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A Phase IIb Randomized Study to Evaluate the Efficacy of Gemcitabine-erlotinib Versus Gemcitabine-erlotinib-capecitabine in Patients With Metastatic Pancreatic Cancer

Phase 2
18 Years
Open (Enrolling)
Metastatic Pancreatic Cancer

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Trial Information

A Phase IIb Randomized Study to Evaluate the Efficacy of Gemcitabine-erlotinib Versus Gemcitabine-erlotinib-capecitabine in Patients With Metastatic Pancreatic Cancer

Inclusion Criteria:

1. Ability to understand and willingness to sign a written informed consent

2. Able, in the investigator's opinion, to fulfill the procedures and explorations of
the study

3. Age ≥ 18 years old

4. ECOG 0-2

5. Life expectancy ≥ 12 weeks

6. Patients with metastatic adenocarcinoma of the pancreas, following 7th edition of TNM

7. Histologically or cytologically confirmed diagnosis of adenocarcinoma of the pancreas

8. Measurable disease following RECIST criteria version 1.1

9. No previous systemic treatment for metastatic pancreatic cancer Adjuvant chemotherapy
al least 6 months before enrollment is allowed. Patients having neoadjuvant
chemotherapy must have completed the treatment at least 4 weeks before trial entry.
Toxicities associated to previous treatment must be resolved before enrollment.
Progression disease (metastatic disease) must be confirmed after adjuvant treatment

10. Adequate bone marrow function as determined by:

- Hemoglobin: ≥ 9 g/dL. (patients with hemoglobin < 9 g/dL could be transfused
before their inclusion on the study)

- Platelets: ≥ 100 x 109/L

- Absolute Neutrophil account (ANC) ≥ 1,5 x 109/L

11. Adequate liver function, as determined by:

- Serum bilirubin ≤ 1,5 x LSN

- AST, ALT ≤ 2,5 x LSN in patients without liver metastasis. In patients with
liver metastasis ≤ 5 x LSN

- Alkaline phosphatase ≤ 2,5 x LSN or ≤ 5 x LSN in patients with liver metastasis.
In patients with bone metastasis ≤ 10 x LSN

12. Adequate renal function, as determined by:

- Creatinine clearance using the Cockcroft-Gault formula ≥ 50.0 ml/min

13. Women of childbearing potential must have a negative serum or urine pregnancy test
performed within 7 days prior to randomization. Postmenopausal women are defined as
those who have been amenorrheic for at least 12 months. Also, both men and women
enrolled in this study must use adequate birth control (eg., abstinence, intrauterine
device, oral contraceptive or double barrier method or be surgically sterile),
starting at the signing of the informed consent and up to at least 6 months after
completion of treatment or the last dose, whichever occurs first

14. Patients must not have undergone a major surgical procedure within 4 weeks prior to
study treatment. The surgical wound should be completely healed

Exclusion Criteria:

1. Local pancreatic cancer (stage IA-IIB) or locally advance cancer (stage III),
following the TNM 7th edition classification. Patients with metastatic disease that
relapse after the initial diagnosis of local or advance disease could be included in
this study

2. Pancreatic endocrine tumor and ampulloma

3. Evidence of carcinomatosis meningitis or brain metastasis. In case of clinical
suspicious of brain metastasis is mandatory to perform a brain TAC/MR 4 weeks prior
de inclusion.

4. Primary tumors developed 5 years previous to the inclusion, except in situ cervix
carcinoma or skin basocellular cancer properly treated

5. Cardiovascular disease clinically significant (active):

- Non-controlled arterial hypertension (Systolic pressure > 150 mg Hg and/or
diastolic pressure > 100 mm Hg on repeated pressure measurements)

- Cerebrovascular accident/ictus (≤ 6 weeks prior to inclusion)

- Myocardial infarction (≤ 6 months prior to inclusion)

- Unstable angina

- Congestive cardiac insufficiency (grade II or superior following to New York
Heart Association (NYHA)

- Severe cardiac arrythmia requiring treatment

6. Significant ophthalmologic anomalies

7. Deficit in Dihydropyrimidine-Dehydrogenase (DPD)

8. Unable to take oral drug. Previous surgical process that affect the absorption or
make the needed to have intravenous feeding or parenteral nutrition with lipids

9. Pregnancy women or in lactation period

10. Antineoplastic treatment (chemotherapy, hormonal treatment, radiotherapy, surgery,
biological therapy or tumor embolization) 4 weeks prior the inclusion

11. Previous treatment with capecitabine or EGFR inhibitor

12. Metabolic disease or any other disease which, in the investigator's opinion, might
interfere with the treatment in study

13. Known hypersensibility to any study drug (gemcitabine, erlotinib, capecitabine) or to
5-fluorouracile and fluoropyrimidines

14. Current infection grade ≥ 2 (CTCAE)

15. Known human immunodeficiency virus infection, or chronic infection with hepatitis B
or C virus, or severe uncontrolled intercurrent infection or other severe
uncontrolled concomitant diseases

16. Medical, psychological, psychiatric or sociological conditions that would interfere
to the patient participation in the study or in the assessment of the results

17. Current or 30 days previous to study treatment with other investigational drug or
participation in other trial

Type of Study:


Study Design:

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Progression free survival

Outcome Time Frame:

4 years

Safety Issue:


Principal Investigator

Antonio Irigoyen, MD

Investigator Role:

Study Chair

Investigator Affiliation:

Hospital de Toledo, Spain


Spain: Ministry of Health

Study ID:




Start Date:

February 2011

Completion Date:

February 2015

Related Keywords:

  • Metastatic Pancreatic Cancer
  • Pancreatic cancer
  • gemcitabine
  • erlotinib
  • capecitabine
  • Pancreatic Neoplasms