RATIONALE: Drugs used in chemotherapy, such as gemcitabine, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Anticoagulants, such as dalteparin, may help prevent blood clots from forming in patients being treated with gemcitabine for pancreatic cancer. PURPOSE: This randomized phase II trial is studying how well gemcitabine works with or without dalteparin in treating patients with locally advanced or metastatic pancreatic cancer.
OBJECTIVES: Primary * Compare the incidence of venous thromboembolism in patients with locally advanced or metastatic pancreatic cancer treated with gemcitabine hydrochloride and dalteparin versus gemcitabine hydrochloride alone. Secondary * Compare the survival benefit, in terms of increased (from 70% to 85%) survival at 12 weeks, of patients treated with these regimens. * Compare the toxicity of these regimens. * Compare the overall survival of patients treated with these regimens. * Compare the time to disease progression in patients treated with these regimens. * Determine the effect of gemcitabine hydrochloride and dalteparin on serological markers of thromboangiogenesis. OUTLINE: This is a multicenter, randomized study. Patients are stratified according to disease progression (locally advanced vs metastatic) and Karnofsky performance status (≥ 80% vs \< 80%). Patients are randomized to 1 of 2 treatment arms. * Arm I: Patients receive gemcitabine hydrochloride IV over 30 minutes once weekly in weeks 1-7 and 9-11. * Arm II: Patients receive low molecular weight dalteparin subcutaneously once daily in weeks 1-12. Patients also receive gemcitabine hydrochloride as in arm I. Blood samples are acquired at baseline for analysis of circulating tissue factor and vascular endothelial growth factor. After completion of study treatment, patients are followed periodically. PROJECTED ACCRUAL: A total of 120 patients will be accrued for this study.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Enrollment
120
Princess Royal Hospital at Hull and East Yorkshire NHS Trust
Hull, England, United Kingdom
Royal Lancaster Infirmary
Lancaster, England, United Kingdom
Saint Bartholomew's Hospital
London, England, United Kingdom
St. George's Hospital
London, England, United Kingdom
Maidstone Hospital
Maidstone, England, United Kingdom
Nottingham City Hospital
Nottingham, England, United Kingdom
Scarborough General Hospital
Scarborough, England, United Kingdom
Scunthorpe General Hospital
Scunthorpe, England, United Kingdom
Incidence of venous thromboembolism reduction
Early survival benefit
Toxicity
Overall survival
Time to disease progression
Effect of drug combination on serological markers of thromboangiogenesis
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