Pancreatic Cancer Clinical Trial
Official title:
Non Resectable But Non Metastatic Adenocarcinoma of the Exocrine Pancreas Non Resecables. Randomised Phase III: Initial Radiochimiotherapy (5-FU, Cisplatine, 60 GY Radiotherapy) Followed by Gemcitabine Versus Gemcitabine Alone
RATIONALE: Drugs used in chemotherapy, such as gemcitabine, fluorouracil, and cisplatin,
work in different ways to stop the growth of tumor cells, either by killing the cells or by
stopping them from dividing. Radiation therapy uses high-energy x-rays to kill tumor cells.
Giving more than one drug (combination chemotherapy) together with radiation therapy may
kill more tumor cells. It is not yet known which treatment regimen is more effective for
pancreatic cancer.
PURPOSE: This randomized phase III trial is studying gemcitabine, fluorouracil, cisplatin,
and radiation therapy to see how well they work compared to gemcitabine alone in treating
patients with nonmetastatic pancreatic cancer that cannot be removed by surgery.
OBJECTIVES:
Primary
- Compare the overall survival of patients with nonresectable, nonmetastatic
adenocarcinoma of the pancreas treated with gemcitabine hydrochloride with vs without
fluorouracil, cisplatin, and radiotherapy followed by gemcitabine hydrochloride.
Secondary
- Compare the toxicities of these regimens in these patients.
- Compare the objective response (complete, partial, or stable) in patients treated with
these regimens.
- Compare the clinical benefit, in terms of general condition and weight maintenance in
patients treated with these regimens.
OUTLINE: This is a randomized, multicenter study. Patients are stratified according to WHO
performance status (0 or 1 vs 2), initial treatment (laparotomy with or without
bilio-digestive diversion) (yes vs no), and peritoneal cytology (positive vs negative).
Patients are randomized to 1 of 2 treatment arms.
- Arm I: Patients receive cisplatin IV over 15 minutes on days 1-5 and 29-33 and
fluorouracil IV continuously on days 1-40. Patients also undergo radiotherapy daily, 5
days a week, for 6 weeks.
- Arm II: Patients receive gemcitabine hydrochloride IV over 15 minutes on day 1.
Treatment repeats every 7 days for 7 weeks.
Beginning in week 11 of arm I or week 9 of arm II, patients receive gemcitabine
hydrochloride IV over 15 minutes on days 1, 8, and 15. Treatment repeats every 4 weeks for
up to 10 courses in the absence of disease progression or unacceptable toxicity.
After completion of study therapy, patients are followed periodically.
PROJECTED ACCRUAL: A total of 190 patients will be accrued for this trial.
;
Allocation: Randomized, Primary Purpose: Treatment
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