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Study of S-1 as Second Line Treatment on Advanced Pancreatic Cancers (APC-S1)

The recruitment status of this study is unknown. The completion date has passed and the status has not been verified in more than two years.
Verified January 2014 by The Affiliated Hospital of the Chinese Academy of Military Medical Sciences.
Recruitment status was:  Active, not recruiting
Information provided by (Responsible Party):
The Affiliated Hospital of the Chinese Academy of Military Medical Sciences Identifier:
First received: February 23, 2010
Last updated: January 15, 2014
Last verified: January 2014
A randomized , open-label, multicenter, phase II study to compare the efficacy of S-1 and S-1 plus Leucovorin as second line treatment on gemcitabine-refractory patients with inoperable or advanced pancreatic cancers,investigate the correlation between efficacy and the expressions of thymidylate synthase, dihydropyrimidine dehydrogenase and orotate phosphoribosyltransferase

Condition Intervention Phase
Pancreatic Cancer Drug: S-1 Drug: S-1 plus Leucovorin Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Randomized , Open-label, Multicenter, Phase II Study to Compare the Efficacy of S-1 and S-1 Plus Leucovorin as Second Line Treatment on Gemcitabine-refractory Patients With Inoperable or Advanced Pancreatic Cancers

Resource links provided by NLM:

Further study details as provided by The Affiliated Hospital of the Chinese Academy of Military Medical Sciences:

Primary Outcome Measures:
  • Progression Free Survival(PFS) [ Time Frame: up to 3 years ]
    Assuming a 1.8 months median PFS in the S-1 arm, the study was designed to detect an improvement in PFS to 3.5 months in the S-1 plus Leucovorin arm, or 96% prolongation. The calculated number of PFS events needed to detect this difference with α (two-side) of 0.05 and power of 0.8 was 70. Assuming an average enrollment rate of 2.2 patients per month during planned 3-years study period, a total of eighty patients would be able to provide sufficient number of PFS events for the study at end of the study. However, a total of 90 patients were planned for the study, in consideration of comparison for safety and the overall survival between the two treatment groups.

Secondary Outcome Measures:
  • overall survival [ Time Frame: up to 3 years ]
  • Tumor response rate [ Time Frame: up to 3 years ]
  • Clinical benefit rate [ Time Frame: up to 3 years ]
  • safety and tolerance [ Time Frame: up to 3 years ]

Enrollment: 92
Study Start Date: February 2010
Estimated Study Completion Date: July 2014
Primary Completion Date: October 2013 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: S-1,
Subjects will receive S-1 until progression
Drug: S-1
40-60mg bid , days 1-14, every 3 weeks
Experimental: S-1 plus Leucovorin
patients will receive S-1 plus Leucovorin until progression
Drug: S-1 plus Leucovorin
S-1 40-60mg bid, days 1-14 , every 3 weeks Leucovorin 25mg bid , days 1-14 , every 3 weeks


Ages Eligible for Study:   18 Years to 75 Years   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  1. Histologically confirmed inoperable or APC.
  2. Failure of one prior gemcitabine-based regimen was required,chemotherapy used as a radiation sensitizer in the adjuvant or locally advanced setting was not considered as a prior regimen. Patients received last adjuvant gemcitabine-based chemotherapy less than (or equal to) six months can be enrolled into this study.
  3. Disease had to be measurable by the Response Evaluation Criteria in Solid Tumors (RECIST) criteria.
  4. Age ≥18 years old.
  5. ECOG performance status 0 or 1.
  6. Written informed consent and able to comply with the protocol.

Exclusion Criteria:

  1. Local (Stage IA to IIB) pancreatic cancer and locally advanced (stage III) pancreatic cancer. Patients relapsing with metastatic disease, after initial diagnoses with local disease can be enrolled into this study.
  2. Previous adjuvant radiotherapy for pancreatic cancer, except for patients with progressive lesions outside the radiation port who completed the radiotherapy at least 6 months prior to study entry.
  3. More than (or equal to) six months since last adjuvant chemotherapy. Adjuvant therapy without gemcitabine based adjuvant therapy is not allowed. Patient must have recovered from all treatment related toxicity prior to enrollment and must have documented evidence of disease progression (metastatic) following prior chemotherapy.
  4. No previous gemcitabine-based therapy for inoperable or APC.
  5. Other primary tumour (including primary brain tumours) within the last 5 years prior to enrollment, except for adequately treated carcinoma in situ of the cervix or basal cell skin cancer.
  6. Evidence of spinal cord compression or current evidence of central nervous system (CNS) metastases.
  7. History or evidence upon neurological exam of CNS disease (unless adequately treated with standard medical therapy) e.g. uncontrolled seizures.
  8. Inability to take oral medication, prior surgical procedures affecting absorption or resulting in the requirement for intravenous alimentation or parenteral nutrition with lipids, and/or active peptic ulcer disease
  9. Pregnant or lactating females. Serum pregnancy test to be assessed within 7 days prior to study treatment start, or within 14 days with a confirmatory urine pregnancy test within 7 days prior to study treatment start
  10. Men and women of childbearing potential (<2 years after last menstruation) not using effective means of contraception (oral contraceptives, intrauterine contraceptive device, barrier method of contraception in conjunction with spermicidal jelly or surgically sterile)
  11. Current or recent (within the 30 days prior to starting study treatment) treatment with another investigational drug or participation in another investigational study
  12. Evidence of any other disease, metabolic dysfunction, physical examination finding, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates use of an investigational drug, or patient at high risk from treatment complications
  13. Known hypersensitivity to any of the study drugs
  Contacts and Locations
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Please refer to this study by its identifier: NCT01074996

China, Beijing
307 Hospital of PLA
Beijing, Beijing, China, 100071
Sponsors and Collaborators
The Affiliated Hospital of the Chinese Academy of Military Medical Sciences
Principal Investigator: Xu jianming, M.D. The Affiliated Hospital of the Chinese Academy of Military Medical Sciences
  More Information

Publications automatically indexed to this study by Identifier (NCT Number):
Responsible Party: The Affiliated Hospital of the Chinese Academy of Military Medical Sciences Identifier: NCT01074996     History of Changes
Other Study ID Numbers: APC-307PLAH-XJM
Study First Received: February 23, 2010
Last Updated: January 15, 2014

Keywords provided by The Affiliated Hospital of the Chinese Academy of Military Medical Sciences:
Pancreatic cancer
S-1 plus Leucovorin
second-line therapy

Additional relevant MeSH terms:
Pancreatic Neoplasms
Digestive System Neoplasms
Neoplasms by Site
Endocrine Gland Neoplasms
Digestive System Diseases
Pancreatic Diseases
Endocrine System Diseases processed this record on August 18, 2017