Pancreas: SLOG vs mFOLFIRINOX as the First-line Treatment in Locally Advanced Uncresectable or Metastatic Pancreatic Cancer
Study Details
Study Description
Brief Summary
A Phase II Randomized Study.Primary objective:to investigate the 6-month progression-free survival (PFS) rate i patients receiving SLOG or mFLFIRINOX as a first-line treatment for locally advanced and metastatic pancreatic cancer.
Condition or Disease | Intervention/Treatment | Phase |
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Phase 2 |
Detailed Description
A total of 130 patients (65patients in each arm) will be calculated, based on the assumption of a 6-month PFS rate of 45% with mFOLFIRINOX vs 60% wuth SLOG, to achieve 75% power, with a drop-out rate of 10%. Two-sided test was performed with type I error=0.10.
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
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Experimental: SLOG 800 mg/m2 gemcitabine at a fixed rate of 10 mg/m2/min followed by a 2-hour intravenous infusion of oxaliplatin on day 1 plus twice daily oral S-1 80-120 mg/day (based on BSA) and oral leucovorin 30 mg twice a day on day 1 to day 7, every 14 days as a cycle |
Drug: S-1
Intervention is administered to patients in this Arm.
Drug: Leucovorin(oral )
Intervention is administered to patients in this Arm.
Drug: Gemcitabine
Intervention is administered to patients in this Arm.
Drug: Oxaliplatin
Intervention is administered to patients in this Arm.
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Experimental: mFOLFIRINOX oxaliplatin at a dose of 85 mg/m2, given as a 2-hour infusion, with the addition, after 30 minutes, of irinotecan at a dose of 150 mg/m2, given as a 90-minute infusion. The treatment was immediately followed by a continuous intravenous infusion via central venous catheter of leucovorin 400 mg/m2 given as a 2-hour infusion and 5-FU 2400 mg/m2 over a 46-hour period on day 1 every 14 days/cycle. |
Drug: Oxaliplatin
Intervention is administered to patients in this Arm.
Drug: Irinotecan
Intervention is administered to patients in this Arm.
Drug: 5-FU
Intervention is administered to patients in this Arm.
Drug: Leucovorin(IV)
Intervention is administered to patients in this Arm.
|
Outcome Measures
Primary Outcome Measures
- progression free survival (PFS) [Since this is an exploratory trial, it takes a sample size of 61 patients per arm entered in 2 years with a minimum 1 year of follow up to reach 75% power with type I error of 10% under the assumptions of exponential survival functions.]
The 6-month PFS rates of the two arms are assumed to be 60% (SLOG) vs. 45% (mFOLFIRINOX)
Eligibility Criteria
Criteria
Inclusion Criteria:
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Patients must have cyto-/histologically confirmed, locally advanced unresectable or metastatic adenocarcinoma of the pancreas (mPAC). Patients who have disease measurable or evaluable on x-ray, CT scan, or physical examination are eligible.
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Patients must have no history of prior chemotherapy for PAC, except those delivered as adjuvant setting that completed at least 6 months before documentation of recurrence by imaging study.
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Patients with prior radiotherapy are eligible if the irradiated area does not involve the only source of measurable / evaluable disease.
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Patients' baseline ECOG performance status must be 1.
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Patients' life expectancy 12 weeks or greater.
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Patients' age 20 and 80.
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Patients with biliary obstruction and adequate drainage procedures before enrollment are eligible.
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Patients must agree to have indwelling venous catheter implanted.
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Women or men and their partners of reproductive potential should agree to use an effective contraceptive method.
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All patients must be informed of the investigational nature of this study and must sign and give written informed consent.
Exclusion Criteria:
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Patients who have major abdominal surgery, radiotherapy or other investigating agents within 4 weeks are not eligible. Patients who have palliative radiotherapy for bony metastasis will be eligible 2 weeks after the completion of radiotherapy.
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Patients with central nervous system metastasis
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Patients with active infection
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Pregnant or breast-nursing women
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Patients with active cardiopulmonary disease or history of ischemic heart disease
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Patients who have peripheral neuropathy > Grade I of any etiology
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Patients who have serious concomitant systemic disorders incompatible with the study, i.e. poorly controlled diabetes mellitus, auto-immune disorders, cirrhosis of the liver, and the rest will be at the discretion of in-charged investigator.
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Patients who have other prior or concurrent malignancy except for adequately treated in situ carcinoma of cervix or adequately treated basal cell carcinoma of skin, or any malignancy remains disease-free for 3 or more years after initial curative treatment
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Patients who are under biologic treatment for their malignancy
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Laboratory tests (hematology, chemistry) outside specified limits:
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WBC ≤ 3 x 10³/mm³
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ANC ≤ 1.5 x 10³/mm³
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Platelets ≤ 100.000/mm³
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Hb ≤ 9.0 g/dl (≤ 5.6 mmol/l)
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GFR < 60 mL/min
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AST and/or ALT > 2.5 x ULN; for patients with significant liver metastasis AST and/or ALT > 5 x ULN
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Total bilirubin > 2 x ULN
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Albumin < 2.5 g/dL
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
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1 | National Institute of Cancer Research | Miaoli | Taiwan |
Sponsors and Collaborators
- National Health Research Institutes, Taiwan
- National Taiwan University Hospital
- Taipei Veterans General Hospital, Taiwan
- China Medical University Hospital
- National Cheng-Kung University Hospital
- Kaohsiung Medical University
- Taipei Medical University Shuang Ho Hospital
- Chang Gung Memorial Hospital
- Tri-Service General Hospital
- E-DA Hospital
Investigators
- Study Chair: Chen Li-Tzong, National Insitute of Cancer Research
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- T5217