Pancreatic Cancer Clinical Trial
Official title:
A Phase II Study of Neoadjuvant Gemcitabine and Oxaliplatin in Patients With Potentially Resectable Previously Untreated Pancreatic Adenocarcinoma
RATIONALE: Drugs used in chemotherapy, such as gemcitabine and oxaliplatin, work in
different ways to stop the growth of tumor cells, either by killing the cells or by stopping
them from dividing. Giving chemotherapy before surgery may make the tumor smaller and reduce
the amount of normal tissue that needs to be removed. Giving chemotherapy after surgery may
kill any tumor cells that remain after surgery.
PURPOSE: This phase II trial is studying how well giving gemcitabine together with
oxaliplatin works in treating patients with pancreatic cancer that can be removed by
surgery.
OBJECTIVES:
Primary
- To determine the overall 18-month survival of patients with radiographically resectable
pancreatic adenocarcinoma treated with neoadjuvant gemcitabine and oxaliplatin followed
by surgical resection and adjuvant gemcitabine.
Secondary
- To determine the safety, toxicity, and feasibility of this regimen in the neoadjuvant
setting.
- To determine the feasibility of obtaining preoperative core tissue biopsies and the
ability to use these biopsies to establish pathologic correlates of response following
neoadjuvant therapy and to determine if xenografts can be developed from these core
tissues.
- To determine the specific tumor marker response (CEA and CA19-9) to neoadjuvant
therapy.
- To determine the prognostic accuracy of serum protein profiles in these patients.
- To determine the overall survival and patterns of tumor recurrence (local vs distant).
OUTLINE:
- Neoadjuvant therapy: Patients receive gemcitabine IV over 100 minutes and oxaliplatin
IV over 2 hours on day 1. Treatment repeats every 14 days for 4 courses in the absence
of disease progression or unacceptable toxicity.
- Surgery: Within 2-6 weeks after completion of neoadjuvant therapy, patients undergo a
laparoscopy that includes a pancreaticoduodenectomy or distal pancreatectomy with or
without splenectomy.
- Adjuvant therapy: Beginning 4-16 weeks after surgery, patients receive gemcitabine IV
over 30 minutes on days 1, 8, and 15. Treatment repeats every 28 days for 5 courses in
the absence of disease progression or unacceptable toxicity.
Patients undergo tumor tissue and blood sample collection periodically for correlative
studies. Samples are analyzed for protein expression and tumor markers (CEA and CA19-9) pre-
and post-neoadjuvant therapy via proteomic analysis. Tumor tissue samples are also banked
for research purposes.
After completion of study treatment, patients are followed every 3 months.
;
Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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