Pancreatic Cancer Clinical Trial
Official title:
Phase III Randomized Study of RFS 2000 (9-Nitro-Camptothecin, 9-NC) Versus Most Appropriate Therapy in Refractory Pancreatic Cancer Patients
RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing
so they stop growing or die. It is not yet known whether nitrocamptothecin is more effective
than other chemotherapy for cancer of the pancreas.
PURPOSE: Randomized phase III trial to compare the effectiveness of nitrocamptothecin with
that of other chemotherapy in treating patients who have recurrent or refractory cancer of
the pancreas.
OBJECTIVES: I. Compare the overall survival, objective response rate, time to treatment
failure, and time to progression in patients with recurrent or refractory adenocarcinoma of
the pancreas treated with oral nitrocamptothecin vs most appropriate chemotherapy. II.
Compare the toxicity of these regimens in these patients.
OUTLINE: This is a randomized, open-label, multicenter study. Patients are stratified
according to Karnofsky performance status (50-70% vs greater than 70%). Patients are
randomized to 1 of 2 treatment arms: Arm I: Patients receive oral nitrocamptothecin on days
1-5. Treatment repeats every week for 8 courses in the absence of disease progression or
unacceptable toxicity. Patients with stable or responding disease after week 8 may receive
additional courses. Arm II: Patients are stratified according to most appropriate therapy
possible (mitomycin or investigator's choice (including best supportive care) vs gemcitabine
vs fluorouracil). Patients who previously received fluorouracil and gemcitabine with or
without radiotherapy receive mitomycin or the investigator's choice of any proven or
experimental chemotherapy regimen previously submitted to the sponsor. Patients who
previously received fluorouracil only, other chemotherapy only, or fluorouracil with other
chemotherapy receive a proven or experimental regimen comprising gemcitabine. Patients who
previously received gemcitabine with other chemotherapy receive a proven or experimental
regimen comprising fluorouracil. Patients with stable or responding disease after week 8 may
receive additional courses if medically indicated. Patients for whom these drugs are not
indicated may receive best supportive care. At the time of disease progression, patients may
receive treatment with nitrocamptothecin. Patients are followed every 3 months for 1 year or
until death.
PROJECTED ACCRUAL: Approximately 400 patients (200 per arm) will be accrued for this study
within 15 months.
;
Allocation: Randomized, Primary Purpose: Treatment
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