RATIONALE: Monoclonal antibodies, such as cetuximab, 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. Cetuximab may also stop the growth of pancreatic cancer by blocking blood flow to the tumor. Drugs used in chemotherapy, such as gemcitabine and oxaliplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving cetuximab together with combination chemotherapy may kill more tumor cells. PURPOSE: This clinical trial is studying how well giving cetuximab together with gemcitabine and oxaliplatin works in treating patients with locally advanced or metastatic pancreatic cancer.
OBJECTIVES: Primary * Determine the progression-free survival of patients with locally advanced or metastatic pancreatic cancer treated with cetuximab, gemcitabine hydrochloride, and oxaliplatin. Secondary * Determine the complete response and partial response in patients treated with this regimen. * Determine the time to progression in patients treated with this regimen. * Determine the duration of response in patients treated with this regimen. * Determine the survival of patients treated with this regimen. * Determine the toxicity of this regimen in these patients. OUTLINE: This is a nonrandomized, open-label, pilot study. Patients receive cetuximab IV over 1-2 hours on days 1 and 8, gemcitabine hydrochloride IV over 100 minutes on day 1, and oxaliplatin IV over 2-4 hours on day 2. Treatment repeats every 14 days in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed every 3 months. PROJECTED ACCRUAL: A total of 40 patients will be accrued for this study.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
42
Cetuximab: an initial loading dose of 400 mg/m2 will be given followed by 250 mg/m2 administered weekly. Cetuximab will be given first followed by gemcitabine on the weeks the patient receives cytotoxic chemotherapy on day 1. Cetuximab will be given as a single agent on Day 8. The treatment will be given on two-week cycles.
Gemcitabine 1000 mg/m2 IV day 1. The treatment will be given on two-week cycles.
Oxaliplatin 100 mg/m2 IV day 2. The treatment will be given on two-week cycles.
University of Miami Sylvester Comprehensive Cancer Center - Miami
Miami, Florida, United States
Progression-free survival
The corresponding progression-free survival curve and cumulative risk of progression as a function of time post treatment initiation will be estimated using the Kaplan-Meier method
Time frame: The cumulative percentage of intent to treat patients who experience disease progression at 1, 2, 3, 4, 5, and 6 months will be characterized with corresponding 95% confidence intervals
Toxicity
Time frame: Frequency and severity of adverse events according to the NCI CTCAE V 3.0 body system and severity criteria will be described.
Response rate (complete response and partial response)
The response rate will be determined by the RECIST criteria. After every 4th cycle; End of Treatment and Follow-up
Time frame: After every 4th cycle; End of Treatment and Follow-up
Duration of response
the time measurement criteria are met for CR or PR (whichever status is recorded first) until the first date that recurrence or PD is objectively documented, taking as reference for PD the smallest measurements recorded since the treatment started
Time frame: The time measurement criteria are met for CR or PR (whichever status is recorded first) until the first date that recurrence or PD is objectively documented
Overall survival
Overall survival will also be estimated using the product-limit method of Kaplan-Meier.
Time frame: Overall survival will also be estimated using the product-limit method of Kaplan-Meier.
Time to progression
The time from the start of the treatment until the criteria for disease progression are met, taking as reference the smallest measurements recorded since the treatment started (also referred to in the RECIST criteria as duration of stable disease).
Time frame: The time from the start of the treatment until the criteria for disease progression are met
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