Metastatic Pancreatic Cancer Clinical Trial
Official title:
Phase I/II Study to Evaluate Nab-paclitaxel in Substitution of CPT11 or Oxaliplatin in FOLFIRINOX Schedule as First Line Treatment in Metastatic Pancreatic Cancer
At this moment, FOLFIRINOX is the best treatment for selected patients (pts) with metastatic
pancreatic cancer (mPC). Investigator would like to evaluate the substitution of CPT11 or
Oxaliplatin in FOLFIRINOX schedule with Nab-paclitaxel (Nab-p) [Nab-FOLFIRI and Nab-FOLFOX].
Doses for Nab-FOLFIRI and Nab-FOLFOX will be determined by the phase I trial. One or both
schedules will be evaluated in successive phase II part.
The primary objective for phase I of the study is to determine the MTD of Nab-p when used in
substitution of OXA or CPT11 in FOLFIRINOX schedule, as first-line treatment in pts with
mPC. The dose finding strategy will be based on the classical 3+3 dose escalation design.
-Analysis sets: Modified intention-to-treat population: it consists of all pts who are
allocated and receive at least one dose of any component of study treatment. Pts will be
grouped according to the randomized treatment assignment. Pts treated during the phase I
step will be not included in this population.
Safety population: it consists of all pts who are allocated and receive at least one dose of
any component of study treatment. Groups are defined by the study treatment actually
received. Pts treated at the MTD during the phase I step will be not included in this
population.
Statistical methods Best ORR will be summarized and 95% confidence limits will be calculated
according to the exact method for each of the treatment arms included in the phase II step.
All the analyses of primary and secondary efficacy variables will be performed on the
modified intention-to-treat population.
The overall incidences of AEs will be summarized. Pts who experienced the same event on more
than one occasion are counted only once in the calculation of the event frequency, at the
highest intensity ever observed.
Serious adverse events will be summarized. All the safety analyses will be performed on the
safety population.
-Sample size: The experimental treatment, to be considered clinically worthwhile, should
determine an overall best RR equal to or greater than 40%. According to the Fleming single
stage design, for a 90% power towards an alternative hypothesis of an ORR equal to or
greater than 40% and a one-sided type I error rate of 5%, respect to the null hypothesis of
an ORR equal to or less than 20%, 42 pts must be included in the final evaluation, in each
arm of the phase II step. According to the exact binomial test, the experimental treatment
will be considered sufficiently promising and candidate to further studies in the case of a
major objective response is seen in at least 14 pts.
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