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The Effect of Gemcitabine Plus Nab-paclitaxel as Secondary Chemotherapy in Advanced Pancreatic Cancer


2018-03-01


2019-01-01


2019-01-01


40

Study Overview

The Effect of Gemcitabine Plus Nab-paclitaxel as Secondary Chemotherapy in Advanced Pancreatic Cancer

Pancreatic cancer is a very poor prognosis and has a high mortality rate. The clinical results have improved somewhat with the combination therapy of chemotherapy as the first-line treatment. However, effective secondary chemotherapy after these first-line treatment failures is limited. Recently, FOLFIRINOX has been used in patients with locally advanced or metastatic pancreatic cancer who have good performance in Korea. Gemcitabine + nab-paclitaxel (GnP) as a second-line treatment after FOLFIRINOX may be expected to be considerable. The aim of this study was to evaluate the efficacy of GnP as a second-line treatment after failed FOLFIRINOX treatment for locally advanced or metastatic pancreatic ductal adenocarcinoma.

Pancreatic cancer is a very poor prognosis and has a high mortality rate. It is not clear that the improvement of clinical outcome due to anticancer drugs is not clear compared to other carcinomas. In particular, the 5-year survival rate of metastatic pancreatic cancer is still only about 2%, and the clinical results have improved somewhat with the combination therapy of chemotherapy as the first-line treatment. However, effective secondary chemotherapy after these first-line treatment failures is limited. Meta-analysis has reported that life expectancy is significantly increased in patients receiving second-line chemotherapy after failure of primary chemotherapy. However, it is not yet clear which cancer treatment is most effective. In the NCCN guideline (ver. 2017.2), the second trial of chemotherapy for locally advanced or metastatic pancreatic cancer is the most recommended clinical trial.Recently, FOLFIRINOX has been used in patients with locally advanced or metastatic pancreatic cancer who have good performance in Korea. The response rate of the treatment is 30%, and many patients require secondary chemotherapy. In a practice guideline published by the American Society of Clinical Oncology, Gemcitabine + nab-paclitaxel(GnP) is the only recommended combination for patients failing primary treatment with FOLFIRINOX. In light of the results of previous reports, the efficacy of GnP as a second-line treatment after FOLFIRINOX may be expected to be considerable, but there is a lack of studies reporting GnP therapy on the second line after FOLFIRINOX failure as a first-line treatment. The aim of this study was to evaluate the efficacy of GnP as a second-line treatment after failed FOLFIRINOX treatment for locally advanced or metastatic pancreatic ductal adenocarcinoma.

  • Pancreatic Adenocarcinoma
  • Chemotherapy Effect
  • DRUG: Chemotherapy (Gemcitabine + nab-paclitaxel)
  • H-1710-067-894

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates Results Reporting Dates Study Record Updates

2017-12-30  

N/A  

2018-02-08  

2018-01-16  

N/A  

2018-02-12  

2018-01-17  

N/A  

2018-01  

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

Design Details

Primary Purpose:
Treatment


Allocation:
Na


Interventional Model:
Single Group


Masking:
None


Arms and Interventions

Participant Group/ArmIntervention/Treatment
EXPERIMENTAL: Gemcitabine + nab-paclitaxel

Case with chemotherapy (Gemcitabine + nab-paclitaxel)

DRUG: Chemotherapy (Gemcitabine + nab-paclitaxel)

  • Nanoparticle albumin-bound paclitaxel (125 mg/m2) miv over 30 min, Day 1,8,15 Gemcitabine (1,000mg/m2) and N/S 150mL miv over 30 min, Day 1,8,15
Primary Outcome MeasuresMeasure DescriptionTime Frame
survival ratesurvival rate at 6 months after 2nd line chemotherapy6 months
Secondary Outcome MeasuresMeasure DescriptionTime Frame
overall survivaloverall survival after 2nd line chemotherapytill death or follow-up loss or end of study up to 2 years
Progression free survivalduration till progression after 2nd line chemotherapytill death or follow-up loss or end of study up to 2 years
Disease control rateSD (stable disease) + PR (partial response) + CR (complete response) after 2nd line chemotherapy6 months
adverse eventall reported adverse events after 2nd line chemotherapytill death or follow-up loss or end of study up to 2 years

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Name: Jin Ho Choi, MD

Phone Number: 82-2-2072-2228

Email: [email protected]

Study Contact Backup

Name: Sang Hyub Lee, MD, Ph.D

Phone Number: 82-2-2072-2228

Email: [email protected]

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person’s general health condition or prior treatments.

Ages Eligible for Study:
ALL

Sexes Eligible for Study:
20 Years

Accepts Healthy Volunteers:

    1. Inclusion criteria
    1. Patient whose age is 20 years or older 2. ECOG Performance Status 0-2 3. Pathologically confirmed pancreatic adenocarcinoma 4. Patients with locally advanced or distant metastasis status 5. Patients who had undergone primary chemotherapy with previous FOLFIRINOX and whose disease progress was confirmed 6. Patients whose consent was obtained (non-insurance agreement) 2. Exclusion Criteria
    1. Those who can not obtain consent 2. Those who refuse chemotherapy 3. ECOG Performance Status 3 or higher 4. Multiple organ failure is accompanied 5. Severe comorbidities other than cancer that do not expect a sufficient survival period over 1 month 6. Allergy to the test drug

Collaborators and Investigators

This is where you will find people and organizations involved with this study.


    • STUDY_DIRECTOR: Sang Hyub Lee, MD, Ph.D, Seoul National University Hospital

    Publications

    The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

    General Publications

    • Huh G, Lee HS, Choi JH, Lee SH, Paik WH, Ryu JK, Kim YT, Bang S, Lee ES. Gemcitabine plus Nab-paclitaxel as a second-line treatment following FOLFIRINOX failure in advanced pancreatic cancer: a multicenter, single-arm, open-label, phase 2 trial. Ther Adv Med Oncol. 2021 Nov 10;13:17588359211056179. doi: 10.1177/17588359211056179. eCollection 2021.