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Gemcitabine With or Without Exatecan Mesylate in Treating Patients With Locally Advanced or Metastatic Pancreatic Cancer

This study has been completed.
Information provided by (Responsible Party):
Daiichi Sankyo, Inc. Identifier:
First received: September 13, 2001
Last updated: May 15, 2012
Last verified: May 2012

RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. It is not yet known if gemcitabine is more effective with or without exatecan mesylate in treating pancreatic cancer.

PURPOSE: Randomized phase III trial to compare the effectiveness of gemcitabine alone to that of gemcitabine and exatecan mesylate in treating patients who have locally advanced or metastatic pancreatic cancer.

Condition Intervention Phase
Pancreatic Cancer Drug: exatecan mesylate Drug: gemcitabine hydrochloride Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Randomized, Open-Label, Multicenter Phase III Study Comparing the Efficacy and Safety of a Combination of Intravenous DX-8951f (Exatecan Mesylate) Plus Gemcitabine to Gemcitabine Alone in Patients With Locally Advanced or Metastatic Cancer of the Exocrine Pancreas Who Have Not Received Prior Chemotherapy

Resource links provided by NLM:

Further study details as provided by Daiichi Sankyo, Inc.:

Study Start Date: July 2001
Study Completion Date: April 2005
Primary Completion Date: April 2005 (Final data collection date for primary outcome measure)
Detailed Description:


  • Compare the overall survival of patients with chemotherapy-naive locally advanced or metastatic cancer of the exocrine pancreas treated with exatecan mesylate and gemcitabine versus gemcitabine alone.
  • Compare the measures of clinical benefit in patients treated with these regimens.
  • Compare the anti-tumor efficacy of these regimens in this patient population.
  • Determine the safety profile of exatecan mesylate and gemcitabine in these patients.

OUTLINE: This is a randomized, open-label, multicenter study. Patients are stratified according to performance status (60% vs 70-80% vs 90-100%), extent of disease (locally advanced vs metastatic), and prior radiotherapy for pancreatic cancer (yes or no). Patients are randomized to one of two treatment arms.

  • Arm I: Patients receive exatecan mesylate (DX-8951f) IV over 30 minutes immediately followed by gemcitabine IV over 30 minutes on days 1 and 8. Treatment repeats every 3 weeks in the absence of disease progression or unacceptable toxicity.
  • Arm II: Patients receive gemcitabine IV over 30 minutes once weekly for up to 7 weeks followed by one week of rest (course 1). For all subsequent courses, patients receive gemcitabine once weekly for 3 weeks followed by one week of rest. Treatment repeats every 4 weeks in the absence of disease progression or unacceptable toxicity.

Patients are followed monthly.

PROJECTED ACCRUAL: Approximately 340 patients (170 per treatment arm) will be accrued for this study within 18 months.


Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No


  • Histologically or cytologically confirmed epithelial cancer of the exocrine pancreas

    • Locally advanced (unresectable) or metastatic disease
  • No islet cell tumor, lymphoma, or sarcoma of the pancreas
  • No known brain metastases



  • 18 and over

Performance status:

  • Karnofsky 60-100%

Life expectancy:

  • Not specified


  • Absolute neutrophil count at least 1,500/mm3
  • Platelet count at least 100,000/mm3


  • Bilirubin no greater than 1.5 times upper limit of normal (ULN)
  • AST no greater than 5 times ULN
  • Albumin at least 2.8 g/dL


  • Creatinine no greater than 1.5 times ULN


  • No active congestive heart failure
  • No uncontrolled angina
  • No myocardial infarction


  • No serious infection or life-threatening illness unrelated to tumor
  • No other malignancy within the past 2 years except nonmelanoma skin cancer or carcinoma in situ of the cervix
  • No overt psychosis or incompetency that would preclude study
  • No history of a positive serology for HIV
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use contraception


Biologic therapy:

  • No prior systemic anticancer immunotherapy for pancreatic cancer
  • No concurrent anticancer immunotherapy or other biologic therapy


  • No prior systemic anticancer chemotherapy for pancreatic cancer
  • Prior fluorouracil as a radiosensitizer allowed
  • No prior gemcitabine as a radiosensitizer
  • No other concurrent anticancer chemotherapy

Endocrine therapy:

  • Concurrent megestrol for appetite stimulation allowed


  • At least 28 days since prior radiotherapy and recovered
  • No prior radiotherapy to more than 25% of estimated bone marrow reserve
  • No concurrent anticancer radiotherapy


  • At least 28 days since prior major surgery and recovered
  • No concurrent surgery for cancer


  • No prior investigational or other systemic anticancer therapy for pancreatic cancer
  • No other concurrent investigational drugs
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT00023972

  Show 74 Study Locations
Sponsors and Collaborators
Daiichi Sankyo, Inc.
Study Chair: Robert L. DeJager, MD, FACP Daiichi Sankyo, Inc.
  More Information

Responsible Party: Daiichi Sankyo, Inc. Identifier: NCT00023972     History of Changes
Other Study ID Numbers: CDR0000068880
Study First Received: September 13, 2001
Last Updated: May 15, 2012

Keywords provided by Daiichi Sankyo, Inc.:
stage III pancreatic cancer
stage IV pancreatic cancer

Additional relevant MeSH terms:
Pancreatic Neoplasms
Digestive System Neoplasms
Neoplasms by Site
Endocrine Gland Neoplasms
Digestive System Diseases
Pancreatic Diseases
Endocrine System Diseases
Antimetabolites, Antineoplastic
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Antiviral Agents
Anti-Infective Agents
Enzyme Inhibitors
Immunosuppressive Agents
Immunologic Factors
Physiological Effects of Drugs
Topoisomerase I Inhibitors
Topoisomerase Inhibitors
Antineoplastic Agents, Phytogenic processed this record on August 18, 2017