Reni M, Zanon S, Peretti U, Chiaravalli M, Barone D, Pircher C, Balzano G, Macchini M, Romi S, Gritti E, Mazza E, Nicoletti R, Doglioni C, Falconi M, Gianni L. Nab-paclitaxel plus gemcitabine with or without capecitabine and cisplatin in metastatic pancreatic adenocarcinoma (PACT-19): a randomised phase 2 trial. Lancet Gastroenterol Hepatol. 2018 Oct;3(10):691-697. doi: 10.1016/S2468-1253(18)30196-1. Epub 2018 Jul 7.

Reference Type BACKGROUND
PMID: 30220407 (View on PubMed)

Reni M, Zanon S, Balzano G, Passoni P, Pircher C, Chiaravalli M, Fugazza C, Ceraulo D, Nicoletti R, Arcidiacono PG, Macchini M, Peretti U, Castoldi R, Doglioni C, Falconi M, Partelli S, Gianni L. A randomised phase 2 trial of nab-paclitaxel plus gemcitabine with or without capecitabine and cisplatin in locally advanced or borderline resectable pancreatic adenocarcinoma. Eur J Cancer. 2018 Oct;102:95-102. doi: 10.1016/j.ejca.2018.07.007. Epub 2018 Aug 24.

Reference Type BACKGROUND
PMID: 30149366 (View on PubMed)

Other Identifiers

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PACT31

Identifier Type: -

Identifier Source: org_study_id

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