The purpose of this study is to evaluate the efficacy of anti-diabetic treatment on improving the overall survival for metastatic pancreatic cancer patients complicated by diabetes receiving gemcitabine and nab-paclitaxel chemotherapy.
About 80% of patients with pancreatic adenocarcinoma have aberrant fasting blood glucose at the time of diagnosis. The consistent association between pancreatic cancer and diabetes mellitus has long been recognized and even been termed as "chicken and egg". Many reports have found that pancreatic cancer can result in diabetes, which is called type 3c diabetes. New-onset diabetes is commonly observed in pancreatic cancer patients and has been considered as a potential screening sign. Moreover, diabetes has been found as a predictor of poor outcome in pancreatic cancer. Pancreatic cancer cells have a strong dependence on glucose and they are well-known for their sweet teeth. High glucose is associated with impaired immunologic reaction, intolerability to chemotherapy, radiotherapy and other major treatments, an increased risk of pancreatic surgery. Given the linkage between pancreatic cancer and diabetes or high blood glucose, a clinical trial is needed to validate the effect of anti-diabetic treatment in type 3c diabetes.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
210
120 mg per square meter of body-surface area on days 1, 8, and 15 every 4 weeks
(1000 mg per square meter) on days 1, 8, and 15 every 4 weeks
Metformin, insulin or other anti-diabetic treatments
Shanghai Cancer Center
Shanghai, China
Overall Survival (OS):
Time from randomization to death from any cause
Time frame: 2 months
Progression-Free Survival (PFS)
Time from enrollment to first tumor progression.
Time frame: 2 months
Blood Glucose Control
Changes in fasting blood glucose levels.
Time frame: One month
Rate of HbA1c Control
Changes in glycated hemoglobin compared to baseline.
Time frame: One month
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Attend follow-ups at designated endocrinology clinics, with proactive inquiry about hypoglycemic measures and medication implementation.