Perioperative NALIRIFOX (liposomal Irinotecan in Combination with Fluorouracil, Leucovorin, and Oxaliplatin) in Resectable Pancreatic Adenocarcinoma: Randomized Phase II Trial

NCT ID: NCT06816914

Last Updated: 2025-02-20

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

PHASE2

Total Enrollment

84 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-03-05

Study Completion Date

2028-02-05

Brief Summary

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To explore the safety and activity of NALIRIFOX (liposomal irinotecan in combination with fluorouracil, leucovorin, and oxaliplatin) in the perioperative and adjuvant treatment in resectable pancreatic adeneocarcinoma.

Detailed Description

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Adjuvant chemotherapy after surgery significantly improved the survival of pancreatic cancer patients, but there is a problem that only about 50% of patients start adjuvant chemotherapy after pancreatectomy. Neoadjuvant chemotherapy might control potential metastatic lesion which are not being detected in early disease status and improve the R0 resection rate. Additionally, it prevents unnecessary surgeries by selecting patients with rapid disease progression. Furthermore, compared with chemotherapy administered after surgery, more patients can complete the planned chemotherapy schedule in neoadjuvant setting. NALIRIFOX was approved its efficacy and safety in metastatic pancreatic cancer, but its role in perioperative setting is unknown. In this study, we want to o explore the safety and activity of NALIRIFOX in the perioperative and adjuvant treatment in resectable pancreatic adeneocarcinoma.

Conditions

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Resectable Pancreatic Adenocarcinoma

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Upfront surgery

Patient in upfront surgery arm will receive operation followed by adjuvant chemotherapy with NALIRIFOX

Group Type ACTIVE_COMPARATOR

NALIRIFOX

Intervention Type DRUG

Patient in upfront surgery arm will receive operation followed by adjuvant chemotherapy with NALIRIFOX; patient in experimental arm will receive neoadjuvant NALIRIFOX followed by operation than adjuvant NALIRIFOX after operation.

Perioperative NALIRIFOX

Patient in experimental arm will receive neoadjuvant NALIRIFOX followed by operation than adjuvant NALIRIFOX after operation.

Group Type EXPERIMENTAL

NALIRIFOX

Intervention Type DRUG

Patient in upfront surgery arm will receive operation followed by adjuvant chemotherapy with NALIRIFOX; patient in experimental arm will receive neoadjuvant NALIRIFOX followed by operation than adjuvant NALIRIFOX after operation.

Interventions

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NALIRIFOX

Patient in upfront surgery arm will receive operation followed by adjuvant chemotherapy with NALIRIFOX; patient in experimental arm will receive neoadjuvant NALIRIFOX followed by operation than adjuvant NALIRIFOX after operation.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* previously untreated, histologically or cytologically proven PDAC
* age between 20 and 75 years at registration
* ECOG performance status of 0 or 1
* AJCC (8th edition) clinical stage I or II with measurable disease (CT or MRI) in the pancreas. (positron emission tomography scan alone not allowed)
* Surgically resectable disease according to NCCN criteria (Version 1.2023 - May 4, 2023):
* no arterial tumor contact (celiac axis, superior mesentery artery, or common hepatic artery).
* no tumor contact with the superior mesentery vein or portal vein or ≤180° contact without vein contour irregularity.
* adequate major organ functions
* Women of childbearing potential (including women with chemical menopause or no menstruation for other medical reasons) must agree to use contraception from the time ofinformed consent until 6 months or more after the last dose of investigational products. Also, women must agree not to breastfeed from the time of informed consent until 6 months or more after the last dose of the investigational product.
* Men must agree to use contraception from the start of study treatment until 3 months or more after the last dose of the investigational product.
* Participants must have signed written informed consent form in accordance with regulatory and institutional guidelines.

Exclusion Criteria

* presence of clinically significant co-morbid medical conditions within 4 weeks prior registration judged by Investigators
* severe arterial thromboembolic events (myocardial infarction, unstable angina pectoris, stroke) in past 6 months
* New York Heart Association class III or IV congestive heart failure, ventricular arrhythmias or uncontrolled blood pressure or known abnormal electrocardiogram (ECG) with clinically significant abnormal findings in past 6 months
* interstitial lung disease that is symptomatic or may interfere with the detection or management of suspected treatment-related pulmonary toxicity within 28 days prior to registration
* presence of diarrhea ≥ CTCAE v.5.0 grade 2
* concomitant systemic infection requiring treatment
* prior organ allograft or allogeneic bone marrow transplantation
* known history of testing positive for human immunodeficiency virus or known acquired immunodeficiency syndrome
* prior or concurrent malignancies within the last 3 years, with the exception of carcinoma in situ of the cervix, or basal type skin cancer
* any major surgery within 4 weeks of study treatment. Participants must have recovered from the effects of major surgery or significant traumatic injury at least 4 weeks before study treatment.
* pregnant women or nursing mothers, or positive pregnancy tests
* severe mental disorder
* current use or any use in past 2 weeks of strong cytochrome P450 3A4 enzyme inducers/inhibitors and/or strong UGT1A inhibitors
* known hypersensitivity to any of the components of study drugs
Minimum Eligible Age

20 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Cheng-Kung University Hospital

OTHER

Sponsor Role collaborator

Chang Gung Memorial Hospital

OTHER

Sponsor Role collaborator

Taipei Veterans General Hospital, Taiwan

OTHER_GOV

Sponsor Role collaborator

National Taiwan University Hospital

OTHER

Sponsor Role collaborator

China Medical University Hospital

OTHER

Sponsor Role collaborator

Kaohsiung Medical University Chung-Ho Memorial Hospital

OTHER

Sponsor Role collaborator

Tri-Service General Hospital

OTHER

Sponsor Role collaborator

Taichung Veterans General Hospital

OTHER

Sponsor Role lead

Responsible Party

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Hsin-Chen Lin

Medical Doctor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Yan-Shen Shan, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

National Cheng-Kung University Hospital

Locations

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Kaohsiung Chang Gung Memorial Hospital

Kaohsiung City, , Taiwan

Site Status RECRUITING

Kaohsiung Medical University Chung-Ho Memorial Hospital

Kaohsiung City, , Taiwan

Site Status RECRUITING

China Medical University Hospital

Taichung, , Taiwan

Site Status RECRUITING

Taichung Veterans General Hospital

Taichung, , Taiwan

Site Status RECRUITING

National Cheng Kung University Hospital

Tainan City, , Taiwan

Site Status RECRUITING

National Taiwan University Hospital

Taipei, , Taiwan

Site Status RECRUITING

Taipei Veterans General Hospital

Taipei, , Taiwan

Site Status RECRUITING

Tri-Service General Hospital

Taipei, , Taiwan

Site Status RECRUITING

Linkou Chang Gung Memorial Hospital

Taoyuan District, , Taiwan

Site Status RECRUITING

Countries

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Taiwan

Central Contacts

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Yan-Shen Shan, MD, PhD

Role: CONTACT

886-6-2353535 ext. 5000

Facility Contacts

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Yen-Yang Chen, MD, PhD

Role: primary

886-07-7317123

Shih-Chang Chuang

Role: primary

886-07-3121101

Li-Yuan Bai, MD, PhD

Role: primary

886-04-22053366

Hsin-Chen Lin, MD

Role: primary

886-23592525 ext. 3175

Yan-Shen Shan, MD, PhD

Role: primary

886-6-2353535 ext. 5000

Ching-Yao Yang, MD, PhD

Role: primary

886-02-23220322

Nai-Jung Chiang, MD, PhD

Role: primary

886-02-28749425

Shiue-Wei Lai

Role: primary

886-02-87923311

Chun-Nan Yeh

Role: primary

886-03-3281200

Other Identifiers

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SF24596A

Identifier Type: -

Identifier Source: org_study_id

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