Pancreatic Adenocarcinoma Metastatic Clinical Trial
Official title:
Evaluation of Tumoral Perfusion Modification by Dynamic Imaging After Chemotherapy Combining Gemcitabine and Nab-paclitaxel (Abraxane) in Patients With Potentially Operable, Locally Advanced or Metastatic Pancreatic Adenocarcinoma
Pancreatic ductal adenocarcinoma (PDAC) is a highly lethal disease with conventional treatments having little impact on disease course. Novel approaches are urgently needed to address inherent resistance to the current therapies and to identify new drugs or combinations that will have a high chance of success in pancreatic cancer patients. This proof-of-concept trial is studying the "dynamic" tumor response after the administration of a short course of gemcitabine and nab-paclitaxel (Abraxane) (a) during a window interval (4 weeks= 1 cycle) before surgery in resectable pancreatic cancer (cohort 1 = 21 patients) and (b) during at least 8 weeks (2 cycles) in locally advanced or metastatic pancreatic cancer (cohort 2 = 10 patients).
Pancreatic cancer is a hypoperfused tumor, characterized by a high stroma density precluding
cytotoxics delivery to the epithelial tumoral compartment. There is thus a rationale for
combining chemotherapy and antistromal drugs like nab-paclitaxel (Abraxane), a solvent
(Cremophor® EL)-free, albumin-bound form of paclitaxel that has been initially developed to
reduce the toxicities associated with Taxol injection while maintaining or improving its
chemotherapeutic effect. This unique protein formulation provides a novel approach of
increasing intra-tumoral concentrations of the drug by a receptor-mediated transport process
allowing transcytosis across the endothelial cell.
Abraxane has been approved for commercialization in 38 countries, including the US, Canada,
the EU, Australia, China, India and Korea for the treatment of women with metastatic breast
cancer. Abraxane alone and in combination is being evaluated in a number of cancers,
including metastatic melanoma, non-small cell lung cancer, pancreatic cancer and other solid
tumors.
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