Hepatic Arterial Infusion in Treating Patients With Locally Advanced, Non-Metastatic Cholangiocarcinoma

This study is currently recruiting participants.
Verified December 2012 by Washington University School of Medicine
Sponsor:
Information provided by (Responsible Party):
Washington University School of Medicine
ClinicalTrials.gov Identifier:
NCT01525069
First received: January 25, 2012
Last updated: December 20, 2012
Last verified: December 2012
  Purpose

This pilot clinical trial studies the safety and effectiveness of continuous hepatic arterial infusion (HAI) of floxuridine (FUDR) alone or in combination with other chemotherapeutic drugs in treating patients with locally advanced cholangiocarcinoma that cannot be removed by surgery. HAI is a method to deliver higher concentrations of FUDR more directly to liver tumors and reduces side effects. HAI alone or in combination with oxaliplatin and/or gemcitabine may significantly improve clinical outcomes of patients with locally advanced cholangiocarcinoma.


Condition Intervention
Cholangiocarcinoma
Liver Neoplasms
Drug: floxuridine, dexamethasone
Drug: floxuridine, dexamethasone, gemcitabine hydrochloride
Drug: floxuridine, dexamethasone, gemcitabine hydrochloride, oxaliplatin

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Pilot Study of Hepatic Arterial Infusion Therapy in Patients With Unresectable or Borderline Resectable Intrahepatic Cholangiocarcinoma

Resource links provided by NLM:


Further study details as provided by Washington University School of Medicine:

Primary Outcome Measures:
  • Toxicity of HAI alone or in combination with systemic oxaliplatin and/or gemcitabine [ Time Frame: 8 weeks ] [ Designated as safety issue: Yes ]
    Document the frequency of grades 3-5 non-hematologic toxicities (dose-limiting toxicities) associated with the treatment regimen by patient and by type of toxicity for each cohort.


Secondary Outcome Measures:
  • Time to progression [ Time Frame: 5 years ] [ Designated as safety issue: No ]
    Describe median time to progression with a 95% confidence interval for each cohort.

  • Response rates [ Time Frame: 8 weeks ] [ Designated as safety issue: No ]
    Describe the overall response rate and the response rate within each cohort with 95% confidence intervals.

  • Overall survival [ Time Frame: 5 years ] [ Designated as safety issue: No ]
    Describe median overall survival with a 95% confidence interval and estimate the overall survival rate at 12 and 24 months with 95% confidence intervals.

  • Number and grade of adverse events post HAI treatment [ Time Frame: 13 months ] [ Designated as safety issue: Yes ]
    Determine safety, tolerability and toxicities based on the number and grade of adverse events associated with this regimen.

  • Imaging biomarkers of tumor response [ Time Frame: 13 months ] [ Designated as safety issue: No ]
    Using magnetic resonance diffusion-weighted imaging (DW-MRI) and dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) before and early during the course of treatment with HAI therapy, validate imaging biomarkers of tumor response


Estimated Enrollment: 36
Study Start Date: April 2012
Estimated Study Completion Date: April 2016
Estimated Primary Completion Date: April 2016 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Cohort A (HAI)
Patients receive FUDR and dexamethasone via continuous HAI for 14 days of a 28-day treatment cycle.
Drug: floxuridine, dexamethasone

floxuridine Given HAI; 0.16mg/kg/day on Days 1-14 of each cycle

dexamethasone, Given HAI; 20mg

Other Names:
  • 5-FUDR, FdUrD, floxuridin, fluorodeoxyuridine, fluoruridine deoxyribose, FUdR
  • Aeroseb-Dex, Decaderm, Decadron, Decaspray, DM, DXM
Experimental: Cohort B (HAI + gemcitabine)
Patients receive FUDR and dexamethasone as in Cohort A. Patients also receive gemcitabine
Drug: floxuridine, dexamethasone, gemcitabine hydrochloride

floxuridine Given HAI; 0.12mg/kg/day on Days 1-14 of each cycle

dexamethasone Given HAI; 20 mg on Days 1-14 of each cycle

gemcitabine hydrochloride Given IV; 1000 mg/m^2 on Days 1, 8 and 15 of each cycle

Other Names:
  • 5-FUDR, FdUrD, floxuridin, fluorodeoxyuridine, fluoruridine deoxyribose, FUdR
  • Aeroseb-Dex, Decaderm, Decadron, Decaspray, DM, DXM
  • dFdC, dFdCyd, difluorodeoxycytidine hydrochloride, gemcitabine, Gemzar, LY-188011
Experimental: Cohort C (HAI + gemcitabine + oxaliplatin)
Patients receive FUDR and dexamethasone as in Cohort A. Patients also receive gemcitabine and oxaliplatin
Drug: floxuridine, dexamethasone, gemcitabine hydrochloride, oxaliplatin

floxuridine Given HAI; 0.12mg/kg/day on Days 1-14 of each cycle

dexamethasone Given HAI; 20mg on Days 1-14 of each cycle

gemcitabine hydrochloride Given IV; 800 mg/m^2 on Days 1 and 15 of each cycle

oxaliplatin Given IV; 85 mg/m^2 on Days 1 and 15 of each cycle

Other Names:
  • 5-FUDR, FdUrD, floxuridin, fluorodeoxyuridine, fluoruridine deoxyribose, FUdR
  • Aeroseb-Dex, Decaderm, Decadron, Decaspray, DM, DXM
  • dFdC, dFdCyd, difluorodeoxycytidine hydrochloride, gemcitabine, Gemzar, LY-188011
  • 1-OHP, Dacotin, Dacplat, diaminocyclohexane oxalatoplatinum, Eloxatin, L-OHP

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patient must have histologically or cytologically confirmed intrahepatic or hilar cholangiocarcinoma with minimal extrahepatic disease
  • Patient must have measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded) as >= 20 mm with conventional techniques or as >= 10 mm with spiral computed tomography (CT) scan/MRI
  • Patient must have disease that is unresectable or borderline resectable with < 70% liver involvement by cancer
  • Patient must be > 18 years old.
  • Patient's Eastern Cooperative Oncology Group (ECOG) performance status must be =< 2 (Karnofsky >= 60%)
  • Absolute neutrophil count >= 1,500/mcL
  • Platelets >= 75,000/mcL
  • Total bilirubin =< 2 mg/dL
  • Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT])/alanine aminotransferase (ALT) (serum glutamic pyruvate transaminase [SGPT]) =< 5 X institutional upper limit of normal
  • Creatinine within normal institutional limits
  • Patient must be able to understand and willing to sign a written informed consent document

Exclusion Criteria:

  • Patients must not have had prior treatment with FUDR
  • Patient must not be receiving any other investigational agents
  • Patient must not have a diagnosis of Gilbert's disease
  • Patient must not have a diagnosis of hepatic encephalopathy
  • Patient must not have had prior external beam radiation to the liver
  • Patient must not have a diagnosis of sclerosing cholangitis
  • Patient must not have any uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
  • Patient must not be pregnant or breastfeeding
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT01525069

Contacts
Contact: William Chapman, M.D. 314-362-7792 chapmanw@wustl.edu
Contact: Laura Daigh, BA 314-362-8547 daighl@wudosis.wustl.edu

Locations
United States, Missouri
Washington University School of Medicine Recruiting
St. Louis, Missouri, United States, 63122
Contact: William Chapman, M.D.     314-362-7992     chapmanw@wustl.edu    
Contact: Laura Daigh, BA     314-362-8547     daighl@wudosis.wustl.edu    
Sub-Investigator: Benjamin Tan, M.D.            
Sub-Investigator: Maria Doyle, M.D.            
Sub-Investigator: William Hawkins, M.D.            
Sub-Investigator: David Linehan, M.D.            
Sub-Investigator: A. Craig Lockhart, M.D.            
Sub-Investigator: Jeffrey Lowell, M.D.            
Sub-Investigator: Joel Picus, M.D.            
Sub-Investigator: Timothy Pluard, M.D.            
Sub-Investigator: Steven Sorscher, M.D.            
Sub-Investigator: Steven Strasberg, M.D.            
Sub-Investigator: Rama Suresh, M.D.            
Sub-Investigator: Andrea Wang-Gillam, M.D., Ph.D.            
Sub-Investigator: Kathryn J. Fowler, M.D.            
Sponsors and Collaborators
Washington University School of Medicine
  More Information

Additional Information:
Publications:
Responsible Party: Washington University School of Medicine
ClinicalTrials.gov Identifier: NCT01525069     History of Changes
Other Study ID Numbers: 201111068
Study First Received: January 25, 2012
Last Updated: December 20, 2012
Health Authority: United States: Institutional Review Board

Additional relevant MeSH terms:
Cholangiocarcinoma
Neoplasms
Liver Neoplasms
Digestive System Neoplasms
Neoplasms by Site
Digestive System Diseases
Liver Diseases
Adenocarcinoma
Carcinoma
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Dexamethasone acetate
Dexamethasone
Dexamethasone 21-phosphate
Gemcitabine
Oxaliplatin
Floxuridine
BB 1101
Anti-Inflammatory Agents
Therapeutic Uses
Pharmacologic Actions
Antiemetics
Autonomic Agents
Peripheral Nervous System Agents
Physiological Effects of Drugs
Central Nervous System Agents
Gastrointestinal Agents
Glucocorticoids
Hormones
Hormones, Hormone Substitutes, and Hormone Antagonists

ClinicalTrials.gov processed this record on June 17, 2013