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The investigators hypothesize that intensification of local therapy will lead to improvements in local control and survival in patients with unresectable and borderline resectable pancreatic cancer. We propose to do this by combining nab-paclitaxel concurrently with dose-escalated radiation therapy. In the first part of this phase I study (sub-trial 1), the nab-paclitaxel dose will be escalated while the radiation dose is held constant at a standardly accepted level. The use of this novel chemoradiotherapy regimen will take advantage of nab-paclitaxel's specific anti-tumor and anti-stromal properties, which may enhance the efficacy of radiation therapy, and thereby improve local control. After the MTD of nab-paclitaxel had been determined, a second arm in sub-trial 1 will evaluate the addition of paricalcitol to nab-paclitaxel concurrently with dose-escalated radiation therapy. In addition, after the MTD of the nab-paclitaxel is reached in sub-trial 1 arm A, in the second part of this study (sub-trial 2), we will administer nab-paclitaxel at the determined MTD concurrently with escalated doses of radiation. We will utilize IMRT or protons to safely deliver high doses of radiation while maximally sparing surrounding normal tissue. Patients will also preferentially have 2-3 fiducial markers placed in or around the tumor for daily localization. Chemotherapy before and/or after chemoradiotherapy may be given as per standard of care. Correlative tissue and serum biomarkers are an important, but optional, part of this study.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Subtrial 1-Arm A (Dose Level 1 of Abraxane) | Experimental | Determine if it is safe or not (via occurrence of dose limiting toxicities) for patients to receive both Abraxane and radiation therapy. |
|
| Subtrial 1-Arm B (Dose Level 2 of Abraxane: 3+4 enrollment) | Experimental | Determine the maximum dose of Abraxane that is allowable and safe for patients receiving both Abraxane and radiation therapy. |
|
| Subtrial 2- Abraxane 125mg; Borderline get 55cGY, unresectable get 57.5cGY until next escalation | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Radiotherapy | Radiation |
|
| Measure | Description | Time Frame |
|---|---|---|
| Number of Adverse Events | 4 years |
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Inclusion Criteria:
Unresectable
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Edgar Ben-Josef, MD | Abramson Cancer Center at Penn Medicine | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Abramson Cancer Center of the University of Pennsylvania | Philadelphia | Pennsylvania | 19104 | United States | ||
| Type | Date | Date Unknown |
|---|---|---|
| Release | Mar 20, 2026 | |
| Reset | Apr 8, 2026 | |
| Release | May 13, 2026 |
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| Abraxane | Drug | Dose varies within subtrial 1 to determine maximum dose. All patients in subtrial 2 receive 125mg Abraxane |
|
|
| Chester County Hospital |
| West Chester |
| Pennsylvania |
| 19380 |
| United States |
| Reset | Jun 8, 2026 |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| Mar 20, 2026 | Apr 8, 2026 | |||
| May 13, 2026 | Jun 8, 2026 |
| ID | Term |
|---|---|
| D011878 | Radiotherapy |
| D000068196 | Albumin-Bound Paclitaxel |
| C520255 | 130-nm albumin-bound paclitaxel |
| ID | Term |
|---|---|
| D013812 | Therapeutics |
| D017239 | Paclitaxel |
| D043823 | Taxoids |
| D043822 | Cyclodecanes |
| D003516 | Cycloparaffins |
| D006840 | Hydrocarbons, Alicyclic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D009930 | Organic Chemicals |
| D004224 | Diterpenes |
| D013729 | Terpenes |
| D000418 | Albumins |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
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