Stereotactic Body Radiation and Tumor Treating Fields for Locally Advanced Pancreas Cancer

NCT ID: NCT05679674

Last Updated: 2026-01-12

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

RECRUITING

Clinical Phase

NA

Total Enrollment

48 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-09-21

Study Completion Date

2027-06-30

Brief Summary

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The purpose of this clinical trial is to determine whether using chemotherapy followed by stereotactic ablative body radiation therapy (SABR) and tumor treating fields (TTF) will slow tumor growth in people with locally advanced pancreas cancer. All participants will receive SABR therapy once per day for five days and use the TTF system for at least 18 hours per day starting on the first day of SABR until the tumor progresses or severe toxicity develops.

Detailed Description

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Conditions

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Pancreas Cancer Locally Advanced Locally Advanced Pancreatic Adenocarcinoma

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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Stereotactic Ablative Body Radiation (SABR) and Tumor Treating Fields (TTF)

50 Gy in five fractions SABR (once per day for 5 days) and use of the TTF system for 18 hours per day starting on the first day of SABR and continuing until abdominal disease progression

Group Type EXPERIMENTAL

Stereotactic Ablative Body Radiation (SABR)

Intervention Type RADIATION

50 Gy in 5 fractions, once per day for 5 days

Tumor Treating Fields (TTF)

Intervention Type DEVICE

Participant will use the system for at least 18 hours per day starting on the first day of SABR until abdominal disease progression. Short treatment breaks are permitted for personal needs (such as to take a shower) and during radiation therapy. An additional treatment break is permitted for up to 48 hours every 21 days.

Interventions

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Stereotactic Ablative Body Radiation (SABR)

50 Gy in 5 fractions, once per day for 5 days

Intervention Type RADIATION

Tumor Treating Fields (TTF)

Participant will use the system for at least 18 hours per day starting on the first day of SABR until abdominal disease progression. Short treatment breaks are permitted for personal needs (such as to take a shower) and during radiation therapy. An additional treatment break is permitted for up to 48 hours every 21 days.

Intervention Type DEVICE

Other Intervention Names

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NovoTTF-100L

Eligibility Criteria

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Inclusion Criteria

* Histologically or cytologically confirmed locally advanced adenocarcinoma of the pancreas. Locally advanced pancreas cancer as per National Comprehensive Cancer Network (NCCN) Guidelines.
* Regional lymph node involvement is permitted if able to be treated with radiation therapy.
* Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
* At least 3 months of prior FOLFIRINOX, modified FOLFIRINOX, and/or gemcitabine/nab-paclitaxel delivered for pancreas cancer without evidence of distant progression on restaging radiographic studies.
* Carbohydrate antigen 19-9 (CA 19-9) ≤500 U/mL on most recent assessment prior to study enrollment.
* Adequate normal organ and marrow function as defined below:

i. Hemoglobin ≥8.0 g/dL that may be achieved with transfusion ii. Absolute neutrophil count (ANC) ≥1500 per mm\^3 iii. Platelet count ≥60,000 per mm\^3 iv. Serum bilirubin ≤1.5 x institutional upper limit of normal (ULN) v. AST (SGOT)/ALT (SGPT) ≤3 x institutional ULN
* People of childbearing potential must agree to use adequate contraception (hormonal or barrier method of birth control, abstinence) prior to study entry and for the duration of study participation. Should a participant become pregnant or suspect they are pregnant while participating in this study, they must inform the treating physician immediately.
* Able to operate the tumor treating field (NovoTTF-100L) system independently or with assistance.
* All participants must sign written informed consent.

Exclusion Criteria

* Distant metastasis from pancreas cancer.
* Contraindication to having a magnetic resonance imaging (MRI) scan.
* Prior abdominal radiation therapy.
* History of any primary malignancy with the exception of:

1. Malignancy treated with curative intent and with no known active disease for at least 3 years before enrollment on this study.
2. Adequately treated non-melanoma skin cancer or lentigo maligna without evidence of disease.
3. Adequately treated carcinoma in situ without evidence of disease (i.e., cervical carcinoma in situ; superficial bladder cancer).
* Any unresolved toxicity (Common Terminology Criteria for Adverse Events version 5.0 \> grade 2) from previous anti-cancer therapy. Participants with irreversible toxicity that is not reasonably expected to worsen by treatment on this study are permitted to enroll on this study.
* History of inflammatory bowel disease (i.e., Crohn's disease, ulcerative colitis).
* Any condition in the opinion of the investigator that would interfere with evaluation of study treatment or interpretation of patient safety or study results.
* Participants who are pregnant or breastfeeding. Patients with an electrical implantable device in the torso. Examples of electrical implanted medical devices include spinal cord stimulators, vagus nerve stimulators, pacemakers, and defibrillators.
* History of significant uncontrolled cardiovascular disease. Significant cardiac disease includes second/third degree heart block; significant ischemic heart disease; poorly controlled hypertension; congestive heart failure of the New York Heart Association (NYHA) Class II or worse.
* History of arrhythmia that is symptomatic or requires treatment. Patients with atrial fibrillation or flutter controlled by medication are not excluded from participation in the trial.
* Known allergy to medical adhesives or conductive hydrogel \[gel used on electrocardiogram (ECG) stickers or transcutaneous electrical nerve stimulation (TENS) electrodes\].
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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NovoCure Ltd.

INDUSTRY

Sponsor Role collaborator

Baptist Health South Florida

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Michael Chuong, M.D.

Role: PRINCIPAL_INVESTIGATOR

Miami Cancer Institute at Baptist Health, Inc.

Locations

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Miami Cancer Institute at Baptist Health, Inc.

Miami, Florida, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Michael Chuong, M.D.

Role: CONTACT

(786) 596-2000

Carla Salazar

Role: CONTACT

(786) 595-7073

Facility Contacts

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Michael Chuong, M.D.

Role: primary

786-596-2000

References

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Hassanzadeh C, Rudra S, Bommireddy A, Hawkins WG, Wang-Gillam A, Fields RC, Cai B, Park J, Green O, Roach M, Henke L, Kim H. Ablative Five-Fraction Stereotactic Body Radiation Therapy for Inoperable Pancreatic Cancer Using Online MR-Guided Adaptation. Adv Radiat Oncol. 2020 Jun 25;6(1):100506. doi: 10.1016/j.adro.2020.06.010. eCollection 2021 Jan-Feb.

Reference Type BACKGROUND
PMID: 33665480 (View on PubMed)

Rudra S, Jiang N, Rosenberg SA, Olsen JR, Roach MC, Wan L, Portelance L, Mellon EA, Bruynzeel A, Lagerwaard F, Bassetti MF, Parikh PJ, Lee PP. Using adaptive magnetic resonance image-guided radiation therapy for treatment of inoperable pancreatic cancer. Cancer Med. 2019 May;8(5):2123-2132. doi: 10.1002/cam4.2100. Epub 2019 Apr 1.

Reference Type BACKGROUND
PMID: 30932367 (View on PubMed)

Chuong MD, Bryant J, Mittauer KE, Hall M, Kotecha R, Alvarez D, Romaguera T, Rubens M, Adamson S, Godley A, Mishra V, Luciani G, Gutierrez AN. Ablative 5-Fraction Stereotactic Magnetic Resonance-Guided Radiation Therapy With On-Table Adaptive Replanning and Elective Nodal Irradiation for Inoperable Pancreas Cancer. Pract Radiat Oncol. 2021 Mar-Apr;11(2):134-147. doi: 10.1016/j.prro.2020.09.005. Epub 2020 Sep 16.

Reference Type BACKGROUND
PMID: 32947042 (View on PubMed)

Jo Y, Oh G, Gi Y, Sung H, Joo EB, Lee S, Yoon M. Tumor treating fields (TTF) treatment enhances radiation-induced apoptosis in pancreatic cancer cells. Int J Radiat Biol. 2020 Dec;96(12):1528-1533. doi: 10.1080/09553002.2020.1838658. Epub 2020 Nov 2.

Reference Type BACKGROUND
PMID: 33074042 (View on PubMed)

Giladi M, Schneiderman RS, Porat Y, Munster M, Itzhaki A, Mordechovich D, Cahal S, Kirson ED, Weinberg U, Palti Y. Mitotic disruption and reduced clonogenicity of pancreatic cancer cells in vitro and in vivo by tumor treating fields. Pancreatology. 2014 Jan-Feb;14(1):54-63. doi: 10.1016/j.pan.2013.11.009. Epub 2013 Dec 4.

Reference Type BACKGROUND
PMID: 24555979 (View on PubMed)

Rivera F, Benavides M, Gallego J, Guillen-Ponce C, Lopez-Martin J, Kung M. Tumor treating fields in combination with gemcitabine or gemcitabine plus nab-paclitaxel in pancreatic cancer: Results of the PANOVA phase 2 study. Pancreatology. 2019 Jan;19(1):64-72. doi: 10.1016/j.pan.2018.10.004. Epub 2018 Oct 17.

Reference Type BACKGROUND
PMID: 30396819 (View on PubMed)

Related Links

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https://cancer.baptisthealth.net/

Miami Cancer Institute at Baptist Health

Other Identifiers

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2020-CHU-003

Identifier Type: -

Identifier Source: org_study_id

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