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Brief Title: Second Line Therapy in Advanced Biliary Tract Cancer
Official Title: A Randomized Phase II Trial of Second Line Therapy in Advanced Biliary Tract Cancer: Capecitabine or Capecitabine Plus Mitomycin C
Study ID: NCT01530503
Brief Summary: The purpose of this study is to assess the therapeutic activity of capecitabine alone or in combination with mitomycin C as second-line therapy in patients with advanced/metastatic biliary adenocarcinoma in progression after gemcitabine and platinum compounds
Detailed Description: Biliary tract adenocarcinoma is an uncommon tumor with a poor prognosis and a median overall survival (OS) rarely exceeding 6 months. Less than 25% of patients are resectable at diagnosis and, even in this subset of patients, relapse rate is high. An improvement of OS and quality of life for patients receiving chemotherapy versus best supportive care was demonstrated in advanced disease. Recently, cisplatin and gemcitabine combination was identified as the new standard first-line chemotherapy, yielding a median progression free survival (PFS) and median OS of 8.5 and 11.7 months, respectively. Despite the outcome improvement, disease progression is a constant and approximately half of patients failing upfront treatment has a good performance status and are willing to undergo further treatment. No standard salvage chemotherapy regimen has been identified. Clinical trials are difficult to perform due to the rarity and heterogeneity of these tumors and to the lack of interest of the pharmaceutical industry. Fluoropyrimidines and mitomycin C have been considered the basis of palliative chemotherapy for a long time. The investigators decided to explore the activity, in terms of PFS, of capecitabine alone or combined with mitomycin C as second-line therapy in patients with pathological diagnosis of advanced biliary tract cancer and progressive disease after gemcitabine and cisplatin, by means of an open label randomized multicentric phase II trial.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
ASUR zona territoriale N. 6 FABRIANO, Fabriano, Ancona, Italy
Fondazione Istituto San Raffaele G. Giglio, Cefalù, Palermo, Italy
Azienda Ospedaliero Universitaria Ospedali Riuniti Umberto I - G.M. Lancisi - G Salesi, Ancona, , Italy
A.O. Ospedali Riuniti, Bergamo, , Italy
Azienda Ospedaliero-Universitaria Policlinico S. Orsola-Malpighi, Bologna, , Italy
Fondazione Piemontese Per la Ricerca sul Cancro, Candiolo (Torino), , Italy
Azienda Ospedaliera di Rilievo Nazionale e di Alta Specializzazione Garibaldi, Catania, , Italy
Ospedale San Raffaele, Milan, , Italy
Istituto Oncologico Veneto I.R.C.C.S., Padova, , Italy
Azienda Ospedaliero-Universitaria Pisana, Pisa, , Italy
Azienda Ospedaliera Regionale San Carlo, Potenza, , Italy
Istituto Nazionale dei Tumori Regina Elena, Roma, , Italy
Ospedale Generale Provinciale, Saronno (VA), , Italy
Azienda Ospedaliera Universitaria San Giovanni Battista di Torino, Torino, , Italy
Azienda Ospedaliero Universitaria Santa Maria della Misericordia, Udine, , Italy
Azienda Ospedaliera Universitaria Integrata, Verona, , Italy
Name: stefano cereda, MD
Affiliation: Ospedale San Raffaele (Milan, Italy)
Role: PRINCIPAL_INVESTIGATOR