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Pancreatic TumorNCT01434550

Phase II Study of First-line SBRT in Patients With Non-Metastatic Unresectable Pancreatic Cancer

A study testing Stereotactic Body Radiation Therapy (SBRT) and Tissue, Blood, Research Imaging (TBRI) in people with Pancreatic Tumor, run by H. Lee Moffitt Cancer Center and Research Institute.

Withdrawn

Withdrawn. The study stopped before anyone enrolled.

Official record
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Trial summary

The purpose of this study is to see if SBRT will be a better way to treat pancreas cancer and to find out what effects, good and/or bad, this treatment will have on participants and their cancer. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Pancreatic Tumor
What is being tested?
Stereotactic Body Radiation Therapy (SBRT) and Tissue, Blood, Research Imaging (TBRI)
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
0 participants
Where
No sites listed yet
Study dates
Mar 2012to Aug 2015
Phase
Interventional
Are there results?
None posted in the registry

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

  • Biopsy proven, non-metastatic, pancreatic cancer
  • Unresectable disease based on institutional standardized criteria for unresectability
  • Eastern Cooperative Oncology Group (ECOG) Performance Status 0-2
  • CT scan of chest and abdomen (3-phase pancreas protocol), and PET-CT within 4 weeks of study entry
  • Patients with biliary or gastroduodenal obstruction must have drainage, duodenal stenting, or gastric bypass prior to initiating radiation
  • All disease must be encompassed in a single radiation field
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  • No evidence or history of an autoimmune dysfunction
  • Negative pregnancy test within 7 days of study entry
  • No prior or concurrent chemotherapy
  • No previous or concurrent immunotherapy for pancreatic cancer
  • Liver enzymes ≤ 3 times upper limit of normal (ULN): total bilirubin (Tbili) ≤ 3.9 (biliary stents are allowed); aspartic transaminase (AST) ≤ 177; alanine transaminase (ALT) ≤ 198; Alkaline phosphatase (ALK-P) ≤ 378
  • Adequate pretreatment organ function: Creatinine no greater than 1.5mg/dL; Total calcium no greater than 11.0mg/dL; prothrombin time (PT) no greater then 14 seconds; partial thromboplastin time (PTT) no greater then 40 seconds
  • Ability to give informed consent
  • Adequate baseline hematopoietic function: total white blood cell count equal to or greater than 3,000/mm³; absolute granulocyte count greater than 1,500/mm³; absolute lymphocyte count greater than 500/mm³; platelet count equal to or greater than 100,000/mm³
  • All Participant inclusion criteria
  • Amenable to leukapheresis as determined by a leukapheresis nurse
  • Primary tumor that is accessible to direct intratumoral injection by CT-guidance confirmed by interventional radiologist
  • No history of autoimmune disease
  • No history of human immunodeficiency virus (HIV) or acquired immune deficiency syndrome (AIDS) or other immunosuppressive diseases
  • No active viral or bacterial infection
  • No use of steroids or any other immunosuppressive drug at least 4 weeks prior to enrollment on study

Who cannot join

  • Prior history of radiotherapy that overlaps with the planned ports to the primary pancreatic tumor
  • Patients with tumors that are not accessible to direct access cannot be included in the study.
  • Prior or concurrent chemotherapy
  • Prior history of antineoplastic therapy or irradiation
  • Prior treatment with anti-tumor vaccines not allowed
  • Patients with a history of autoimmune diseases
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  • A history of HIV infection, AIDS or other immunosuppressive disease state. The need to exclude patients with HIV/AIDS is because one of the endpoints of the study is immune response. People with HIV have a compromised immune system and enrollment in this study could confound the results (TBRI only)
  • Patients requiring corticosteroids are ineligible because one of the endpoints of the study is immune response. Since steroids modulate the immune system, enrollment of patients on steroids could confound the results. There must be no use of corticosteroids in the fours weeks preceding entry into the study (TBRI only).
  • Active bacterial, fungal or viral infection
  • Active bleeding (hemoptysis, melena, etc.)
  • Women who are currently pregnant or actively breast feeding. Women of childbearing potential must have a negative serum pregnancy test and must use effective contraception during trial participation
  • Any medical or psychiatric illness which in the opinion of the principal investigator might compromise a patient's ability to tolerate or complete treatment
  • Any patient requiring blood thinners (due to risk of gastrointestinal [GI] bleed)

About this study

Official title: Phase II Study of First-line Stereotactic Body Radiation Therapy (SBRT) in Patients With Non-Metastatic Unresectable Pancreatic Cancer

The purpose of this study is to see if SBRT will be a better way to treat pancreas cancer and to find out what effects, good and/or bad, this treatment will have on participants and their cancer.

Read the detailed description

The standard treatment for cancer of the pancreas is surgery (if possible), external beam radiation therapy and/or chemotherapy. These standard treatments are not a cure and often extend life by just a few months. Recently, a new approach has been developed, called stereotactic body radiation therapy (SBRT). Based on the results of earlier studies using SBRT, the study doctors at Moffitt feel this is a reasonable alternative to the standard treatment for your disease.

Stereotactic body radiation therapy (SBRT) delivers high radiation doses to the tumor every day for 5 days which gives the usual 5-6 week course of radiation in less than a week. It has also been shown to have much less side effects.

The purpose of this study is to see if SBRT will be a better way to treat pancreas cancer and to find out what effects, good and/or bad, this treatment will have on you and your cancer.

Six patients will be asked to be part of a subgroup called TBRI (Tissue, Blood, Research Imaging). In this subgroup, the investigators want to study if there is early death of tumor cells from the treatment by looking at the tumor using PET/CT scans and biopsies, and by testing your body's white blood cells taken by a procedure called leukapheresis. You do not have to take part in the TBRI subgroup to get treatment on this study with SBRT.

Being tested
Stereotactic Body Radiation Therapy (SBRT), Tissue, Blood, Research Imaging (TBRI)
Keywords
pancreas, pancreatic cancer, SBRT, stereotactic body radiation, radiation therapy, unresectable, non-metastatic, tissue, blood, research imaging, TBRI
Medical subject headings
Pancreatic Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Stereotactic Body Radiation Therapy (SBRT)Radiation

    Also called extracranial lesions, high-dose fractions, radiosurgery

    Everyone who takes part in this study will receive SBRT. After making an individual radiation plan for each participant, they will receive 5 days of radiation to the pancreas. Participants will have follow-up visits with blood tests one month after the end of SBRT and then every 3 months for 3 years. They will also have CT scans (chest and pancreas) and FDG PET/CT (body) at 1 month and then at 3, 6, 9 and 12 months.

  • Tissue, Blood, Research Imaging (TBRI)Radiation

    Also called CT guided biopsy, Imaging to evaluate cell death, Aposense-PET imaging

    Post-SBRT procedures (day 1, 3, 5 of SBRT, and 4 weeks after) A) Endoscopic or CT guided biopsy of treated pancreatic cancer to assess

    1. Necrosis/apoptosis
    2. Lymphocyte infiltrate and antigen presenting cells B) Imaging to evaluate cell death (day 1, 3, 5 of SBRT, and 4 weeks after)
    3. Aposense-PET imaging
Study groups in NCT01434550
Study groupRoleWhat they receive
TBRI Subgroup: TBRI and SBRTActive comparatorSix patients will be asked to be part of a subgroup called TBRI (Tissue, Blood, Research Imaging). In this subgroup, we want to study if there is early death of tumor cells from the treatment by looking at the tumor using PET/CT scans and biopsies, and by testing the participant's body's white blood cells taken by a procedure called leukapheresis. Participants do not have to take part in the TBRI subgroup to get treatment on this study with SBRT. SBRT: 1. 30 Gy in 5 fractions to pancreatic tumor 2. 50 Gy in 5 daily consecutive fractions unresectable portion and avoiding bowel, stomach, and duodenum
Receives: Radiation: Stereotactic Body Radiation Therapy (SBRT); Radiation: Tissue, Blood, Research Imaging (TBRI)
SBRT AloneActive comparator1. 30 Gy in 5 fractions to pancreatic tumor 2. 50 Gy in 5 daily consecutive fractions unresectable portion and avoiding bowel, stomach, and duodenum
Receives: Radiation: Stereotactic Body Radiation Therapy (SBRT)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of Participants With Overall Survival (OS)

    Patients will be followed for 36 months to determine overall survival even after completion of the experimental portion of the protocol. Patients will be followed every 3 months. All patients will be referred for chemotherapy at the completion of radiation.

    Measured: 36 Months

Secondary outcomes (2)
  1. Number of Participants With Reduction in Size of Primary Tumor

    Patients will undergo 64 slice helical computed tomography (CT) scan and feeding (FDG) pressure equalizing tube (PET)-CT scan pretreatment and at the conclusion of the study which will be separated by a 5 week time span. Subsequent helical CT and FDG PET-CT scans will be performed at 3, 6, 9 and 12 months with CA 19-9 levels. The Response Evaluation Criteria In Solid Tumors (RECIST) criteria will be used to measure clinical response. Time to local and distant disease progression will also be measured.

    Measured: 12 Months

  2. Number of Participants With Adverse Events (AEs)

    Toxicity response will be assessed and reported using the NCI Common Terminology Criteria for Adverse Events (CTCAE) version 4.0.

    Measured: 36 Months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted15 Sep 2011 (estimated)
  2. Study startMar 2012
  3. Primary completionAug 2015 (estimated)
  4. Study completionAug 2015 (estimated)

Why it stopped: research cancelled

Resources

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 N/A
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
0 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01434550
Sponsor's protocol ID
MCC-16459
Status last verified
Feb 2017
First submitted
13 Sep 2011
Last updated
23 Feb 2017
Results posted
No
Data monitoring committee
Yes

Questions about this trial

What is this clinical trial studying?

A study testing Stereotactic Body Radiation Therapy (SBRT) and Tissue, Blood, Research Imaging (TBRI) in people with Pancreatic Tumor, run by H. Lee Moffitt Cancer Center and Research Institute.

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 21 inclusion and 13 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: withdrawn, as of the sponsor's last update on 23 Feb 2017. Status can change between updates, so confirm with the study contact before making plans.

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.

Are results available for this study?

The study was withdrawn before enrolling participants, so there are no results.

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?

Number of Participants With Overall Survival (OS) (time frame: 36 Months). 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 23 Feb 2017.

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