Participants are eligible for this study who were treated for advanced biliary tract cancer (BTC) but the treatment either did not make the cancer better or is no longer working. The treatment for patients whose advanced BTC either did not make the cancer better or is no longer working is a combination of chemotherapy drugs called FOLFOX which consists of fluorouracil and oxaliplatin. Studies have shown that other treatments may work better to treat advanced BTC. In this study, investigators want to see if treating patients with the drug combination of trifluridine/tipiracil (FTD/TPI) and another drug called oxaliplatin works better than FOLFOX for advanced BTC as second-line therapy. FTD/TPI are pills that are taken by mouth, whereas oxaliplatin is given intravenously (by IV).
BTCs are difficult to treat. It is estimated that in the United States (US) approximately 15,000-20,000 people will be diagnosed with a BTC per year. In 2024, liver and intrahepatic bile duct cancers were the 5th leading cause of death from cancer among men and 7th among women in the US (1). Most people with BTCs have cancer that has spread or cannot be removed with surgery, so systemic treatments are the only option. However, the median survival after being diagnosed with an advanced BTC is still only 4.5 months, so it is important that we find better treatment options (2). This study is evaluating the combination of a medicine called trifluridine/tipiracil (FTD/TPI) and a medicine called oxaliplatin in treating advanced BTCs. While FTD/TPI has been used to treat other types of cancer, it is not yet approved to treat BTCs, so it is experimental. On the other hand, oxaliplatin is a medicine that has been previously used to treat BTCs.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
27
FTD/TPI will be taken by mouth on Days 1-5 of the 14-day treatment cycle. The starting does is 25mg/m2 twice per day.
Oxaliplatin is given on Day 1 of each 14-day cycle. It is given intravenously (by IV) over 2 hours.
University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center
Cleveland, Ohio, United States
RECRUITINGCleveland Clinic Taussig Cancer Center, Case Comprehensive Cancer Center
Cleveland, Ohio, United States
NOT_YET_RECRUITINGDisease control rate (DCR) by RECIST v1.1
DCR is the percentage of participants whose cancer did not get worse after treatment (i.e. the percentage of participants who had CR, PR, or SD, as defined below), and this will be measured by Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 criteria. Per RECIST v1.1, Complete Response (CR) is defined as disappearance of all target lesions. Partial Response (PR) is defined as a 30% decrease in the sum of diameters of target lesions. Progressive Disease (PD) is defined as a 20% increase in the sum of diameters of target lesions with an absolute increase of at least 5 millimeters (mm) or the appearance of one or more new lesions. Stable Disease (SD) is defined as neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD.
Time frame: Every 8 weeks until treatment discontinuation, up to 6 months
Safety and tolerability
Measured by the grade of adverse events (AEs) per CTCAE version 5.0
Time frame: Day 1
Safety and tolerability
Measured by the grade of adverse events (AEs) per CTCAE version 5.0
Time frame: At treatment discontinuation, up to 6 months
Safety and tolerability
Measured by the grade of adverse events (AEs) per CTCAE version 5.0
Time frame: 30 days post-study treatment discontinuation, up to 6 months
Safety and tolerability
Measured by the incidence of adverse events (AEs)
Time frame: Day 1
Safety and tolerability
Measured by the incidence of adverse events (AEs)
Time frame: At treatment discontinuation, up to 6 months
Safety and tolerability
Measured by the incidence of adverse events (AEs)
Time frame: 30 days post-study treatment discontinuation, up to 6 months
Safety and tolerability
Measured by the duration of adverse events (AEs)
Time frame: Day 1
Safety and tolerability
Measured by the duration of adverse events (AEs)
Time frame: At treatment discontinuation, up to 6 months
Safety and tolerability
Measured by the duration of adverse events (AEs)
Time frame: 30 days post-study treatment discontinuation, up to 6 months
Objective response rate (ORR) by RECIST v1.1
ORR is the percentage of participants whose cancer got better after treatment (i.e. the percentage of participants who had CR or PR, as defined below), and this will be measured by Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 criteria. Per RECIST v1.1, Complete Response (CR) is defined as disappearance of all target lesions. Partial Response (PR) is defined as a 30% decrease in the sum of diameters of target lesions. Progressive Disease (PD) is defined as a 20% increase in the sum of diameters of target lesions with an absolute increase of at least 5 millimeters (mm) or the appearance of one or more new lesions. Stable Disease (SD) is defined as neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD.
Time frame: Every 8 weeks until treatment discontinuation, up to 6 months
Progression free survival (PFS)
Progression-Free Survival (PFS) is defined as the duration of time from start of treatment to time of progression or death, whichever occurs first.
Time frame: 2 years post-study treatment
Overall survival (OS)
Overall survival (OS) is defined as the duration of time from start of treatment to time of death from any cause.
Time frame: 2 years post-study treatment
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