Purpose

The prognosis for patients with localized pancreatic adenocarcinoma who are not surgical candidates is poor. Patients characterized as having "borderline resectable" disease treated with preoperative chemo-radiotherapy fair somewhat better - although many of these patients are not converted to resectability. It may be argued that intensification of local and regional therapy might 1.) Increase the share of patients able to undergo curative surgery and 2.) Improve the local disease control interval and extend survival for patients who remain unresectable. Therefore, the purpose of this research study is to determine if an increase in the number of surgical resection pancreatic adenocarcinoma is higher than historical data by using a combined treatment of proton radiation with capecitabine (oral chemotherapy).

Condition

Eligibility

Eligible Ages
Over 18 Years
Eligible Sex
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  • Biopsy proven unresectable adenocarcinoma of the pancreas. - Have either unresectable, borderline resectable or medically inoperable carcinoma of the pancreas, or refusing surgery. - A biliary obstruction is able to participate as long as a drainage tube is in place prior to starting treatment with Proton radiation, - Participants of child-producing potential must be willing to use contraception while on treatment and for at least 12 months thereafter. - Required pretreatment laboratory parameters: - Absolute granulocyte count (AGC/ANC) ≥ 1.8 thou/mm3 - Platelet count ≥ 100,000/mm3 - Bilirubin < 2 mg/dl - ALT/SGPT < 3x upper limit of normal - Creatinine < 3 mg/dl

Exclusion Criteria

  • Evidence of distant metastasis. - Prior surgical resection. - Previous history of invasive malignancy (except non-melanoma skin cancer and low to intermediate risk prostate cancer) unless the participant has been disease free for 5 years prior to registration. - Active or untreated infection, - Pregnant or breastfeeding women or subjects of child producing potential not willing to use medically acceptable contraception while on treatment and for at least 12 months thereafter. - Previous Radiation to the abdomen.

Study Design

Phase
Phase 2
Study Type
Interventional
Allocation
N/A
Intervention Model
Single Group Assignment
Primary Purpose
Treatment
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
Proton Radiation with capecitabine
The following will be performed in this group: Proton Radiation Therapy with concomitant oral chemotherapy, capecitabine taken on radiation treatment days for 6 weeks. A surgical resection will be performed between 8 and 16 weeks if radiographic studies suggest operability.
  • Radiation: Proton Radiation
    Proton Radiation 40.50 Gy relative biological effectiveness (RBE) in 18 fractions to gross disease and elective nodal volume followed by a 22.50 Gy (RBE) in 10 fraction boost to gross disease. Total dose 63 Gy (RBE) in 28 fractions over 6 weeks.
    Other names:
    • Proton Beam Radiation
  • Drug: Capecitabine
    Concomitant oral chemotherapy, capecitabine 1000mg by mouth twice daily, 5 days a week (M-F) on radiation days only.
    Other names:
    • Xeloda
  • Procedure: Surgical resection
    Surgery between 8 and 16 weeks of radiotherapy completion if radiographic studies suggest operability.

Recruiting Locations

Northwestern Medicine Chicago Proton Center
Warrenville 4915525, Illinois 4896861 60555
Contact:
Don Smith, MS, CCRC
630-933-7820
donald.smith3@nm.org

McLaren Proton Therapy Center
Flint 4992982, Michigan 5001836 48532
Contact:
Taylor Brewer
313-576-8526
brewert@karmanos.org

Inova Schar Cancer Institute
Fairfax 4758023, Virginia 6254928 22031
Contact:
Sangeetha Moturi
571-472-0343
sangeetha.moturi@inova.org

More Details

NCT ID
NCT02598349
Status
Recruiting
Sponsor
Proton Collaborative Group

Detailed Description

Participants as part of this research study will receive Proton radiation over 6 weeks with oral chemotherapy (capecitabine) only taken on radiation days. In addition, If surgery is an option, then surgical resection will be performed at least 8 weeks after treatment with radiation and chemotherapy.

Notice

Study information shown on this site is derived from ClinicalTrials.gov (a public registry operated by the National Institutes of Health). The listing of studies provided is not certain to be all studies for which you might be eligible. Furthermore, study eligibility requirements can be difficult to understand and may change over time, so it is wise to speak with your medical care provider and individual research study teams when making decisions related to participation.