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NCT01926197

Phase 3 Study of FOLFIRINOX (mFFX) +/- SBRT in Locally Advanced Pancreatic Cancer

Completed Phase 3 Results posted Last updated 28 October 2022
What this trial tests

Phase 3 trial testing Oxaliplatin in Pancreatic Cancer in 27 participants. Completed in 30 September 2022.

Timeline
14 August 2013
Primary endpoint
30 September 2021
30 September 2022

Quick facts

Lead sponsorStanford University
PhasePhase 3
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingnone
Primary purposetreatment
Enrollment27
Start date14 August 2013
Primary completion30 September 2021
Estimated completion30 September 2022
Sites9 locations across Canada, United States

Drugs / interventions tested

Conditions studied

Sponsor

Stanford University

Who can join

18 and older, any sex, with Pancreatic Cancer. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Progression-free Survival (PFS) Primary · 38 months

Progression-free survival (PFS) means the period of time that a participant remains alive without tumor progression either locally or at a distant site in the body (metastasis). The effect of the study treatments was assessed as the median PFS of participants in the treatment groups. The outcome is reported as the median PFS with standard deviation.

GroupValue95% CI
Modified FOLFIRINOX6.5± 6.6
Modified FOLFIRINOX Plus Stereotactic Body Radiotherapy8.4± 9.5
Local Progression-free Survival (Local PFS) Secondary · 38 months

Local progression-free survival (PFS) means the period of time that a participant remains alive without recurrence or advancement of the disease at the baseline sites of the tumor (local progression). The effect of the study treatments was assessed as the median local PFS of participants in the treatment groups. The outcome is reported as the median local PFS with standard deviation.

GroupValue95% CI
Modified FOLFIRINOX6.5± 6.6
Modified FOLFIRINOX Plus Stereotactic Body Radiotherapy8.4± 10.5
Progression-free Survival (PFS) at 1 Year Secondary · 1 year

Progression-free survival (PFS) means the period of time that a participant remains alive without tumor progression either locally or at a distant site in the body (metastasis). The effect of the study treatments was assessed as the number of participants in each treatment group that remained alive without tumor progression, at 1 year after treatment. The outcome is reported as a number without dispersion.

GroupValue95% CI
Modified FOLFIRINOX5
Modified FOLFIRINOX Plus Stereotactic Body Radiotherapy2
Metastasis-free Survival (MFS) Secondary · 62 months

Metastasis-free survival (MFS) means the period of time that a participant remains alive without the appearance of new tumor lesions a distant site in the body (metastasis). The effect of the study treatments was assessed as the median MFS of participants in the treatment groups. The outcome is reported as the median PFS with standard deviation.

GroupValue95% CI
Modified FOLFIRINOX12.9± 6.4
Modified FOLFIRINOX Plus Stereotactic Body Radiotherapy10.8± 16.9
Overall Survival (OS) Secondary · 62 months

The effect of the study treatments was assessed as the length of time participants in each treatment group that remained alive. The outcome is reported as the median OS with standard deviation.

GroupValue95% CI
Modified FOLFIRINOX12.9± 6.4
Modified FOLFIRINOX Plus Stereotactic Body Radiotherapy13.4± 16.6
Grade 2 or Greater Gastrointestinal (GI) Toxicity Secondary · 3 months

Toxicity means an adverse event related to the study treatment. Toxicity was assessed between treatment groups as the number of treatment-related , ≥ grade 2 events of gastritis, fistula, enteritis, or ulcer; plus any other Grade 3 to 5 gastrointestinal (GI) toxicity. The outcome is reported as the number of defined adverse events by preferred term for each treatment group, occurring within 3 months of the start of treatment. These adverse events by definition are all within the Common Terminology Criteria for Adverse Events (CTCAE) version 4.01 Gastrointestinal Body System. The outcome is rep

Blood in stool (melena)
GroupValue95% CI
Modified FOLFIRINOX1
Modified FOLFIRINOX Plus Stereotactic Body Radiotherapy0
Colitis
GroupValue95% CI
Modified FOLFIRINOX1
Modified FOLFIRINOX Plus Stereotactic Body Radiotherapy0
Colonic obstruction
GroupValue95% CI
Modified FOLFIRINOX1
Modified FOLFIRINOX Plus Stereotactic Body Radiotherapy0
Diarrhea
GroupValue95% CI
Modified FOLFIRINOX3
Modified FOLFIRINOX Plus Stereotactic Body Radiotherapy0
Duodenal perforation
GroupValue95% CI
Modified FOLFIRINOX0
Modified FOLFIRINOX Plus Stereotactic Body Radiotherapy1
Fistula, anal
GroupValue95% CI
Modified FOLFIRINOX0
Modified FOLFIRINOX Plus Stereotactic Body Radiotherapy3
Fluid in abdomen (ascites)
GroupValue95% CI
Modified FOLFIRINOX0
Modified FOLFIRINOX Plus Stereotactic Body Radiotherapy2
Gastrointestinal bleed (hemorrhage)
GroupValue95% CI
Modified FOLFIRINOX1
Modified FOLFIRINOX Plus Stereotactic Body Radiotherapy1

Adverse events — posted to ClinicalTrials.gov

Time frame: up to 62 months. Reporting threshold: 0%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Modified FOLFIRINOX
Serious: 5/12 (42%)
Deaths: 7/12
Modified FOLFIRINOX Plus Stereotactic Body Radiotherapy
Serious: 7/13 (54%)
Deaths: 8/13

Serious adverse events (10 terms)

ReactionSystemModified FOLFIRINOXModified FOLFIRINOX Plus S…
Bleed (hemorrhage), gastrointestinal upperGastrointestinal disorders
Other, hemoglobin decreasedBlood and lymphatic system disorders
Pain, abdominalGastrointestinal disorders
DiarrheaGastrointestinal disorders
Bleed (hemorrhage), gastrointestinalGastrointestinal disorders
NauseaGastrointestinal disorders
Pain, intractable (due to disease progression)General disorders
Lung infection - Klebsiella pneumoniaInfections and infestations
SepsisInfections and infestations
Other, renal failureRenal and urinary disorders
Other adverse events (163 terms — click to expand)

ReactionSystemModified FOLFIRINOXModified FOLFIRINOX Plus S…
FatigueGeneral disorders
Aspartate aminotransferase increasedInvestigations
AnemiaBlood and lymphatic system disorders
DiarrheaGastrointestinal disorders
Platelet count decreasedInvestigations
NauseaGastrointestinal disorders
Pain, abdominalGastrointestinal disorders
Alkaline phosphatase increasedInvestigations
Weight lossInvestigations
HyperglycemiaMetabolism and nutrition disorders
HypoalbuminemiaMetabolism and nutrition disorders
Lymphocyte count decreasedInvestigations
Decreased appetite (anorexia)Metabolism and nutrition disorders
Nerve damage or injury (neuropathy)Nervous system disorders
HypertensionVascular disorders
White blood cell (WBC) count elevated (leukocytosis)Blood and lymphatic system disorders
ConstipationGastrointestinal disorders
HypokalemiaMetabolism and nutrition disorders
Alanine aminotransferase increasedInvestigations
White blood cell decreasedInvestigations
HypocalcemiaMetabolism and nutrition disorders
HyponatremiaMetabolism and nutrition disorders
PainGeneral disorders
BloatingGastrointestinal disorders
VomitingGastrointestinal disorders
Edema, peripheralGeneral disorders
HiccupsRespiratory, thoracic and mediastinal disorders
Indigestion (dyspepsia)Gastrointestinal disorders
Oral inflammation (mucositis)Gastrointestinal disorders
ChillsGeneral disorders
Lymphocyte count increasedInvestigations
Neutrophil count decreasedInvestigations
Pain, backMusculoskeletal and connective tissue disorders
Bad taste in mouth (dysgeusia)Nervous system disorders
DizzinessNervous system disorders
Nerve damage or injury (neuropathy), peripheralNervous system disorders
AnxietyPsychiatric disorders
DepressionPsychiatric disorders
Labored breathing (dyspnea)Respiratory, thoracic and mediastinal disorders
Ringing in the ears (tinnitus)Ear and labyrinth disorders

Most-reported serious reactions: Bleed (hemorrhage), gastrointestinal upper, Other, hemoglobin decreased, Pain, abdominal, Diarrhea, Bleed (hemorrhage), gastrointestinal, Nausea, Pain, intractable (due to disease progression), Lung infection - Klebsiella pneumonia.

Data from ClinicalTrials.gov NCT01926197 adverse events section.

Sponsor's own description

The goal of this study is to determine the safety and efficacy of a chemotherapy regimen known as Modified FOLFIRINOX (mFFX) alone or with the addition of Stereotactic Body Radiotherapy (SBRT). We hope to learn if this new treatment combination helps to control the disease and improve survival for patients with locally advanced pancreatic cancer.

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Multidisciplinary standards of care and recent progress in pancreatic ductal adenocarcinoma.
    Grossberg AJ, Chu LC, Deig CR, Fishman EK, et al · · 2020 · cited 368× · PMID 32683683 · DOI 10.3322/caac.21626
  2. Trial Watch: Chemotherapy with immunogenic cell death inducers.
    Vacchelli E, Aranda F, Eggermont A, Galon J, et al · · 2014 · cited 123× · PMID 24800173 · DOI 10.4161/onci.27878
  3. Locally Advanced Pancreatic Cancer: Work-Up, Staging, and Local Intervention Strategies.
    van Veldhuisen E, van den Oord C, Brada LJ, Walma MS, et al · · 2019 · cited 62× · PMID 31336859 · DOI 10.3390/cancers11070976
  4. Locally Advanced Pancreatic Cancer: A Review of Local Ablative Therapies.
    Ruarus A, Vroomen L, Puijk R, Scheffer H, et al · · 2018 · cited 55× · PMID 29320420 · DOI 10.3390/cancers10010016
  5. Current status on the place of FOLFIRINOX in metastatic pancreatic cancer and future directions.
    Lambert A, Gavoille C, Conroy T. · · 2017 · cited 40× · PMID 28835777 · DOI 10.1177/1756283x17713879
  6. A comprehensive analysis of clinical trials in pancreatic cancer: what is coming down the pike?
    Katayama ES, Hue JJ, Bajor DL, Ocuin LM, et al · · 2020 · cited 39× · PMID 33014285 · DOI 10.18632/oncotarget.27727
  7. Neoadjuvant Treatment in Locally Advanced Pancreatic Cancer (LAPC) Patients with FOLFIRINOX or Gemcitabine NabPaclitaxel: A Single-Center Experience and a Literature Review.
    Napolitano F, Formisano L, Giardino A, Girelli R, et al · · 2019 · cited 31× · PMID 31337045 · DOI 10.3390/cancers11070981
  8. Novel approaches in the management of pancreatic ductal adenocarcinoma: potential promises for the future.
    Goel G, Sun W. · · 2015 · cited 31× · PMID 25935754 · DOI 10.1186/s13045-015-0141-5

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Trials by the same sponsor.

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