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Pancreatic NeoplasmsPhase 2LAPACTNCT02301143

Phase 2 Nab® -Paclitaxel (Abraxane®) Plus Gemcitabine in Subjects With Locally Advanced Pancreatic Cancer (LAPC)

A Phase 2 study testing nab-Paclitaxel, Gemcitabine and Chemoradiation in people with Pancreatic Neoplasms, run by Celgene at 42 sites in 5 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

This clinical study is in subjects who are 18 years old or older with locally advanced pancreatic cancer who have not received prior treatment for their pancreatic cancer. The study treats all subjects with nab-Paclitaxel plus gemcitabine for approximately 6 months of treatment. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Pancreatic Neoplasms
What is being tested?
nab-Paclitaxel, Gemcitabine and Chemoradiation
Could I receive a placebo?
No, everyone receives an active treatment
How many people
107 participants
Where
42 sitesin 5 countries
Study dates
21 Apr 2015to 26 Apr 2018
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Non- metastasis, unresectable, adenocarcinoma pancreatic cancer patients
  • No prior anticancer therapy for pancreatic cancer
  • •≥ 18 years of age with a performance status of 0 or 1•Adequate complete blood counts, hepatic function, and renal function
  • Signed informed Consent

Who cannot join

  • Active bacterial, viral, or fungal infection
  • Infection with hepatitis B or C, or history of human immunodeficiency virus (HIV) infection, or receiving immunosuppressive or myelosuppressive
  • Subjects with sensory neuropathy, ascites, or plastic biliary stent.
  • Serious medical risk factors involving any of the major organ systems, or serious psychiatric disorders (including but not limited to connective tissue disorders, lung disease, and cardiac or seizure disorders)
  • Women who are pregnant or breast feeding

Trial locations and contacts

42 sites in 5 countries.

42 sites in 5 countries

United States23 sites
  • Saint Joseph Mercy Ann Arbor Hospital

    Ann Arbor, Michigan, 48106

  • Piedmont Cancer Institute PC

    Atlanta, Georgia, 30318

  • Tufts - New England Medical Center

    Boston, Massachusetts, 02111

  • Roswell Park Cancer Institute

    Buffalo, New York, 14263

  • Levine Cancer Institute

    Charlotte, North Carolina, 28204

  • Mark H Zangmeister Center

    Columbus, Ohio, 43219

  • Karmanos Cancer Center Wayne State University

    Detroit, Michigan, 48201

  • Houston Methodist Cancer Center

    Houston, Texas, 77030

  • Clinical Research Alliance

    Lake Success, New York, 11042

  • Dartmouth Hitchcock Medical Center

    Lebanon, New Hampshire, 03756

  • Regional Cancer Care Associates LLC

    Morristown, New Jersey, 07962

  • Vanderbilt University Medical Center

    Nashville, Tennessee, 37232-5505

  • Smilow Cancer Hospital At Yale-New Haven

    New Haven, Connecticut, 06510

  • Cancer Treatment Centers of America - Southeastern Regional Medical Center

    Newnan, Georgia, 30265

  • Florida Hospital Cancer Institute

    Orlando, Florida, 32804

  • UC Davis Cancer Center

    Sacramento, California, 95817

  • Scripps Clinic Torrey Pines

    San Diego, California, 92037

  • ME Center for Cancer Medicine

    Scarborough, Maine, 04074

  • Mayo Clinic - Arizona

    Scottsdale, Arizona, 85259

  • State University of New York Upstate Medical Center

    Syracuse, New York, 13215

  • Montefiore Einstein Cancer Center

    The Bronx, New York, 10461

  • Georgetown University Medical Center Lombardi Cancer Center

    Washington D.C., District of Columbia, 20007

  • University of Massachusetts

    Worcester, Massachusetts, 01655

Other trials in United States

France6 sites
  • Centre Regional de lutte contre le cancer Paul Papin

    Angers, 49933

  • CHRU Besancon

    Besançon, 25000

  • Centre Hospitalier Belfort Montbeliard

    Besançon

  • Hopital Beaujon

    Clichy

  • Hopital Saint Antoine

    Paris, 75012

  • Hopital Haut Leveque

    Pessac, 33604

Other trials in France

Canada5 sites
  • Tom Baker Cancer Center

    Calgary, Alberta, T2N 4N2

  • Cross Cancer Institute

    Edmonton, Alberta, T6G 1Z2

  • CHUM Hôpital Saint-Luc

    Montreal, Quebec, H2L 4M1

  • McGill University

    Montreal, Quebec, H2W 1S6

  • British Columbia Cancer Agency

    Vancouver, British Columbia, V5Z 4E6

Other trials in Canada

Spain5 sites
  • Hospital Universitario a Coruna

    A Coruña, 15006

  • ICO-Hospital Germans Trias i Pujol

    Barcelona, 08916

  • Hospital Clinico San Carlos

    Madrid, 28040

  • Hospital Universitario Marques de Valdecilla

    Santander, 39008

  • Hospital Miguel Servet

    Zaragoza, 50009

Other trials in Spain

Italy3 sites
  • Ospedale Sacro Cuore di Gesu FatebeneFratelli

    Benevento, 82100

  • Azienda Ospedaliera Universitaria San Martino

    Genova, 16132

  • Policlinico Universitario Campus Biomedico Di Roma

    Roma, 128

Other trials in Italy

About this study

Official title: Nab-paclitaxel (Abraxane) Plus Gemcitabine in Subjects With Locally Advanced Pancreatic Cancer (LAPC): An International, Open-label, Multi-center, Phase 2 Study (LAPACT).

This clinical study is in subjects who are 18 years old or older with locally advanced pancreatic cancer who have not received prior treatment for their pancreatic cancer. The study treats all subjects with nab-Paclitaxel plus gemcitabine for approximately 6 months of treatment. Subjects who complete the treatment will choose, with their treating physicians, what additional treatment should be given: more nab-Paclitaxel plus gemcitabine, Chemoradiation therapy, or surgery to treat the locally advanced pancreatic cancer.

Read the detailed description

This is an international, non-randomized, open-label, multi-center, Phase 2 study in subjects who are 18 years old or older with locally advanced pancreatic cancer who have not received prior treatment for their pancreatic cancer. All subjects will be treated with nab-paclitaxel plus gemcitabine for 6 cycles followed by an Investigator's Choice of continuation of treatment with nab-paclitaxel plus gemcitabine, chemoradiation therapy, or surgery.

Safety assessments by laboratory testing and physical exams will be conducted through-out the study.

Efficacy assessments by physical exam will be preformed through-out the study and tumor imaging will be conducted approximately every 2 months.

Subjects will be considered active study participants from enrollment up to, but not including, survival follow-up period.

Being tested
nab-Paclitaxel, Gemcitabine, Chemoradiation, Capecitabine, Surgery
Keywords
Pancreatic Neoplasms, Pancreatic Cancer, Locally advanced pacriatic cancer, nab-Paclitaxel, Abraxane, Gemcitabine, ABI-007
Medical subject headings
Pancreatic Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT02301143
Study groupRoleWhat they receive
nab-Paclitaxel plus GemcitabineExperimentalnab-Paclitaxel 125 mg/m2 intravenous (IV) infusion over approximately 30 to 45 minutes on Days 1, 8, and 15, followed by gemcitabine 1000 mg/m2 IV infusion over approximately 30 minutes on Days 1, 8, and 15 of each 28-day cycle Subjects who complete 6 cycles of nab-paclitaxel and gemcitabine without disease progression or unacceptable toxicities, the Investigator will then determine the best option for the subject. * Continuation of nab-paclitaxel and gemcitabine therapy to disease progression or unacceptable toxicity OR * Chemoradiation therapy consisting of the concurrent use of capecitabine or gemcitabine with radiation according to institutional practice OR * Surgical intervention
Receives: Drug: nab-Paclitaxel; Drug: Gemcitabine; Drug: Chemoradiation; Drug: Capecitabine; Procedure: Surgery

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Kaplan-Meier Estimates for Time to Treatment Failure (TTF)

    TTF was defined as the time after the first dose of study therapy to discontinuation of study therapy due to disease progression, death by any cause, or the start of a new non-protocol-defined anticancer therapy/surgery. If a participant does not progress, die or start a new non-protocol-defined anticancer therapy, the participant was censored on the last tumor assessment date.

    Tumor evaluations of CT or MRI scans were assessed by the investigative sites and response determined according to Response Evaluation Criteria in Solid Tumors (RECIST) guidelines, version 1.1.

    The definition for progressive disease (PD) was >= 20% increase in the sum of diameters of target lesions from nadir, and the sum showed an absolute increase of >= 5 mm; the progression of a non-target lesion or the appearance of any new lesions is also considered progression.

    Median and its 90% confidence interval (CI) of TTF were estimated using the method of Brookmeyer and Crowley.

    Measured: Day 1 of study treatment up to 28.75 months; (maximum time for the last tumor assessment)

Secondary outcomes (10)
  1. Disease Control Rate (DCR): Percentage of Participants With Complete (CR) or Partial Response (PR), or Stable Disease (SD) for ≥ 16 Weeks According to RECIST Version 1.1

    DCR was defined as the percentage of participants with a CR or PR or SD from of date of first treatment to 16 weeks. Tumor assessments after start of non-protocol-defined anticancer therapy were excluded.

    RECIST 1.1 Definition:

    • CR: disappearance of all target and non-target lesions; any pathological lymph nodes (target or non-target) must have reduction in short axis to < 10 mm and no new lesions diagnosed.
    • PR: a >= 30% decrease in the sum of diameters of target lesions from baseline; no evidence of progression in any of the non-target lesions diagnosed at baseline; and no new lesions diagnosed.
    • SD: neither sufficient shrinkage to qualify for PR nor sufficient increase of lesions to qualify for PD.

    The two-sided 90% binomial confidence intervals (CIs) were estimated by Wilson score method.

    Measured: Day 1 of study treatment up to the end of investigator choice period plus 28 days; up to 76.9 weeks

  2. Overall Response Rate (ORR): Percentage of Participants With Complete (CR) or Partial Response (PR) According to RECIST Version 1.1

    ORR was defined as the percentage of participants that achieved a combined incidence of complete (CR) and partial response (PR) using RECIST 1.1 guidelines as assessed by the investigator. Assessments after new non-protocol-defined anticancer therapy are excluded. For participants who had resectable surgery in Investigator Choice period, assessments after surgical intervention are excluded.

    RECIST 1.1 Definition:

    • CR: disappearance of all target and non-target lesions; any pathological lymph nodes (target or non-target) must have reduction in short axis to < 10 mm and no new lesions diagnosed.
    • PR: a >= 30% decrease in the sum of diameters of target lesions from baseline; no evidence of progression in any of the non-target lesions diagnosed at baseline; and no new lesions diagnosed.

    The two-sided 90% binomial confidence intervals (CIs) were estimated by Wilson score method

    Measured: Day 1 of study treatment up to the end of investigator choice period plus 28 days; up to 76.9 weeks

  3. Kaplan-Meier Estimate of Progression-Free Survival (PFS)

    Progression-free Survival (PFS) was defined as the time from the date of the first dose to the date of disease progression or death (by any cause), whichever is earlier. The analysis day was calculated from enrollment date for one participant who was not treated. Participants who have no disease progression or have not died were censored to last tumor assessment date with progression-free.

    The definition for progressive disease (PD) was at least a 20% increase in the sum of diameters of target lesions from nadir; the sum must also demonstrate an absolute increase of >= 5 mm; the progression of a non-target lesion or the appearance of any new lesions is also considered progression.

    Median and its 90% confidence interval of PFS were estimated using the method of Brookmeyer and Crowley.

    Measured: Day 1 of study treatment up to 28.75 months (maximum time for the last tumor assessment)

  4. Kaplan-Meier Estimates for Overall Survival (OS)

    Overall survival was defined as the time from the date of first dose of study therapy to the date of death (by any cause). Participants who were alive at the end of study or clinical data cut were censored on the last known time that the participant was alive or the clinical cutoff date, whichever was earlier. Median and its 90% confidence interval of OS were estimated using the method of Brookmeyer and Crowley

    Measured: Day 1 of study treatment up to 31.34 months (maximum time for survival follow-up)

  5. Participant Counts in Response Categories Using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30): Global Health Status and 5 Functioning Scales

    The European Organization for Research and Treatment of Cancer Quality-of-Life questionnaire (EORTC QLQ-C30) is a validated health-related quality of life (HRQoL) measure. The EORTC QLQ-C30 is composed of both multi-item scales and single-item measures, including 5 functional scales, 3 symptom scales, 6 single symptom items, and 1 global health status / quality of life scale. No item occurs in more than one scale. All reported measures are transformed to a 0 - 100 scale. In the Global Health Status and 5 functional scales, 0 = worst possible quality of life/health status and 100 = best possible quality of life/health status. The best score on treatment is the best score from all post-baseline visits and is compared to the baseline to get the following responder categories. Responder categories: - Improved: >=10 increase from baseline - Stable: neither increase nor decrease >10 - Worsened: >=10 decrease from baseline

    Measured: Baseline (Day -1), Day 1 of each cycle, for up to 19 cycles each cycle consisting of 28 days and the 28-day follow-up visit

  6. Participant Counts in Response Categories Using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30): Symptom Scales and Single Symptom Items

    The European Organization for Research and Treatment of Cancer Quality-of-Life questionnaire (EORTC QLQ-C30) is a validated health-related quality of life (HRQoL) measure. The EORTC QLQ-C30 is composed of both multi-item scales and single-item measures, including 5 functional scales, 3 symptom scales, 6 single symptom items, and 1 global health status / quality of life scale. No item occurs in more than one scale. All reported measures are transformed to a 0 to 100 scale. In the symptom scales and single symptom items, 0 = optimal health state and 100 = worst possible health state. The best score on treatment is the best score from all post-baseline visits and is compared to the baseline to get the following responder categories. Responder categories: - Improved: >=10 decrease from baseline - Stable: neither increase nor decrease >10 - Worsened: >=10 increase from baseline

    Measured: Baseline (Day -1), Day 1 of each cycle, for up to 19 cycles each cycle consisting of 28 days and the 28-day follow-up visit

  7. Participant Counts in Response Categories Using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire For Pancreatic Cancer (EORTC-QLQ PAN26): Six Summary Scales

    The EORTC pancreatic cancer module is a validated tool intended for patients at all disease stages undergoing surgical resection, palliative surgical intervention, endoscopic palliation or palliative chemotherapy. The module includes 26 questions, organized into 7 scales and 10 individual item scores. All reported measures are transformed to a 0 to 100 scale. Six summary scales reported are: - Pancreatic Pain - Digestive Symptoms - Altered Bowel Habits - Hepatic Scale - Body Image - Sexuality Scores of 0 = optimal health state and 100 = worst possible health state. The best score on treatment is the best score from all post-baseline visits and is compared to the baseline. Responder categories: - Improved: >=MID decrease from baseline - Stable: no increase or decrease >MID - Worsened: >=MID increase from baseline MID = half the baseline standard deviation

    Measured: Baseline (Day -1), Day 1 of each cycle, for up to 19 cycles each cycle consisting of 28 days and the 28-day follow-up visit

  8. Participant Counts in Response Categories Using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire For Pancreatic Cancer (EORTC-QLQ PAN26): Satisfaction With Health Care Scale

    The EORTC pancreatic cancer module is a validated tool intended for patients at all disease stages undergoing surgical resection, palliative surgical intervention, endoscopic palliation or palliative chemotherapy. The module includes 26 questions, organized into 7 scales and 10 individual item scores. The summary scale for Satisfaction with Health Care is reported. All reported measures are transformed to a 0 to 100 scale. Scores of 0 = not satisfied, worst possible health state and 100 = extremely satisfied, best possible health state. The best score on treatment is the best score from all post-baseline visits and is compared to the baseline to get the following responder categories. Responder categories: - Improved: >=MID increase from baseline - Stable: no increase or decrease >MID - Worsened: >=MID decrease from baseline MID = half the baseline standard deviation

    Measured: Baseline (Day -1), Day 1 of each cycle, for up to 19 cycles each cycle consisting of 28 days and the 28-day follow-up visit

  9. Participant Counts in Response Categories Using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire For Pancreatic Cancer (EORTC-QLQ PAN26): 10 Individual Item Scores

    The EORTC pancreatic cancer module is a validated tool intended for patients at all disease stages undergoing surgical resection, palliative surgical intervention, endoscopic palliation or palliative chemotherapy. The module includes 26 questions, organized into 7 scales and 10 individual item scores. The 10 individual item scores are reported. All reported measures are transformed to a 0 to 100 scale. Scores of 0 = best possible health state and 100 = worst possible health state. The best score on treatment is the best score from all post-baseline visits and is compared to the baseline to get the following responder categories. Responder categories: - Improved: >=MID decrease from baseline - Stable: no increase or decrease >MID - Worsened: >=MID increase from baseline MID = half the baseline standard deviation

    Measured: Baseline (Day -1), Day 1 of each cycle, for up to 19 cycles each cycle consisting of 28 days and the 28-day follow-up visit

  10. Participants With Treatment Emergent Adverse Events (TEAEs)

    TEAEs are defined as any adverse event (AE) that begin or worsen on or after the start of study drug or procedure of the study period through the maximum duration of the period plus 28 days. The severity of AEs was graded based on National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE), Version 4.0 and the scale: Grade 1 = Mild Grade 2 = Moderate Grade 3 = Severe Grade 4 = Life threatening Grade 5 = Death. Relation to study drug was determined by the investigator. A treatment-related TEAE is defined as TEAE which was considered to be related to one or both of the study drugs and reported as 'Suspected' on the case report form. AEs with a missing relationship were treated as 'treatment-related' in data summaries. IP (investigational product) refers to nab-Paclitaxel and/or Gemcitabine. "Related" TEAE refers to relation to study drug (IP).

    Measured: Day 1 of study drug up to end of the study; up to 31.3 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted25 Nov 2014 (estimated)
  2. Study start21 Apr 2015
  3. Primary completion21 Nov 2017
  4. Study completion26 Apr 2018

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
107 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02301143
Sponsor's protocol ID
ABI-007-PANC-007
Acronym
LAPACT
Status last verified
Mar 2019
First submitted
14 Nov 2014
Last updated
20 Mar 2019
Data monitoring committee
No

Publications

  • Philip PA, Lacy J, Portales F, Sobrero A, Pazo-Cid R, Manzano Mozo JL, Kim EJ, Dowden S, Zakari A, Borg C, Terrebonne E, Rivera F, Sastre J, Bathini V, Lopez-Trabada D, Asselah J, Saif MW, Shiansong Li J, Ong TJ, Nydam T, Hammel P. Nab-paclitaxel plus gemcitabine in patients with locally advanced pancreatic cancer (LAPACT): a multicentre, open-label phase 2 study. Lancet Gastroenterol Hepatol. 2020 Mar;5(3):285-294. doi: 10.1016/S2468-1253(19)30327-9. Epub 2020 Jan 14.

    PubMed 31953079

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing nab-Paclitaxel, Gemcitabine and Chemoradiation in people with Pancreatic Neoplasms, run by Celgene at 42 sites in 5 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 20 Mar 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 42 sites in United States, France, Canada, Spain, Italy. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 8 Jan 2019). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Kaplan-Meier Estimates for Time to Treatment Failure (TTF) (time frame: Day 1 of study treatment up to 28.75 months; (maximum time for the last tumor assessment)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02301143, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 20 Mar 2019.

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