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ADH-1, Gemcitabine Hydrochloride and Cisplatin in Treating Patients With Locally Advanced or Metastatic Pancreatic or Biliary Tract Cancer That Cannot Be Removed by Surgery

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ClinicalTrials.gov Identifier: NCT01825603
Recruitment Status : Completed
First Posted : April 5, 2013
Last Update Posted : January 30, 2018
Sponsor:
Collaborators:
Adherex Technologies, Inc.
National Cancer Institute (NCI)
Information provided by (Responsible Party):
Jean Grem, MD, University of Nebraska

Brief Summary:
This phase I trial studies the side effects and best dose of ADH-1 when given together with gemcitabine hydrochloride and cisplatin in treating patients with pancreatic or biliary tract cancer that has spread from where it started to nearby tissue or lymph nodes (locally advanced) or spread to other parts of the body (metastatic) and cannot be removed by surgery. ADH-1 may stop the growth of cancer cells by blocking blood flow to the tumor. Drugs used in chemotherapy, such as gemcitabine hydrochloride and cisplatin, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Giving ADH-1 together with gemcitabine hydrochloride and cisplatin may kill more tumor cells.

Condition or disease Intervention/treatment Phase
Ampulla of Vater Adenocarcinoma Gallbladder Adenocarcinoma Metastatic Pancreatic Adenocarcinoma Pancreatic Adenocarcinoma Stage III Ampulla of Vater Cancer Stage III Intrahepatic Cholangiocarcinoma Stage III Pancreatic Cancer Stage IIIA Gallbladder Cancer Stage IIIA Hilar Cholangiocarcinoma Stage IIIB Gallbladder Cancer Stage IIIB Hilar Cholangiocarcinoma Stage IV Ampulla of Vater Cancer Stage IVA Gallbladder Cancer Stage IVA Hilar Cholangiocarcinoma Stage IVA Intrahepatic Cholangiocarcinoma Stage IVA Pancreatic Cancer Stage IVB Gallbladder Cancer Stage IVB Hilar Cholangiocarcinoma Stage IVB Intrahepatic Cholangiocarcinoma Stage IVB Pancreatic Cancer Drug: ADH-1 Drug: Cisplatin Drug: Gemcitabine Hydrochloride Other: Laboratory Biomarker Analysis Phase 1

Detailed Description:

PRIMARY OBJECTIVES:

I. To evaluate the toxicities and determine the recommended dose of ADH-1 given twice weekly for 3 weeks in combination with cisplatin and fixed-dose rate gemcitabine (gemcitabine hydrochloride) given on weeks 1 and 2 of the 3 week schedule for 3 cycles in patients with locally advanced or metastatic pancreatic or biliary tract adenocarcinomas.

SECONDARY OBJECTIVES:

I. To evaluate changes in the levels of intercellular adhesion molecule 1 (ICAM-1), E-selectin, vascular endothelial growth factor (VEGF), soluble vascular endothelial growth factor receptor (VEGFR) and basic fibroblast growth factor (B-FGF) during therapy with ADH-1, cisplatin and gemcitabine.

II. Radiographic assessment of disease status after 3 cycles of chemotherapy with ADH-1, cisplatin and gemcitabine.

III. To evaluate progression-free and overall survival of patients with locally advanced or metastatic pancreatic or biliary tract adenocarcinomas treated with ADH-1 given with cisplatin and fixed dose rate gemcitabine for 3 cycles. Patients with stable or responsive disease after 3 cycles will continue on maintenance cisplatin and fixed dose rate gemcitabine.

OUTLINE: This is a dose-escalation study of ADH-1.

Patients receive ADH-1 intravenously (IV) over 20-80 minutes on days 1, 4, 8, 11, 15, and 18, cisplatin IV and gemcitabine hydrochloride IV over 30 minutes on days 1 and 8. Treatment repeats every 3 weeks for 3 courses in the absence of disease progression or unacceptable toxicity. Patients with stable or responsive disease may receive maintenance therapy with cisplatin and gemcitabine hydrochloride.

After completion of study treatment, patients are followed up every 3 months for 2 years.


Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 17 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase I Study of ADH-1 and Gemcitabine Plus Cisplatin in Patients With Unresectable or Metastatic Pancreatic and Biliary Tract Cancers
Study Start Date : April 2013
Primary Completion Date : June 2017
Study Completion Date : June 2017


Arm Intervention/treatment
Experimental: Treatment (ADH-1, cisplatin, gemcitabine hydrochloride)
Patients receive ADH-1 IV over 20-80 minutes on days 1, 4, 8, 11, 15, and 18, cisplatin IV and gemcitabine hydrochloride IV over 30 minutes on days 1 and 8. Treatment repeats every 3 weeks for 3 courses in the absence of disease progression or unacceptable toxicity. Patients with stable or responsive disease may receive maintenance therapy with cisplatin and gemcitabine hydrochloride.
Drug: ADH-1
Given IV
Other Name: Exherin
Drug: Cisplatin
Given IV
Other Names:
  • Abiplatin
  • Blastolem
  • Briplatin
  • CDDP
  • Cis-diammine-dichloroplatinum
  • Cis-diamminedichloridoplatinum
  • Cis-diamminedichloro Platinum (II)
  • Cis-diamminedichloroplatinum
  • Cis-dichloroammine Platinum (II)
  • Cis-platinous Diamine Dichloride
  • Cis-platinum
  • Cis-platinum II
  • Cis-platinum II Diamine Dichloride
  • Cismaplat
  • Cisplatina
  • Cisplatinum
  • Cisplatyl
  • Citoplatino
  • Citosin
  • Cysplatyna
  • DDP
  • Lederplatin
  • Metaplatin
  • Neoplatin
  • Peyrone's Chloride
  • Peyrone's Salt
  • Placis
  • Plastistil
  • Platamine
  • Platiblastin
  • Platiblastin-S
  • Platinex
  • Platinol
  • Platinol- AQ
  • Platinol-AQ
  • Platinol-AQ VHA Plus
  • Platinoxan
  • Platinum
  • Platinum Diamminodichloride
  • Platiran
  • Platistin
  • Platosin
Drug: Gemcitabine Hydrochloride
Given IV
Other Names:
  • dFdCyd
  • Difluorodeoxycytidine Hydrochloride
  • Gemzar
  • LY-188011
Other: Laboratory Biomarker Analysis
Correlative studies



Primary Outcome Measures :
  1. Recommended dose of ADH-1, defined as the highest dose tested which results in dose-limiting toxicities in no more than 1 of 6 evaluable patients based on the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0 [ Time Frame: 21 days ]
    The incidence rates of adverse events will be described by dose level. The frequency of occurrence of overall toxicity, categorized by toxicity grades, will be described.


Secondary Outcome Measures :
  1. Changes in the levels of ICAM-1, E-selectin, VEGF, soluble VEGFR and B-FGF [ Time Frame: After all patients complete cycle 1, about 2 years after initial patient enrolled ]
    Summarized using descriptive statistics

  2. Progression-free survival [ Time Frame: From the first date of therapy until the first notation of clinical progression, relapse or death from any cause, assessed up to 2 years ]
    Plotted following the method of Kaplan and Meier.

  3. Survival [ Time Frame: From the first date of therapy until the date of death from any cause, assessed up to 2 years ]
    Plotted following the method of Kaplan and Meier.



Information from the National Library of Medicine

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Ages Eligible for Study:   19 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patients must have adenocarcinoma of the pancreas or biliary tree (intrahepatic or extrahepatic cholangiocarcinoma, gallbladder or ampulla of Vater) that is locally advanced, but non-resectable, metastatic or residual disease after attempted surgical resection
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0-2 or better
  • Absolute neutrophil count (ANC) of 2000 per mcL or higher
  • Platelet count of 100,000 per mcL or higher
  • Patients must have a serum creatinine that is at or below the upper limits of the institutional normal range OR a creatinine clearance of 60 mL per min or higher corrected for body surface area (BSA)
  • The total bilirubin must be at or below 2.0 mg/dL in the absence of biliary obstruction; if the patient has biliary obstruction, biliary decompression will be required; either endoscopic placement of a biliary stent or percutaneous transhepatic drainage is acceptable; once biliary drainage has been established, institution of protocol therapy may proceed when the total bilirubin falls to 3.0 mg/dL or lower
  • Patients need not have measurable disease for this study
  • The patient must be aware of the neoplastic nature of his/her disease and willingly provide written, informed consent after being informed of the procedure to be followed, the experimental nature of the therapy, alternatives, potential benefits, side-effects, risks, and discomforts
  • Women of reproductive potential must be non-pregnant and non-nursing and must agree to employ an effective barrier method of birth control throughout the study and for up to 6 months following treatment
  • Women of child-bearing potential must have a negative pregnancy test within 7 days of initiating study; (no childbearing potential is defined as age 55 years or older and no menses for two years or any age with surgical removal of the uterus and/or both ovaries)

Exclusion Criteria:

  • Patients may not have received prior chemotherapy for metastatic adenocarcinoma of the pancreas or biliary tract; prior adjuvant chemotherapy is acceptable provided that 6 months or longer has elapsed since completion of the prior therapy
  • History of allergy to platinum compounds or to antiemetics appropriate for administration in conjunction with protocol-directed chemotherapy
  • Uncontrolled inter-current illness including, but not limited to ongoing or active infection requiring intravenous antibiotics, symptomatic congestive heart failure, unstable angina pectoris, or serious, uncontrolled cardiac arrhythmia, that might jeopardize the ability of the patient to receive the chemotherapy program outlined in this protocol with reasonable safety
  • Pregnant and nursing women are excluded from this study
  • Patients with prior malignancy will be excluded except for adequately treated basal cell or squamous cell skin cancer, adequately treated noninvasive carcinomas, or other cancers from which the patient has been disease-free for at least 5 years

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 ClinicalTrials.gov identifier (NCT number): NCT01825603


Locations
United States, Nebraska
University of Nebraska Medical Center
Omaha, Nebraska, United States, 68198
Sponsors and Collaborators
University of Nebraska
Adherex Technologies, Inc.
National Cancer Institute (NCI)
Investigators
Principal Investigator: Jean Grem University of Nebraska

Responsible Party: Jean Grem, MD, Principal Investigator, University of Nebraska
ClinicalTrials.gov Identifier: NCT01825603     History of Changes
Other Study ID Numbers: 470-12
NCI-2013-00406 ( Registry Identifier: CTRP (Clinical Trial Reporting Program) )
470-12 ( Other Identifier: University of Nebraska Medical Center )
P30CA036727 ( U.S. NIH Grant/Contract )
P50CA127297 ( U.S. NIH Grant/Contract )
First Posted: April 5, 2013    Key Record Dates
Last Update Posted: January 30, 2018
Last Verified: January 2018

Additional relevant MeSH terms:
Adenocarcinoma
Pancreatic Neoplasms
Cholangiocarcinoma
Gallbladder Neoplasms
Biliary Tract Neoplasms
Klatskin Tumor
Carcinoma
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Neoplasms
Digestive System Neoplasms
Neoplasms by Site
Endocrine Gland Neoplasms
Digestive System Diseases
Pancreatic Diseases
Endocrine System Diseases
Biliary Tract Diseases
Gallbladder Diseases
Gemcitabine
Cisplatin
Antineoplastic Agents
Antimetabolites, Antineoplastic
Antimetabolites
Molecular Mechanisms of Pharmacological Action
Antiviral Agents
Anti-Infective Agents
Enzyme Inhibitors
Immunosuppressive Agents
Immunologic Factors
Physiological Effects of Drugs