Circulating Tumor Cells as Tools for Therapy Response in Nab-paclitaxel Treated Metastatic Pancreatic Cancer Patients

Metastatic Pancreatic Cancer Clinical Trial

— PACT-ACT-v6  

Official title:

A Novel Therapy for Locally Advanced and Metastatic Pancreatic Cancer Based on Nanoparticle Albumin-bound Paclitaxel and Gemcitabine: Circulating Tumor Cells as a Potential Biomarker for Treatment Monitoring, -Response and Survival

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02707159
• Other study ID #: 2013/1743
• Secondary ID: 2013-000633-13
• Status: Completed
• Phase: Phase 2
• Start date: November 2014
• Est. completion date: January 2019

Study information

• Verified date: March 2016
• Source: Helse Stavanger HF
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The majority patients diagnosed with pancreatic cancer have metastatic disease at the time of diagnosis. The prognosis is extremely poor with a 5-year survival rate of less than 5%. Treatment with chemotherapy can improve efficacy, but still the median progression-free survival in patients receiving nab-paclitaxel and gemcitabine is only 5,5 months and median overall survival is less than one year. There is a urgent need for tools for predicting the efficacy of the treatment. The current trial aims at investigating the biomarker potential of circulating tumor cells (CTCs) in metastatic pancreatic cancer patients treated by gemcitabine and nab-paclitaxel.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 70
• Est. completion date: January 2019
• Est. primary completion date: October 2017
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 80 Years

Eligibility

Inclusion Criteria:

• Male or female > 18 years up to 80 years

• Histologically or cytologically proven adenocarcinoma of the pancreas before start of treatment. Also patients for whom there is a strong suspicion of unresectable pancreatic cancer will before the diagnosis is confirmed be asked for consent to take 2 additional biopsies at the time of diagnostic biopsy retrieval, in case the histological analysis confirms that they can be included.

• Locally advanced (primarily unresectable) and/or metastatic disease.

• Presence of at least one measurable lesion according to the RECIST criteria, not restricted to previously irradiated area or limited to bone, pleural effusion or ascites.

• ECOG/WHO performance status =2

• Absolute neutrophil count (ANC) >1.5 x 109 /L and platelet count >100 x 109/L

• Total bilirubin < 1.5 times the upper limit of the normal range at the institution (ULN) or AST or ALT < 2 x ULN. If liver metastases are present, patients can be included if total bilirubin < 5× ULN or AST/ALT <10× ULN. Dose reductions of paclitaxel will be performed when bilirubin >2xULN, depending on increase of the bilirubin level according to the recommendations of the Summary of Product Characteristics.

• Serum creatinin < 1,5 ULN / calculated creatine clearance > 60 ml/min.

• Written informed consent

Exclusion Criteria:

• Current infection, bowel obstruction or subobstruction, or other uncontrolled intercurrent illness.

• Prior medical treatment for advanced pancreatic cancer

• Confirmed brain metastasis.

• Concurrent or past history of another malignancy except curatively treated non-melanoma skin cancer or in situ carcinoma of the cervix.

• Treatment with any other investigational drug more than 30 days prior to study entry.

• Allergy to anyone of the included drugs.

• Female patient breast feeding or pregnancy

• Not able/ or not willing to use adequate contraception (defined below). A pregnancy test will be included in the baseline visit for women of childbearing potential.

Related Conditions & MeSH terms

• Metastatic Pancreatic Cancer
• Neoplastic Cells, Circulating
• Pancreatic Neoplasms

Intervention

Drug:
• Nab paclitaxel / gemcitabine
Patients will receive gemcitabine/nab-paclitaxel combination chemotherapy

Locations

Country	Name	City	State
Norway	Stavanger University Hospital	Stavanger

Sponsors (1)

Lead Sponsor	Collaborator
Helse Stavanger HF

Country where clinical trial is conducted

Norway, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Change in levels of circulating tumor cells (CTCs) during treatment		Baseline and 9 months
Secondary	Post-baseline over-all survival		Baseline and 9 months
Secondary	Post-baseline disease-specific survival		Baseline and 9 months
Secondary	Post-baseline time to progression		Baseline and 9 months
Secondary	Clinical response to treatment by RECIST 1.1	Radiologic, clinical and biochemical assessment	Baseline and 9 months
Secondary	Changes in quality of life during treatment	Quality of Life is assessed every 4 weeks during treatment and then every 8th weeks.	Baseline and 9 months