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High Dose Ascorbic Acid (AA) + Nanoparticle Paclitaxel Protein Bound + Cisplatin + Gemcitabine (AA NABPLAGEM) in Patients Who Have Metastatic Pancreatic Cancer

Sponsor:
Collaborators:
Information provided by (Responsible Party):
Hitendra Patel,University of California, San Diego
September 21, 2018
October 5, 2018
October 5, 2018
October 2018
October 2021   (Final data collection date for primary outcome measure)
Maximum tolerated dose (MTD)[ Time Frame: 18 weeks ]
To determine the maximum tolerated dose (MTD) of high dose ascorbic acid (AA) with triple therapy of nanoparticle paclitaxel protein bound + cisplatin + gemcitabine (NABPLAGEM) in patients with advanced stage IV metastatic pancreatic cancer

Disease Control Rate[ Time Frame: 18 weeks ]
CR+ PR+SD

Same as current
  • Incidence of Treatment-Emergent Grade 2-5 Adverse Events assessed using NCI CTCAE v4.03 toxicity criteria[ Time Frame: 18 weeks ]
  • Percent of patients who normalize their CA19-9[ Time Frame: 18 weeks ]
  • progression free survival (PFS)[ Time Frame: 18 weeks ]
  • overall survival (OS)[ Time Frame: 18 weeks ]
  • Quality of Life scale[ Time Frame: 18 weeks ]
    MD Anderson Symptom Inventory (MDASI-GI)
  • Pain scale[ Time Frame: 18 weeks ]
    Brief pain inventory (BPI)
 

High Dose Ascorbic Acid (AA) + Nanoparticle Paclitaxel Protein Bound + Cisplatin + Gemcitabine (AA NABPLAGEM) in Patients Who Have Metastatic Pancreatic Cancer

Phase IB/II Trial of High Dose Ascorbic Acid (AA) + Nanoparticle Paclitaxel Protein Bound + Cisplatin + Gemcitabine (AA NABPLAGEM) in Patients Who Have No Prior Therapy for Their Metastatic Pancreatic Cancer

The purpose of this study is to see if a combination of paclitaxel protein bound (also known as nab-paclitaxel), gemcitabine, and cisplatin when given with high dose Ascorbic Acid will be safe and effective in individuals with untreated metastatic pancreatic cancer. Vitamin C is a nutrient found in food and dietary supplements. It protects cells and also plays a key role in making collagen (which provides strength and structure to skin, bones, tissues and tendons). High-dose vitamin C may be given by intravenous (IV) infusion (through a vein into the bloodstream) or orally (taken by mouth). When taken by intravenous infusion, vitamin C can reach much higher levels in the blood than when the same amount is taken by mouth. Some human studies of high-dose IV vitamin C in patients with cancer have shown improved quality of life, as well as improvements in physical, mental, and emotional functions, symptoms of fatigue, nausea and vomiting, pain, and appetite loss. Intravenous high-dose ascorbic acid has caused very few side effects in clinical trials.

Interventional
Phase 1/Phase 2
Allocation:
Intervention Model: Single Group Assignment
Intervention Model Description: Ascorbic Acid Paclitaxel Protein Bound Cisplatin Gemcitabine
Masking: Interventional
Masking Description:
Primary Purpose: Treatment
  • Drug: Ascorbic Acid
    25, 37.5, 56.25 or 75 grams/m2
  • Drug: Paclitaxel protein-bound
    125mg/m2 over 30 minute IV infusions on days 1 and 8 repeated every 21 days
  • Drug: Cisplatin
    25mg/m2 in 500*mL of NS over 60minute IV infusion on days 1 and 8 repeated every 21 days
  • Drug: Gemcitabine
    1000mg/m2 in 500*mL over 30 minute IV infusion on days 1 and 8 repeated every 21 days
  • Experimental: AA NABPLAGEM
    ascorbic acid paclitaxel protein-bound cisplatin gemcitabine
 
Not yet recruiting
24
Same as current
October 2022
October 2021   (Final data collection date for primary outcome measure)
Inclusion Criteria: - Histologically or cytologically confirmed metastatic pancreatic adenocarcinoma (with measurable disease according to RECIST 1.1 criteria). - Adequate organ function Exclusion Criteria: - Patients must have received no previous radiotherapy, surgery, chemotherapy or investigational therapy for the treatment of metastatic disease. Prior treatments in the adjuvant setting with gemcitabine and/or 5-FU or gemcitabine administered as a radiation sensitizer are allowed, provided at least 6 months have elapsed since completion of the last dose - Palliative surgery and/or radiation treatment less than 4 weeks prior to initiation of study treatment. - Exposure to any investigational agent within 4 weeks prior to initiation of study treatment. - Patients who need constant use of finger stick blood glucose monitoring for tight control of their diabetes - Any person with a G6PD deficiency - History of renal oxalate stones - Patient is taking acetaminophen at any dose, or any medication that contains acetaminophen within 72 hours of first dose of ascorbic acid. - Has a known additional malignancy that is progressing or requires active treatment. Exceptions include basal cell carcinoma of the skin or squamous cell carcinoma of the skin that has undergone potentially curative therapy or in situ cervical cancer. - Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis. Patients with previously treated brain metastases may participate provided they are stable (without evidence of progression by imaging for at least four weeks prior to the first dose of trial treatment and any neurologic symptoms have returned to baseline), have no evidence of new or enlarging brain metastases, and are not using steroids for at least 7 days prior to trial treatment. This exception does not include carcinomatous meningitis which is excluded regardless of clinical stability. - Is pregnant or breastfeeding - Current, serious, clinically significant cardiac arrhythmias or receiving a digitalis derivative.
Sexes Eligible for Study: All
18 Years and older   (Adult, Older Adult)
No
 
 
Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Plan to Share IPD:
Hitendra Patel,University of California, San Diego
Hitendra Patel
Principal Investigator: Hitendra Patel, MD University of California, San Diego
University of California, San Diego
October 2018

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP
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