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Capecitabine or Observation After Surgery in Treating Patients With Biliary Tract Cancer

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00363584
Recruitment Status : Completed
First Posted : August 15, 2006
Last Update Posted : August 26, 2013
Information provided by:
National Cancer Institute (NCI)

Brief Summary:

RATIONALE: Drugs used in chemotherapy, such as capecitabine, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving capecitabine after surgery may kill any tumor cells that remain after surgery. Sometimes, after surgery, the tumor may not need more treatment until it progresses. In this case, observation may be sufficient. It is not yet known whether capecitabine is more effective than observation in treating biliary tract cancer.

PURPOSE: This randomized phase III trial is studying capecitabine to see how well it works compared with observation in treating patients with biliary tract cancer.

Condition or disease Intervention/treatment Phase
Extrahepatic Bile Duct Cancer Gallbladder Cancer Liver Cancer Drug: capecitabine Other: clinical observation Procedure: adjuvant therapy Phase 3

Detailed Description:



  • To determine whether adjuvant chemotherapy with capecitabine has any effect on 2-year survival compared to expectant treatment alone (observation) in patients who have undergone a macroscopically complete surgical resection of a biliary tract cancer.


  • To compare capecitabine versus observation in terms of 5-year survival, relapse-free survival, toxicity, quality of life, and health economics.

OUTLINE: This is a multicenter, prospective, randomized study. Patients are stratified according to surgical center, disease site (hilar/extrahepatic cholangiocarcinoma vs intrahepatic cholangiocarcinoma vs gallbladder vs intrapancreatic/common bile duct), type of resection (R0 vs R1), and ECOG performance status (0 vs 1 vs 2). Patients are randomized to 1 of 2 treatment arms.

  • Arm I: Patients receive oral capecitabine twice a day on days 1-14. Treatment repeats every 3 weeks for 8 courses in the absence of disease progression or unacceptable toxicity.
  • Arm II: Patients undergo expectant treatment (observation). Quality of life is assessed at baseline, every 3 months for 1 year, and then every 6 months for 1 year.

All patients are followed for up to 5 years post-randomization.

Peer Reviewed and Funded or Endorsed by Cancer Research UK

PROJECTED ACCRUAL: A total of 360 patients will be accrued for this study.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 360 participants
Allocation: Randomized
Primary Purpose: Treatment
Official Title: A Randomised Clinical Trial Evaluating Adjuvant Chemotherapy With Capecitabine Compared to Expectant Treatment Alone (Observation) Following Surgery for Biliary Tract Cancer
Study Start Date : March 2006
Actual Primary Completion Date : August 2013

Primary Outcome Measures :
  1. Survival at 2 years

Secondary Outcome Measures :
  1. Survival at 5 years
  2. Relapse-free survival
  3. Toxicity
  4. Quality of life
  5. Health economics

Information from the National Library of Medicine

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


  • Histologically confirmed biliary tract cancer (including intrahepatic or extrahepatic/hilar cholangiocarcinoma or muscle invasive gallbladder cancer or cancer of the distal bile duct)

    • Must have undergone a radical surgical approach which includes liver resection, pancreatic resection, or less commonly both
    • Patients with pathological evidence of microscopic involvement of the margins of the excised specimen are eligible as long as resection is macroscopically complete
  • Must be able to start treatment within 12 weeks of surgery
  • No pancreatic or periampullary cancer
  • No mucosal gallbladder cancer


  • ECOG performance status 0-2
  • Urea < 1.5 times upper limit of normal (ULN)
  • Creatinine < 1.5 times ULN
  • Glomerular filtration rate ≥ 60 mL/min (if < 60 mL/min, adequate renal function for capecitabine must be confirmed by isotope EDTA)
  • Hemoglobin ≥ 10 g/dL
  • WBC ≥ 3,000/mm³
  • Absolute neutrophil count ≥ 1,500/mm³
  • Platelet count ≥ 100,000/mm³
  • Bilirubin ≤ 3 times ULN
  • ALT and AST ≤ 5 times ULN
  • Adequate surgical biliary drainage with no evidence of infection
  • Not pregnant or nursing
  • Negative pregnancy test for women of childbearing age and childbearing potential
  • Fertile patients must use effective contraception during study treatment and for at least 3 months after study treatment has ended
  • Must provide written informed consent
  • No history of other malignant diseases within the past 5 years other than adequately treated nonmelanoma skin cancer or in situ carcinoma of the uterine cervix
  • No serious co-existing medical condition likely to interfere with protocol treatment, including a potential serious infection
  • No evidence of significant clinical disorder or laboratory finding that makes it undesirable for the patient to participate in the trial
  • No psychological, familial, sociological, or geographical factors considered likely to preclude study compliance
  • No other serious uncontrolled medical conditions
  • No unresolved biliary tree obstruction


  • See Disease Characteristics
  • Completely recovered from prior surgery
  • No use of other investigational agents within 28 days prior to and during study treatment
  • No prior chemotherapy or radiotherapy for biliary tract cancer
  • No other concurrent anticancer chemotherapy, radiotherapy, or investigational agent

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00363584

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United Kingdom
Basildon University Hospital
Basildon, England, United Kingdom, SS16 5NL
Basingstoke and North Hampshire NHS Foundation Trust
Basingstoke, England, United Kingdom, RG24 9NA
Cancer Research UK Clinical Trials Unit - Birmingham
Birmingham, England, United Kingdom, B15 2TT
Royal Bournemouth Hospital
Bournemouth, England, United Kingdom, BH7 7DW
Bristol Haematology and Oncology Centre
Bristol, England, United Kingdom, BS2 8ED
Addenbrooke's Hospital
Cambridge, England, United Kingdom, CB2 2QQ
Walsgrave Hospital
Coventry, England, United Kingdom, CV2 2DX
Princess Alexandra Hospital
Essex, England, United Kingdom, CM20 1QX
St. Luke's Cancer Centre at Royal Surrey County Hospital
Guildford, England, United Kingdom, GU2 7XX
Calderdale Royal Hospital
Halifax, England, United Kingdom, HX3 0PW
Huddersfield Royal Infirmary
Huddersfield, West Yorks, England, United Kingdom, HD3 3EA
Cancer Research UK Clinical Centre at St. James's University Hospital
Leeds, England, United Kingdom, LS16 6QB
Leicester Royal Infirmary
Leicester, England, United Kingdom, LE1 5WW
Leicester General Hospital
Leicester, England, United Kingdom, LE5 4PW
Royal Liverpool University Hospital
Liverpool, England, United Kingdom, L7 8XP
Aintree University Hospital
Liverpool, England, United Kingdom, L9 7AL
Saint Bartholomew's Hospital
London, England, United Kingdom, EC1A 7BE
Helen Rollason Cancer Care Centre at North Middlesex Hospital
London, England, United Kingdom, N18 1QX
UCL Cancer Institute
London, England, United Kingdom, NW3 2QG
St. Thomas' Hospital
London, England, United Kingdom, SE1 7EH
King's College Hospital
London, England, United Kingdom, SE5 9RS
Royal Marsden - London
London, England, United Kingdom, SW3 6JJ
Hammersmith Hospital
London, England, United Kingdom, W12 OHS
University College of London Hospitals
London, England, United Kingdom, WIT 3AA
Maidstone Hospital
Maidstone, England, United Kingdom, ME16 9QQ
Christie Hospital
Manchester, England, United Kingdom, M20 4BX
North Manchester General Hospital - Penine Actute Hospitals Trust
Manchester, England, United Kingdom, M8 6RB
Clatterbridge Centre for Oncology
Merseyside, England, United Kingdom, CH63 4JY
Northern Centre for Cancer Treatment at Newcastle General Hospital
Newcastle-Upon-Tyne, England, United Kingdom, NE4 6BE
Freeman Hospital
Newcastle-Upon-Tyne, England, United Kingdom, NE7 7DN
St. Mary's Hospital
Newport, England, United Kingdom, PO30 5TG
Nottingham City Hospital
Nottingham, England, United Kingdom, NG5 1PB
Derriford Hospital
Plymouth, England, United Kingdom, PL6 8DH
Portsmouth Oncology Centre at Saint Mary's Hospital
Portsmouth Hants, England, United Kingdom, PO3 6AD
Alexandra Healthcare NHS
Redditch, Worcestershire, England, United Kingdom, B98 7UB
Salisbury District Hospital
Salisbury, England, United Kingdom, SP2 8BJ
Cancer Research Centre at Weston Park Hospital
Sheffield, England, United Kingdom, S1O 2SJ
Southampton General Hospital
Southampton, England, United Kingdom, SO16 6YD
Royal Marsden - Surrey
Sutton, England, United Kingdom, SM2 5PT
Southend University Hospital NHS Foundation Trust
Westcliff-On-Sea, England, United Kingdom, SS0 0RY
Yeovil District Hospital
Yeovil, England, United Kingdom, BA21 4AT
Ninewells Hospital
Dundee, Scotland, United Kingdom, DD1 9SY
Edinburgh Cancer Centre at Western General Hospital
Edinburgh, Scotland, United Kingdom, EH4 2XU
Beatson West of Scotland Cancer Centre
Glasgow, Scotland, United Kingdom, G12 0YN
Perth Royal Infirmary
Perth, Scotland, United Kingdom, PH1 1NX
Velindre Cancer Center at Velindre Hospital
Cardiff, Wales, United Kingdom, CF14 2TL
Sponsors and Collaborators
University Hospital Southampton NHS Foundation Trust
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OverallOfficial: Clive Stubbs Cancer Research Campaign Clinical Trials Centre

Layout table for additonal information Identifier: NCT00363584     History of Changes
Other Study ID Numbers: CDR0000492266
First Posted: August 15, 2006    Key Record Dates
Last Update Posted: August 26, 2013
Last Verified: October 2011
Keywords provided by National Cancer Institute (NCI):
localized resectable adult primary liver cancer
cholangiocarcinoma of the extrahepatic bile duct
cholangiocarcinoma of the gallbladder
adenocarcinoma of the gallbladder
adenocarcinoma with squamous metaplasia of the gallbladder
anaplastic carcinoma of the gallbladder
localized gallbladder cancer
localized extrahepatic bile duct cancer
squamous cell carcinoma of the gallbladder
adult primary cholangiocellular carcinoma
Additional relevant MeSH terms:
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Liver Neoplasms
Biliary Tract Neoplasms
Gallbladder Neoplasms
Bile Duct Neoplasms
Digestive System Neoplasms
Neoplasms by Site
Digestive System Diseases
Liver Diseases
Biliary Tract Diseases
Gallbladder Diseases
Bile Duct Diseases
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Antimetabolites, Antineoplastic
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents