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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT06149689
Other study ID # PTCA199-7
Secondary ID
Status Recruiting
Phase Phase 2
First received
Last updated
Start date January 10, 2024
Est. completion date October 31, 2026

Study information

Verified date March 2024
Source Fudan University
Contact Ying Yang, MD
Phone 86 64175590
Email yangying@fudanpci.org
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The purpose of this study is to evaluate the efficacy of mFOLFIRINOX plus radiotherapy to Patients with CA19-9-normal Advanced Pancreatic Cancer.


Description:

Pancreatic adenocarcinoma (PDAC) is a highly lethal malignancy with a 5-year survival less than 10%. Approximately 80% of patients with pancreatic cancer are diagnosed at an advanced stage. Chemotherapy is one of the major treatments for advanced pancreatic cancer. In 2011, the PRODIGE trial has shown that oxaliplatin, irinotecan, fluorouracil, and leucovorin (FOLFIRINOX) was associated with a survival advantage but had increased toxicity. Carbohydrate antigen 19-9 (CA19-9) is the most widely used biomarker in pancreatic cancer. Circulating CA19-9 levels are positively correlated with tumor burden and stage in pancreatic cancer with a diagnostic sensitivity of approximately 80%, suggesting that approximately 20% of patients have normal CA19-9 levels. It is well recognized that Lewis (-) individuals, constituting approximately 10% of the population, have low or no secretion of CA19-9 due to the lack of critical enzyme involved in CA19-9 biosynthesis. Thus, approximately 10% of patients with pancreatic cancer have normal CA19-9 levels regardless of tumor stage. Our previously retrospective study has shown that CA19-9-normal advanced pancreatic cancer may be more sensitive to chemotherapy combined with radiotherapy. The purpose of this study is to evaluate the efficacy of mFOLFIRINOX plus radiotherapy to patients with CA19-9-normal advanced pancreatic cancer. Progression-free survival (PFS), objective response rate (ORR), overall survival (OS) and disease control rate (DCR) are measured every four weeks.


Recruitment information / eligibility

Status Recruiting
Enrollment 30
Est. completion date October 31, 2026
Est. primary completion date October 31, 2025
Accepts healthy volunteers No
Gender All
Age group 18 Years to 80 Years
Eligibility Inclusion Criteria: - Ability to understand and the willingness to sign a written informed consent document. - Age = 18 years and = 80 years. - Eastern Cooperative Oncology Group (ECOG) performance status 0-2. - Histologically or cytologically confirmed advanced pancreas adenocarcinoma. - Patients who have not received any form of anti-tumor therapy. - Baseline serum CA19-9 = 37 U/mL, CEA= 5.2 ng/mL, and CA125 = 35 U/mL. - Presence of at least of one measurable lesion in agreement to RECIST criteria. - The expected survival = 3 months. - Adequate organ performance based on laboratory blood tests. - Women of childbearing potential and men must agree to use adequate contraception prior to study entry and for the duration of study participation. Exclusion Criteria: - Pregnant or nursing women. - Patients who have received any form of anti-tumor therapy. - Baseline serum CA19-9 > 37 U/mL, CEA > 5.2 ng/mL, or CA125 > 35 U/mL. - The diagnosis was confirmed by pathology as non-adenocarcinoma of pancreas. - Inflammation of the digestive tract, including pancreatitis, cholecystitis, cholangitis, etc. - Severe and uncontrollable accompanying diseases that may affect protocol compliance or interfere with the interpretation of results. - Renal insufficiency or dialysis - Other serious accompanying illnesses, which, in the researcher's opinion, could seriously adversely affect the safety of the treatment. - Patients who are allergic to oxaplatin or other chemotherapy drugs. - Patients who are unwilling or unable to comply with study procedures.

Study Design


Related Conditions & MeSH terms


Intervention

Combination Product:
mFOLFIRINOX plus radiotherapy
Patients with advanced pancreatic adenocarcinoma will receive a modified FOLFIRINOX regimen (oxaliplatin [70 mg per square meter of body surface area], irinotecan [130 mg per square meter], leucovorin [200 mg per square meter], and fluorouracil [2000 mg per square meter] every 2 weeks). Four-week chemotherapy is considered as a cycle. Patients will be recommended to receive Intensity-Modulated Radiation Therapy (IMRT) after about 4~6 cycles of chemotherapy. The following treatment after radiotherapy will be applied according to the newest edition of National Comprehensive Cancer Network (NCCN) guideline.

Locations

Country Name City State
China Shanghai Cancer Center Shanghai

Sponsors (1)

Lead Sponsor Collaborator
Fudan University

Country where clinical trial is conducted

China, 

References & Publications (3)

Luo G, Jin K, Guo M, Cheng H, Liu Z, Xiao Z, Lu Y, Long J, Liu L, Xu J, Liu C, Gao Y, Ni Q, Yu X. Patients with normal-range CA19-9 levels represent a distinct subgroup of pancreatic cancer patients. Oncol Lett. 2017 Feb;13(2):881-886. doi: 10.3892/ol.201 — View Citation

Luo G, Liu C, Guo M, Cheng H, Lu Y, Jin K, Liu L, Long J, Xu J, Lu R, Ni Q, Yu X. Potential Biomarkers in Lewis Negative Patients With Pancreatic Cancer. Ann Surg. 2017 Apr;265(4):800-805. doi: 10.1097/SLA.0000000000001741. — View Citation

Luo G, Liu C, Guo M, Long J, Liu Z, Xiao Z, Jin K, Cheng H, Lu Y, Ni Q, Yu X. CA19-9-Low&Lewis (+) pancreatic cancer: A unique subtype. Cancer Lett. 2017 Jan 28;385:46-50. doi: 10.1016/j.canlet.2016.10.046. Epub 2016 Nov 10. — View Citation

Outcome

Type Measure Description Time frame Safety issue
Primary Overall survival,OS OS of subjects from recruiting to the time of death from any cause At the end of Cycle 1 (each cycle is 21 days)
Secondary progression-free survival, PFS PFS of subjects from recruiting to the time of disease progression At the end of Cycle 1 (each cycle is 21 days)
Secondary objective response rate (ORR) CR + PR At the end of Cycle 1 (each cycle is 21 days)
Secondary disease control rate (DCR) CR + PR + SD At the end of Cycle 1 (each cycle is 21 days)
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