Calcitriol in Advanced Intrahepatic Cholangiocarcinoma
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Purpose
Cholangiocarcinoma (CCA), cancer of the bile duct, is the first cause of cancer death of the people in the northeast of Thailand. The incidence of CCA in this region is highest not only in the country but in the world. CCA is a slow growing but highly metastatic tumor. At present, there is no standard chemotherapy or effective treatment for CCA. Most of the patients have short survival after diagnosis. Strong evidences from in vitro, animal and clinical studies indicate that vitamin D can prevent and control growth of cancer. Our preclinical studies in CCA cell lines, animal and patient tissue culture indicate that vitamin D effectively reduce growth of CCA. Supplementation of vitamin D to chemotherapeutic drugs enhance drug toxicity and better response. At present, there are several clinical trials in USA on supplementation of vitamin D or its analogs to cancer patients. The side effect or toxicity of using vitamin D supplementation is low, some patients had stable disease and some had good response. The current study is set up a clinical trial phase II of vitamin D (calcitriol) in combination with 5-fluorouracil, Mitomycin C and Leucovorin in an open label-non-randomized study to evaluate the tumor response in patients with advanced intrahepatic cholangiocarcinoma. This study will provide an alternative/effective chemotherapy treatment for CCA patients. Better survival and improved quality of life are also expected.
| Condition | Intervention | Phase |
|---|---|---|
|
Advanced Intrahepatic Cholangiocarcinoma |
Drug: Calcitriol |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | A Clinical Trial Phase II of Calcitriol in Combination With 5-fluorouracil, Mitomycin C and Leucovorin in an Open Label-non-randomized Study to Evaluate the Tumor Response in Patients With Advanced Intrahepatic Cholangiocarcinoma |
- To assess safety and tolerability of calcitriol in combination with 5-fluorouracil/mitomycin C/leucovorin. [ Time Frame: 3-6 months ] [ Designated as safety issue: Yes ]
- To assess quality of life (QOL) of patients who are received calcitriol in combination with 5-fluorouracil/mitomycin C/leucovorin. [ Time Frame: 3-6 months ] [ Designated as safety issue: Yes ]
- To assess the response of calcitriol in combination with 5-fluorouracil/mitomycin C/leucovorin in patients with advanced intrahepatic cholangiocarcinoma. [ Time Frame: 3-6 months ] [ Designated as safety issue: Yes ]
| Estimated Enrollment: | 28 |
| Study Start Date: | January 2010 |
| Estimated Study Completion Date: | October 2012 |
| Estimated Primary Completion Date: | October 2011 (Final data collection date for primary outcome measure) |
-
Drug: Calcitriol
- OUTLINE: This is a dose-limiting toxicity study of calcitriol.
- EVALUAITON: During the initial phase, 14 patients will be accrued for this study. If the number of patient's response to calcitriol and 5-fluorouracil/mitomycin C/leucovorin is less than 1/14, the study will be stopped. However there is one patient who responses to calcitriol and 5-fluorouracil/mitomycin C/leucovorin, the new 14 patients will be accrued during the secondary phase of study.
Eligibility| Ages Eligible for Study: | 30 Years to 65 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Proven histological or cytological diagnosis of advanced intrahepatic cholangiocarcinoma (stage III, IV); Patients are ineligible for surgery.
- Patients must have measurable or evaluable disease.
- Age between 30-65 years
- Performance status must be ECOG 0-1.
- No prior use of chemotherapy or palliative radiation
- Tumor size by CT scan must be larger than 10 mm.x10 mm.
- Life expectancy of at least 12 weeks.
- Adequate bone marrow, hepatic, and renal function, as evidenced by the following: WBC > 3.0 x 109/L, neutrophils > 1.5 x 109 /L; platelet count > 100 x 109/L; Hct > 30%; total bilirubin < 1 mg/dL; Liver enzymes (alkaline phosphatase, AST, ALT) < 3 times the upper limit of the normal range. Creatinine within the normal range.
- Female patients must not be pregnant; they must be post-menopausal or practicing an accepted form of birth control. If pregnancy is a possibility, a pregnancy test will be required prior to initiation of therapy.
- Patients must be accessible for treatment and follow-up.
- Patient and investigator signed study-specific consent form, indicating the investigational nature of the study.
Exclusion Criteria:
- Known hypersensitivity to Vitamin D, 5-fluorouracil, mitomycin C
- Hypercalcemia (patients with corrected serum calcium > 10.5 mg/dL) and hyperparathyroid
- History of renal/bladder stones
- History of nephrectomy
- 30 days prior to study entry, CT scan or ultrasound shows renal/bladder stones.
- Patients with congestive heart failure or arrhythmia or unstable angina within 6 months prior study
- Pregnancy/Lactation
- Palliative radiation or adjuvant therapy or chemotherapy in tumor area
- No other concurrent malignancies
- No active infection
- Metastasis at central nervous system
- Metastasis at Bone
- Renal insufficiency (creatinine > 1.5 mg/dL)
- Patients who are in other concurrent cancer clinical trial
Contacts and Locations| Contact: Vajarabhongsa Bhudisawasdi, MD | 66-43-348393 | JOEVAJARA@gmail.com |
| Contact: Sopit Wongkham, PhD | 66-43-348386 | Sopit@kku.ac.th |
| Thailand | |
| Srinagarind Hospital, Faculty of Medicine, Khon Kaen University | Not yet recruiting |
| Khon Kaen, Thailand, 40002 | |
| Contact: Vajarabhongsa Bhudisawasdi, MD 66-43-348393 JOEVAJARA@gmail.com | |
| Contact: Sopit Wongkham, PhD 66-43-348386 Sopit@kku.ac.th | |
| Principal Investigator: Vajarabhongsa Bhudisawasdi, MD | |
| Principal Investigator: | Vajarabhongsa Bhudisawasdi, MD | Department of Surgery, Faculty of Medicine, Liver fluke and cholangiocarcinoma research center, Khon Kaen University |
More Information
No publications provided
| Responsible Party: | Vajarabhongsa Bhudisawasdi, Department of Surgery, Faculty of Medicine, Liver fluke and cholangiocarcinoma research center, Khon Kaen University |
| ClinicalTrials.gov Identifier: | NCT01039181 History of Changes |
| Other Study ID Numbers: | P-09-00171 |
| Study First Received: | December 22, 2009 |
| Last Updated: | December 23, 2009 |
| Health Authority: | Thailand: Khon Kaen University Ethics Committee for Human Research |
Keywords provided by National Science and Technology Development Agency, Thailand:
|
Vitamin D Calcitriol cholangiocarcinoma Clinical trial |
Additional relevant MeSH terms:
|
Cholangiocarcinoma Liver Neoplasms Adenocarcinoma Carcinoma Neoplasms, Glandular and Epithelial Neoplasms by Histologic Type Neoplasms Digestive System Neoplasms Neoplasms by Site Digestive System Diseases Liver Diseases Calcitriol Vitamin D Vitamins Fluorouracil |
Micronutrients Growth Substances Physiological Effects of Drugs Pharmacologic Actions Bone Density Conservation Agents Calcium Channel Agonists Membrane Transport Modulators Molecular Mechanisms of Pharmacological Action Vasoconstrictor Agents Cardiovascular Agents Therapeutic Uses Antimetabolites Antimetabolites, Antineoplastic Antineoplastic Agents Immunosuppressive Agents |
ClinicalTrials.gov processed this record on May 19, 2013