A Study of FOLFOX6 With Bevacizumab for Biliary System Carcinoma

Biliary Tract Cancer Clinical Trial

Official title:

A Single-Center, Open-Labeled, Phase II Trial of Modified FOLFOX6 With Bevacizumab in Patients With Advanced Biliary System Carcinoma

Clinical Trial Details — Status: Terminated

Administrative data

• NCT number: NCT00881504
• Other study ID #: OX-07-006
• Secondary ID: 2007-411
• Status: Terminated
• Phase: Phase 2
• First received: April 13, 2009
• Last updated: October 16, 2014
• Start date: June 2009
• Est. completion date: December 2011

Study information

• Verified date: September 2014
• Source: Georgetown University
• Contact: n/a
• Is FDA regulated: No
• Health authority: United States: Institutional Review Board
• Study type: Interventional

Clinical Trial Summary

This study is for patients with biliary tract cancer that has spread and who are not candidates for surgical resection.

The purpose of this research is to determine if bevacizumab can be safely administered with Modified FOLFOX 6 and find out what effects, good and/or bad, this type of treatment has on biliary cancer.

In this study, a combination of chemotherapy, Modified FOLFOX6 and a biologic agent, bevacizumab will be tested.

Subjects on this study will receive chemotherapy and bevacizumab every 2 weeks until their disease gets worse or they are unable to tolerate treatment.

Description:

This is a single-center, open labeled, single-arm study in patients with previously untreated unresectable biliary tract cancer. This trial will follow a Simon's two-stage optimal design. For the first stage, 9 patients will be accrued. If none of the 9 patients have controlled disease with mFOLFOX6 in combination with bevacizumab, the combination will be rejected and the trial stopped. However, if at least 1 patient of the 9 (11%) respond to treatment in the first stage, then an additional 15 patients will be entered into the second stage, for a total of 24 patients in the phase II study. If 3 (13%) or more patients respond to therapy, then the combination will be considered for further investigation.

Recruitment information / eligibility

• Status: Terminated
• Enrollment: 9
• Est. completion date: December 2011
• Est. primary completion date: February 2011
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Histologically or cytologically confirmed diagnosis of non-resectable adenocarcinoma of the biliary tract, including carcinomas of the gallbladder, the intrahepatic or extrahepatic biliary tract, and ampullary cancer

• Measurable or evaluable disease

• Locally advanced disease that is inoperable ot patients who have had disease recurrence after curative surgical attempt

• Ambulatory with an ECOG performance status of 0-1

• Adequate organ and marrow function

• Must agree to avoid pregnancy prior to study entry and throughout the duration of study participation

• Ability to understand and the willingness to sign a written informed consent document

Exclusion Criteria:

• Any prior chemotherapy

• Patients who are receiving other investigational agents

• Patients who have received radiotherapy to more than 25% of their bone marrow for any reason

• Peripheral neuropathy >/= 2

• Known brain metastases, uncontrolled seizure disorder, encephalitis

• Prior history of hypertensive crisis or hypertensive encephalopathy, uncontrolled hypertension,unstable angina, congestive heart failure of New York Heart Association (NYHA) class 2 or greater, left ventricular ejection fraction less than 50%, clinically significant vascular disease, serious cardiac arrhythmia requiring medication, cardiomyopathy

• History of myocardial infarction, unstable angina or stroke/transient ischemic attack (TIA) within 6 months

• History of allergy to oxaliplatin, 5-fluoruracil (5-FU), Leucovorin, or Bevacizumab

• History of intra-abdominal abscess within 4 weeks of study entry, abdominal fistula, gastrointestinal perforation, active peptic ulcer disease, or inflammatory bowel disease

• Evidence of bleeding diathesis or coagulopathy

• Serious non-healing wound, ulcer, or bone fracture

• Major surgical procedure, open biopsy, or significant traumatic injury within 4 weeks of study entry or anticipation of need for major surgery during the course of the study

• Minor surgical procedures such as core biopsies within 7 days before enrollment, chemotherapy port placement within 24 hours

• Patients on full-dose anticoagulants who have out of range international normalized ratio (INR) or active bleeding

• Concurrent malignancy unless the subject has been curatively treated and disease free for >/= 2 years or the cancer was non-melanoma skin cancer or early cervical cancer

• Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection or psychiatric illness/social situations that would limit compliance with study requirements

• Known HIV or Hepatitis B or C

• Life expectancy less than 12 weeks

• Pregnant or nursing women

Study Design

Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Related Conditions & MeSH terms

• Biliary Tract Cancer
• Biliary Tract Neoplasms

Intervention

Drug:
• "Bevacizumab" in combination with "modified FOLFOX6".
Oxaliplatin 85 mg/m2 IV on Day 1 5-FU: 400 mg/m2 IV bolus on Day 1, followed by 2400 mg/M2 over 46 hours Leucovorin: 400 mg IV Day 1 Bevacizumab: 10 mg/kg IV on Day 1 Repeat cycles every 2 weeks until death, disease progression, unacceptable toxicity, patient refusal, or treatment delay > 4 weeks

Locations

Country	Name	City	State
United States	Georgetown University Medical Center	Washington	District of Columbia

Sponsors (2)

Lead Sponsor	Collaborator
Georgetown University	Sanofi

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Progression-free Survival	Progression-free Survival is defined as the time from randomization (or study initiation) until objective tumor progression or death.	2 years	No
Secondary	Safety and Toxicity	The number of patients who underwent FOLFOX dose reductions as a result of Grade 3 toxicity.	8 weeks	Yes