This phase I trial studies the side effects and best dose of gemcitabine hydrochloride and dasatinib when given together with erlotinib hydrochloride in treating patients with pancreatic cancer that has spread to other places in the body or 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. Dasatinib and erlotinib hydrochloride may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Giving gemcitabine hydrochloride and dasatinib together with erlotinib hydrochloride may kill more tumor cells.
PRIMARY OBJECTIVES: I. To determine the maximum tolerated dose (also phase II recommended dose) of the combination of gemcitabine (gemcitabine hydrochloride), erlotinib (erlotinib hydrochloride) and dasatinib in patients with advanced pancreatic adenocarcinoma. SECONDARY OBJECTIVES: I. To determine the safety profile of the combination of gemcitabine, erlotinib and dasatinib. II. To evaluate the response rate and response duration of advanced pancreatic adenocarcinoma treated with dasatinib, erlotinib and gemcitabine. III. To determine progression-free survival and overall survival for this group of patients. IV. To determine the utility of advanced magnetic resonance imaging techniques to assess in vivo effects of therapy (changes in tumor vascularity, cellularity). V. To assess the use of serum markers as predictors of response and outcome. OUTLINE: This is a dose-escalation study of gemcitabine hydrochloride and dasatinib. Patients receive gemcitabine hydrochloride intravenously (IV) over 30-60 minutes on days 1, 8, and 15, and dasatinib orally (PO) once daily (QD) and erlotinib hydrochloride PO QD on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up for 30 days and then every 4 weeks thereafter.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
19
Vanderbilt University/Ingram Cancer Center
Nashville, Tennessee, United States
Maximum tolerated dose of gemcitabine hydrochloride and dasatinib given together with erlotinib hydrochloride, determined by incidence of dose-limiting toxicity graded according to NCI CTCAE v 4.0
Time frame: Up to 4 weeks after completion of study treatment
Overall survival (OS)
The OS curves will be estimated by the Kaplan-Meier method. Median OS and its 95% confidence intervals will be estimated.
Time frame: The time from enrollment until the time of death due to any cause, assessed up to 6 years
Progression free survival (PFS)
The PFS curves will be estimated by the Kaplan-Meier method. Median PFS and its 95% confidence intervals will be estimated.
Time frame: The time from enrollment until the first occurrence of radiographic or clinical evidence of disease progression or death due to any cause, assessed up to 6 years
Response rate, assessed according to RECIST
The response rate and its 95% confidence interval will be calculated using the exact binominal method.
Time frame: Up to 6 years
Response duration
The response duration for the responders will be summarized using mean, median and standard deviation.
Time frame: The time from when measurement criteria are met for complete response or partial response (whichever is first recorded) until the date that recurrent or progressive disease is objectively documented, assessed up to 6 years
Serious and other significant adverse events (AEs), graded according to NCI CTCAE v 4.0
The patient incidence of AEs will be summarized by preferred term, severity and relationship to study drug. Cross tabulations will be provided to summarize frequencies of abnormalities.
Time frame: Up to 30 days after completion of study treatment
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