Pancreatic cancer is the fourth cause of cancer mortality: there are different treatment approaches to locally advanced pancreatic cancer management. Generally, gemcitabine alone is considered a reasonable approach for advanced pancreatic cancer patients but we need a chemotherapeutic regimen able to prevent as much as possible a progression of the disease. Nab-paclitaxel (Abraxane) recently demonstrated an interesting activity profile in advanced pancreatic cancer. A combination of Nab-paclitaxel and gemcitabine has been demonstrated superior to gemcitabine alone in metastatic patients.
Study population: Locally advanced unresectable pancreatic cancer patients Elegibility criteria: * Written informed consent * Age \>18 \< 75 years * Histologically/cytologically confirmed locally advanced, unresectable pancreatic cancer * At least one lesion measurable with CT or MRI scan * Performance Status (ECOG) 0-1 at study entry * Life expectancy of at least 3 months * Adequate marrow, liver and renal function * Effective contraception if the risk of conception exists (in the Informed Consent for the patients the descriptions of possible contraceptives is reported
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
124
Chemotherapy will consist of nab-paclitaxel 125 mg/mq over 30 min and gemcitabine 1000 mg/mq weekly on days 1, 8 and 15 of a 28-day cycle
gemcitabine 1000 mg/mq over 30 minutes on days 1, 8 and 15 of a 28-day cycle.
A.O. Universitaria Ospedali Riuniti
Ancona, AN, Italy
Istituto Tumori Giovanni Paolo II
Bari, BA, Italy
A.O. Treviglio-Caravaggio, P.le Ospedale n1
Treviglio, Bergamo, Italy
A.O. Humanitas Gavazzeni
Bergamo, BG, Italy
A.O. Ospedale G.Rummo
Benevento, BN, Italy
ASDAA Bolzano
Progression Rate
Assuming an expected progression rate in the control arm of 40% and an auspicated progression rate in the experimental arm of 20%,with one-tailed alpha=0.05, 80% power, 124 patients are required for the final analysis
Time frame: progression rate is evaluated after 3 cycles of chemotherapy
Quality of Response
All patients must be considered in response analysis, including those who discontinue treatment or who die for any reason prior to response evaluations
Time frame: Response to treatment is evaluated according to the RECIST criteria at the end of chemotherapy
Esplore the effects of nab-paclitaxel in terms of toxicity
Treatment-emergent adverse events, drug-related adverse events and safety laboratory parameters will be analysed by treatment groups and CTCAE grade
Time frame: every 3 cycles of chemotherapy
Progression Free Survival
Progression free survival time will be defined as the time from randomization until the date of first observed disease progression (radiological or clinical, whichever is earlier) or death due to any cause, if death occurs before progression is documented. Patients who did not progress will be censored at the last date they were known to be alive. Patients who died of disease and for whom a date of progression is not available will be considered to have progressed on the day of their death
Time frame: time from the start of the treatment until PD or death
Overall Survival
Overall survival time will be defined as the time from randomization to the date of death. If the subject has not died, survival will be censored on the last date the subject was known to be alive (last date of follow up).
Time frame: the time from randomization to the date of death
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Bolzano, BZ, Italy
Policlinico Universitario D.Casula
Monserrato, Cagliari, Italy
Azienda Ospedaliera Sant'Anna
Como, CO, Italy
A.O. Ospedale S.Martino
Genova, GE, Italy
A.O. Polo Oncologico Vito Fazzi
Lecce, LE, Italy
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