Gemcitabine Hydrochloride and Oxaliplatin or Observation in Treating Patients With Biliary Tract Cancer That Has Been Removed by Surgery

This study is currently recruiting participants. (see Contacts and Locations)
Verified March 2011 by National Cancer Institute (NCI)
Information provided by:
National Cancer Institute (NCI) Identifier:
First received: March 10, 2011
Last updated: NA
Last verified: March 2011
History: No changes posted

RATIONALE: Drugs used in chemotherapy, such as gemcitabine hydrochloride and oxaliplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Observation is watching a patient's condition but not giving treatment until symptoms appear. It is not yet known whether giving gemcitabine hydrochloride together with oxaliplatin is more effective than observation in treating patients with biliary tract cancer that has been removed by surgery.

PURPOSE: This randomized phase III trial is studying giving gemcitabine hydrochloride together with oxaliplatin to see how well it works compared with observation in treating patients with biliary tract cancer that has been removed by surgery.

Condition Intervention Phase
Extrahepatic Bile Duct Cancer
Gallbladder Cancer
Liver Cancer
Drug: gemcitabine hydrochloride
Drug: oxaliplatin
Other: clinical observation
Procedure: adjuvant therapy
Procedure: quality-of-life assessment
Phase 3

Study Type: Interventional
Study Design: Masking: Open Label
Primary Purpose: Treatment
Official Title: Phase III Multicenter Randomized Study Comparing the Effect of Adjuvant Chemotherapy for Six Months With Gemcitabine-Oxaliplatin 85 mg/m2 (GEMOX 85) to Observation in Patients Who Underwent Surgery for Cancer of the Bile Ducts

Resource links provided by NLM:

Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Disease-free survival [ Designated as safety issue: No ]
  • Quality of life [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Overall survival [ Designated as safety issue: No ]
  • Toxicity of adjuvant chemotherapy [ Designated as safety issue: Yes ]

Estimated Enrollment: 190
Study Start Date: July 2009
Estimated Primary Completion Date: July 2016 (Final data collection date for primary outcome measure)
Detailed Description:



  • Compare disease-free survival (DFS) of patients with resected biliary tract cancer treated with adjuvant gemcitabine hydrochloride and oxaliplatin versus clinical observation.
  • Compare quality of life of these patients.


  • Compare overall survival of these patients.
  • Determine the toxicity of the chemotherapy in these patients.
  • Explore prognostic factors for DFS including resection result (R0 vs R1), location of primary tumor (intrahepatic vs extrahepatic vs gallbladder), evolution of CA19-9, and lymph node involvement (N0 vs N+ and Nx). (Exploratory)
  • Study pathological factors in surgical specimens to identify main characteristics and phenotypic clinicoanatomical biliary tract cancers before therapy. (Exploratory)
  • Identify nontumor-associated liver injury and factors that may facilitate the emergence of biliary tract cancers. (Exploratory)
  • Identify signaling pathways that may predict response to therapy. (Exploratory)
  • Determine the molecular characteristics to differentiate tumors according to their position in the biliary tract (extrahepatic bile duct, intrahepatic cholangiocarcinoma site [hilar], and peripheral cholangiocarcinoma vesicle site). (Exploratory)

OUTLINE: This is a multicenter study. Patients are randomized to 1 of 2 treatment arms.

  • Arm I: Patients receive gemcitabine hydrochloride IV over 100 minutes on day 1 and oxaliplatin IV over 2 hours on day 2. Treatment repeats every 14 days for 12 courses.
  • Arm II: Patients undergo clinical observation only every 4 weeks for 5 months. Quality of life is assessed at baseline, at 3 and 6 months, and then at all follow-up visits.

After completion of study therapy, patients are followed up at 6 months, every 3 months for 2 years, and then every 6 months for 3 years.


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


  • Histologically proven adenocarcinoma of the intrahepatic bile ducts, gallbladder, or extrahepatic bile ducts

    • Mixed forms of hepatocholangiocarcinomas included provided the cholangiocarcinoma is predominant
  • Underwent surgical resection of the disease (R0 or R1) at least 4 weeks but no more than 13 weeks ago
  • Nonmetastatic disease as assessed by abdominal MRI and chest x-ray
  • No cancer of the pancreas or duodenum invading the bile duct and ampulla of Vater


  • ECOG performance status 0-2
  • Hemoglobin ≥ 10 g/dL (transfusion allowed)
  • ANC ≥ 1,500/mm³
  • Platelet count ≥ 75,000/mm³
  • Creatinine clearance > 40 mL/min
  • Prothrombin time > 60% OR INR < 1.5 (without anticoagulant therapy)
  • Transaminases ≤ 5 times upper limit of normal (ULN)
  • Alkaline phosphatase ≤ 2.5 times ULN
  • Conjugated bilirubin ≤ 35 μmol/L (after biliary drainage, if necessary)
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • No contraindications to oxaliplatin and gemcitabine hydrochloride therapy
  • Prior invasive cancer allowed provided it has been in complete remission for ≥ 5 years
  • No other concurrent invasive cancer except adequately treated carcinoma in situ of the cervix or basal cell carcinoma
  • No other severe, unresolved disease
  • No mental illness
  • No HIV positivity
  • No grade 1 angina or symptomatic angina ≥ grade 2
  • No sensitive peripheral neuropathy
  • No uncontrolled diabetes
  • No inability to undergo medical tests due to geographical, social, or psychological reasons
  • No prisoners or patients under guardianship
  • No Child B or C cirrhosis


  • See Disease Characteristics
  • No prior neoadjuvant chemotherapy or radiotherapy
  • No prior organ transplantation
  • No concurrent participation in another clinical trial of an experimental agent
  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: NCT01313377

Hopital Saint Antoine Recruiting
Paris, France, 75571
Contact: Contact Person    33-1-4928-2345   
Centre Eugene Marquis Recruiting
Rennes, France, 35042
Contact: Contact Person    33-2-9925-3180   
CHU Sainte-Etienne - Hopital Nord Recruiting
Sainte-Etienne, France, 42255
Contact: Contact Person    33-4-7782-8320   
Sponsors and Collaborators
Principal Investigator: Eveline Boucher, MD Centre Eugene Marquis
  More Information Identifier: NCT01313377     History of Changes
Other Study ID Numbers: CDR0000696193  FRE-FNCLCC-ACCORD-18/0803  FRE-FNCLCC-PRODIGE-12  EUDRACT-2008-004560-39  EU-20982 
Study First Received: March 10, 2011
Last Updated: March 10, 2011
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
adenocarcinoma of the extrahepatic bile duct
cholangiocarcinoma of the extrahepatic bile duct
liver and intrahepatic biliary tract cancer
localized extrahepatic bile duct cancer
adenocarcinoma of the gallbladder
cholangiocarcinoma of the gallbladder
localized gallbladder cancer

Additional relevant MeSH terms:
Gallbladder Neoplasms
Bile Duct Neoplasms
Bile Duct Diseases
Biliary Tract Diseases
Biliary Tract Neoplasms
Digestive System Diseases
Digestive System Neoplasms
Gallbladder Diseases
Neoplasms by Site
Anti-Infective Agents
Antimetabolites, Antineoplastic
Antineoplastic Agents
Antiviral Agents
Enzyme Inhibitors
Immunologic Factors
Immunosuppressive Agents
Molecular Mechanisms of Pharmacological Action
Physiological Effects of Drugs processed this record on May 26, 2016