Preoperative Folfirinox, Radiation Therapy for Resectable Adenocarcinoma of the Pancreas

Sponsor
M.D. Anderson Cancer Center (Other)
Overall Status
Completed
CT.gov ID
NCT01560949
Collaborator
(none)
34
1
1
80.2
0.4

Study Details

Study Description

Brief Summary

The goal of this clinical research study is to learn if a chemotherapy combination called modified Folfirinox (or mFolfirinox), followed by a combination of gemcitabine and radiation therapy, followed by surgery, can help to control pancreatic cancer. The safety of this treatment will also be studied.

mFolfirinox consists of 5-FU, oxaliplatin, and irinotecan. These 3 drugs, along with gemcitabine, are each designed to block the growth of cancer cells, which may lead to cancer cell death.

Condition or Disease Intervention/Treatment Phase
Phase 2

Detailed Description

Study Drug Administration:

You will receive up to 3 phases of study therapy: the systemic chemotherapy phase, the chemoradiation phase, and surgery, if possible.

During the systemic chemotherapy phase, you will receive mFolfirinox 1 time every 2 weeks (Weeks 1, 3, 5, 7, 9 and 11) for 12 weeks. You will receive oxaliplatin by vein over a 2-hour period. After receiving oxaliplatin, you will receive irinotecan by vein over a 90-minute period. After receiving irinotecan, you will then receive 5-FU through a portable pump for the next 46 hours. You will take the portable pump home with you and will receive instructions on how to use it.

You will begin receiving chemoradiation within 6 weeks after you have finished receiving the Week 11 dose of mFolfirinox. However, you will not begin receiving it until you have recovered from side effects of the chemotherapy.

During the chemoradiation phase, you will receive gemcitabine over about 35 minutes 1 time each week for 5 weeks. You will also receive radiation therapy 5 days a week (Monday through Friday) for 5 1/2 weeks (a total of 28 treatments). If you miss any of the days of radiation, they will be made up at the end of treatment so that you will receive the full amount of radiation. You will be given a separate consent form that explains the radiation procedure and the risks it may present.

After the chemoradiation phase, you will not receive any treatment for 4-6 weeks so your body can recover. If after this time the disease has not gotten worse or spread to other parts of the body, you will have surgery to try to remove the tumor. You will be given a separate consent form for the surgery that describes how it is performed and its risks.

If the disease has gotten worse or spread to other parts of the body, you will not be able to have surgery. The study doctor will discuss other therapy options with you.

Study Visits:
At Weeks 1, 3, 5, 7, 9, and 11 of the systemic chemotherapy phase:
  • You will have a physical exam, including measurement of your weight and vital signs (blood pressure and heart rate).

  • Blood (about 3 tablespoons) will be drawn for routine tests.

Within 4 weeks before beginning the chemoradiation phase:
  • You will have CT or MRI scans to check the status of the disease.

  • Blood (about 1 tablespoon) will be drawn for tumor marker testing.

At Weeks 1, 2, 3, 4, 5, and 6 of the chemoradiation phase:
  • You will have a physical exam, including measurement of your weight and vital signs.

  • Blood (about 2-3 tablespoons) will be collected for routine tests. At Week 6, an additional 2 teaspoons of blood will be drawn for CTC testing.

About 4 to 6 weeks after you complete the chemoradiation phase:
  • Blood (about 1 tablespoon) will be drawn for tumor marker testing.

  • You will have CT or MRI scans to check the status of the disease.

If you are eligible to have surgery after the chemoradiation phase, the following tests and procedures will also be performed:

  • Blood (about 4 teaspoons total) will be drawn within 2 weeks before surgery for CTC testing. Blood will also be collected during surgery, if the surgeon thinks it is safe and feasible.

  • Tumor tissue collected during a previous procedure will be used for biomarker testing. An additional sample of tumor tissue will be collected from the tissue removed during surgery and used for biomarker testing. Biomarkers are found in the blood/tissue and may be related to your reaction to the study drug.

Length of Study:

You will receive study treatment over the course of up to 30 weeks. You will be taken off study if the disease gets worse, the study doctor thinks it is in your best interest, or if you do not follow the study directions.

You may choose to stop receiving the study treatment at any time. If you choose to stop, you should tell the study doctor or a member of the staff right away. They will make sure that proper procedures are followed and a final visit will be scheduled for your safety.

Follow-up:

Blood (about 2 teaspoons) will be collected for CTC testing 2-3 months after your surgery, if you were one of the first 30 participants enrolled in the study.

You will have a CT or MRI scan of the abdomen and pelvis every 4 months for 2 years to check the status of the disease.

This is an investigational study. 5-FU, oxaliplatin, irinotecan, and gemcitabine are each FDA approved and commercially available to treat different types of cancer:

  • 5-FU: pancreatic, gastric, breast, colon/rectum, and skin cancer (basal cell carcinoma)

  • Oxaliplatin: colon and rectal cancer

  • Irinotecan: colorectal cancer

  • Gemcitabine: pancreatic, lung, ovarian, and breast cancer.

The use of these 4 drugs together and in combination with radiation therapy for the treatment of pancreatic cancer is investigational.

Up to 33 patients will be enrolled in this study. All will be enrolled at MD Anderson.

Study Design

Study Type:
Interventional
Actual Enrollment :
34 participants
Allocation:
N/A
Intervention Model:
Single Group Assignment
Masking:
None (Open Label)
Primary Purpose:
Treatment
Official Title:
A Phase II Study of Preoperative Systemic Chemotherapy (Modified FOLFIRINOX) Followed by Radiation Therapy for Patients With High Risk Resectable and Borderline Resectable Adenocarcinoma of the Pancreas
Actual Study Start Date :
Jun 14, 2012
Actual Primary Completion Date :
Feb 20, 2019
Actual Study Completion Date :
Feb 20, 2019

Arms and Interventions

Arm Intervention/Treatment
Experimental: Chemotherapy + Radiation

SYSTEMIC PHASE: Chemotherapy with Oxaliplatin followed by Irinotecan followed by 5-FU. m FOLFIRINOX - oxaliplatin 75 mg/m2 d1 + irinotecan 150 mg/m2 d1 + 5-FUl 2,000 mg/m2 46h continuous infusion, every other week for 6 cycles (12 weeks). CHEMORADIATION PHASE: This phase will start at least 2 weeks, but no more than 6 weeks after completion of the last cycle of mFOLFIRINOX. Chemoradiation with Gemcitabine: 350 mg/m2 IV over 35 minutes every week for 5 doses beginning day 1 (days 1, 8, 15, 22, 29) Radiation: External beam radiation therapy will be delivered 5 days/week +/- 2 days over 5.5 weeks with 18-MeV photons. 3D conformal RT, a total dose of 50.4 Gy prescribed to the 95% isodose at 1.8 Gy/fraction (28 fractions) to the GTV + 1.5 cm margin. SURGERY- At least 4-6 weeks after last dose of Gemcitabine, if no local progression or distant metastasis. Patients whose scans show unequivocal local or distant progression are not candidates for surgery.

Drug: Oxaliplatin
75 mg/m2 by vein on Day 1 of weeks 1, 3, 5, 7, 9 and 11 for 12 weeks.
Other Names:
  • Eloxatin
  • Drug: Irinotecan
    150 mg/m2 by vein on Day 1 of weeks 1, 3, 5, 7, 9 and 11 for 12 weeks.
    Other Names:
  • CPT-11
  • Camptosar
  • Drug: 5-FU
    2000 mg/m2 by vein over 46 hour continuous infusion, on Days 1 - 2 during weeks 1, 3, 5, 7, 9 and 11 for 12 weeks.
    Other Names:
  • 5-Fluorouracil
  • Adrucil
  • Efudex
  • Drug: Gemcitabine
    350 mg/m2 by vein every week for 5 doses beginning Day 1 (days 1, 8, 15, 22, 29).
    Other Names:
  • Gemcitabine Hydrochloride
  • Gemzar
  • Radiation: Radiation Therapy
    External beam radiation therapy delivered 5 days/week +/- 2 days over 5.5 weeks with 18-MeV photons. 3D conformal RT, a total dose of 50.4 Gy 1.8 Gy/fraction (28 fractions).
    Other Names:
  • XRT
  • RT
  • Outcome Measures

    Primary Outcome Measures

    1. Number of Participants With Resectability Rate [43 months]

      Patients with borderline resectable treated with preoperative modified FOLFIRINOX chemotherapy, followed by gemcitabine-based chemoradiation therapy. At least 4- 6 weeks after the last dose of gemcitabine if there is no local progression or distant metastasis, patients were scheduled for surgery.

    Secondary Outcome Measures

    1. Number of Participants With R0 Margin Resection [43 months]

      The specimen was designated R0 if no tumor cells were identified at any of the resection margins.

    2. Disease Free Survival (DFS) [54 months]

      Disease free survival (DFS) was defined as the time interval from the date of surgery to the date of disease recurrence or death or the date of a participant was last known to be alive without disease recurrence.

    3. Number of Participants That Were SMAD4 Positive Before and After Surgery [43 months]

      Tumor tissue collected pre-therapy and post-therapy for surgically resected patients was assessed for SMAD4 status and classified as either present or absent based on immunohistochemistry evaluation.

    4. Overall Survival [54 months]

      Overall survival (OS) was defined as the time interval from the date of diagnosis to the date of death due to any cause or the date a patient was last known to be alive. Estimated by using the Kaplan-Meier method.

    5. Number of Participants With Local and Distant Failure [43 months]

    6. Number of Participants Correlative Studies Including DPC4 (SMAD4) Staining and Circulating Tumor Cells (CTC) Pre-Surgery [43 months]

      Tumor tissue collected pre-therapy and post-therapy for surgically resected patients was assessed for SMAD4 status and classified as either present or absent based on immunohistochemistry evaluation.

    7. Number of Participants Correlative Studies Including DPC4 (SMAD4) Staining and Circulating Tumor Cells (CTC) Post-Surgery [43 months]

      Tumor tissue collected pre-therapy and post-therapy for surgically resected patients was assessed for SMAD4 status and classified as either present or absent based on immunohistochemistry evaluation.

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    18 Years and Older
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    No
    Inclusion Criteria:
    1. Cytologic or histologic proof of adenocarcinoma of the pancreas is required prior to treatment. Patients with Islet cell tumors are not eligible.

    2. Only untreated patients with high risk pancreatic adenocarcinomas will be eligible for the study. For this study, such patients are defined as those who meet one or more of the following radiographic or serologic criteria: a)Primary tumor that involves the superior mesenteric vein causing a vein deformity or segmental venous occlusion with a patent vessel above and below suitable for reconstruction. b)Primary tumor that involves </= 180 degrees of the superior mesenteric artery (SMA), celiac axis or any of its branches on CT or MRI. c) Primary tumor that abuts or encases (>/= 50% of the vessel circumference) a short segment of the common hepatic artery (typically at the gastroduodenal artery origin)

    3. (continuation of #2). d) Patients with a high CA19-9 (=/>500mg/dl) in the presence of a bilirubin =/< 2.0 mg/dL. e) Radiographic findings consistent with malignant peripancreatic lymphadenopathy outside the planned field on CT or MRI f) Radiographic findings of indeterminate liver or peritoneal lesions on CT or MRI concerning but not diagnostic of metastatic disease.

    4. Patients cannot have known hepatic or peritoneal metastases detected by ultrasound (US), CT scan, MRI or laparotomy.

    5. There will be no upper age restriction; patients with Eastern Cooperative Oncology Group (ECOG) 0-1 are eligible.

    6. Adequate renal, and bone marrow function: a) Leukocytes >/= 3,000/uL. b) Absolute neutrophil count >/=1,500/uL.c) Platelets >/=100,000/Ul. d) Serum creatinine </= 2.0 mg/dL.

    7. Hepatic function (endoscopic or percutaneous drainage as needed). a)Total bilirubin </= 2 X institutional upper limits of normal (ULN). b) AST (SGOT)/ALT (SGPT) </= 5 X institutional ULN.

    8. Patients must have no fever or evidence of infection or other coexisting medical condition that would preclude protocol therapy.

    9. Women of childbearing potential (defined as those who have not undergone a hysterectomy or who have not been postmenopausal for at least 24 consecutive months) must agree to practice adequate contraception and to refrain from breast feeding.

    10. Patients must sign a study-specific consent form.

    Exclusion Criteria:
    1. Patients whose tumors are defined as locally advanced cancer or metastatic cancer are not eligible.

    2. Unstable angina or New York Heart Association (NYHA) Grade II or greater congestive heart failure; multiple comorbidity that preclude a major abdominal surgery.

    3. Known presence of metastases.

    4. Inability to comply with study and/or follow-up procedures.

    5. Patients < 18 years of age.

    6. Pregnant women with a positive (blood B-HCG) pregnancy test are excluded from this study.

    7. Patients with an active second malignancy with the exception of non-melanoma skin cancer.

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 University of Texas MD Anderson Cancer Center Houston Texas United States 77030

    Sponsors and Collaborators

    • M.D. Anderson Cancer Center

    Investigators

    • Principal Investigator: Gauri Varadhachary, MD, MBBS, M.D. Anderson Cancer Center

    Study Documents (Full-Text)

    More Information

    Additional Information:

    Publications

    None provided.
    Responsible Party:
    M.D. Anderson Cancer Center
    ClinicalTrials.gov Identifier:
    NCT01560949
    Other Study ID Numbers:
    • 2011-1208
    • NCI-2012-00571
    First Posted:
    Mar 22, 2012
    Last Update Posted:
    Aug 10, 2020
    Last Verified:
    Jul 1, 2020

    Study Results

    Participant Flow

    Recruitment Details June 2012 to November 2015. All recruitment done at The University of Texas, MD Anderson Cancer Center.
    Pre-assignment Detail A total of 34 participants enrolled in study 1 participant withdrew consent before initiating treatment.
    Arm/Group Title Systemic Phase: mFOLFIRINOX
    Arm/Group Description Systemic: Oxaliplatin at 75 mg/m2 IV on day 1, Irinotecan at 150 mg/m2 IV on day 1, 5 fluorouracil at 2000 mg/m2 IV 46 hour continuous infusion on day 1 - 2, every other week for 6 cycles (12 weeks). Chemo: Gemcitabine at 350 mg/m2 IV weekly for 5 doses beginning day 1. External beam radiation therapy delivered 5 days/week, a total dose of 50.4 Gy. Surgery: At least 4 - 6 weeks after the last dose of Gemcitabine if there is no local progression or distant metastasis
    Period Title: Systemic Phase: mFOLFIRINOX
    STARTED 33
    COMPLETED 27
    NOT COMPLETED 6
    Period Title: Systemic Phase: mFOLFIRINOX
    STARTED 23
    COMPLETED 23
    NOT COMPLETED 0
    Period Title: Systemic Phase: mFOLFIRINOX
    STARTED 18
    COMPLETED 15
    NOT COMPLETED 3

    Baseline Characteristics

    Arm/Group Title Systemic Phase: mFOLFIRINOX
    Arm/Group Description Oxaliplatin at 75 mg/m2 IV on day 1, Irinotecan at 150 mg/m2 IV on day 1, 5 fluorouracil at 2000 mg/m2 IV 46 hour continuous infusion on day 1 - 2, every other week for 6 cycles (12 weeks)
    Overall Participants 33
    Age (Count of Participants)
    <=18 years
    0
    0%
    Between 18 and 65 years
    18
    54.5%
    >=65 years
    15
    45.5%
    Sex: Female, Male (Count of Participants)
    Female
    12
    36.4%
    Male
    21
    63.6%
    Ethnicity (NIH/OMB) (Count of Participants)
    Hispanic or Latino
    3
    9.1%
    Not Hispanic or Latino
    30
    90.9%
    Unknown or Not Reported
    0
    0%
    Race (NIH/OMB) (Count of Participants)
    American Indian or Alaska Native
    0
    0%
    Asian
    2
    6.1%
    Native Hawaiian or Other Pacific Islander
    0
    0%
    Black or African American
    2
    6.1%
    White
    26
    78.8%
    More than one race
    0
    0%
    Unknown or Not Reported
    3
    9.1%
    Region of Enrollment (participants) [Number]
    United States
    33
    100%

    Outcome Measures

    1. Primary Outcome
    Title Number of Participants With Resectability Rate
    Description Patients with borderline resectable treated with preoperative modified FOLFIRINOX chemotherapy, followed by gemcitabine-based chemoradiation therapy. At least 4- 6 weeks after the last dose of gemcitabine if there is no local progression or distant metastasis, patients were scheduled for surgery.
    Time Frame 43 months

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title Surgery
    Arm/Group Description At least 4 - 6 weeks after the last dose of Gemcitabine if there is no local progression or distant metastasis.
    Measure Participants 33
    Count of Participants [Participants]
    15
    45.5%
    2. Secondary Outcome
    Title Number of Participants With R0 Margin Resection
    Description The specimen was designated R0 if no tumor cells were identified at any of the resection margins.
    Time Frame 43 months

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title Surgery
    Arm/Group Description At least 4 - 6 weeks after the last dose of Gemcitabine if there is no local progression or distant metastasis.
    Measure Participants 15
    Count of Participants [Participants]
    10
    30.3%
    3. Secondary Outcome
    Title Disease Free Survival (DFS)
    Description Disease free survival (DFS) was defined as the time interval from the date of surgery to the date of disease recurrence or death or the date of a participant was last known to be alive without disease recurrence.
    Time Frame 54 months

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title All Phases
    Arm/Group Description Oxalipaltin + irinotecan + 5-fluorouracil, every other week for 6 cycles (12 weeks) followed by gemcitabine weekly for 5 doses with radiation therapy 5 days/week. Then surgery at least 4-6 weeks after the last dose of gemcitabine if no local progression or distant metastasis.
    Measure Participants 33
    Median (95% Confidence Interval) [months]
    11.1
    4. Secondary Outcome
    Title Number of Participants That Were SMAD4 Positive Before and After Surgery
    Description Tumor tissue collected pre-therapy and post-therapy for surgically resected patients was assessed for SMAD4 status and classified as either present or absent based on immunohistochemistry evaluation.
    Time Frame 43 months

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title Surgery
    Arm/Group Description At least 4 - 6 weeks after the last dose of Gemcitabine if there is no local progression or distant metastasis.
    Measure Participants 15
    SMAD4 positive before surgery
    4
    12.1%
    SMAD4 positive after surgery
    4
    12.1%
    5. Secondary Outcome
    Title Overall Survival
    Description Overall survival (OS) was defined as the time interval from the date of diagnosis to the date of death due to any cause or the date a patient was last known to be alive. Estimated by using the Kaplan-Meier method.
    Time Frame 54 months

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title All Phases(Systematic,Chemoradiation w/ Gemcitabine & Surgery)
    Arm/Group Description Oxalipaltin + irinotecan + 5-fluorouracil, every other week for 6 cycles (12 weeks) followed by gemcitabine weekly for 5 doses with radiation therapy 5 days/week. Then surgery at least 4-6 weeks after the last dose of gemcitabine if no local progression or distant metastasis.
    Measure Participants 33
    Median (95% Confidence Interval) [months]
    24
    6. Secondary Outcome
    Title Number of Participants With Local and Distant Failure
    Description
    Time Frame 43 months

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title Surgery
    Arm/Group Description At least 4 - 6 weeks after the last dose of Gemcitabine if there is no local progression or distant metastasis.
    Measure Participants 15
    Local recurrence
    0
    0%
    Distant recurrence
    10
    30.3%
    7. Secondary Outcome
    Title Number of Participants Correlative Studies Including DPC4 (SMAD4) Staining and Circulating Tumor Cells (CTC) Pre-Surgery
    Description Tumor tissue collected pre-therapy and post-therapy for surgically resected patients was assessed for SMAD4 status and classified as either present or absent based on immunohistochemistry evaluation.
    Time Frame 43 months

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title Surgery
    Arm/Group Description At least 4 - 6 weeks after the last dose of Gemcitabine if there is no local progression or distant metastasis.
    Measure Participants 6
    Present
    4
    12.1%
    Absent
    2
    6.1%
    8. Secondary Outcome
    Title Number of Participants Correlative Studies Including DPC4 (SMAD4) Staining and Circulating Tumor Cells (CTC) Post-Surgery
    Description Tumor tissue collected pre-therapy and post-therapy for surgically resected patients was assessed for SMAD4 status and classified as either present or absent based on immunohistochemistry evaluation.
    Time Frame 43 months

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title Surgery
    Arm/Group Description At least 4 - 6 weeks after the last dose of Gemcitabine if there is no local progression or distant metastasis.
    Measure Participants 11
    Present
    4
    12.1%
    Absent
    7
    21.2%

    Adverse Events

    Time Frame 4 years,6 months
    Adverse Event Reporting Description Toxicity was continuously monitored throughout the study, which includes grade 4 hematological toxicity and grade 3 or higher non-hematological toxicity.
    Arm/Group Title Systemin Phase: mFOLFIRINOX Chemoradiation Phase: Radiation With Gemcitabine Surgery
    Arm/Group Description Oxalipaltin 75 mg/m2 IV on day 1, irinotecan 150 mg/m2 IV on day 1, 5-fluorouracil 2,000 mg/m2 IV 46 hours continuous infusion, every other week for 6 cycles (12 weeks). Gemcitabine 350 mg/m2 IV weekly for 5 doses beginning day 1. External beam radiation therapy 5 days/week, a total dose of 50.4 Gy. At least 4-6 weeks after the last dose of gemcitabine if there is no local progression or distant metastasis
    All Cause Mortality
    Systemin Phase: mFOLFIRINOX Chemoradiation Phase: Radiation With Gemcitabine Surgery
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 0/33 (0%) 0/23 (0%) 0/18 (0%)
    Serious Adverse Events
    Systemin Phase: mFOLFIRINOX Chemoradiation Phase: Radiation With Gemcitabine Surgery
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 5/33 (15.2%) 2/23 (8.7%) 0/18 (0%)
    Cardiac disorders
    Miocardial Infarction 1/33 (3%) 0/23 (0%) 0/18 (0%)
    Atrial fibrilation 1/33 (3%) 0/23 (0%) 0/18 (0%)
    Gastrointestinal disorders
    Duodenal hemorrhage 0/33 (0%) 1/23 (4.3%) 0/18 (0%)
    Duodenal ulcer 0/33 (0%) 1/23 (4.3%) 0/18 (0%)
    Gastric ulcer 0/33 (0%) 1/23 (4.3%) 0/18 (0%)
    Nausea 0/33 (0%) 1/23 (4.3%) 0/18 (0%)
    Gastro-esophageal hemorrhage 0/33 (0%) 1/23 (4.3%) 0/18 (0%)
    General disorders
    Multi-organ failure (Septic shock) 1/33 (3%) 0/23 (0%) 0/18 (0%)
    Infections and infestations
    Divice related infection 1/33 (3%) 0/23 (0%) 0/18 (0%)
    Investigations
    Neutrophil count decreased 1/33 (3%) 0/23 (0%) 0/18 (0%)
    Metabolism and nutrition disorders
    Dehydration 1/33 (3%) 0/23 (0%) 0/18 (0%)
    Nervous system disorders
    Dizziness 2/33 (6.1%) 0/23 (0%) 0/18 (0%)
    Respiratory, thoracic and mediastinal disorders
    Dyspnea 1/33 (3%) 0/23 (0%) 0/18 (0%)
    Lower respiratory infection 1/33 (3%) 0/23 (0%) 0/18 (0%)
    Other (Not Including Serious) Adverse Events
    Systemin Phase: mFOLFIRINOX Chemoradiation Phase: Radiation With Gemcitabine Surgery
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 33/33 (100%) 23/23 (100%) 5/18 (27.8%)
    Blood and lymphatic system disorders
    Anemia 7/33 (21.2%) 2/23 (8.7%) 1/18 (5.6%)
    Gastrointestinal disorders
    Diarrhea 20/33 (60.6%) 5/23 (21.7%) 0/18 (0%)
    Mucositis oral 8/33 (24.2%) 2/23 (8.7%) 0/18 (0%)
    Vomiting 11/33 (33.3%) 8/23 (34.8%) 0/18 (0%)
    Nausea 25/33 (75.8%) 15/23 (65.2%) 0/18 (0%)
    Anorexia 18/33 (54.5%) 10/23 (43.5%) 1/18 (5.6%)
    Flatulence 4/33 (12.1%) 2/23 (8.7%) 0/18 (0%)
    Abdominal cramping/pain 13/33 (39.4%) 7/23 (30.4%) 0/18 (0%)
    Constipation 6/33 (18.2%) 5/23 (21.7%) 0/18 (0%)
    General disorders
    Fatigue 28/33 (84.8%) 18/23 (78.3%) 1/18 (5.6%)
    Investigations
    Alanine aminotransferase increased 13/33 (39.4%) 4/23 (17.4%) 0/18 (0%)
    Aspartate aminotranferase increased 9/33 (27.3%) 1/23 (4.3%) 0/18 (0%)
    Alkaline Phosphatase increased 8/33 (24.2%) 4/23 (17.4%) 0/18 (0%)
    Neutrophil count decreased 10/33 (30.3%) 10/23 (43.5%) 0/18 (0%)
    Weight loss 8/33 (24.2%) 5/23 (21.7%) 3/18 (16.7%)
    Platelet count 11/33 (33.3%) 18/23 (78.3%) 0/18 (0%)
    Metabolism and nutrition disorders
    Hypomagnesemia 9/33 (27.3%) 7/23 (30.4%) 1/18 (5.6%)
    Hypokalemia 6/33 (18.2%) 0/23 (0%) 1/18 (5.6%)
    Hyponalbuminemia 5/33 (15.2%) 4/23 (17.4%) 0/18 (0%)
    Musculoskeletal and connective tissue disorders
    Musculo-skeletal - other 3/33 (9.1%) 0/23 (0%) 0/18 (0%)
    Nervous system disorders
    Paresthesia 13/33 (39.4%) 2/23 (8.7%) 0/18 (0%)
    Dysesthesia 18/33 (54.5%) 0/23 (0%) 0/18 (0%)
    Peripheral sensory neuropathy 11/33 (33.3%) 1/23 (4.3%) 0/18 (0%)
    Dizziness 3/33 (9.1%) 1/23 (4.3%) 0/18 (0%)
    Dysguesia 5/33 (15.2%) 0/23 (0%) 0/18 (0%)
    Respiratory, thoracic and mediastinal disorders
    Allergic rhinitis 4/33 (12.1%) 0/23 (0%) 0/18 (0%)
    Hiccups 5/33 (15.2%) 0/23 (0%) 0/18 (0%)
    Voice alteration 3/33 (9.1%) 1/23 (4.3%) 0/18 (0%)
    Skin and subcutaneous tissue disorders
    Alopesia 12/33 (36.4%) 3/23 (13%) 0/18 (0%)
    Skin hyperpigmentation 4/33 (12.1%) 0/23 (0%) 0/18 (0%)
    Vascular disorders
    Flushing 3/33 (9.1%) 1/23 (4.3%) 0/18 (0%)

    Limitations/Caveats

    [Not Specified]

    More Information

    Certain Agreements

    All Principal Investigators ARE employed by the organization sponsoring the study.

    There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.

    Results Point of Contact

    Name/Title Dr. Gauri R Varadhachary,Professor, GI Medical Oncology
    Organization UT MD Anderson Cancer Center
    Phone (713) 792-2828
    Email gvaradha@mdanderson.org
    Responsible Party:
    M.D. Anderson Cancer Center
    ClinicalTrials.gov Identifier:
    NCT01560949
    Other Study ID Numbers:
    • 2011-1208
    • NCI-2012-00571
    First Posted:
    Mar 22, 2012
    Last Update Posted:
    Aug 10, 2020
    Last Verified:
    Jul 1, 2020