Stage IV Pancreatic CancerPhase 1/2NCT00617708
S0727 Gemcitabine Hydrochloride and Erlotinib Hydrochloride With or Without Monoclonal Antibody Therapy in Treating Patients With Metastatic Pancreatic Cancer That Cannot Be Removed By Surgery
A Phase 1/2 study testing cixutumumab, erlotinib hydrochloride and gemcitabine hydrochloride in people with Stage IV Pancreatic Cancer, run by National Cancer Institute (NCI) at 146 sites in United States.
Trial summary
This randomized phase I/II trial is studying the side effects and best dose of monoclonal antibody therapy when given together with gemcitabine hydrochloride and erlotinib hydrochloride and to see how well they work compared with giving gemcitabine hydrochloride and erlotinib hydrochloride alone as first-line therapy… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Stage IV Pancreatic Cancer
- What is being tested?
- cixutumumab, erlotinib hydrochloride and gemcitabine hydrochloride
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 134 participants
- Where
- 146 sitesUnited States
- Study dates
- Mar 2008to 25 Feb 2014
- Phase
- Phase 1/2
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Histologically or cytologically confirmed pancreatic adenocarcinoma
- Stage IV disease (any T, any N, M1 [distant metastases])
- Unresectable disease
- Histologic diagnosis based on a metastatic site must be compatible with pancreatic cancer
- Measurable and/or nonmeasurable disease
- No endocrine or neuroendocrine tumors, lymphoma of the pancreas, or ampullary cancer
Show all 69Show fewer
- No macroscopic residual disease post-resection as the only site of disease
- No clinically significant ascites
- No known brain metastases
- Patients with neurologic signs or symptoms must undergo brain imaging studies AND studies must be negative for disease
- Zubrod performance status 0-1
- ANC ≥ 1,500/mcL
- Platelet count ≥ 100,000/mcL
- Hemoglobin ≥ 9 g/dL
- Leukocytes ≥ 3,000/mcL
- Total bilirubin normal
- SGOT or SGPT ≤ 2.5 times upper limit of normal (ULN)
- Serum creatinine ≤ 1.5 times ULN OR creatinine clearance ≥ 60 mL/min
- Fasting serum glucose < 120 mg/dL or below the ULN
- Patients with diabetes mellitus who meet this criterion must be on a stable dietary or therapeutic regimen for this condition
- INR ≤ 1.5 and PTT ≤ 5 seconds above ULN
- Not pregnant or nursing
- Fertile patients must use effective contraception
- Willing to submit previously collected tumor tissue specimens
- No history of allergic reaction attributed to compounds of similar chemical or biological composition to anti-IGF-1R recombinant monoclonal antibody IMC-A12
- No active acute or chronic infections requiring antibiotics
- No significant ongoing cardiac problems, including any of the following:
- Myocardial infarction within the past 6 months
- Uncontrolled hypertension
- Unstable angina
- Uncontrolled arrhythmia
- Congestive heart failure
- No known HIV infection
- No other prior malignancy, except for the following:
- Adequately treated basal cell or squamous cell skin cancer
- Carcinoma in situ of the cervix
- Adequately treated stage I or II cancer from which the patient is currently in complete remission
- Any other cancer from which the patient has been disease-free for 5 years
- At least 14 days since prior surgery
- At least 28 days since prior radiotherapy for palliation to metastatic sites
- Patient must have other untreated metastatic sites that would qualify them for this protocol
- At least 6 months since prior adjuvant chemotherapy
- No prior chemotherapy, hormonal therapy, immunotherapy, or chemoradiotherapy for advanced or locally advanced pancreatic cancer, including drugs that target either EGFR or IGFR
- No plans to receive concurrent chemotherapy, hormonal therapy, radiotherapy, immunotherapy, or any other type of therapy for treatment of cancer
- No prior gemcitabine hydrochloride
- No prior chimerized or murine monoclonal antibody therapy
- No concurrent CYP3A4 inducers including, but not limited to, any of the following:
- Rifampicin
- Rifabutin
- Rifapentine
- Phenytoin
- Carbamazepine
- Phenobarbital
- Hypericum perforatum (St. John's wort)
- No concurrent CYP3A4 inhibitors including, but not limited to, any of the following:
- Atazanavir
- Clarithromycin
- Indinavir
- Itraconazole
- Ketoconazole
- Nefazodone
- Nelfinavir
- Ritonavir
- Saquinavir
- Telithromycin
- Troleandomycin
- Voriconazole
- Concurrent prophylactic low-dose coumadin or low molecular weight heparin allowed provided coagulation criteria are met
- Full-dose anticoagulation allowed provided coagulation criteria are met and are under strict control and monitoring
Who cannot join
None listed.
Trial locations and contacts
146 sites in 1 country.
146 sites in 1 country
United States146 sites
Akron General Medical Center
Akron, Ohio, 44307
University of New Mexico Cancer Center
Albuquerque, New Mexico, 87106
Christus Saint Frances Cabrini Hospital
Alexandria, Louisiana, 71301
The Don and Sybil Harrington Cancer Center
Amarillo, Texas, 79106
American Fork Hospital
American Fork, Utah, 84003
Randolph Hospital
Asheboro, North Carolina, 27203
Piedmont Hospital
Atlanta, Georgia, 30309
Atlanta Regional CCOP
Atlanta, Georgia, 30342
Northside Hospital
Atlanta, Georgia, 30342
Saint Joseph's Hospital of Atlanta
Atlanta, Georgia, 30342
Well Star Cobb Hospital
Austell, Georgia, 30106
Sinai Hospital of Baltimore
Baltimore, Maryland, 21215
Bronson Battle Creek
Battle Creek, Michigan, 49017
PeaceHealth Saint Joseph Medical Center
Bellingham, Washington, 98225
Alta Bates Summit Medical Center-Herrick Campus
Berkeley, California, 94704
Mecosta County Medical Center
Big Rapids, Michigan, 49307
Montana Cancer Consortium CCOP
Billings, Montana, 59101
Northern Rockies Radiation Oncology Center
Billings, Montana, 59101
Saint Vincent Healthcare
Billings, Montana, 59101
Hematology-Oncology Centers of the Northern Rockies PC
Billings, Montana, 59102
Billings Clinic
Billings, Montana, 59107-7000
Boston Medical Center
Boston, Massachusetts, 02118
Bozeman Deaconess Cancer Center
Bozeman, Montana, 59715
Bozeman Deaconess Hospital
Bozeman, Montana, 59715
Harrison Bremerton Hematology and Oncology
Bremerton, Washington, 98310
Mills - Peninsula Hospitals
Burlingame, California, 94010
Saint James Community Hospital and Cancer Treatment Center
Butte, Montana, 59701
Rocky Mountain Oncology
Casper, Wyoming, 82609
East Bay Radiation Oncology Center
Castro Valley, California, 94546
Eden Hospital Medical Center
Castro Valley, California, 94546
Valley Medical Oncology Consultants-Castro Valley
Castro Valley, California, 94546
Sandra L Maxwell Cancer Center
Cedar City, Utah, 84720
Medical University of South Carolina
Charleston, South Carolina, 29425
Carolinas Medical Center
Charlotte, North Carolina, 28203
Presbyterian Hospital
Charlotte, North Carolina, 28204
Veterans Administration Medical Center - Cincinnati
Cincinnati, Ohio, 45220
University of Cincinnati
Cincinnati, Ohio, 45267
John B Amos Cancer Center
Columbus, Georgia, 31904
Dekalb Medical Center
Decatur, Georgia, 30033
Cancer Care Center of Decatur
Decatur, Illinois, 62526
Decatur Memorial Hospital
Decatur, Illinois, 62526
Wayne State University
Detroit, Michigan, 48202
City of Hope Medical Center
Duarte, California, 91010
Crossroads Cancer Center
Effingham, Illinois, 62401
Arnot Ogden Medical Center
Elmira, New York, 14905
Poudre Valley Hospital
Fort Collins, Colorado, 80524
Valley Medical Oncology Consultants-Fremont
Fremont, California, 94538
University of Texas Medical Branch at Galveston
Galveston, Texas, 77555-0565
Glendale Memorial Hospital and Health Center
Glendale, California, 91204
Wayne Memorial Hospital
Goldsboro, North Carolina, 27534
Grand Rapids Clinical Oncology Program
Grand Rapids, Michigan, 49503
Saint Mary's Health Care
Grand Rapids, Michigan, 49503
Spectrum Health at Butterworth Campus
Grand Rapids, Michigan, 49503
Benefis Healthcare- Sletten Cancer Institute
Great Falls, Montana, 59405
Berdeaux, Donald MD (UIA Investigator)
Great Falls, Montana, 59405
Great Falls Clinic
Great Falls, Montana, 59405
Marin General Hospital
Greenbrae, California, 94904
Sutter Health Western Division Cancer Research Group
Greenbrae, California, 94904
Cone Health Cancer Center
Greensboro, North Carolina, 27403
Northern Montana Hospital
Havre, Montana, 59501
Saint Peter's Community Hospital
Helena, Montana, 59601
Margaret R Pardee Memorial Hospital
Hendersonville, North Carolina, 28791
Baylor College of Medicine
Houston, Texas, 77030
Ben Taub General Hospital
Houston, Texas, 77030
Methodist Hospital
Houston, Texas, 77030
Saint Luke's Episcopal Hospital
Houston, Texas, 77030
Veterans Administration Medical Center
Houston, Texas, 77030
University of Mississippi Medical Center
Jackson, Mississippi, 39216
NEA Baptist Memorial Hospital
Jonesboro, Arkansas, 72401
Glacier Oncology PLLC
Kalispell, Montana, 59901
Kalispell Medical Oncology
Kalispell, Montana, 59901
Kalispell Regional Medical Center
Kalispell, Montana, 59901
Truman Medical Center
Kansas City, Missouri, 64108
Saint Luke's Cancer Institute
Kansas City, Missouri, 64111
Saint Luke's Hospital of Kansas City
Kansas City, Missouri, 64111
Saint Joseph Health Center
Kansas City, Missouri, 64114
North Kansas City Hospital
Kansas City, Missouri, 64116
Heartland Hematology and Oncology Associates Incorporated
Kansas City, Missouri, 64118
Research Medical Center
Kansas City, Missouri, 64132
Columbia Basin Hematology and Oncology PLLC
Kennewick, Washington, 99336
Gwinnett Medical Center
Lawrenceville, Georgia, 30045
Saint Luke's East - Lee's Summit
Lee's Summit, Missouri, 64086
Liberty Hospital
Liberty, Missouri, 64068
Liberty Radiation Oncology Clinic
Liberty, Missouri, 64068
Logan Regional Hospital
Logan, Utah, 84321
University of Southern California
Los Angeles, California, 90033-0804
Wellstar Kennestone Hospital
Marietta, Georgia, 30060
Contra Costa Regional Medical Center
Martinez, California, 94553-3156
Memorial Hospital Of Martinsville
Martinsville, Virginia, 24115
Community Medical Hospital
Missoula, Montana, 59801
Montana Cancer Specialists
Missoula, Montana, 59802
Saint Patrick Hospital - Community Hospital
Missoula, Montana, 59802
Guardian Oncology and Center for Wellness
Missoula, Montana, 59804
Skagit Valley Hospital
Mount Vernon, Washington, 98274
El Camino Hospital
Mountain View, California, 94040
Intermountain Medical Center
Murray, Utah, 84157
Mercy Health Partners-Mercy Campus
Muskegon, Michigan, 49444
Highland General Hospital
Oakland, California, 94602
Alta Bates Summit Medical Center - Summit Campus
Oakland, California, 94609
Bay Area Breast Surgeons Inc
Oakland, California, 94609
Bay Area Tumor Institute
Oakland, California, 94609
Larry G Strieff MD Medical Corporation
Oakland, California, 94609
Tom K Lee Inc
Oakland, California, 94609
McKay-Dee Hospital Center
Ogden, Utah, 84403
University of California Medical Center At Irvine-Orange Campus
Orange, California, 92868
Menorah Medical Center
Overland Park, Kansas, 66209
Saint Luke's South Hospital
Overland Park, Kansas, 66213
Valley Care Health System - Pleasanton
Pleasanton, California, 94588
Valley Medical Oncology Consultants
Pleasanton, California, 94588
Harrison Poulsbo Hematology and Oncology
Poulsbo, Washington, 98370
Utah Valley Regional Medical Center
Provo, Utah, 84604-3337
Annie Penn Memorial Hospital
Reidsville, North Carolina, 27320
Southern Regional Medical Center
Riverdale, Georgia, 30274
Highland Hospital
Rochester, New York, 14620
Interlakes Foundation Inc-Rochester
Rochester, New York, 14623
University of Rochester
Rochester, New York, 14642
Harbin Clinic Medical Oncology and Clinical Research
Rome, Georgia, 30165
William Beaumont Hospital
Royal Oak, Michigan, 48073
Heartland Regional Medical Center
Saint Joseph, Missouri, 64506
Saint Joseph Oncology Inc
Saint Joseph, Missouri, 64507
Intermountain Health Care
Salt Lake City, Utah, 84103
Utah Cancer Specialists-Salt Lake City
Salt Lake City, Utah, 84106
LDS Hospital
Salt Lake City, Utah, 84143
California Pacific Medical Center
San Francisco, California, 94118
Doctors Medical Center- JC Robinson Regional Cancer Center
San Pablo, California, 94806
Memorial Health University Medical Center
Savannah, Georgia, 31403
Saint Joseph's-Candler Health System
Savannah, Georgia, 31405
Harborview Medical Center
Seattle, Washington, 98104
Minor and James Medical PLLC
Seattle, Washington, 98104
Fred Hutchinson Cancer Research Center/University of Washington Cancer Consortium
Seattle, Washington, 98109
Group Health Cooperative
Seattle, Washington, 98112
Swedish Medical Center-First Hill
Seattle, Washington, 98122-4307
The Polyclinic
Seattle, Washington, 98122
University of Washington Medical Center
Seattle, Washington, 98195
Shawnee Mission Medical Center
Shawnee Mission, Kansas, 66204
Welch Cancer Center
Sheridan, Wyoming, 82801
Cancer Care Northwest - Spokane South
Spokane, Washington, 99202
Evergreen Hematology and Oncology PS
Spokane, Washington, 99218
Saint Louis University Hospital
St Louis, Missouri, 63110
Dixie Medical Center Regional Cancer Center
St. George, Utah, 84770
Scott and White Memorial Hospital
Temple, Texas, 76508
Munson Medical Center
Traverse City, Michigan, 49684
South Georgia Medical Center
Valdosta, Georgia, 31603
Sutter Solano Medical Center
Vallejo, California, 94589
Wenatchee Valley Medical Center
Wenatchee, Washington, 98801
Metro Health Hospital
Wyoming, Michigan, 49519
About this study
Official title: A Phase I and Randomized Phase II Trial of Gemcitabine + Erlotinib (NSC-718781) + IMC-A12 (NSC-742460) vs. Gemcitabine + Erlotinib as First-Line Treatment in Patients With Metastatic Pancreatic Cancer
This randomized phase I/II trial is studying the side effects and best dose of monoclonal antibody therapy when given together with gemcitabine hydrochloride and erlotinib hydrochloride and to see how well they work compared with giving gemcitabine hydrochloride and erlotinib hydrochloride alone as first-line therapy in treating patients with metastatic pancreatic cancer that cannot be removed by surgery. Drugs used in chemotherapy, such as gemcitabine hydrochloride, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Erlotinib hydrochloride may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Monoclonal antibodies can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Giving erlotinib hydrochloride and gemcitabine hydrochloride together with monoclonal antibody therapy may kill more tumor cells.
Read the detailed description
PRIMARY OBJECTIVES:
- To assess the appropriate dose of IMC-A12 (cixutumumab) to use in combination with gemcitabine (gemcitabine hydrochloride) and erlotinib (erlotinib hydrochloride). (Phase I) II. To assess progression-free survival in patients with metastatic pancreatic cancer treated with IMC-A12 plus gemcitabine and erlotinib compared to those treated with gemcitabine plus erlotinib alone. (Phase II) III. To assess overall survival in each of the two treatment arms in this group of patients. (Phase II) IV. To assess the total response probability (confirmed and unconfirmed, complete and partial responses) in each of the two treatment arms in the subset of this group of patients with measurable disease. (Phase II) V. To assess the qualitative and quantitative toxicities in each of the two treatment arms in this group of patients. (Phase II)
OUTLINE: This is a multicenter, phase I, dose-escalation study of cixutumumab followed by a randomized, phase II study.
Patients are initially enrolled into the phase I portion of the study to determine the recommended phase II dose (RPTD) of cixutumumab. Once the RPTD is determined, patients are enrolled into the phase II portion of the study.
PHASE I (LIMITED INSTITUTIONS): Patients receive erlotinib hydrochloride orally (PO) once daily on days 1-28, gemcitabine hydrochloride intravenously (IV) over 30 minutes on days 1, 8, and 15, and cixutumumab IV over 60 minutes on days 1, 8, 15, and 22. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity.
PHASE II (ALL SWOG MEMBERS): Patients are randomized to 1 of 2 treatment arms.
ARM I: Patients receive erlotinib hydrochloride, gemcitabine hydrochloride, and cixutumumab at the RPTD as in phase I.
ARM II: Patients receive erlotinib hydrochloride and gemcitabine hydrochloride as in arm I.
In both arms, treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity.
Previously collected tumor tissue is obtained for gene expression analyses by RT-PCR, RNA isolation, and cDNA synthesis. Blood samples are collected periodically for correlative studies. Samples are assessed for the potential relationship between gene expression levels, germline polymorphisms, Ras and P13K mutations and progression-free survival and overall survival.
After completion of study treatment, patients are followed every 6 months for up to 3 years.
- Conditions
- Stage IV Pancreatic Cancer
- Being tested
- cixutumumab, erlotinib hydrochloride, gemcitabine hydrochloride
- Medical subject headings
- Pancreatic Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
cixutumumabBiological
Also called anti-IGF-1R recombinant monoclonal antibody IMC-A12, IMC-A12
Given IV
erlotinib hydrochlorideDrug
Also called CP-358,774, erlotinib, OSI-774
Given PO
Also called dFdC, difluorodeoxycytidine hydrochloride, gemcitabine, Gemzar
Given IV
| Study group | Role | What they receive |
|---|---|---|
| Arm I (erlotinib, gemcitabine, cixutumumab) | Experimental | Patients receive erlotinib hydrochloride PO once daily on days 1-28, gemcitabine hydrochloride IV over 30 minutes on days 1, 8, and 15, and cixutumumab IV over 60 minutes on days 1, 8, 15, and 22. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity. Receives: Biological: cixutumumab; Drug: erlotinib hydrochloride; Drug: gemcitabine hydrochloride |
| Arm II (erlotinib, gemcitabine) | Active comparator | Patients receive erlotinib hydrochloride and gemcitabine hydrochloride as in arm I. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity. Receives: Drug: erlotinib hydrochloride; Drug: gemcitabine hydrochloride |
What is being measured
The primary outcome is the main question the study is designed to answer.
Maximum Tolerated Dose Determination
Maximum dose of IMC-A12 (in combination with erlotinib and gemcitabine) at which 3/10 or fewer patients have dose-limiting toxicities (DLT). Toxicities graded according to the NCI Common Terminology Criteria for Adverse Events Version 3.0 (CTCAE 3.0). DLT apply only during cycle 1 and should be drug-related (possible, probable, or definite).
Measured: 28 days
Progression-Free Survival
From date of registration to date of first documentation of progression or symptomatic deterioration, or death due to any cause. Patients last known to be alive and progression free are censored at date of last contact.
Measured: Up to 3 years
Secondary outcomes (3)
Overall Survival
From date of registration to date of death due to any cause. Patients last known to be alive are censored at date of last contact.
Measured: Up to 3 years
Response
Confirmed response (CR) is two or more objective statuses of CR a minimum of four weeks apart documented before progression or symptomatic deterioration. Partial response (PR) is two or more objective statuses of PR or better a minimum of four weeks apart documented before progression or symptomatic deterioration. Unconfirmed CR is one objective status of CR documented before progression or symptomatic deterioration but not qualifying as CR or PR. Unconfirmed PR is one objective status of PR documented before progression or symptomatic deterioration but not qualifying as CR, PR or unconfirmed CR.
Measured: Up to 3 years
Toxicity
Number of patients with Grade 3 through 5 adverse events that are related to study drug. Only adverse events that are possibly, probably or definitely related to study drug are reported.
Measured: Up to 3 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted18 Feb 2008 (estimated)
- Study startMar 2008
- Primary completion1 Sep 2012
- Study completion25 Feb 2014
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for Stage IV Pancreatic CancerStudies of the same condition, open and under way.
- More trials run by National Cancer Institute (NCI)The sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 1/2
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 134 participants (actual)
Sponsor and investigators
- Lead sponsor
- National Cancer Institute (NCI)
- Sponsor type
- US National Institutes of Health
- Responsible party
- Sponsor
- Investigators
- Philip Philip, Principal investigator, SWOG Cancer Research Network
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00617708
- Sponsor's protocol ID
- NCI-2009-00797
- Other IDs
- NCI-2009-00797, CDR0000586427, SWOG-S0727, S0727, S0727, U10CA032102
- Status last verified
- Jan 2022
- First submitted
- 15 Feb 2008
- Last updated
- 8 Feb 2022
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
Study at a glance
From the registry record, last updated by the sponsor on 8 Feb 2022. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase I and Randomized Phase II Trial of Gemcitabine + Erlotinib (NSC-718781) + IMC-A12 (NSC-742460) vs. Gemcitabine + Erlotinib as First-Line Treatment in Patients With Metastatic Pancreatic Cancer
- ClinicalTrials.gov ID
- NCT00617708
- Acronym / sponsor ID
- NCI-2009-00797
- Conditions
- Stage IV Pancreatic Cancer
- Phase
- Phase 1/2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 134 participants (actual)
- Lead sponsor
- National Cancer Institute (NCI)US National Institutes of Health
- Study start
- Mar 2008
- Primary completion
- 1 Sep 2012 (actual)
- Study completion
- 25 Feb 2014 (actual)
- First posted
- 18 Feb 2008 (estimated)
- Results
- Posted 5 Dec 2013
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This randomized phase I/II trial is studying the side effects and best dose of monoclonal antibody therapy when given together with gemcitabine hydrochloride and erlotinib hydrochloride and to see how well they work compared with giving gemcitabine hydrochloride and erlotinib hydrochloride alone as first-line therapy in treating patients with metastatic pancreatic cancer that cannot be removed by surgery. Drugs used in chemotherapy, such as gemcitabine hydrochloride, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Erlotinib hydrochloride may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Monoclonal antibodies can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Giving erlotinib hydrochloride and gemcitabine hydrochloride together with monoclonal antibody therapy may kill more tumor cells.
Detailed description
PRIMARY OBJECTIVES:
- To assess the appropriate dose of IMC-A12 (cixutumumab) to use in combination with gemcitabine (gemcitabine hydrochloride) and erlotinib (erlotinib hydrochloride). (Phase I) II. To assess progression-free survival in patients with metastatic pancreatic cancer treated with IMC-A12 plus gemcitabine and erlotinib compared to those treated with gemcitabine plus erlotinib alone. (Phase II) III. To assess overall survival in each of the two treatment arms in this group of patients. (Phase II) IV. To assess the total response probability (confirmed and unconfirmed, complete and partial responses) in each of the two treatment arms in the subset of this group of patients with measurable disease. (Phase II) V. To assess the qualitative and quantitative toxicities in each of the two treatment arms in this group of patients. (Phase II)
OUTLINE: This is a multicenter, phase I, dose-escalation study of cixutumumab followed by a randomized, phase II study.
Patients are initially enrolled into the phase I portion of the study to determine the recommended phase II dose (RPTD) of cixutumumab. Once the RPTD is determined, patients are enrolled into the phase II portion of the study.
PHASE I (LIMITED INSTITUTIONS): Patients receive erlotinib hydrochloride orally (PO) once daily on days 1-28, gemcitabine hydrochloride intravenously (IV) over 30 minutes on days 1, 8, and 15, and cixutumumab IV over 60 minutes on days 1, 8, 15, and 22. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity.
PHASE II (ALL SWOG MEMBERS): Patients are randomized to 1 of 2 treatment arms.
ARM I: Patients receive erlotinib hydrochloride, gemcitabine hydrochloride, and cixutumumab at the RPTD as in phase I.
ARM II: Patients receive erlotinib hydrochloride and gemcitabine hydrochloride as in arm I.
In both arms, treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity.
Previously collected tumor tissue is obtained for gene expression analyses by RT-PCR, RNA isolation, and cDNA synthesis. Blood samples are collected periodically for correlative studies. Samples are assessed for the potential relationship between gene expression levels, germline polymorphisms, Ras and P13K mutations and progression-free survival and overall survival.
After completion of study treatment, patients are followed every 6 months for up to 3 years.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Arm I (erlotinib, gemcitabine, cixutumumab) | Experimental | Biological: cixutumumab, Drug: erlotinib hydrochloride, Drug: gemcitabine hydrochloridePatients receive erlotinib hydrochloride PO once daily on days 1-28, gemcitabine hydrochloride IV over 30 minutes on days 1, 8, and 15, and cixutumumab IV over 60 minutes on days 1, 8, 15, and 22. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity. |
| Arm II (erlotinib, gemcitabine) | Active comparator | Drug: erlotinib hydrochloride, Drug: gemcitabine hydrochloridePatients receive erlotinib hydrochloride and gemcitabine hydrochloride as in arm I. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (69 listed)
- Histologically or cytologically confirmed pancreatic adenocarcinoma
- Measurable and/or nonmeasurable disease
- No endocrine or neuroendocrine tumors, lymphoma of the pancreas, or ampullary cancer
- No macroscopic residual disease post-resection as the only site of disease
- No clinically significant ascites
Key exclusion criteria (0 listed)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| cixutumumabAlso: anti-IGF-1R recombinant monoclonal antibody IMC-A12, IMC-A12Given IV | Biological | Arm I (erlotinib, gemcitabine, cixutumumab) |
| erlotinib hydrochlorideAlso: CP-358,774, erlotinib, OSI-774Given PO | Drug | Arm I (erlotinib, gemcitabine, cixutumumab), Arm II (erlotinib, gemcitabine) |
| gemcitabine hydrochlorideAlso: dFdC, difluorodeoxycytidine hydrochloride, gemcitabine, GemzarGiven IV | Drug | Arm I (erlotinib, gemcitabine, cixutumumab), Arm II (erlotinib, gemcitabine) |
Primary outcome
Maximum Tolerated Dose Determination
Time frame: 28 days
Maximum dose of IMC-A12 (in combination with erlotinib and gemcitabine) at which 3/10 or fewer patients have dose-limiting toxicities (DLT). Toxicities graded according to the NCI Common Terminology Criteria for Adverse Events Version 3.0 (CTCAE 3.0). DLT apply only during cycle 1 and should be drug-related (possible, probable, or definite).
Progression-Free Survival
Time frame: Up to 3 years
From date of registration to date of first documentation of progression or symptomatic deterioration, or death due to any cause. Patients last known to be alive and progression free are censored at date of last contact.
3 secondary outcomes
Overall Survival
Time frame: Up to 3 years
Response
Time frame: Up to 3 years
Toxicity
Time frame: Up to 3 years
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 8 Feb 2022.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
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RecruitingObservational study
Collecting Blood Samples From Patients With and Without Cancer to Evaluate Tests for Early Cancer Detection
Acute Lymphoblastic Leukemia, Acute Myeloid Leukemia
Active, not recruitingPhase 2
Hypofractionated Stereotactic Body Radiation & Fluorouracil or Capecitabine for Locally Advanced Pancreatic Cancer
Pancreatic Adenocarcinoma, Recurrent Pancreatic Carcinoma
Active, not recruitingPhase 1
Vaccine Therapy and Sargramostim in Treating Patients With Pancreas Cancer That Cannot Be Removed By Surgery
Locally Advanced Pancreatic Adenocarcinoma, Pancreatic Acinar Cell Carcinoma
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Philip Philip principal investigator
SWOG Cancer Research Network
146 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 1/2 study testing cixutumumab, erlotinib hydrochloride and gemcitabine hydrochloride in people with Stage IV Pancreatic Cancer, run by National Cancer Institute (NCI) at 146 sites in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 69 inclusion and 0 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 8 Feb 2022. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 146 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this combined phase mean?
Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 5 Dec 2013). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Maximum Tolerated Dose Determination (time frame: 28 days). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Feb 2022.