Pancreatic CancerPhase 3NCT01926197
Phase 3 Study of FOLFIRINOX (mFFX) +/- SBRT in Locally Advanced Pancreatic Cancer
A Phase 3 study testing Oxaliplatin, Irinotecan and Leucovorin in people with Pancreatic Cancer, run by Stanford University at 9 sites in 2 countries.
Trial summary
The goal of this study is to determine the safety and efficacy of a chemotherapy regimen known as Modified FOLFIRINOX (mFFX) alone or with the addition of Stereotactic Body Radiotherapy (SBRT). Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Pancreatic Cancer
- What is being tested?
- Oxaliplatin, Irinotecan and Leucovorin
- Type of treatment
- Injection or infusion, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 27 participants
- Where
- 9 sitesin 2 countries
- Study dates
- 14 Aug 2013to 30 Sep 2022
- Phase
- Phase 3
- 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-confirmed adenocarcinoma of the pancreas
- Determined unresectable by a pancreatic cancer surgeon or a multi-disciplinary or gastrointestinal oncology Tumor Board.
- Stable or better disease on re-staging scans
- Typically, tumors < 8.0 cm in greatest axial dimension but final determination of eligibility based upon radiation normal tissue constraints
- Eastern Cooperative Oncology Group (ECOG) Performance Status 0, 1, or 2
- Leukocytes (white blood cells, WBC) ≥ 3,000/mL
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- Absolute neutrophil count (ANC) ≥ 1,500/mL
- Platelets ≥ 50,000/mL
- Total bilirubin ≤ 1.5 X institutional upper limit of normal (ULN)
- Aspartate aminotransferase (AST) / alanine aminotransferase (ALT) ≤ 2.5 X institutional ULN
- Creatinine within normal institutional limits
- Ability to understand and the willingness to sign an informed consent form
- Life expectancy > 6 months
Who cannot join
- Metastatic disease
- Prior radiotherapy to the upper abdomen/liver.
- Prior chemotherapy for pancreatic cancer, other than up to 4 cycles of modified FOLFIRINOX.
- Age < 18 years
- Uncontrolled intercurrent illness including, but not limited to:
- Ongoing or active infection (or infections requiring systemic antibiotic treatment)
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- Symptomatic congestive heart failure
- Unstable angina pectoris
- Cardiac arrhythmia
- Psychiatric illness/social situations that would limit compliance with study requirements.
- Any concurrent malignancy other than non-melanoma skin cancer, non-invasive bladder cancer, or carcinoma in situ of the cervix. Patients with a previous malignancy without evidence of disease for > 5 years will be allowed to enter the trial.
- Pregnant or lactating
- Women of child-bearing potential who are unwilling or unable to use an acceptable method of birth control (hormonal or barrier method of birth control; abstinence) for duration of the study
- Women who are not post-menopausal (as defined in Appendix III) and have a positive urine or serum pregnancy test or refuse to take a pregnancy test
- Male subjects who are unwilling or unable to use effective contraception for duration of the study
Trial locations and contacts
9 sites in 2 countries.
9 sites in 2 countries
United States7 sites
Medical University of South Carolina
Charleston, South Carolina, 29425
University of Texas Southwestern Medical Center
Dallas, Texas, 75390
UCLA
Los Angeles, California, 60153
Loyola University
Maywood, Illinois, 60153
UCSF
San Francisco, California, 94143
Swedish Cancer Institute
Seattle, Washington, 98107
Stanford University, School of Medicine
Stanford, California, 94305
Canada2 sites
Princess Margaret Cancer Centre
Toronto, Ontario
BC Cancer Agency
Vancouver, British Columbia, V5Z 4E6
About this study
Official title: A Randomized Phase III Study Evaluating Modified FOLFIRINOX (mFFX) With or Without Stereotactic Body Radiotherapy (SBRT) in the Treatment of Locally Advanced Pancreatic Cancer: A Pancreatic Cancer Radiotherapy Study Group (PanCRS) Trial
The goal of this study is to determine the safety and efficacy of a chemotherapy regimen known as Modified FOLFIRINOX (mFFX) alone or with the addition of Stereotactic Body Radiotherapy (SBRT). We hope to learn if this new treatment combination helps to control the disease and improve survival for patients with locally advanced pancreatic cancer.
Read the detailed description
Primary Objective:
To determine progression free survival for mFFX +/- SBRT.
Secondary Objectives:
- To determine metastasis free survival following mFFX chemotherapy alone or with SBRT.
- To determine the overall survival in pancreatic cancer patients treated with chemotherapy +/- SBRT.
- To determine local progression-free survival in pancreatic cancer patients after chemotherapy +/- SBRT.
- To evaluate acute (within 3 months of treatment) grade 2 or greater gastritis, fistula, enteritis, or ulcer and any other grade 3-4 gastrointestinal toxicity within 3 months of treatment.
- To evaluate the utility of FDG-PET for treatment planning and estimation of progression free survival.
- To identify new biomarkers in pancreatic cancer.
- To evaluate the quality of life of patients before and after either chemotherapy or chemotherapy and SBRT.
- Conditions
- Pancreatic Cancer
- Being tested
- Oxaliplatin, Irinotecan, Leucovorin, 5FU, Stereotactic Body Radiotherapy (SBRT)
- Medical subject headings
- Pancreatic Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
OxaliplatinDrug
Also called Eloxatin
Oxaliplatin 85 mg/m² IV over 2 hours on Day 1 of a 14-day cycle.
IrinotecanDrug
Also called Camptosar, Camptothecin-11 (CPT-11), Campto, Onivyde
Irinotecan 180 mg/m² IV over 90 minutes on Day 1 of a 14-day cycle.
LeucovorinDrug
Also called Folinic acid, Wellcovorin, Citrovorum Factor
Leucovorin 400 mg/m² IV over 2 hours on Day 1 of a 14-day cycle.
5FUDrug
Also called 5-fluorouracil, Tolak, Fluoroplex, Efudex
5FU 2,400 mg/m² IV over 46 to 48 hours starting on Day 1 of a 14-day cycle.
Stereotactic Body Radiotherapy (SBRT)Radiation
Radiotherapy treatment starting about 8 weeks after modified FOLFIRINOX induction chemotherapy, administered as 5 fractions of 8 Grey (Gy) each, on 5 separate days.
| Study group | Role | What they receive |
|---|---|---|
| Modified FOLFIRINOX | Active comparator | Modified FOLFIRINOX (mFFX), a chemotherapeutic treatment regimen of 5FU, leucovorin, irinotecan, and oxaliplatin. Receives: Drug: Oxaliplatin; Drug: Irinotecan; Drug: Leucovorin; Drug: 5FU |
| Modified FOLFIRINOX plus Stereotactic Body Radiotherapy | Experimental | Modified FOLFIRINOX (mFFX), a chemotherapeutic treatment regimen of 5FU, leucovorin, irinotecan, and oxaliplatin, in combination with stereotactic body radiotherapy (SBRT) Receives: Drug: Oxaliplatin; Drug: Irinotecan; Drug: Leucovorin; Drug: 5FU; Radiation: Stereotactic Body Radiotherapy (SBRT) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Progression-free Survival (PFS)
Progression-free survival (PFS) means the period of time that a participant remains alive without tumor progression either locally or at a distant site in the body (metastasis). The effect of the study treatments was assessed as the median PFS of participants in the treatment groups. The outcome is reported as the median PFS with standard deviation.
Measured: 38 months
Secondary outcomes (5)
Local Progression-free Survival (Local PFS)
Local progression-free survival (PFS) means the period of time that a participant remains alive without recurrence or advancement of the disease at the baseline sites of the tumor (local progression). The effect of the study treatments was assessed as the median local PFS of participants in the treatment groups. The outcome is reported as the median local PFS with standard deviation.
Measured: 38 months
Progression-free Survival (PFS) at 1 Year
Progression-free survival (PFS) means the period of time that a participant remains alive without tumor progression either locally or at a distant site in the body (metastasis). The effect of the study treatments was assessed as the number of participants in each treatment group that remained alive without tumor progression, at 1 year after treatment.
The outcome is reported as a number without dispersion.
Measured: 1 year
Metastasis-free Survival (MFS)
Metastasis-free survival (MFS) means the period of time that a participant remains alive without the appearance of new tumor lesions a distant site in the body (metastasis). The effect of the study treatments was assessed as the median MFS of participants in the treatment groups. The outcome is reported as the median PFS with standard deviation.
Measured: 62 months
Overall Survival (OS)
The effect of the study treatments was assessed as the length of time participants in each treatment group that remained alive. The outcome is reported as the median OS with standard deviation.
Measured: 62 months
Grade 2 or Greater Gastrointestinal (GI) Toxicity
Toxicity means an adverse event related to the study treatment. Toxicity was assessed between treatment groups as the number of treatment-related , ≥ grade 2 events of gastritis, fistula, enteritis, or ulcer; plus any other Grade 3 to 5 gastrointestinal (GI) toxicity. The outcome is reported as the number of defined adverse events by preferred term for each treatment group, occurring within 3 months of the start of treatment. These adverse events by definition are all within the Common Terminology Criteria for Adverse Events (CTCAE) version 4.01 Gastrointestinal Body System. The outcome is reported as numbers without dispersion.
All-cause Mortality mFFX 7 SBRT 8
Measured: 3 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted20 Aug 2013 (estimated)
- Study start14 Aug 2013
- Primary completion30 Sep 2021
- Study completion30 Sep 2022
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 Pancreatic CancerStudies of the same condition, open and under way.
- More trials run by Stanford UniversityThe 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 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 27 participants (actual)
Sponsor and investigators
- Lead sponsor
- Stanford University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Lucas Kas Vitzthum, Stanford University
- Investigators
- Daniel T Chang, Principal investigator, Stanford University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01926197
- Sponsor's protocol ID
- IRB-27492
- Other IDs
- PANC0015, NCI-2013-01658
- Status last verified
- Oct 2022
- First submitted
- 15 Aug 2013
- Last updated
- 28 Oct 2022
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 28 Oct 2022. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Randomized Phase III Study Evaluating Modified FOLFIRINOX (mFFX) With or Without Stereotactic Body Radiotherapy (SBRT) in the Treatment of Locally Advanced Pancreatic Cancer: A Pancreatic Cancer Radiotherapy Study Group (PanCRS) Trial
- ClinicalTrials.gov ID
- NCT01926197
- Acronym / sponsor ID
- IRB-27492
- Conditions
- Pancreatic Cancer
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 27 participants (actual)
- Lead sponsor
- Stanford UniversityUniversity, hospital or other
- Study start
- 14 Aug 2013 (actual)
- Primary completion
- 30 Sep 2021 (actual)
- Study completion
- 30 Sep 2022 (actual)
- First posted
- 20 Aug 2013 (estimated)
- Results
- Posted 28 Oct 2022
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this study is to determine the safety and efficacy of a chemotherapy regimen known as Modified FOLFIRINOX (mFFX) alone or with the addition of Stereotactic Body Radiotherapy (SBRT). We hope to learn if this new treatment combination helps to control the disease and improve survival for patients with locally advanced pancreatic cancer.
Detailed description
Primary Objective:
To determine progression free survival for mFFX +/- SBRT.
Secondary Objectives:
- To determine metastasis free survival following mFFX chemotherapy alone or with SBRT.
- To determine the overall survival in pancreatic cancer patients treated with chemotherapy +/- SBRT.
- To determine local progression-free survival in pancreatic cancer patients after chemotherapy +/- SBRT.
- To evaluate acute (within 3 months of treatment) grade 2 or greater gastritis, fistula, enteritis, or ulcer and any other grade 3-4 gastrointestinal toxicity within 3 months of treatment.
- To evaluate the utility of FDG-PET for treatment planning and estimation of progression free survival.
- To identify new biomarkers in pancreatic cancer.
- To evaluate the quality of life of patients before and after either chemotherapy or chemotherapy and SBRT.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Modified FOLFIRINOX | Active comparator | Drug: Oxaliplatin, Drug: Irinotecan, Drug: Leucovorin, Drug: 5FUModified FOLFIRINOX (mFFX), a chemotherapeutic treatment regimen of 5FU, leucovorin, irinotecan, and oxaliplatin. |
| Modified FOLFIRINOX plus Stereotactic Body Radiotherapy | Experimental | Drug: Oxaliplatin, Drug: Irinotecan, Drug: Leucovorin, Drug: 5FU, Radiation: Stereotactic Body Radiotherapy (SBRT)Modified FOLFIRINOX (mFFX), a chemotherapeutic treatment regimen of 5FU, leucovorin, irinotecan, and oxaliplatin, in combination with stereotactic body radiotherapy (SBRT) |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (13 listed)
- Histologically-confirmed adenocarcinoma of the pancreas
- Determined unresectable by a pancreatic cancer surgeon or a multi-disciplinary or gastrointestinal oncology Tumor Board.
- Stable or better disease on re-staging scans
- Typically, tumors < 8.0 cm in greatest axial dimension but final determination of eligibility based upon radiation normal tissue constraints
- Eastern Cooperative Oncology Group (ECOG) Performance Status 0, 1, or 2
Key exclusion criteria (15 listed)
- Metastatic disease
- Prior radiotherapy to the upper abdomen/liver.
- Prior chemotherapy for pancreatic cancer, other than up to 4 cycles of modified FOLFIRINOX.
- Age < 18 years
- Uncontrolled intercurrent illness including, but not limited to:
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 |
|---|---|---|
| OxaliplatinAlso: EloxatinOxaliplatin 85 mg/m² IV over 2 hours on Day 1 of a 14-day cycle. | Drug | Modified FOLFIRINOX, Modified FOLFIRINOX plus Stereotactic Body Radiotherapy |
| IrinotecanAlso: Camptosar, Camptothecin-11 (CPT-11), Campto, OnivydeIrinotecan 180 mg/m² IV over 90 minutes on Day 1 of a 14-day cycle. | Drug | Modified FOLFIRINOX, Modified FOLFIRINOX plus Stereotactic Body Radiotherapy |
| LeucovorinAlso: Folinic acid, Wellcovorin, Citrovorum FactorLeucovorin 400 mg/m² IV over 2 hours on Day 1 of a 14-day cycle. | Drug | Modified FOLFIRINOX, Modified FOLFIRINOX plus Stereotactic Body Radiotherapy |
| 5FUAlso: 5-fluorouracil, Tolak, Fluoroplex, Efudex5FU 2,400 mg/m² IV over 46 to 48 hours starting on Day 1 of a 14-day cycle. | Drug | Modified FOLFIRINOX, Modified FOLFIRINOX plus Stereotactic Body Radiotherapy |
| Stereotactic Body Radiotherapy (SBRT)Radiotherapy treatment starting about 8 weeks after modified FOLFIRINOX induction chemotherapy, administered as 5 fractions of 8 Grey (Gy) each, on 5 separate days. | Radiation | Modified FOLFIRINOX plus Stereotactic Body Radiotherapy |
Primary outcome
Progression-free Survival (PFS)
Time frame: 38 months
Progression-free survival (PFS) means the period of time that a participant remains alive without tumor progression either locally or at a distant site in the body (metastasis). The effect of the study treatments was assessed as the median PFS of participants in the treatment groups. The outcome is reported as the median PFS with standard deviation.
5 secondary outcomes
Local Progression-free Survival (Local PFS)
Time frame: 38 months
Progression-free Survival (PFS) at 1 Year
Time frame: 1 year
Metastasis-free Survival (MFS)
Time frame: 62 months
Overall Survival (OS)
Time frame: 62 months
Grade 2 or Greater Gastrointestinal (GI) Toxicity
Time frame: 3 months
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 28 Oct 2022.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Individual participant dataSharing planned: No
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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.
Daniel T Chang principal investigator
Stanford University
9 sites in 2 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Oxaliplatin, Irinotecan and Leucovorin in people with Pancreatic Cancer, run by Stanford University at 9 sites in 2 countries.
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 13 inclusion and 15 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 28 Oct 2022. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 9 sites in United States, Canada. 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 phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
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 28 Oct 2022). 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?
Progression-free Survival (PFS) (time frame: 38 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 28 Oct 2022.