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| ID | Type | Description | Link |
|---|---|---|---|
| P30CA068485 | U.S. NIH Grant/Contract | View source | |
| VU-VICC-GI-0815 |
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| Name | Class |
|---|---|
| National Cancer Institute (NCI) | NIH |
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RATIONALE: Sorafenib and erlotinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Sorafenib may also stop the growth of tumor cells by blocking blood flow to the tumor. Giving sorafenib together with erlotinib may kill more tumor cells.
PURPOSE: This phase II trial is studying how well giving sorafenib together with erlotinib works in treating patients with pancreatic cancer that cannot be removed by surgery.
OBJECTIVES:
Primary
Secondary
OUTLINE: Patients receive oral sorafenib tosylate once or twice daily and oral erlotinib hydrochloride once daily on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
Serum samples are collected at baseline and at 8-week intervals to measure Ca 19-9 levels, and plasma and buffy coat samples are collected at baseline and at week 8 for proteomic assessment and genotyping of single-nucleotide polymorphisms associated with response and toxicity to erlotinib hydrochloride.
After completion of study treatment, patients are followed up every 3 months.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Treatment | Experimental | Sorafenib + Erlotinib |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Sorafenib | Drug | 400 mg taken by mouth 1 time per day. |
| |
| Erlotinb |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Patients With Progression-free Survival | Number of patients with progression-free survival at 8 weeks | at 8 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Response Rate | Per RECIST criteria v. 1.0: measurable lesions: CR disappearance of target lesions, PR > 30% decrease in the sum of the longest diameter (LD) of target lesions, PD > 20% increase in the sum of the LD of target lesions or appearance of new lesions, SD neither sufficient decrease nor increase of the sum of smallest sum of the LD of target lesions | at 4 months |
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DISEASE CHARACTERISTICS:
Microscopically confirmed diagnosis of pancreatic adenocarcinoma
Measurable or evaluable disease by RECIST criteria
No known brain metastases
PATIENT CHARACTERISTICS:
ECOG performance status 0-2
ANC ≥ 1,500/mm^3
Platelet count ≥ 100,000/mm^3
Total bilirubin ≤ 1.5 times upper limit of normal (ULN)
ALT and AST ≤ 2.5 times ULN (≤ 5 times ULN for patients with liver involvement)
Creatinine ≤ 1.5 times ULN
INR < 1.5 or PT/PTT normal unless patients are receiving anticoagulation treatments
Negative pregnancy test
Not pregnant or nursing
Fertile patients must use effective barrier contraception before, during, and for at least 6 months after completion of study treatment
Able to swallow whole pills
No patients who currently smoke
No cardiac disease, including any of the following:
No uncontrolled hypertension defined as systolic BP > 150 mm Hg or diastolic BP > 90 mm Hg despite optimal medical management
No arterial thrombotic or embolic events (e.g., cerebrovascular accident, including transient ischemic attacks) within the past 6 months
No pulmonary hemorrhage/bleeding event ≥ CTCAE grade 2 in the past 4 weeks
No other hemorrhage/bleeding event ≥ CTCAE grade 3 in the past 4 weeks
No significant traumatic injury in the past 4 weeks
No known untreated malabsorption problem (e.g., ulcerative colitis, Crohn's disease)
No known HIV positivity or chronic hepatitis B or C
No known or suspected allergy to sorafenib tosylate or erlotinib hydrochloride
No active clinically serious infection > CTCAE grade 2
No serious non-healing wound, ulcer, or bone fracture
No evidence or history of bleeding diathesis or coagulopathy (except for cancer-related blood clots)
No dermatitis ≥ CTCAE grade 2 at baseline
No patients who currently smoke
PRIOR CONCURRENT THERAPY:
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| Name | Affiliation | Role |
|---|---|---|
| Jordan D. Berlin, MD | Vanderbilt-Ingram Cancer Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Purchase Cancer Group - Paducah | Paducah | Kentucky | 42002 | United States | ||
| Erlanger Cancer Center at Erlanger Hospital - Baroness |
37 patients consented and went on study. Six patients were ineligible.
This study enrolled patients from October 2008 until February 2011.
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| ID | Title | Description |
|---|---|---|
| FG000 | Treatment | Sorafenib + Erlotinib |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Treatment | Sorafenib + Erlotinib |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Number of Patients With Progression-free Survival | Number of patients with progression-free survival at 8 weeks | Patients who received treatment for >= 8 weeks. 14 study patients were treated for < 8 weeks due to toxicity (5), disease progression (5), did not receive study drug (1), respiratory failure (1), drug held more than 28 days (1), patient withdrawal (1). The remaining 13 participants did not have a progression-free survival at 8 weeks. | Posted | Number | participants | at 8 weeks |
|
|
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Treatment | Sorafenib + Erlotinib |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| nausea | Gastrointestinal disorders |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| diarrhea | Gastrointestinal disorders |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Jordan Berlin, MD | Vanderbilt-Ingram Cancer Center | 615-343-4128 | jordan.berlin@vanderbilt.edu |
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| ID | Term |
|---|---|
| D010190 | Pancreatic Neoplasms |
| ID | Term |
|---|---|
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D004701 | Endocrine Gland Neoplasms |
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| ID | Term |
|---|---|
| D000077157 | Sorafenib |
| ID | Term |
|---|---|
| D010671 | Phenylurea Compounds |
| D014508 | Urea |
| D000577 | Amides |
| D009930 | Organic Chemicals |
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| Drug |
150 mg taken by mouth 1 time per day. |
|
| Number of Patients With Progression-free Survival | Participants with progression-free survival at 4 months. | at 4 months |
| Number of Patients With Worst Grade Toxicities | Number of patients with worst-grade toxicity at each of five grades (grade 1 to 5, with 5 most severe) following NCI Common Toxicity Criteria: 1 = mild, 2 = moderate, 3 = severe, 4 = life-threatening, disabling, 5 = death. | every 4 weeks and every 8 weeks in follow-up to resolution of toxicity |
| Chattanooga |
| Tennessee |
| 37403 |
| United States |
| Baptist Regional Cancer Center at Baptist Riverside | Knoxville | Tennessee | 37901 | United States |
| Vanderbilt-Ingram Cancer Center - Cool Springs | Nashville | Tennessee | 37064 | United States |
| Vanderbilt-Ingram Cancer Center at Franklin | Nashville | Tennessee | 37064 | United States |
| Vanderbilt-Ingram Cancer Center | Nashville | Tennessee | 37232-6838 | United States |
| Withdrawal by Subject |
|
| disease progression |
|
| Participants |
|
| Age, Continuous | Mean | Standard Deviation | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| Participants |
|
|
| Secondary | Response Rate | Per RECIST criteria v. 1.0: measurable lesions: CR disappearance of target lesions, PR > 30% decrease in the sum of the longest diameter (LD) of target lesions, PD > 20% increase in the sum of the LD of target lesions or appearance of new lesions, SD neither sufficient decrease nor increase of the sum of smallest sum of the LD of target lesions | Participants who received treatment for 4 or more months. The remaining 10 participants received treatment for less than 4 months and were not evaluable. | Posted | Number | participants | at 4 months |
|
|
|
| Secondary | Number of Patients With Progression-free Survival | Participants with progression-free survival at 4 months. | Patients with progression-free survival at 4 months. The remaining 17 patients were not available for evaluation at 4 months due to toxicity (5), disease progression (5), patient withdrawal (1),respiratory failure (1), study drug held more than 28 days (1), and no study drug (1. | Posted | Number | participants | at 4 months |
|
|
|
| Secondary | Number of Patients With Worst Grade Toxicities | Number of patients with worst-grade toxicity at each of five grades (grade 1 to 5, with 5 most severe) following NCI Common Toxicity Criteria: 1 = mild, 2 = moderate, 3 = severe, 4 = life-threatening, disabling, 5 = death. | All patients who received treatment with the study drugs. One patient did not receive treatment. | Posted | Number | participants | every 4 weeks and every 8 weeks in follow-up to resolution of toxicity |
|
|
|
| 27 |
| 37 |
| 36 |
| 37 |
| vomiting | Gastrointestinal disorders |
|
| acidosis | Metabolism and nutrition disorders |
|
| hyperglycemia | Metabolism and nutrition disorders |
|
| constipation | Gastrointestinal disorders |
|
| dehydration | Gastrointestinal disorders |
|
| Pain, NOS | General disorders |
|
| dyspnea | Respiratory, thoracic and mediastinal disorders |
|
| death - NOS | General disorders |
|
| skin rash | Skin and subcutaneous tissue disorders |
|
| infection with unknown ANC, artery | Infections and infestations |
|
| bladder infection | Infections and infestations |
|
| infection, normal ANC | Infections and infestations |
|
| infection, Hickman catheter | Infections and infestations |
|
| hyperbilirubinemia | Metabolism and nutrition disorders |
|
| hemoglobin | Investigations |
|
| fatigue | General disorders |
|
| hyponatremia | Metabolism and nutrition disorders |
|
| confusion | Psychiatric disorders |
|
| calcium, serum-low-hypocalcemia | Metabolism and nutrition disorders |
|
| hypokalemia | Metabolism and nutrition disorders |
|
| pain in abdomen | Gastrointestinal disorders |
|
| diarrhea | Gastrointestinal disorders |
|
| enteritis | Gastrointestinal disorders |
|
| hypocalcemia | Pregnancy, puerperium and perinatal conditions |
|
| hypochloremia | Metabolism and nutrition disorders |
|
| thrombosis | Vascular disorders |
|
| hemorrhage, GI | Gastrointestinal disorders |
|
| fever | General disorders |
|
| pain, right upper quadrant | General disorders |
|
| infection with unknown ANC, blood | Infections and infestations |
|
| infection with unknown ANC, wound | Infections and infestations |
|
| AST, SGOT | Metabolism and nutrition disorders |
|
| alkaline phosphatase | Metabolism and nutrition disorders |
|
| obstruction, GI | Gastrointestinal disorders |
|
| infection with unknown ANC, lung | Infections and infestations |
|
| cardiac ischemia/infarction | Cardiac disorders |
|
| pain in back | Musculoskeletal and connective tissue disorders |
|
| distension, abdominal | Gastrointestinal disorders |
|
| pulmonary, upper respiratory | Respiratory, thoracic and mediastinal disorders |
|
| pain in stomach | Gastrointestinal disorders |
|
| edema, limb | General disorders |
|
| ammonia level increase | Metabolism and nutrition disorders |
|
| appendicitis | Infections and infestations |
|
| deep vein thrombosis | Vascular disorders |
|
| nausea | Gastrointestinal disorders |
|
| anorexia | Metabolism and nutrition disorders |
|
| vomiting | Gastrointestinal disorders |
|
| dehydration | Gastrointestinal disorders |
|
| mucositis/stomatitis | Gastrointestinal disorders |
|
| constipation | Gastrointestinal disorders |
|
| flatulence | Gastrointestinal disorders |
|
| heartburn/dyspepsia | Gastrointestinal disorders |
|
| fatigue | General disorders |
|
| weight loss | Metabolism and nutrition disorders |
|
| hyperglycemia | Metabolism and nutrition disorders |
|
| alkaline phosphatase | Investigations |
|
| AST, SGOT | Metabolism and nutrition disorders |
|
| ALT, SGPT | Metabolism and nutrition disorders |
|
| hyponatremia-sodium, low | Metabolism and nutrition disorders |
|
| hypokalemia | Metabolism and nutrition disorders |
|
| hyperbilirubinemia | Metabolism and nutrition disorders |
|
| hypocalcemia | Metabolism and nutrition disorders |
|
| hypomagnesemia | Metabolism and nutrition disorders |
|
| hypophosphatemia | Metabolism and nutrition disorders |
|
| hypermagnesemia | Metabolism and nutrition disorders |
|
| hemoglobin | Investigations |
|
| lymphopenia | Investigations |
|
| platelets | Investigations |
|
| leukocytes | Metabolism and nutrition disorders |
|
| rash-acne/acneiform | Skin and subcutaneous tissue disorders |
|
| dry skin | Skin and subcutaneous tissue disorders |
|
| rash-hand-foot skin reaction | Skin and subcutaneous tissue disorders |
|
| pain, abdomen NOS | Gastrointestinal disorders |
|
| pain, back | Musculoskeletal and connective tissue disorders |
|
| pain, headaches | Nervous system disorders |
|
| dysarthria/voice changes | Nervous system disorders |
|
| dyspnea | Respiratory, thoracic and mediastinal disorders |
|
| cough | Respiratory, thoracic and mediastinal disorders |
|
| confusion | Respiratory, thoracic and mediastinal disorders |
|
| depression | Psychiatric disorders |
|
| Neuropathy-sensory | Nervous system disorders |
|
| edema limb | General disorders |
|
| constitutional symptoms, other | General disorders |
|
| albumin, serum-low | Metabolism and nutrition disorders |
|
| glucose, serum-high-hyperglycemia | Metabolism and nutrition disorders |
|
| Taste alteration | Gastrointestinal disorders |
|
| fever (in the absence of neutropenia , where neutropenia is defined as ANC<1.0 x 10e9/L) | Infections and infestations |
|
| Insomnia | Nervous system disorders |
|
| sweating | Skin and subcutaneous tissue disorders |
|
| Metabolic/Laboratory, other | Metabolism and nutrition disorders |
|
| dermatology/Skin, other | Skin and subcutaneous tissue disorders |
|
| Pruritis, itching | Skin and subcutaneous tissue disorders |
|
| Pain-chest/thorax | Respiratory, thoracic and mediastinal disorders |
|
| Pain-sinus | Respiratory, thoracic and mediastinal disorders |
|
| pain-throat/pharynx/larynx | Respiratory, thoracic and mediastinal disorders |
|
| Pulmonary/Upper Respiratory, other | Respiratory, thoracic and mediastinal disorders |
|
| Tremor | Nervous system disorders |
|
| Hypertension | Cardiac disorders |
|
| Infection-other | Infections and infestations |
|
| Infection with unknown ANC-upper airway NOS | Respiratory, thoracic and mediastinal disorders |
|
| Musculoskeletal/soft tissue-other | Musculoskeletal and connective tissue disorders |
|
| Vascular-other | Vascular disorders |
|
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| D004066 |
| Digestive System Diseases |
| D010182 | Pancreatic Diseases |
| D004700 | Endocrine System Diseases |
| D001555 |
| Benzene Derivatives |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D009536 | Niacinamide |
| D009539 | Nicotinic Acids |
| D000147 | Acids, Heterocyclic |
| D006571 | Heterocyclic Compounds |
| D011725 | Pyridines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| Title | Measurements |
|---|---|
|
| Progressive Disease |
|
|
| number of patients with worst grade toxicity - 4 |
|
| number of patients with worst grade toxicity - 5 |
|