NCT03524508 · CITED IN SOURCE DOCUMENTS

Nal-IRI(Nanoliposomal Irinotecan) Plus 5-FU/LV in Metastatic Biliary Tract Cancer

An NCI or FDA source cites this study. A citation does not establish that it applies to an individual diagnosis.

Phase: PHASE2
Status at capture: COMPLETED
Registry last update: 2022-08-24

The purpose of this study is to evaluate the efficacy and safety of combination of fluorouracil/folinic acid and liposomal irinotecan(Onivyde) compared with fluoruracil/folinic acid in patients with metastatic biliary tract cancer which progressed on 1st line gemcitabine/cisplatin.

Open the original ClinicalTrials.gov record → · Download preserved record

What did the study report?

Outcomes, safety and baseline populations are separate source sections. Quality-of-life measures appear under their original outcome titles.

No posted result sections were captured. Registered plans do not establish that a treatment works.

Who could take part

eligibility Criteria: Inclusion Criteria: 1. Signed and written informed consent form 2. ≥ 19 years of age 3. Histologically or cytologically confirmed cholangiocarcinoma 4. Documented metastatic disease 5. At least one measurable lesion according to the RECIST v1.1 6. Disease progression on gemcitabine-cisplatin combination therapy 7. For patients whose disease recurred after curative resection (R0 or R1), previous adjuvant 5-FU-based chemotherapy is allowed if there is at least 6 month-interval between the last dose of adjuvant chemotherapy and recurrence of disease. 8. Adequate hepatic, renal and hematological function AST(Aspartate Aminotransferase), ALT(Alanine Aminotransferase) ≤ 100 IU/L (100 U/L), Cr(Creatinine) ≤ 1.5mg/dL 9. Eastern Cooperative Oncology Group (ECOG) Performance status 0-1 Exclusion Criteria: 1. Serum total bilirubin ≥2 x ULN(upper limit of normal) (biliary drainage is allowed for biliary obstruction) 2. Severe renal impairment (Clcr ≤ 30 ml/min) 3. Inadequate bone marrow reserves as evidenced by: * ANC(Absolute Neutrophile Count) ≤ 1,500 cells/μl; or * Platelet count ≤ 100,000 cells/μl; or * Hemoglobin ≤ 9 g/dL 4. ECOG performance status 2-4 5. Any clinically significant disorder impacting the risk-benefit balance negatively per physician's judgment 6. Any clinically significant gastrointestinal disorder, including hepatic disorders, bleeding, inflammation, occlusion, or diarrhea \> grade 2 7. Severe arterial thromboembolic events (myocardial infarction, unstable angina pectoris, stroke) in last 6 months 8. NYHA(New York Heart Association) Class III or IV congestive heart failure, ventricular arrhythmias or uncontrolled blood pressure. Or known abnormal ECG with clinically significant abnormal findings 9. Active infection or an unexplained fever \>38.5°C (excluding tumor fever), which in the physician's opinion might compromise the patient's health 10. Current use or any use in last two weeks of strong CYP3A-enzyme inducers/inhibitors and/or strong UGT1A inhibitors 11. Known hypersensitivity to any of the components of Onivyde other liposomal irinotecan formulations, irinotecan, fluoropyrimidines, or leucovorin. 12. Breast feeding, known pregnancy, positive serum pregnancy test or unwillingness to use an effective method of contraception, during therapy and for 3 months following the last dose of Onivyde. Females of Childbearing Potential must either agree to use and be able to take effective contraceptive birth control measures (Pearl Index \< 1) or agree to practice complete abstinence from heterosexual intercourse during the course of the study and for at least 3 months after last application of program treatment. A female subject is considered to be of childbearing potential unless she is age ≥ 50 years and naturally amenorrhoeic for ≥ 2 years, or unless she is surgically sterile. Males must agree not to father a child (including not donating sperm) during the course of the trial and for at least 6 months after last administration of study drugs. 13. Previous treatment with combination drug tegafur, gimeracil, and oteracil potassium with seven days before enrollment. 14. Current treatment with Sorivudine. 15. Severe fatigue or bone marrow depression after prior radiotherapy or antineoplastic therapy 16. Pregnancy or women with child-bearing potential or lactating 17. Non-malignant severe co-morbidity 18. Previous second-line anti-cancer therapy (e.g., Tegafur) 19. History of other malignancy with a disease-free interval \<5 years (Registration is permitted if it has minimal impact on prognosis, such as carcinoma in situ and papillary thyroid cancer) 20. History or current eveidence of brain metastasis
healthy Volunteers: false
minimum Age: 19 Years
sex: ALL
std Ages: ADULT
OLDER_ADULT

Treatment arms and interventions

arm Groups

description
Onivyde 70 mg/m2 (90 minutes), dl-LV 400mg/m2 or l-LV 200mg/m2 (30 minutes), 5-FU 2400 mg/m2 (46 hours) IV every 2 weeks.
intervention Names
Drug: Onivyde
Drug: 5-FU/LV
label
5-FU/LV/Onivyde
type
EXPERIMENTAL
description
dl-LV 400mg/m2 or l-LV 200mg/m2 (30 minutes), 5-FU 2400 mg/m2 (46 hours) IV every 2 weeks.
intervention Names
Drug: 5-FU/LV
label
5FU/LV
type
ACTIVE_COMPARATOR

interventions

arm Group Labels
5-FU/LV/Onivyde
description
The recommended dose and regimen of Onivyde is 70 mg/m2 intravenously over 90 minutes, followed by dl-LV 400mg/m2 or l-LV 200mg/m2 intravenously over 30 minutes, followed by 5-FU 2400 mg/m2 intravenously over 46 hours, administered every 2 weeks.
name
Onivyde
other Names
Liposomal irinotecan
type
DRUG
arm Group Labels
5-FU/LV/Onivyde
5FU/LV
description
The recommended dose and regimen of dl-LV 400mg/m2 or l-LV 200mg/m2 intravenously over 30 minutes, followed by 5-FU 2400 mg/m2 intravenously over 46 hours, administered every 2 weeks
name
5-FU/LV
other Names
Fluorouracil/Folinic acid
type
DRUG

Study design

allocation

RANDOMIZED

intervention Model

PARALLEL

masking Info

masking: NONE

primary Purpose

TREATMENT

Enrollment

count: 178
type: ACTUAL

Registered outcome plans (not posted results)

primary Outcomes

description
Progression-free survival is the time from the date of enrollment to the earlier of the date of confirmed progression or death from any cause.
measure
Progression Free Survival by independent central reviewer
time Frame
from the date of enrollment to the earlier of the date of confirmed progression or death from any cause. (assessed up to 36 months)

secondary Outcomes

description
Overall survival is the time from the date of enrollment to death from any cause
measure
Overall Survival
time Frame
from the date of enrollment to death from any cause. (assessed up to 36 months)
description
The response rate is the proportion of eligible patients with measurable lesions with a overall response of CR(Complete Response) or PR(Partial Response)
measure
Response rates determined by the investigator according to the RECIST(Response Evaluation Criteria in Solid Tumors) v1.1
time Frame
from the date of enrollment to end of treatment. (assessed up to 36 months)
description
EORTC-QLQ C-30 questionnaires will be performed at screening visit, at pre-dose (Cycle 1 Day1) of every subsequent cycle, at the end of treatment visit. It is a 30-item questionnaire. It has 4-point scales for the item number 1 to 28. These are coded with the same response categories as items 1 to 28, namely "not at all=1" "a little=2" "quite a bit=3" and "very much=4" It has 7-point scale for question number 29 to 30. These are coded with the same response categories as items 29 to 30, namely "worst=1" to "best=7" Total score will be minimum 30 and maximum 126.
measure
EORTC-QLQ (European Organization for Research and Treatment of Cancer - Quality of life Questionnaire) C30 (version 3.0)
time Frame
from the date of Screening to end of treatment. (assessed up to 36 months)
description
Severity of adverse events will be graded by NCI-CTCAE (National Cancer Institute - Common Terminology Criteria for Adverse Events) v4.03
measure
Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability]
time Frame
from the date of enrollment to 30 days after last treatment. (assessed up to 36 months)
description
Progression-free survival is the time from the date of enrollment to the earlier of the date of confirmed progression or death from any cause.
measure
Progression Free Survival by investigator assessment
time Frame
from the date of enrollment to the earlier of the date of confirmed progression or death from any cause. (assessed up to 36 months)
description
The response rate is the proportion of eligible patients with measurable lesions with a overall response of CR(Complete Response) or PR(Partial Response)
measure
Response rates determined by the independent central reviewer
time Frame
from the date of enrollment to end of treatment. (assessed up to 36 months)

Full study description

brief Summary: The purpose of this study is to evaluate the efficacy and safety of combination of fluorouracil/folinic acid and liposomal irinotecan(Onivyde) compared with fluoruracil/folinic acid in patients with metastatic biliary tract cancer which progressed on 1st line gemcitabine/cisplatin.
detailed Description: This study is a multicenter, open-label, randomized, phase II study comparing the efficacy and safety between fluorouracil/folinic acid plus liposomal irinotecan and fluoruracil/folinic acid monotherapy in patients with metastatic biliary tract cancer which progressed on 1st line gemcitabine/cisplatin. Eligible patients will be included in this study and treated according to the protocol. Study treatment will be continued until disease progression, unacceptable toxicity, or patient's decision/consent withdrawal. Local investigators will determine disease progression, radiologic or clinical deterioration.

Source references

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