A Study Comparing Combination Chemotherapy to Gemcitabine Hydrochloride and Nab-Paclitaxel Given Before Surgery for Treating Patients who have Pancreatic Cancer that can be Removed by Surgery

Overview

About this study

The purpose of this study is to assess the best 2-year overall survival when comparing fluorouracil, irinotecan hydrochloride, and oxaliplatin (combination chemotherapy) to gemcitabine hydrochloride and nab-paclitaxel, given before surgery for treating patients who have pancreatic cancer that can be removed by surgery. Drugs used in chemotherapy, such as fluorouracil, irinotecan hydrochloride, oxaliplatin, gemcitabine hydrochloride, and nab-paclitaxel, 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 more than one drug (combination chemotherapy) may kill more tumor cells. It is not yet known whether combination chemotherapy is more effective than gemcitabine hydrochloride and nab-paclitaxel before surgery for treating pancreatic cancer.

Participation eligibility

Participant eligibility includes age, gender, type and stage of disease, and previous treatments or health concerns. Guidelines differ from study to study, and identify who can or cannot participate. There is no guarantee that every individual who qualifies and wants to participate in a trial will be enrolled. Contact the study team to discuss study eligibility and potential participation.

Inclusion Criteria

  • Must have histologically or cytologically proven pancreatic adenocarcinoma
    • Histologies other than adenocarcinoma, or any mixed histologies, will NOT be eligible
  • Must have measurable disease in the pancreas
  • Computed tomography (CT) scans or magnetic resonance imaging (MRIs) used to assess measurable disease must have been completed within 28 days prior to registration
  • All disease must be assessed and documented on the baseline tumor assessment form
  • Must have resectable primary tumor based on contrast-enhanced CT or MRI of the chest, abdomen, or pelvis
    • CT or MRI without contrast as part of positron emission tomography [PET]/CT or PET/MRI is NOT acceptable 
    • Resectable is defined as
      • No involvement of the celiac artery, common hepatic artery, and superior mesenteric artery (and, if present, replaced right hepatic artery)
      • No involvement, or < 180° interface between tumor and vessel wall, of the portal vein and/or superior mesenteric vein, and patent portal vein/splenic vein confluence
      • No evidence of metastatic disease
      • For tumors of the body and tail of the pancreas, involvement of the splenic artery and vein of any degree is considered resectable disease
  • CT scans or MRIs used to assess disease at baseline must be submitted for central review
  • Must have surgical consult to verify patient is a surgical candidate within 21 days prior to registration
  • Must not have received prior surgery, radiation therapy, chemotherapy, targeted therapy, or any investigational therapy for pancreatic cancer
  • Must have a Zubrod performance status of 0-1
  • Absolute neutrophil count (ANC) ≥ 1,500/mcL
  • Platelets ≥ 100,000/mcL
  • Hemoglobin ≥ 9 g/dL
  • Total bilirubin ≤ 1.5 x institutional upper limit of normal (IULN)
  • Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 2.5 x IULN
  • Serum albumin ≥ 3 g/dL
  • Serum creatinine ≤ IULN within 14 days prior to registration
  • Sites must seek additional patient consent for the future use of specimens
  • Must be informed of the investigational nature of this study and must sign and give written informed consent in accordance with institutional and federal guidelines
  • As a part of the OPEN registration process the treating institution's identity is provided in order to ensure that the current (within 365 days) date of institutional review board approval for this study has been entered in the system

Exclusion Criteria

  • Uncontrolled intercurrent illness including, but not limited to
    • Ongoing or active infection
    • Symptomatic congestive heart failure
    • Unstable angina pectoris
    • Cardiac arrhythmia
    • Psychiatric illness/social situations that would limit compliance with study requirements
  • Prior malignancy
    • Except for adequately treated basal (or squamous cell) skin cancer, in situ cervical cancer, in situ breast (ductal or lobular) cancer, or other cancer for which the patient has been disease and treatment-free for two years
  • Pregnant or nursing
    • Women/men of reproductive potential must have agreed to use an effective contraceptive method for up to 3 months after the final administered dose of chemotherapy
    • A woman is considered to be of "reproductive potential" if she has had menses at any time in the preceding 12 consecutive months
    • In addition to routine contraceptive methods, "effective contraception" also includes heterosexual celibacy and surgery intended to prevent pregnancy (or with a side-effect of pregnancy prevention) defined as a hysterectomy, bilateral oophorectomy or bilateral tubal ligation
      • However, if at any point a previously celibate patient chooses to become heterosexually active during the time period for use of contraceptive measures, he/she is responsible for beginning contraceptive measures

Participating Mayo Clinic locations

Study statuses change often. Please contact the study team for the most up-to-date information regarding possible participation.

Mayo Clinic Location Status Contact

Rochester, Minn.

Mayo Clinic principal investigator

Mark Truty, M.D., M.S.

Closed for enrollment

Contact information:

Cancer Center Clinical Trials Referral Office

(855) 776-0015

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More information

Publications

Publications are currently not available

Study Results Summary

Not yet available

Supplemental Study Information

Not yet available

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CLS-20318089

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