Avastin, Fluorouracil, Doxorubicin and Streptozocin in Locally Advanced and Metastatic Pancreatic Endocrine Tumors

Overview[ - collapse ][ - ]

Purpose Open label, single-arm phase II study of avastin combined with fluorouracil, doxorubicin and streptozocin administered in 28-day cycles. Treatment will continue until progression of disease, or until withdrawal due to toxicity, or up to a maximum of 12 cycles (48 weeks). In order to reduce the risk of cardiac toxicity, doxorubicin will be administered for a maximum of 8 cycles. If disease has not progressed after 12 cycles of treatment, avastin monotherapy will continue until disease progression or withdrawal due to toxicity.
ConditionPancreatic Cancer
InterventionDrug: Avastin
Drug: Fluorouracil
Drug: Doxorubicin
Drug: Streptozocin
Drug: Dexamethasone
Drug: Ondansetron
PhasePhase 2
SponsorH. Lee Moffitt Cancer Center and Research Institute
Responsible PartyH. Lee Moffitt Cancer Center and Research Institute
ClinicalTrials.gov IdentifierNCT00609765
First ReceivedJanuary 24, 2008
Last UpdatedNovember 21, 2013
Last verifiedMarch 2011

Tracking Information[ + expand ][ + ]

First Received DateJanuary 24, 2008
Last Updated DateNovember 21, 2013
Start DateAugust 2007
Estimated Primary Completion DateMarch 2008
Current Primary Outcome MeasuresNumber of Participants With Progression Free Survival (PFS) at 12 Months [Time Frame: 12 months] [Designated as safety issue: No]We planned to calculate the One Year Progression Free Survival rate. The event for PFS analyses was the first occurrence of disease progression or death and patients who did not progress or died would be censored at the date of last tumor evaluation (e.g. one-year).
Current Secondary Outcome MeasuresThe Number of Participants With Radiographic Response [Time Frame: 2 years] [Designated as safety issue: Yes]Objective Radiographic Response Rate (ORR). We planned to calculate the sum of complete response (CR) and partial response (PR) in target lesions.

Descriptive Information[ + expand ][ + ]

Brief TitleAvastin, Fluorouracil, Doxorubicin and Streptozocin in Locally Advanced and Metastatic Pancreatic Endocrine Tumors
Official TitlePhase II Study of Avastin, Fluorouracil, Doxorubicin and Streptozocin in Locally Advanced and Metastatic Pancreatic Endocrine Tumors
Brief Summary
Open label, single-arm phase II study of avastin combined with fluorouracil, doxorubicin and
streptozocin administered in 28-day cycles. Treatment will continue until progression of
disease, or until withdrawal due to toxicity, or up to a maximum of 12 cycles (48 weeks). In
order to reduce the risk of cardiac toxicity, doxorubicin will be administered for a maximum
of 8 cycles. If disease has not progressed after 12 cycles of treatment, avastin monotherapy
will continue until disease progression or withdrawal due to toxicity.
Detailed Description
Patients will need to come for 24 study visits in all. Most study visits will take about 2
hours. At some of these study visits, the doctor

- Will do a physical exam

- Will take blood for routine lab tests

- Will do a urinalysis

- Will administer study medication Some study visits may be longer because patient will
have a CT scan or an MRI.

At patient's last visit, they will have a CT scan or MRI.

After treatment starts, patient will:

- Have their blood pressure monitored with every dose of Avastin® (about every 2 weeks).

- Have a history and physical with every chemotherapy cycle (about every 4 weeks).

- Have their blood taken for routine blood tests with every chemotherapy cycle (about
every 4 weeks).

- Have a CT scan or MRI during every other cycle (about every 8 weeks).

- Have a MUGA scan during every 4 cycles (about 16 weeks).

- Have blood taken for tumor markers during every cycle only if their markers were high
at baseline.

- Patients will receive study medication to treat their cancer:

- Fluorouracil on days 1 through 5 of each cycle through cycle 12

- Doxorubicin on day 1 of each cycle through cycle 8

- Streptozocin on days 1 through 5 of each cycle through cycle 12

- Avastin® on days 1 and 15 of each cycle through cycle 12
Study TypeInterventional
Study PhasePhase 2
Study DesignAllocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
ConditionPancreatic Cancer
InterventionDrug: Avastin
Every 28 Days: Avastin 5mg/kg iv days 1 and 15
Other Names:
bevacizumabDrug: Fluorouracil
Every 28 Days: Fluorouracil 400mg/m^2 iv bolus daily days 1-5
Other Names:
  • Fluoroplex
  • 5-FU
  • Efudex
Drug: Doxorubicin
Every 28 Days: Doxorubicin 40mg/m^2 iv bolus day 1
Other Names:
Adriamycin®Drug: Streptozocin
Every 28 Days: Streptozocin 400mg/m2 iv bolus daily days 1-5
Other Names:
Zanosar®Drug: Dexamethasone
Premedication: Dexamethasone 20mg intravenously days 1-5
Other Names:
DecadronDrug: Ondansetron
Premedication: Ondansetron 16mg intravenously days 1-5
Other Names:
Zofran
Study Arm (s)Experimental: Protocol Specified Chemotherapy
Protocol Specified Chemotherapy Every 28 Days: Avastin, Fluorouracil, Doxorubicin, Streptozocin.
Premedications: Dexamethasone, Ondansetron

Recruitment Information[ + expand ][ + ]

Recruitment StatusTerminated
Estimated Enrollment1
Estimated Completion DateMarch 2008
Estimated Primary Completion DateMarch 2008
Eligibility Criteria
Inclusion Criteria:

- Patients must have locally advanced (unresectable) or metastatic, well or moderately
differentiated pancreatic endocrine tumors.

- Measurable disease on CT scan or MRI.

- Age ≥ 18 years and ≤ 80 years.

- Use of effective means of contraception (men and women) in subjects of child-bearing
potential

- Adequate renal function (serum creatinine ≤1.5, urine protein:creatinine ratio <1.0
or urine dipstick for proteinuria < 2+ (patients discovered to have ≥ 2+ proteinuria
on dipstick urinalysis at baseline should undergo a 24 hour urine collection and must
demonstrate ≤ 1 g of protein in 24 hours to be eligible).

- Adequate hepatic function (bilirubin ≤2.0, AST and ALT ≤ 3x ULN.

- Adequate hematologic function (WBC ≥ 3,000, ANC ≥ 1500, platelets ≥ 100,000)

Exclusion Criteria:

- Prior therapy with fluorouracil, doxorubicin, streptozocin or avastin

- Ejection fraction on MUGA <50%

- ECOG performance status > 2

- Current, recent (within 4 weeks of the first infusion of this study), or planned
participation in an experimental drug study other than a Genentech-sponsored avastin
cancer study

- Inadequately controlled hypertension (defined as systolic blood pressure >150 and/or
diastolic blood pressure > 100 mmHg on antihypertensive medications)

- Any prior history of hypertensive crisis or hypertensive encephalopathy

- Unstable angina

- New York Heart Association (NYHA) Grade II or greater congestive heart failure

- History of myocardial infarction or unstable angina within 6 months prior to study
enrollment

- History of stroke or transient ischemic attack within 6 months prior to study
enrollment

- Significant vascular disease (e.g., aortic aneurysm, aortic dissection)

- Symptomatic peripheral vascular disease

- Evidence of bleeding diathesis or coagulopathy

- Presence of central nervous system or brain metastases

- Major surgical procedure, open biopsy, or significant traumatic injury within 28 days
prior to Day 0, anticipation of need for major surgical procedure during the course
of the study

- Core biopsy or other minor surgical procedure, excluding placement of a vascular
access device, within 7 days prior to study enrollment

- Pregnant (positive pregnancy test) or lactating. Use of effective means of
contraception (men and women) in subjects of child-bearing potential

- Proteinuria at screening as demonstrated by either

- Urine protein: creatinine (UPC) ratio ≥ 1.0 at screening OR

- Urine dipstick for proteinuria ≥ 2+ (patients discovered to have ≥2+ proteinuria
on dipstick urinalysis at baseline should undergo a 24 hour urine collection and
must demonstrate ≤ 1g of protein in 24 hours to be eligible).

- History of abdominal fistula, gastrointestinal perforation, or intra-abdominal
abscess within 6 months prior to Day 0

- Evidence of duodenal invasion on CT scan, MRI, or endoscopy

- Known hypersensitivity to any component of avastin

- Serious, non-healing wound, ulcer, or bone fracture

- Inability to comply with study and/or follow-up procedures
GenderBoth
Ages18 Years
Accepts Healthy VolunteersNo
ContactsNot Provided
Location CountriesUnited States

Administrative Information[ + expand ][ + ]

NCT Number NCT00609765
Other Study ID NumbersMCC-14961
Has Data Monitoring CommitteeYes
Information Provided ByH. Lee Moffitt Cancer Center and Research Institute
Study SponsorH. Lee Moffitt Cancer Center and Research Institute
CollaboratorsGenentech
Investigators Principal Investigator: Larry Kvols, M.D. H. Lee Moffitt Cancer Center and Research InstitutePrincipal Investigator: Jonathan Strosberg, M.D. H. Lee Moffitt Cancer Center and Research Institute
Verification DateMarch 2011

Locations[ + expand ][ + ]

H. Lee Moffitt Cancer Center and Research Institute
Tampa, Florida, United States, 33612