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Brief Title: Gemcitabine and Radiation Therapy Compared With Gemcitabine Alone in Treating Patients Who Have Undergone Surgery for Pancreatic Cancer
Official Title: Randomized Phase II/III Study Comparing Gemcitabine Followed by Gemcitabine Plus Concomitant Radiation (50.4 Gy) Versus Control After Curative Pancreaticoduodenectomy for Pancreatic Head Cancer
Study ID: NCT00064207
Brief Summary: RATIONALE: Drugs used in chemotherapy such as gemcitabine use different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Radiation therapy uses high-energy x-rays to kill tumor cells. Giving these treatments after surgery may kill any tumor cells that remain after surgery. It is not yet known whether giving gemcitabine together with radiation therapy is more effective than gemcitabine alone following surgery in treating pancreatic cancer. PURPOSE: This randomized phase II/III trial is studying how well giving gemcitabine together with radiation therapy works and compares it to gemcitabine alone in treating patients who have undergone surgery for pancreatic cancer.
Detailed Description: OBJECTIVES: Phase II: * Determine the feasibility of gemcitabine followed by chemoradiotherapy with gemcitabine vs gemcitabine alone after prior curative resection in patients with pancreatic head adenocarcinoma. * Compare the tolerability of these regimens, in terms of acute and late toxicity, in these patients. Phase III: * Compare the disease-free and overall survival of patients treated with these regimens . * Compare the quality of life of patients treated with these regimens. * Compare the toxicity of these regimens in these patients. * Determine the sites of recurrence in patients treated with these regimens. OUTLINE: This is a randomized, multicenter study. Patients are stratified according to ECOG/WHO performance status (0-1 vs 2), participating center, and N stage (N0 vs N1 vs NX). Patients are randomized to 1 of 2 treatment arms. * Arm I: Within 8 weeks after prior surgical resection, patients receive gemcitabine IV over 30 minutes on days 1, 8, and 15. Treatment repeats every 4 weeks for 2 courses. Patients then receive additional gemcitabine IV over 30 minutes on days 57, 64, 71, 78, 85, and 92. Beginning on day 57, patients also undergo radiotherapy once daily, 5 days a week, for 6 weeks. Treatment continues in the absence of disease progression or unacceptable toxicity. * Arm II: Patients receive gemcitabine IV over 30 minutes on days 1, 8, and 15. Treatment repeats every 4 weeks for 4 courses. Quality of life (QOL) is assessed in both arms, according to the following schedules: * Arm I: QOL is assessed at baseline; at 3 weeks after the beginning of chemoradiotherapy; after the completion of chemoradiotherapy; every 3 months for 2 years; and then every 6 months for 1 year. * Arm II: QOL is assessed at baseline; at 12 weeks; at 16 weeks; every 3 months for 2 years; and then every 6 months for 1 year. Patients are followed every 3 months for 2 years and then every 6 months thereafter. PROJECTED ACCRUAL: A total of 538 patients (269 per treatment arm) will be accrued for this study within 3 years.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
Hopital Universitaire Erasme, Brussels, , Belgium
Universitair Ziekenhuis Gent, Ghent, , Belgium
Hopital de Jolimont, Haine Saint Paul, , Belgium
Cazk Groeninghe - Campus St-Niklaas, Kortrijk, , Belgium
CHU Liege - Domaine Universitaire du Sart Tilman, Liege, , Belgium
Algemeen Ziekenhuis Sint-Augustinus, Wilrijk, , Belgium
Centre Hospitalier d'Abbeville, Abbeville, , France
Centre Hospitalier d'Annecy, Annecy, , France
Institut Sainte Catherine, Avignon, , France
Hopital Duffaut, Avignon, , France
C.H.G. Beauvais, Beauvais, , France
Centre Hospitalier de Blois, Blois, , France
Clinique Tivoli, Bordeaux, , France
Polyclinique Bordeaux Nord Aquitaine, Boucher, , France
Centre Hospitalier Universitaire Ambroise Pare - Boulogne, Boulogne Billancourt, , France
Centre Hospitalier Docteur Duchenne, Boulogne Sur Mer, , France
Centre Hospitalier Pierre Oudot, Bourgoin-Jallieu, , France
CHU de Caen, Caen, , France
CHR Clermont Ferrand, Hotel dieu, Clermont-Ferrand, , France
Hopital Beaujon, Clichy, , France
Louis Mourier Hospital, Colombes Cedex, , France
Centre Hospitalier Universitaire Henri Mondor, Creteil, , France
Centre Hospitalier de Dax, Dax, , France
Hopital Du Bocage, Dijon, , France
Centre Hospitalier Intercommunal St. Aubin les Elbeuf, Elbeuf, , France
CHU de Grenoble - Hopital de la Tronche, Grenoble, , France
Centre Hospitalier Departemental, La Roche Sur Yon, , France
Clinique Victor Hugo, Le Mans, , France
Hopital Robert Boulin, Libourne, , France
Centre Hospital Regional Universitaire de Limoges, Limoges, , France
Clinique Saint Jean, Lyon, , France
Centre Leon Berard, Lyon, , France
CHU de la Timone, Marseille, , France
Centre Hospitalier General de Mont de Marsan, Mont-de-Marsan, , France
Centre Regional de Lutte Contre le Cancer - Centre Val d'Aurelle, Montpellier, , France
Centre Hospitalier de Mulhouse, Mulhouse, , France
C.H.U. de Nimes - Groupe Hospitals-Universitaire Caremeau, Nimes, , France
Hopital Europeen Georges Pompidou, Paris, , France
Hopital Bichat - Claude Bernard, Paris, , France
Hopital Saint Antoine, Paris, , France
CHU Pitie-Salpetriere, Paris, , France
Hopital Cochin, Paris, , France
Hopital Tenon, Paris, , France
C.H.G. De Pau, Pau, , France
Centre Hospitalier Lyon Sud, Pierre Benite, , France
CHU Poitiers, Poitiers, , France
Hopital Charles Nicolle, Rouen, , France
Centre Paul Strauss, Strasbourg, , France
Hopital Universitaire Hautepierre, Strasbourg, , France
Centre Hospitalier Universitaire Bretonneau de Tours, Tours, , France
Centre Alexis Vautrin, Vandoeuvre-les-Nancy, , France
Charite - Campus Charite Mitte, Berlin, , Germany
Robert Roessle Comprehensive Cancer Center at University of Berlin - Charite Campus Buch, Berlin, , Germany
Universitaetsklinikum Duesseldorf, Duesseldorf, , Germany
Johannes Gutenberg University, Mainz, , Germany
Munich Oncologic Practice at Elisenhof, Munich, , Germany
Rambam Medical Center, Haifa, , Israel
Academisch Medisch Centrum at University of Amsterdam, Amsterdam, , Netherlands
Hopital Cantonal Universitaire de Geneve, Geneva, , Switzerland
Name: Jean-Luc Van Laethem, MD, PhD
Affiliation: Erasme University Hospital
Role: STUDY_CHAIR
Name: Volker G. Budach, MD, PhD
Affiliation: Charite University, Berlin, Germany
Role: STUDY_CHAIR
Name: Pascal Hammel, MD, PhD
Affiliation: Hopital Beaujon
Role: STUDY_CHAIR