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Brief Title: S0727 Gemcitabine Hydrochloride and Erlotinib Hydrochloride With or Without Monoclonal Antibody Therapy in Treating Patients With Metastatic Pancreatic Cancer That Cannot Be Removed By Surgery
Official Title: A Phase I and Randomized Phase II Trial of Gemcitabine + Erlotinib (NSC-718781) + IMC-A12 (NSC-742460) vs. Gemcitabine + Erlotinib as First-Line Treatment in Patients With Metastatic Pancreatic Cancer
Study ID: NCT00617708
Brief Summary: This randomized phase I/II trial is studying the side effects and best dose of monoclonal antibody therapy when given together with gemcitabine hydrochloride and erlotinib hydrochloride and to see how well they work compared with giving gemcitabine hydrochloride and erlotinib hydrochloride alone as first-line therapy in treating patients with metastatic pancreatic cancer that cannot be removed by surgery. Drugs used in chemotherapy, such as gemcitabine hydrochloride, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Erlotinib hydrochloride may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Monoclonal antibodies can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Giving erlotinib hydrochloride and gemcitabine hydrochloride together with monoclonal antibody therapy may kill more tumor cells.
Detailed Description: PRIMARY OBJECTIVES: I. To assess the appropriate dose of IMC-A12 (cixutumumab) to use in combination with gemcitabine (gemcitabine hydrochloride) and erlotinib (erlotinib hydrochloride). (Phase I) II. To assess progression-free survival in patients with metastatic pancreatic cancer treated with IMC-A12 plus gemcitabine and erlotinib compared to those treated with gemcitabine plus erlotinib alone. (Phase II) III. To assess overall survival in each of the two treatment arms in this group of patients. (Phase II) IV. To assess the total response probability (confirmed and unconfirmed, complete and partial responses) in each of the two treatment arms in the subset of this group of patients with measurable disease. (Phase II) V. To assess the qualitative and quantitative toxicities in each of the two treatment arms in this group of patients. (Phase II) OUTLINE: This is a multicenter, phase I, dose-escalation study of cixutumumab followed by a randomized, phase II study. Patients are initially enrolled into the phase I portion of the study to determine the recommended phase II dose (RPTD) of cixutumumab. Once the RPTD is determined, patients are enrolled into the phase II portion of the study. PHASE I (LIMITED INSTITUTIONS): Patients receive erlotinib hydrochloride orally (PO) once daily on days 1-28, gemcitabine hydrochloride intravenously (IV) over 30 minutes on days 1, 8, and 15, and cixutumumab IV over 60 minutes on days 1, 8, 15, and 22. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity. PHASE II (ALL SWOG MEMBERS): Patients are randomized to 1 of 2 treatment arms. ARM I: Patients receive erlotinib hydrochloride, gemcitabine hydrochloride, and cixutumumab at the RPTD as in phase I. ARM II: Patients receive erlotinib hydrochloride and gemcitabine hydrochloride as in arm I. In both arms, treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity. Previously collected tumor tissue is obtained for gene expression analyses by RT-PCR, RNA isolation, and cDNA synthesis. Blood samples are collected periodically for correlative studies. Samples are assessed for the potential relationship between gene expression levels, germline polymorphisms, Ras and P13K mutations and progression-free survival and overall survival. After completion of study treatment, patients are followed every 6 months for up to 3 years.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
NEA Baptist Memorial Hospital, Jonesboro, Arkansas, United States
Alta Bates Summit Medical Center-Herrick Campus, Berkeley, California, United States
Mills - Peninsula Hospitals, Burlingame, California, United States
East Bay Radiation Oncology Center, Castro Valley, California, United States
Eden Hospital Medical Center, Castro Valley, California, United States
Valley Medical Oncology Consultants-Castro Valley, Castro Valley, California, United States
City of Hope Medical Center, Duarte, California, United States
Valley Medical Oncology Consultants-Fremont, Fremont, California, United States
Glendale Memorial Hospital and Health Center, Glendale, California, United States
Marin General Hospital, Greenbrae, California, United States
Sutter Health Western Division Cancer Research Group, Greenbrae, California, United States
University of Southern California, Los Angeles, California, United States
Contra Costa Regional Medical Center, Martinez, California, United States
El Camino Hospital, Mountain View, California, United States
Highland General Hospital, Oakland, California, United States
Alta Bates Summit Medical Center - Summit Campus, Oakland, California, United States
Bay Area Breast Surgeons Inc, Oakland, California, United States
Bay Area Tumor Institute, Oakland, California, United States
Larry G Strieff MD Medical Corporation, Oakland, California, United States
Tom K Lee Inc, Oakland, California, United States
University of California Medical Center At Irvine-Orange Campus, Orange, California, United States
Valley Care Health System - Pleasanton, Pleasanton, California, United States
Valley Medical Oncology Consultants, Pleasanton, California, United States
California Pacific Medical Center, San Francisco, California, United States
Doctors Medical Center- JC Robinson Regional Cancer Center, San Pablo, California, United States
Sutter Solano Medical Center, Vallejo, California, United States
Poudre Valley Hospital, Fort Collins, Colorado, United States
Piedmont Hospital, Atlanta, Georgia, United States
Atlanta Regional CCOP, Atlanta, Georgia, United States
Northside Hospital, Atlanta, Georgia, United States
Saint Joseph's Hospital of Atlanta, Atlanta, Georgia, United States
Well Star Cobb Hospital, Austell, Georgia, United States
John B Amos Cancer Center, Columbus, Georgia, United States
Dekalb Medical Center, Decatur, Georgia, United States
Gwinnett Medical Center, Lawrenceville, Georgia, United States
Wellstar Kennestone Hospital, Marietta, Georgia, United States
Southern Regional Medical Center, Riverdale, Georgia, United States
Harbin Clinic Medical Oncology and Clinical Research, Rome, Georgia, United States
Memorial Health University Medical Center, Savannah, Georgia, United States
Saint Joseph's-Candler Health System, Savannah, Georgia, United States
South Georgia Medical Center, Valdosta, Georgia, United States
Cancer Care Center of Decatur, Decatur, Illinois, United States
Decatur Memorial Hospital, Decatur, Illinois, United States
Crossroads Cancer Center, Effingham, Illinois, United States
Menorah Medical Center, Overland Park, Kansas, United States
Saint Luke's South Hospital, Overland Park, Kansas, United States
Shawnee Mission Medical Center, Shawnee Mission, Kansas, United States
Christus Saint Frances Cabrini Hospital, Alexandria, Louisiana, United States
Sinai Hospital of Baltimore, Baltimore, Maryland, United States
Boston Medical Center, Boston, Massachusetts, United States
Bronson Battle Creek, Battle Creek, Michigan, United States
Mecosta County Medical Center, Big Rapids, Michigan, United States
Wayne State University, Detroit, Michigan, United States
Grand Rapids Clinical Oncology Program, Grand Rapids, Michigan, United States
Saint Mary's Health Care, Grand Rapids, Michigan, United States
Spectrum Health at Butterworth Campus, Grand Rapids, Michigan, United States
Mercy Health Partners-Mercy Campus, Muskegon, Michigan, United States
William Beaumont Hospital, Royal Oak, Michigan, United States
Munson Medical Center, Traverse City, Michigan, United States
Metro Health Hospital, Wyoming, Michigan, United States
University of Mississippi Medical Center, Jackson, Mississippi, United States
Truman Medical Center, Kansas City, Missouri, United States
Saint Luke's Cancer Institute, Kansas City, Missouri, United States
Saint Luke's Hospital of Kansas City, Kansas City, Missouri, United States
Saint Joseph Health Center, Kansas City, Missouri, United States
North Kansas City Hospital, Kansas City, Missouri, United States
Heartland Hematology and Oncology Associates Incorporated, Kansas City, Missouri, United States
Research Medical Center, Kansas City, Missouri, United States
Saint Luke's East - Lee's Summit, Lee's Summit, Missouri, United States
Liberty Hospital, Liberty, Missouri, United States
Liberty Radiation Oncology Clinic, Liberty, Missouri, United States
Heartland Regional Medical Center, Saint Joseph, Missouri, United States
Saint Joseph Oncology Inc, Saint Joseph, Missouri, United States
Saint Louis University Hospital, Saint Louis, Missouri, United States
Montana Cancer Consortium CCOP, Billings, Montana, United States
Northern Rockies Radiation Oncology Center, Billings, Montana, United States
Saint Vincent Healthcare, Billings, Montana, United States
Hematology-Oncology Centers of the Northern Rockies PC, Billings, Montana, United States
Billings Clinic, Billings, Montana, United States
Bozeman Deaconess Cancer Center, Bozeman, Montana, United States
Bozeman Deaconess Hospital, Bozeman, Montana, United States
Saint James Community Hospital and Cancer Treatment Center, Butte, Montana, United States
Benefis Healthcare- Sletten Cancer Institute, Great Falls, Montana, United States
Berdeaux, Donald MD (UIA Investigator), Great Falls, Montana, United States
Great Falls Clinic, Great Falls, Montana, United States
Northern Montana Hospital, Havre, Montana, United States
Saint Peter's Community Hospital, Helena, Montana, United States
Glacier Oncology PLLC, Kalispell, Montana, United States
Kalispell Medical Oncology, Kalispell, Montana, United States
Kalispell Regional Medical Center, Kalispell, Montana, United States
Community Medical Hospital, Missoula, Montana, United States
Montana Cancer Specialists, Missoula, Montana, United States
Saint Patrick Hospital - Community Hospital, Missoula, Montana, United States
Guardian Oncology and Center for Wellness, Missoula, Montana, United States
University of New Mexico Cancer Center, Albuquerque, New Mexico, United States
Arnot Ogden Medical Center, Elmira, New York, United States
Highland Hospital, Rochester, New York, United States
Interlakes Foundation Inc-Rochester, Rochester, New York, United States
University of Rochester, Rochester, New York, United States
Randolph Hospital, Asheboro, North Carolina, United States
Carolinas Medical Center, Charlotte, North Carolina, United States
Presbyterian Hospital, Charlotte, North Carolina, United States
Wayne Memorial Hospital, Goldsboro, North Carolina, United States
Cone Health Cancer Center, Greensboro, North Carolina, United States
Margaret R Pardee Memorial Hospital, Hendersonville, North Carolina, United States
Annie Penn Memorial Hospital, Reidsville, North Carolina, United States
Akron General Medical Center, Akron, Ohio, United States
Veterans Administration Medical Center - Cincinnati, Cincinnati, Ohio, United States
University of Cincinnati, Cincinnati, Ohio, United States
Medical University of South Carolina, Charleston, South Carolina, United States
The Don and Sybil Harrington Cancer Center, Amarillo, Texas, United States
University of Texas Medical Branch at Galveston, Galveston, Texas, United States
Baylor College of Medicine, Houston, Texas, United States
Ben Taub General Hospital, Houston, Texas, United States
Methodist Hospital, Houston, Texas, United States
Saint Luke's Episcopal Hospital, Houston, Texas, United States
Veterans Administration Medical Center, Houston, Texas, United States
Scott and White Memorial Hospital, Temple, Texas, United States
American Fork Hospital, American Fork, Utah, United States
Sandra L Maxwell Cancer Center, Cedar City, Utah, United States
Logan Regional Hospital, Logan, Utah, United States
Intermountain Medical Center, Murray, Utah, United States
McKay-Dee Hospital Center, Ogden, Utah, United States
Utah Valley Regional Medical Center, Provo, Utah, United States
Dixie Medical Center Regional Cancer Center, Saint George, Utah, United States
Intermountain Health Care, Salt Lake City, Utah, United States
Utah Cancer Specialists-Salt Lake City, Salt Lake City, Utah, United States
LDS Hospital, Salt Lake City, Utah, United States
Memorial Hospital Of Martinsville, Martinsville, Virginia, United States
PeaceHealth Saint Joseph Medical Center, Bellingham, Washington, United States
Harrison Bremerton Hematology and Oncology, Bremerton, Washington, United States
Columbia Basin Hematology and Oncology PLLC, Kennewick, Washington, United States
Skagit Valley Hospital, Mount Vernon, Washington, United States
Harrison Poulsbo Hematology and Oncology, Poulsbo, Washington, United States
Harborview Medical Center, Seattle, Washington, United States
Minor and James Medical PLLC, Seattle, Washington, United States
Fred Hutchinson Cancer Research Center/University of Washington Cancer Consortium, Seattle, Washington, United States
Group Health Cooperative, Seattle, Washington, United States
Swedish Medical Center-First Hill, Seattle, Washington, United States
The Polyclinic, Seattle, Washington, United States
University of Washington Medical Center, Seattle, Washington, United States
Cancer Care Northwest - Spokane South, Spokane, Washington, United States
Evergreen Hematology and Oncology PS, Spokane, Washington, United States
Wenatchee Valley Medical Center, Wenatchee, Washington, United States
Rocky Mountain Oncology, Casper, Wyoming, United States
Welch Cancer Center, Sheridan, Wyoming, United States
Name: Philip Philip
Affiliation: SWOG Cancer Research Network
Role: PRINCIPAL_INVESTIGATOR