Gemcitabine With or Without WX-671 in Treating Patients With Locally Advanced Pancreatic Cancer That Cannot Be Removed By Surgery
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Purpose
RATIONALE: Drugs used in chemotherapy, such as gemcitabine, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. WX-671 may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Giving gemcitabine together with WX-671 may kill more tumor cells.
PURPOSE: This randomized phase II trial is studying how well gemcitabine works when given together with WX-671 or when given alone in treating patients with locally advanced pancreatic cancer that cannot be removed by surgery.
| Condition | Intervention | Phase |
|---|---|---|
|
Pancreatic Cancer |
Drug: gemcitabine hydrochloride Drug: Serine Proteinase Inhibitor WX-671 |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | A Randomized, Open Label, Phase II Proof of Concept Study of WX-671 in Combination With Gemcitabine vs.Gemcitabine Alone in Patients With Locally Advanced, Non Resectable Pancreatic Cancer in Order to Evaluate the Anti-Tumor Activity of the Combination Therapy |
- Efficacy, in terms of response rate, progression-free survival, time to first metastasis, overall survival, and tumor and uPA system-related markers [ Time Frame: 3 years ] [ Designated as safety issue: No ]
- Safety, in terms of vital signs, ECG, biochemistry, hematology (including coagulation), and adverse events [ Time Frame: 3 years ] [ Designated as safety issue: Yes ]
| Enrollment: | 95 |
| Study Start Date: | April 2007 |
| Study Completion Date: | May 2010 |
| Primary Completion Date: | May 2010 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Active Comparator: Gemcitabine |
Drug: gemcitabine hydrochloride
1000 mg/m2 as 30 min i.v. infusion once weekly for 7/8 weeks and then every 3/4 weeks
Other Name: GEMZAR
|
| Experimental: Gemcitabine plus 200 mg WX-671 |
Drug: Serine Proteinase Inhibitor WX-671
oral, daily
Other Name: MESUPRON
|
| Experimental: Gemcitabine plus 400 mg WX-671 |
Drug: Serine Proteinase Inhibitor WX-671
oral, daily
Other Name: MESUPRON
|
Detailed Description:
OBJECTIVES:
Primary
- Assess the antitumor activity of two different doses of anti-uPA serine protease inhibitor WX-671 when given in combination with gemcitabine hydrochloride in patients with locally advanced unresectable pancreatic cancer.
- Compare the efficacy, in terms of response rate, progression-free survival, time to first metastasis, overall survival, and tumor and uPA system-related markers, of these regimens in these patients.
- Compare the safety, in terms of vital signs, ECG, biochemistry, hematology (including coagulation), and adverse events, of these regimens.
OUTLINE: This is an open-label, randomized, multicenter study. Patients are randomized to 1 of 3 treatment arms.
- Arm I: Patients receive of oral anti-uPA serine protease inhibitor WX-671 once daily in weeks 1-8 (weeks 1-4 of each subsequent course) and gemcitabine hydrochloride IV over 30 minutes once weekly in weeks 1-7 (weeks 1-3 of each subsequent course) of course 1. All subsequent courses repeat every 4 weeks in the absence of disease progression or unacceptable toxicity.
- Arm II: Patients receive oral anti-uPA serine protease inhibitor WX-671 (at a lower dose than in arm I) once daily in weeks 1-8 (weeks 1-4 of each subsequent course) and gemcitabine hydrochloride IV over 30 minutes once weekly in weeks 1-7 (weeks 1-3 of each subsequent course) of course 1. All subsequent courses repeat every 4 weeks in the absence of disease progression or unacceptable toxicity.
- Arm III: Patients receive gemcitabine hydrochloride IV over 30 minutes once weekly in weeks 1-7 (weeks 1-3 of each subsequent course) of course 1. All subsequent courses repeat every 4 weeks in the absence of disease progression or unacceptable toxicity.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
DISEASE CHARACTERISTICS:
Inclusion criteria:
- Locally advanced, unresectable, non-metastatic, histologically proven pancreatic adenocarcinoma (lymph nodes will not be considered metastases)
Exclusion criteria:
- Any distant metastases
PATIENT CHARACTERISTICS:
Inclusion criteria:
- ECOG performance status ≤ 1
- Life expectancy > 12 weeks
- Normal 12-lead ECG or only clinically insignificant abnormalities in the judgment of the investigator
- Female patients of child-bearing potential will be required to use an effective method of birth control for the duration of the study to prevent pregnancy
- ANC ≥ 1,500/mm³
- Platelet count ≥ 100,000/mm³
- Hemoglobin ≥ 9 g/dL
- Total bilirubin ≤ 1.5 times ULN
- AST and ALT ≤ 2.5 times ULN
- Alkaline phosphatase ≤ 2.5 times ULN
- Creatinine ≤ 2 times ULN or creatinine clearance > 45 mL/min
Exclusion criteria:
- History of or current primary blood coagulation or bleeding disorders such as hemophilia
- Any unrelated illness, e.g., active infection, inflammation, medical condition or laboratory abnormalities, which in the judgment of the investigator might significantly affect the patient's study participation
- Any surgical or medical condition that might significantly alter the absorption, distribution, metabolism or excretion of any drug
- Significant cardiac insufficiency (NYHA classification III or IV), presence of unstable angina or myocardial infarction within the previous 6 months, use of ongoing maintenance therapy for life threatening arrhythmia or known pulmonary hypertension
- Any secondary malignancies within the last 5 years except for surgically cured non-melanoma skin cancer or cervical carcinoma in situ
- Pregnancy (positive serum pregnancy test) or lactation
- Known hepatitis B/C or HIV infection
- Known hypersensitivity to any of the components in the anti-uPA serine protease inhibitor WX-671 capsules or gemcitabine hydrochloride infusion or other medical reasons for not being able to receive adequate pre-medication (for example, antihistamine or anti-inflammatory agents)
PRIOR CONCURRENT THERAPY:
Permitted:
- Growth factors for treatment (not prophylaxis, i.e., epoetin alfa), analgesics, blood transfusions, antibiotics, bisphosphonates, other hormonal therapy for contraceptive practice, replacement therapy such as thyroid replacement or adrenal insufficiency as appropriate and medications for acute or chronic conditions not listed under the exclusion criteria
- Embolization (i.e. for hematuria)
Subjects can receive blood transfusions as medically appropriate during the study
- Subjects who require a blood transfusion during screening must have stable hemoglobin (≥9.0 g/dL [5.6 mmol/L]) without the need for further transfusions within 2 weeks before the first dose of anti-uPA serine protease inhibitor WX-671 to remain eligible
- Prophylactic use of growth factors to support neutrophils
Prohibited:
- Anticoagulant or thrombolytic therapy within four weeks prior to start of treatment (except low dose anticoagulant therapy with unfractionated heparin ≤ 15000 IU/d, low molecular weight heparin ≤ 5000 IE anti-Xa activity or acetyl salicylic acid ≤ 100 mg/d at the discretion of the investigator)
- Anticancer therapies such as biologic therapy and chemotherapy (other than study drugs)
- Radiation therapy (during the treatment phase of the protocol; increased bone pain not controlled by medication and requiring palliative therapy will be considered disease progression)
- Laser treatment
- Any other investigational agent
- Thalidomide
- Immunosuppressive therapies (inhaled or replacement dose corticosteroids are permitted).
Contacts and Locations
Show 39 Study Locations| Study Chair: | Carola Mala, PhD | Wilex |
More Information
Additional Information:
No publications provided
| Responsible Party: | Wilex |
| ClinicalTrials.gov Identifier: | NCT00499265 History of Changes |
| Other Study ID Numbers: | CDR0000553460, WILEX-WX-60-004 |
| Study First Received: | July 10, 2007 |
| Last Updated: | March 28, 2012 |
| Health Authority: | Germany: Federal Institute for Drugs and Medical Devices Hungary: National Institute of Pharmacy Italy: Ministry of Health Russia: Ministry of Health of the Russian Federation Spain: Ministry of Health Ukraine: Ministry of Health |
Keywords provided by Wilex:
|
recurrent pancreatic cancer stage III pancreatic cancer adenocarcinoma of the pancreas |
Additional relevant MeSH terms:
|
Pancreatic Neoplasms Digestive System Neoplasms Neoplasms by Site Neoplasms Endocrine Gland Neoplasms Digestive System Diseases Pancreatic Diseases Endocrine System Diseases Protease Inhibitors Serine Proteinase Inhibitors Gemcitabine Enzyme Inhibitors |
Molecular Mechanisms of Pharmacological Action Pharmacologic Actions Antimetabolites, Antineoplastic Antimetabolites Antineoplastic Agents Therapeutic Uses Antiviral Agents Anti-Infective Agents Immunosuppressive Agents Immunologic Factors Physiological Effects of Drugs Radiation-Sensitizing Agents |
ClinicalTrials.gov processed this record on June 18, 2013