AzTrials
AzTrials

Resectable Pancreatic Ductal AdenocarcinomaRADAR-PANCNCT04875325

Recurrent Disease Detection After Resection of Pancreatic Adenocarcinoma Using a Standardized Surveillance Strategy

A study testing Standardized surveillance in people with Resectable Pancreatic Ductal Adenocarcinoma and Recurrent Pancreatic Ductal Adenocarcinoma, run by UMC Utrecht at 11 sites in 2 countries.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
Search all trials

Trial summary

A randomized controlled trial, nested within an existing prospective cohort (Dutch Pancreatic Cancer Project; PACAP) and the United Kingdom (UK) Pancreas Cancer: Observations of Practice and survival; PACOPS) according to the 'trials within cohorts' (TwiCs) design in which the effect of a standardized surveillance… Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Standardized surveillance
Could I receive a placebo?
No, everyone receives an active treatment
How many people
306 participants
Where
11 sitesin 2 countries
Study dates
16 Mar 2021to Oct 2026
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

  • Participation in the PACAP and PACOPS-cohort with written informed consent for being randomized in future studies
  • Histologically confirmed macroscopically radical resected (R0-R1) pancreatic adenocarcinoma
  • Minimum age of 18 years

Who cannot join

  • Exclusion criteria for contrast-enhanced CT-scan, following the protocol of the department of radiology in each affiliated hospital
  • Mentally or physically incapable of consent
  • Participation in other studies with a study-specific follow-up

Trial locations and contacts

11 sites in 2 countries.

11 sites in 2 countries

Netherlands10 sites
  • Amsterdam University Medical Center VUmc

    Amsterdam, North Holland, 1081 HV

  • Onze Lieve Vrouwe Gasthuis

    Amsterdam, North Holland, 1091 AC

  • Amsterdam University Medical Center AMC

    Amsterdam, North Holland, 1105 AZ

  • Catharina Ziekenhuis

    Eindhoven, North Brabant, 5623 EJ

  • Medisch Spectrum Twente

    Enschede, Overijssel, 7512 KZ

  • University Medical Center Groningen

    Groningen, Provincie Groningen, 9713 GZ

  • Maastricht UMC

    Maastricht, Limburg, 6229 HX

  • Sint Antonius Ziekenhuis

    Nieuwegein, Utrecht, 3435 CM

  • Radboud University Medical Center

    Nijmegen, Gelderland, 6525 GA

  • University Medical Center Utrecht

    Utrecht, Utrecht, 3584 CX

Other trials in Netherlands

United Kingdom1 site
  • University of Birmingham

    Birmingham, B15 2TT

Other trials in United Kingdom

About this study

Official title: Recurrent Disease Detection After Resection of Pancreatic Adenocarcinoma Using a Standardized Surveillance Strategy: a Nationwide Randomized Controlled Trial

A randomized controlled trial, nested within an existing prospective cohort (Dutch Pancreatic Cancer Project; PACAP) and the United Kingdom (UK) Pancreas Cancer: Observations of Practice and survival; PACOPS) according to the 'trials within cohorts' (TwiCs) design in which the effect of a standardized surveillance, with serial tumor marker testing and routine imaging, compared to current non-standardized practice, on overall survival and quality of life in patients with primary resected PDAC is investigated. The most important secondary endpoint is quality of life. Other secondary endpoints are clinical and radiological patterns of PDAC recurrence, the compliance of patients to our standardized follow-up strategy, the impact of a standardized surveillance on (eligibility for) additional treatment, and the tolerance of additional treatment. The need for this clinical trial is emphasized by the the emergence of more potent local and more effective systemic treatments for PDAC recurrence, leading to a rising interest in early diagnosis by a standardized approach to follow-up with routine imaging and serial serum tumor marker testing.

Read the detailed description

Rationale: Radical resection combined with (neo)adjuvant chemotherapy offers the best chances for long-term survival for patients with resectable localized pancreatic ductal adenocarcinoma (PDAC). However, even after radical resection, almost all patients will experience local and/or distant disease recurrence after sufficient follow-up, mostly within 2 years. There is a lack of evidence based effective therapeutic options for the significant group of patients with local recurrence only, in terms of improved survival and/or quality of life. In the case of metastatic disease effective chemotherapy has shown to improve survival, but with a median gain survival of 3-4 months. Taken together, this had led to a hesitant attitude towards postoperative recurrence-focused follow-up. Therefore, in most European countries, including the Netherlands, a standardized approach to follow-up after surgery for PDAC is lacking. Furthermore, current PDAC guidelines regarding follow-up are based on expert opinion and other low-level evidence. However, the emergence of more potent local and more effective systemic treatments for PDAC has led to a rising interest in early diagnosis of PDAC recurrence. To detect PDAC recurrence at an early stage and identify patients with good performance status who are most likely to benefit from additional (experimental) treatment, a standardized approach to follow-up with routine imaging and serial serum tumor marker testing is needed. To determine whether early detection of recurrence can lead to improved survival and quality of life, further studies are warranted.

Objective: The main objective is to evaluate the impact of a standardized surveillance, with serial tumor marker testing and routine imaging, on overall survival and quality of life in patients with primary resected PDAC, compared to current non-standardized practice.

Study design: A randomized controlled trial, nested within an existing prospective cohort (Dutch Pancreatic Cancer Project; PACAP) and the United Kingdom (UK) Pancreas Cancer: Observations of Practice and survival; PACOPS) according to the 'trials within cohorts' (TwiCs) design.

Study population: PACAP or PACOPS-participants with histologically confirmed radical resection (R0-R1) of PDAC, who provided informed consent for being randomized in future studies.

Interventions: Standardized surveillance, existing of clinical evaluation, serum cancer antigen (CA) 19-9 testing, and contrast-enhanced computed tomography (CT-) imaging of chest and abdomen every 3 months during the first 2 years after surgery.

Comparison: Non-standardized clinical follow-up.

Endpoints: The main study endpoint is overall survival. The most important secondary endpoint is quality of life. Other secondary endpoints are clinical and radiological patterns of PDAC recurrence, the compliance of patients to our standardized follow-up strategy, the impact of a standardized surveillance on (eligibility for) additional treatment, and the tolerance of additional treatment.

Being tested
Standardized surveillance
Keywords
Standardized Surveillance, Follow-up, CA 19-9, Computed Tomography Scan

What participants receive

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

  • Standardized surveillanceOther

    Standardized 3-monthly surveillance with routine imaging and serum tumor marker testing.

Study groups in NCT04875325
Study groupRoleWhat they receive
Standardized surveillanceExperimentalStandardized surveillance strategy with routine imaging and serum tumor marker testing.
Receives: Other: Standardized surveillance
Non-standardized surveillanceNo interventionNon-standardized surveillance strategy according to current clinical practice.

What is being measured

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

  1. Overall survival

    The interval between the date of PDAC resection and either death from any cause or last follow-up.

    Measured: From date of PDAC resection until date of death from any cause or date of last follow-up, whichever came first, assessed up to 24 months

Secondary outcomes (16)
  1. Compliance of the standardized surveillance strategy

    The percentage of patients that either accepts or refuses participation in the intervention-arm, i.e. is willing to undergo a standardized follow-up regime.

    Measured: Through completion of patient inclusion, an average of 1.5 years

  2. Recurrence-free interval

    The interval between the date of PDAC resection and the date of first radiological signs of recurrence, or last follow-up if recurrence is not observed.

    Measured: From date of PDAC resection until date of first radiological signs of recurrence, or last follow-up if recurrence is not observed, whichever came first, assessed up to 24 months

  3. Prognostic patient specific characteristics and tumor related factors for disease recurrence

    Measured: From date of randomization until disease recurrence or last follow-up, assessed up to 24 months

  4. Role of serum tumor marker testing in detecting recurrent PDAC assessed by the calculated diagnostic accuracy values

    Measured: From date of randomization until disease recurrence or last follow-up, assessed up to 24 months

  5. Eligibility for additional (experimental) treatment at the time of recurrence diagnosis based on the ECOG or Karnofsky performance state, or inclusion criteria for study-related treatment of recurrence

    Measured: At the time of recurrence diagnosis. Assessed through the study, up to 24 months

  6. Reasons to refrain from treatment for recurrence

    e.g. poor condition, patients wish, deteriorated condition, progressive disease, advise treating clinician, death, wait-and-see, age.

    Measured: At the time the patient is assessed eligible for additional treatment. Assessed through the study, up to 24 months

  7. Patients' tolerance of additional treatment for PDAC recurrence as assessed by incidence of adverse events (graded according to NCI CTCAE Version 5.0)

    Measured: Through study completion, an average of 2 years

  8. Morbidity associated with diagnostic testing assessed by the side-effects of diagnostic testing (i.e. fear of disease recurrence)

    Measured: From date of randomization until disease recurrence or last follow-up, whichever came first, assessed up to 24 months

  9. Patient reported non-disease specific health-related Quality of Life (HRQoL) as assessed using the EQ-5D-5L

    Part of the Patient Reported Outcome Measures (PROMs) that are being standardly measured in PACAP and PACOPS-participants.

    Measured: At baseline and at 3, 6, 9, 12, 18 and 24 months and every subsequent year after enrollment in the PACAP and PACOPS-cohort. Assessed through study completion, up to 24 months

  10. Overall costs of a standardized surveillance strategy versus the costs as incurred with the current non-standardized follow-up assessed according to the EQ-5D questionnaire as part of the PACAP and PACOPS-project, and calculated using to a Markov model

    Measured: After study completion (estimated duration of 3.5 years)

  11. Patient reported chemotherapy-induced peripheral neuropathy as assessed using the EORTC QLQ-CIPN20

    Part of the Patient Reported Outcome Measures (PROMs) that are being standardly measured in PACAP and PACOPS-participants.

    Measured: At baseline and at 3, 6, 9, 12, 18 and 24 months and every subsequent year after enrollment in the PACAP and PACOPS-cohort. Assessed through study completion, up to 24 months

  12. Patient reported Quality of Life as assessed using the happiness, hospital, anxiety and depression scale (HADS)

    Part of the Patient Reported Outcome Measures (PROMs) that are being standardly measured in PACAP and PACOPS-participants.

    Measured: At baseline and at 3, 6, 9, 12, 18 and 24 months and every subsequent year after enrollment in the PACAP and PACOPS-cohort. Assessed through study completion, up to 24 months

  13. Patient reported Quality of Life as assessed using Exocrine Pancreatic Insufficiency (EPI) questionnaire

    Part of the Patient Reported Outcome Measures (PROMs) that are being standardly measured in PACAP and PACOPS-participants.

    Measured: At baseline and at 3, 6, 9, 12, 18 and 24 months and every subsequent year after enrollment in the PACAP and PACOPS-cohort. Assessed through study completion, up to 24 months

  14. Patient reported Quality of Life as assessed using the worry of progression of cancer scale (WOPS)

    Part of the Patient Reported Outcome Measures (PROMs) that are being standardly measured in PACAP and PACOPS-participants.

    Measured: At baseline and at 3, 6, 9, 12, 18 and 24 months and every subsequent year after enrollment in the PACAP and PACOPS-cohort. Assessed through study completion, up to 24 months

  15. Patient reported cancer-specific HRQoL as assessed using the EORTC QLQ-C30

    Part of the Patient Reported Outcome Measures (PROMs) that are being standardly measured in PACAP and PACOPS-participants.

    Measured: At baseline and at 3, 6, 9, 12, 18 and 24 months and every subsequent year after enrollment in the PACAP and PACOPS-cohort. Assessed through study completion, up to 24 months

  16. Patient reported tumor-specific HRQoL as assessed using the EORTC LQPAN26

    Part of the Patient Reported Outcome Measures (PROMs) that are being standardly measured in PACAP and PACOPS-participants.

    Measured: At baseline and at 3, 6, 9, 12, 18 and 24 months and every subsequent year after enrollment in the PACAP and PACOPS-cohort. Assessed through study completion, up to 24 months

Timeline

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

  1. First posted6 May 2021
  2. Study start16 Mar 2021
  3. Primary completionOct 2026 (estimated)
  4. Study completionOct 2026 (estimated)

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
Other
Allocation
Randomised
Intervention model
Parallel groups
Model description
Trials within Cohorts (TwiCs)
Masking
None (open label)
Enrolment
306 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04875325
Sponsor's protocol ID
NL67115.041.18
Other IDs
20-762
Acronym
RADAR-PANC
Status last verified
Sep 2024
First submitted
17 Mar 2021
Last updated
19 Sep 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: De-identified data generated during the RADAR-PANC trial will be made available to other researcher upon request from I.Q. Molenaar.

Publications

  • Daamen LA, van Goor IWJM, Groot VP, Andel PCM, Brosens LAA, Busch OR, Cirkel GA, Mohammad NH, Heerkens HD, de Hingh IHJT, Hoogwater F, van Laarhoven HWM, Los M, Meijer GJ, de Meijer VE, Pande R, Roberts KJ, Stoker J, Stommel MWJ, van Tienhoven G, Verdonk RC, Verkooijen HM, Wessels FJ, Wilmink JW, Besselink MG, van Santvoort HC, Intven MPW, Molenaar IQ; Dutch Pancreatic Cancer Group. Recurrent disease detection after resection of pancreatic ductal adenocarcinoma using a recurrence-focused surveillance strategy (RADAR-PANC): protocol of an international randomized controlled trial according to the Trials within Cohorts design. Trials. 2024 Jun 20;25(1):401. doi: 10.1186/s13063-024-08223-5.

    PubMed 38902836

Questions about this trial

What is this clinical trial studying?

A study testing Standardized surveillance in people with Resectable Pancreatic Ductal Adenocarcinoma and Recurrent Pancreatic Ductal Adenocarcinoma, run by UMC Utrecht at 11 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 3 inclusion and 3 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: status not confirmed, as of the sponsor's last update on 19 Sep 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 11 sites in Netherlands, United Kingdom. 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.

Are results available for this study?

Results are not available in the source record.

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?

Overall survival (time frame: From date of PDAC resection until date of death from any cause or date of last follow-up, whichever came first, assessed up to 24 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04875325, which also lists 1 linked publication.

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 19 Sep 2024.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in