Stage IV Pancreatic Cancer Clinical Trial
Official title:
A Phase II Trial of 17-N-Allylamino-17-Demethoxygeldanamycin (17-AAG) in Combination With Gemcitabine in Patients With Metastatic Pancreatic Adenocarcinoma
This randomized phase II trial is studying three different schedules of gemcitabine hydrochloride and tanespimycin to see how well they work in treating patients with stage IV pancreatic cancer. Drugs used in chemotherapy, such as gemcitabine hydrochloride and tanespimycin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more tumor cells
PRIMARY OBJECTIVES:
I. To assess the effect of gemcitabine hydrochloride and tanespimycin (17-AAG) on 6-month
survival rate in patients with stage IV pancreatic adenocarcinoma.
SECONDARY OBJECTIVES:
I. To determine the overall survival of these patients. II. To determine the time to disease
progression (TTP) in these patients. III. To determine the confirmed response rate and
duration of response in these patients.
IV. To determine the time to treatment failure in these patients. V. To determine the
adverse events in these patients.
TERTIARY OBJECTIVES:
I. To determine the effects of treatment on molecular targets, such as CDK4, akt,
phospho-akt, Hsp90, Hsp70, and CHK1, and correlate these with clinical endpoints, including
survival at 6 months, TTP, response rate, and overall survival.
II. To determine the effect of gemcitabine hydrochloride metabolizing enzyme genotype on
toxicity, and clinical outcome.
OUTLINE: This is a multicenter study. Patients are stratified according to Eastern
Cooperative Oncology Group (ECOG) performance status (0, 1, or 2). Patients are randomized
to 1 of 3 treatment arms.
ARM I: Patients receive gemcitabine hydrochloride intravenously (IV) over 30 minutes on days
1 and 8 and tanespimycin IV over 1 hour on day 9 of course one.
ARM II: Patients receive gemcitabine hydrochloride IV over 30 minutes on days 1 and 8 and
tanespimycin IV over 1 hour on days 2 and 9 of course one.
ARM III: Patients receive gemcitabine hydrochloride IV over 30 minutes on day 8 and
tanespimycin IV over 1 hour on days 1 and 9 of course one. Beginning with course two (and
for all subsequent courses), all patients receive gemcitabine hydrochloride IV over 30
minutes on days 1 and 8 and tanespimycin IV over 1 hour on days 2 and 9.
Treatment repeats every 3 weeks in the absence of disease progression or unacceptable
toxicity. Blood samples are collected at baseline and periodically during treatment for
pharmacogenetic studies. Tumor tissue samples that are available are also collected for
laboratory studies. Samples are analyzed for number of circulating tumor cells, levels of
intracellular targets (e.g., CDK4, akt, phospho-akt, Hsp90, Hsp70, and CHK1), single
nucleotide DNA polymorphisms, and Vav1 expression. Samples are analyzed by reverse
transcriptase-polymerase chain reaction, immunofluorescence, and immunohistochemistry.
After completion of study treatment, patients are followed periodically for up to 2 years.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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