Pancreatic Neoplasms Clinical Trial
Official title:
A Phase I/II Study of Etanercept and Gemcitabine in Patients With Advanced Stage and Chemotherapy Naive Pancreatic Adenocarcinoma
The aims of this protocol are:
1. To study the safety and tolerability of the combination of etanercept and gemcitabine in
patients with advanced pancreatic cancer:
2. To estimate the anti-tumor effect as measured by the proportion of patients free of
disease-progression at six months after treatment initiation.
Rationale: The standard treatment for pancreatic cancer is gemcitabine. This study combines
gemcitabine with etanercept, a drug that binds with tumor necrosis factor (TNF) molecules and
blocks their activity through inhibiting their interaction with cell surface TNF receptors.
TNF is the name for a protein in the body that often helps fight foreign substances. However,
research suggests that pancreatic tumors develop resistance to TNF and then use it to support
cancer growth. Combining etanercept, a TNF inhibitor, with gemcitabine is a novel approach to
advanced pancreatic cancer. Because etanercept has not been tested in combination with
gemcitabine, a Phase I study will be conducted first to identify the safest dosage of
etanercept, and then a Phase II study will evaluate the efficacy of this combination.
Purpose: This study is evaluating the safety of etanercept and gemcitabine for advanced
pancreatic cancer in Phase I, and the efficacy of etanercept and gemcitabine for this
condition in Phase II. TNF and other inflammatory markers will also be measured in the study.
Treatment: Patients in this study will receive gemcitabine and etanercept. Gemcitabine will
be administered through an intravenous infusion weekly for seven weeks followed by one week
of rest. Additional treatments with gemcitabine will be given for three weeks followed by one
week of rest. Patients will administer etanercept to themselves through a small injection
underneath the skin twice each week. Six patients will initially be enrolled in Phase I. If
severe side effects appear in at least two patients in Phase I, then additional patients will
be enrolled and treated with lower dosages of gemcitabine. When the treatments do not produce
unacceptable side effects, the Phase I portion of the study will end and Phase II will begin
enrolling patients. Patients in the Phase II portion of the study will also receive
gemcitabine and etanercept at the safest dosages identified in Phase I. Several tests and
exams will be given throughout both portions of the study to closely monitor patients.
Treatments will be discontinued due to disease growth or unacceptable side effects.
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