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Pancreatic CancerPhase 3PREOPANC-3NCT04927780

Perioperative or Adjuvant mFOLFIRINOX for Resectable Pancreatic Cancer

A Phase 3 study testing Leucovorin Calcium, Fluorouracil and Irinotecan Hydrochloride in people with Pancreatic Cancer and Pancreatic Ductal Adenocarcinoma, run by Erasmus Medical Center at 21 sites in 2 countries.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

The PREOPANC-3 study is a randomized, multicenter, phase 3 trial. Patients with resectable pancreatic cancer will be randomly assigned (1:1) to 8 cycles of neoadjuvant mFOLFIRINOX followed by surgery and 4 cycles of adjuvant mFOLFIRINOX (arm 1) or to upfront surgery followed by 12 cycles of adjuvant mFOLFIRINOX (arm… Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Leucovorin Calcium, Fluorouracil and Irinotecan Hydrochloride
Could I receive a placebo?
No, everyone receives an active treatment
How many people
378 participants
Where
21 sitesin 2 countries
Study dates
7 Sep 2021to Jul 2029
Phase
Phase 3
Are there results?
Not yet: the study is under way

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 (Bethesda 5 or 6) confirmed pancreatic ductal adenocarcinoma.
  • Resectable tumor according to Dutch Pancreatic Cancer Group criteria: no arterial contact and venous contact with the superior mesenteric vein or portal vein of 90 degrees or less
  • No evidence for metastatic disease
  • WHO performance status of 0 or 1
  • Ability to undergo surgery and mFOLFIRINOX chemotherapy
  • Leucocytes (WBC) ≥ 3.0 x 10^9/L
Show all 11Show fewer
  • Platelets ≥ 100 x 10^9/L
  • Hemoglobin ≥ 6.0 mmol/l
  • Renal function: eGFR ≥ 40 ml/min
  • Age ≥ 18 years
  • Written informed consent

Who cannot join

  • Prior radiotherapy, chemotherapy, or surgery for pancreatic cancer.
  • Prior chemotherapy precluding mFOLFIRINOX.
  • Previous malignancy (excluding non-melanoma skin cancer, pancreatic neuroendocrine tumor (pNET) <2cm, and gastrointestinal stromal tumor (GIST) <2cm), unless no evidence of disease and diagnosed more than 3 years before diagnosis of pancreatic cancer, or with a life expectancy of more than 5 years from date of inclusion.
  • Pregnancy or lactation.
  • Serious concomitant systemic disorders that would compromise the safety of the patient or his/her ability to complete the study, at the discretion of the investigator.

Trial locations and contacts

21 sites in 2 countries.

21 sites in 2 countries

Netherlands18 sites
  • Jeroen Bosch Hospital

    's-Hertogenbosch

  • Meander Medical Center

    Amersfoort

  • Amsterdam UMC

    Amsterdam

  • OLVG

    Amsterdam

  • Amphia Hospital

    Breda

  • Deventer Hospital

    Deventer

  • Catharina Hospital

    Eindhoven

  • Medisch Spectrum Twente

    Enschede

  • University Medical Center Groningen

    Groningen

  • Tjongerschans Hospital

    Heerenveen

  • Medical Center Leeuwarden

    Leeuwarden

  • Leiden University Medical Center

    Leiden

  • Maastricht UMC+

    Maastricht

  • Radboud University Medical Center

    Nijmegen

  • Erasmus MC University Medical Center

    Rotterdam

  • Maasstad Ziekenhuis

    Rotterdam

  • Regional Academic Center Utrecht, Antonius Hospital

    Utrecht

  • Isala Hospital

    Zwolle

Other trials in Netherlands

Sweden3 sites
  • Sahlgrenska University Hospital

    Gothenburg

  • Skåne University Hospital

    Lund

  • Karolinska University Hospital

    Stockholm

Other trials in Sweden

About this study

Official title: Perioperative Versus Adjuvant FOLFIRINOX for Resectable Pancreatic Cancer: the PREOPANC-3 Study

The PREOPANC-3 study is a randomized, multicenter, phase 3 trial. Patients with resectable pancreatic cancer will be randomly assigned (1:1) to 8 cycles of neoadjuvant mFOLFIRINOX followed by surgery and 4 cycles of adjuvant mFOLFIRINOX (arm 1) or to upfront surgery followed by 12 cycles of adjuvant mFOLFIRINOX (arm 2).

The primary objective of the trial is to determine whether perioperative mFOLFIRINOX improves overall survival compared with adjuvant mFOLFIRINOX in patients with resectable pancreatic cancer.

Keywords
Neoadjuvant Therapy, Adjuvant Chemotherapy, Oxaliplatin, Irinotecan, Leucovorin, Fluorouracil, Pancreatic Neoplasms, Pancreatectomy
Medical subject headings
Pancreatic Neoplasms

What participants receive

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

Study groups in NCT04927780
Study groupRoleWhat they receive
Arm 1: Perioperative mFOLFIRINOXExperimentalPatients in the intervention arm (arm 1) start with neoadjuvant mFOLFIRINOX (consisting of oxaliplatin 85 mg/m², irinotecan 150 mg/m², leucovorin 400 mg/m², all at day 1, and fluorouracil continuous IV infusion 2.4 g/m² over 46 hours). Cycles are repeated every 14 days. After eight cycles, surgical resection is performed in the absence of unresectable or metastatic disease. After resection, four cycles of adjuvant mFOLFIRINOX are scheduled.
Receives: Drug: Leucovorin Calcium; Drug: Fluorouracil; Drug: Irinotecan Hydrochloride; Drug: Oxaliplatin; Procedure: Resection
Arm 2: Adjuvant mFOLFIRINOXActive comparatorPatients in the comparator arm (arm 2) start with surgery. After resection, 12 cycles of adjuvant mFOLFIRINOX (consisting of oxaliplatin 85 mg/m², irinotecan 150 mg/m², leucovorin 400 mg/m², all at day 1, and fluorouracil continuous IV infusion 2.4 g/m² over 46 hours) are scheduled.
Receives: Drug: Leucovorin Calcium; Drug: Fluorouracil; Drug: Irinotecan Hydrochloride; Drug: Oxaliplatin; Procedure: Resection

What is being measured

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

  1. Overall survival

    The time between randomization and death from any cause. Patients alive at last follow-up are censored.

    Measured: Up to 5 years after randomization.

Secondary outcomes (27)
  1. Progression free survival

    The time between randomization and locoregional progressive disease before or during treatment (resulting in irresectability), the occurrence of distant metastases, recurrent pancreatic cancer after surgery or death from any cause. Patients alive and free of these events at last follow-up are censored.

    Measured: Up to 5 years after randomization.

  2. Distant metastases free survival

    The time between randomization and the occurrence of distant metastases or death from any cause. Patients alive and free of these events at last follow-up are censored.

    Measured: Up to 5 years after randomization.

  3. Locoregional progression free survival

    The time between randomization and locoregional progression before or during treatment (resulting in irresectability), locoregional recurrence after resection or death from any cause. Patients alive and free of these events at last follow-up are censored.

    Measured: Up to 5 years after randomization.

  4. Distant metastases free interval

    The time between randomization and the occurrence of distant metastases. Distant metastases are considered an event and patients are censored at death or last follow-up when without this event.

    Measured: Up to 5 years after randomization.

  5. Locoregional progression free interval

    The time between randomization and locoregional progression before or during treatment (resulting in irresectability), or locoregional recurrence after resection. Locoregional progressive disease before or during treatment or locoregional recurrence after resection are considered an event and patients are censored at death or last follow-up when free of these events.

    Measured: Up to 5 years after randomization.

  6. Chemotherapy start rate

    The percentage of patients who received at least one cycle of scheduled chemotherapy.

    Measured: 4 months

  7. Number of chemotherapy cycles received.

    The number of mFOLFIRINOX cycles patients received.

    Measured: 9 months

  8. Chemotherapy completion rate

    The percentage of patients who completed all cycles of scheduled chemotherapy.

    Measured: 9 months

  9. Dose intensity

    The amount of drug delivered as a percentage of planned dose according to the protocol.

    Measured: 9 months

  10. Staging laparoscopy rate

    The percentage of patients that actually underwent a staging laparoscopy, regardless whether a surgical exploration or resection was performed.

    Measured: At the time of surgery.

  11. Laparoscopy yield

    The percentage of patients that underwent staging laparoscopy and were diagnosed with metastatic or unresectable disease during this procedure.

    Measured: At the time of surgery.

  12. Surgical exploration rate

    The percentage of patients who underwent a surgical exploration (open or minimally-invasive), regardless whether a resection was performed.

    Measured: At the time of surgery.

  13. Resection rate

    The percentage of patients that underwent a curative-intent resection.

    Measured: At the time of surgery.

  14. Microscopically margin-negative (R0) resection rate

    The percentage of patients that underwent a microscopically margin-negative (R0) resection. The resection is considered R0 if there is no tumor within 1 mm of the margins.

    Measured: At the time of surgery.

  15. Lymph node-negative (N0) resection rate

    The percentage of patients that underwent a resection with negative lymph nodes (N0) in the surgical specimen.

    Measured: At the time of surgery.

  16. Pathologic response

    Tumor regression score in the surgical specimen

    Measured: At the time of surgery.

  17. Adverse events as assessed by the CTCAE version 5.0

    Adverse events are assessed during neoadjuvant therapy and adjuvant therapy.

    Measured: Until 30 days after last chemotherapy.

  18. Postoperative complications

    According to the Clavien-Dindo classification and by the International Study Group of Pancreatic Surgery and International Study Group of Liver Surgery.

    Measured: Up to 90 days after surgery.

  19. Serum CA 19-9 and CEA response

    The change in carbohydrate antigen 19-9 (CA 19-9) and carcinoembryonic antigen (CEA) after surgery and after 4, 8, and 12 cycles of mFOLFIRINOX compared to baseline.

    Measured: 9 months

  20. Clinical response rate according to RECIST criteria version 1.1

    Response comparing baseline and restaging after 4 and 8 cycles of mFOLFIRINOX

    Measured: At the time of surgery.

  21. Patient reported cancer-specific health-related Quality of Life (HRQoL) as assessed using the EORTC QLQ-C30

    At baseline and at 3, 6, 9, 12, 18 and 24 months and every subsequent year

    Measured: Up to 5 years after randomization.

  22. Patient reported non-disease specific HRQoL as assessed using the EQ-5D-5L

    At baseline and at 3, 6, 9, 12, 18 and 24 months and every subsequent year

    Measured: Up to 5 years after randomization.

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

    At baseline and at 3, 6, 9, 12, 18 and 24 months and every subsequent year

    Measured: Up to 5 years after randomization.

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

    At baseline and at 3, 6, 9, 12, 18 and 24 months and every subsequent year

    Measured: Up to 5 years after randomization.

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

    At baseline and at 3, 6, 9, 12, 18 and 24 months and every subsequent year

    Measured: Up to 5 years after randomization.

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

    At baseline and at 3, 6, 9, 12, 18 and 24 months and every subsequent year

    Measured: Up to 5 years after randomization.

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

    At baseline and at 3, 6, 9, 12, 18 and 24 months and every subsequent year

    Measured: Up to 5 years after randomization.

Timeline

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

  1. First posted16 Jun 2021
  2. Study start7 Sep 2021
  3. Primary completionJan 2027 (estimated)
  4. Study completionJul 2029 (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 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
378 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04927780
Sponsor's protocol ID
MEC-2021-0002
Other IDs
2020-005141-16
Acronym
PREOPANC-3
Status last verified
May 2026
First submitted
8 Jun 2021
Last updated
15 May 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes

Publications

  • van Dam JL, Verkolf EMM, Dekker EN, Bonsing BA, Bratlie SO, Brosens LAA, Busch OR, van Driel LMJW, van Eijck CHJ, Feshtali S, Ghorbani P, de Groot DJA, de Groot JWB, Haberkorn BCM, de Hingh IH, van der Holt B, Karsten TM, van der Kolk MB, Labori KJ, Liem MSL, Loosveld OJL, Molenaar IQ, Polee MB, van Santvoort HC, de Vos-Geelen J, Wumkes ML, van Tienhoven G, Homs MYV, Besselink MG, Wilmink JW, Groot Koerkamp B; Dutch Pancreatic Cancer Group. Perioperative or adjuvant mFOLFIRINOX for resectable pancreatic cancer (PREOPANC-3): study protocol for a multicenter randomized controlled trial. BMC Cancer. 2023 Aug 7;23(1):728. doi: 10.1186/s12885-023-11141-5.

    PubMed 37550634

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Leucovorin Calcium, Fluorouracil and Irinotecan Hydrochloride in people with Pancreatic Cancer and Pancreatic Ductal Adenocarcinoma, run by Erasmus Medical Center at 21 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 11 inclusion and 5 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: under way, not looking for participants, as of the sponsor's last update on 15 May 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 21 sites in Netherlands, Sweden. 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?

This study is still under way. Results are not available in the source record yet.

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: Up to 5 years after randomization.). 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 NCT04927780, 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 15 May 2026.

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