Pancreatic Neoplasms Clinical Trial
Official title:
A Phase I/II Trial of the HIV Protease Inhibitor Nelfinavir and Concurrent Radiation and Chemotherapy in Patients With Locally Advanced Pancreatic Cancer
This study is designed to evaluate if nelfinavir works as a radiation sensitizer in combination with gemcitabine (a chemotherapy). We are also looking to establish the maximum dose of gemcitabine that is tolerated with the nelfinavir and radiation therapy, so the dose of gemcitabine is increased based on how previous trial participants tolerated their dose of gemcitabine.
This trial utilizes gemcitabine (a chemotherapy agent commonly used for pancreatic cancer)
and nelfinavir (an anti-retroviral agent FDA-approved for use in HIV+ patients) in addition
to radiation therapy for treatment of borderline resectable pancreatic cancer. The trial
seeks to determine the maximum tolerated dose of gemcitabine when administered concurrently
with radiation therapy and 1250 mg nelfinavir twice daily.
The gemcitabine and radiation is standard; the dose of gemcitabine does vary nationally and
internationally as to what the 'best dose' is. Administered weekly, doses can range from 400
mg/m2 to 1000 mg/m2. Thus, this is why the proposed clinical trial escalates the gemcitabine.
The gemcitabine will be administered weekly during radiation therapy for a total of 6 cycles.
After completion of radiation therapy, the subjects will be evaluated by the surgeons for
resectability. This ends the active portion of the clinical trial; the subjects will be
followed for long-term progression free survival and for overall survival.
Primary endpoints for this trial are identifying the maximum tolerated dose of gemcitabine
when administered concurrently with nelfinavir and radiation therapy (the phase I portion of
this study) and the rate of resectability (typically, utilizing gemcitabine plus radiation
therapy will convert up to 30% of patients from borderline resectable to resectable) for the
phase II portion of the study.
Interim analyses and stopping rules are in place if an effect size is not observed in the
therapeutic group compared to published reports of response to standard chemoradiation for
borderline resectable cases.
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