Biliary Tract Cancer Clinical Trial
Official title:
A Phase I Study of Adjuvant Chemotherapy With Gemcitabine Plus Cisplatin in Patients With Biliary Tract Cancer Undergoing Curative Resection Without Major Hepatectomy
To decide maximum tolerated dose and recommended dose of treatment using gemcitabine plus cisplatin combination therapy in patients with biliary tract cancer undergoing resection without major hepatectomy.
Surgery currently remains the only potentially curative treatment for biliary tract cancer
(BTC), and most patients develop recurrence. Therefore, effective adjuvant chemotherapy is
required to increase the curability of surgery and to prolong the survival in these patients.
However, to date, no standard adjuvant chemotherapy has been established, and a guideline for
BTC treatment recommends that trials of adjuvant chemotherapy be carried out.
Based on results from clinical studies in unresectable BTC, gemcitabine, platinum agent,
fluoropyrimidine are considered to have activity against BTC. These agents are expected to be
effective in the postoperative adjuvant therapy for BTC, Thus, randomized controlled trials
with gemcitabine are ongoing, and the results are expected. Recently, in the ABC-02 study,
the first prospective multicenter phase III study in patients with unresectable BTC,
gemcitabine/cisplatin combination chemotherapy was compared with gemcitabine monotherapy and
showed that the combination therapy significantly prolonged MST (from 8.1 to 11.7 months; P <
0.001). Gemcitabine/cisplatin combination therapy is now considered to be the standard
regimen for unresectable BTC, and we expect this regimen to be effective for postoperative
adjuvant therapy.
Though hepatectomy is frequently performed in surgery for BTC, it is unclear that the effect
of anticancer agent is affected by hepatectomy. Because gemcitabine is metabolized by
cytidine deaminase primarily in the liver, it considered to have decreased the metabolic
ability of gemcitabine after hepatectomy. Some clinical studies demonstrated that patient
with hepatectomy could not tolerate the standard dose and schedule of gemcitabine. In the
adjuvant chemotherapy with gemcitabine, it is necessary to examine separately whether
hepatectomy was undergone or not.
In this study, we aimed to assess the safety and efficacy of gemcitabine/cisplatin
combination chemotherapy in patients with biliary tract cancer undergoing curative resection
without hepatectomy.
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