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Sponsored by: |
The University of Texas Health Science Center, Houston |
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Information provided by: | The University of Texas Health Science Center, Houston |
ClinicalTrials.gov Identifier: | NCT00178763 |
Thermal therapy/hyperthermia (heat) can increase the effect of chemotherapy treatments. Thermal therapy by itself can also kill cancer cells. By using fever-range whole-body thermal therapy, cancer cells can be treated wherever they are throughout the entire body. In this study, we are testing a combination of fever-range heat treatment and chemotherapy to document 1) if it improves the effect of the chemotherapy drugs, 2) if it helps the body fight the cancer cells, and 3) if this treatment is safe for the patient. This study does not offer thermal therapy alone. Any patient with measurable, inoperable or metastatic pancreatic cancer may be treated; however, the they will need to undergo specific medical tests to make sure this treatment would be safe for them.
We hypothesize that a combined-modality therapy using fever-range whole-body hyperthermia (FR-WBH; temperature = 40 o C; duration = 6 h), administered in an optimized time/sequence schedule with cisplatin, gemcitabine HCl (gemcitabine), and metronomically administered, low-dose interferon-alpha (IFN-alpha) to patients with inoperable or metastatic pancreas cancer, will, without inducing intolerable toxicity: 1.) decrease the pancreatic cancer size; 2.) improve quality of life; 3.) enhance the immune response against the cancer; 4.) increase survival; and 5.) allow inoperable pancreatic cancer to be converted to operable disease.
Condition | Intervention | Phase |
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Pancreatic Neoplasms |
Device: Heckel Infrared Radiant Heat Device Other: cisplatin, gemcitabine, interferon-alpha Other: thermochemotherapy |
Phase II |
Study Type: | Interventional |
Study Design: | Treatment, Non-Randomized, Open Label, Uncontrolled, Single Group Assignment, Safety/Efficacy Study |
Official Title: | Phase II Clinical Trial of Cisplatin + Gemcitabine in Combination With Mild, Fever-Range Whole-Body Hyperthermia to Treat Patients With Advanced, Inoperable Pancreatic Cancer |
Estimated Enrollment: | 36 |
Study Start Date: | September 2002 |
Estimated Study Completion Date: | June 2011 |
Estimated Primary Completion Date: | June 2010 (Final data collection date for primary outcome measure) |
Arms | Assigned Interventions |
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1: Experimental
All protocol subjects are treated with fever-range whole-body thermal therapy combined in an optimized schedule with cisplatin + gemcitabine + metronomic low-dose interferon-alpha
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Device: Heckel Infrared Radiant Heat Device
thermotherapy, maintain a core temperature of 40 degrees centigrade for 6 hours duration
Other: cisplatin, gemcitabine, interferon-alpha
cisplatin 60 mg/m2 administered over 3 hours intravenously 36 hours before heat. gemcitabine 600 mg/m2 administered intravenously over 1 hour during 40 degree heat. interferon-alpha 1 million international units subcutaneously daily during protocol.
Other: thermochemotherapy
fever-range whole-body thermal therapy to 40 degrees centigrade combined with cisplatin 60 mg/m2 + gemcitabine 600 mg/m2 + daily interferon alpha 1 million units.
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Once you are accepted for this study, you will need to have a central venous line (CV line or port) inserted if you do not already have one. (This may have this done by your own physician, or we would be happy to help you with this procedure).
The treatment cycle begins with 6 hours of intravenous (IV) hydration followed by an infusion of the anti-cancer drug, Cisplatin. In addition, at the beginning of this treatment, you will begin low-dose Interferon-alpha injections, once a day, for the entire duration of your participation in this study. The drug, Interferon-alpha, interrupts the division of cancer cells, destroys tumor blood vessels, and slows tumor growth.
Forty-eight hours after the Cisplatin infusion, you will be treated with fever-range thermal therapy (whole-body hyperthermia, or heat). When your core body temperature reaches 104oF (40oC), a 30-minute (IV) infusion of another chemotherapy drug, Gemcitabine (gemzar) is given. Cisplatin, low-dose Interferon-a and Gemcitabine are the only chemotherapy drugs used in this treatment plan. No other chemotherapy drugs are allowed to be given under this treatment plan.
The fever-range whole-body heat treatment is carried out while you are lightly sedated. With this sedation, you will be awake during the treatment but you will not be uncomfortable. This sedation is used to reduce any discomfort of the 6-hour heat treatment procedure yet will allow you to speak to your nurses.
Your body temperature is raised to 104oF (40oC) over a period of 60-120 minutes. When the body first reaches the target 104oF, we administer the Gemcitabine chemotherapy over 60 minutes and continue to maintain the 104 oF body temperature for six hours. At the conclusion of the six hours of thermal treatment, you will be cooled to your normal body temperature, which takes about 30-45 minutes. The entire treatment lasts approximately 8 hours. After the treatment is completed, we will observe you for 2 to 12 hours to make sure you have tolerated the treatment without a problem.
You will continue the daily low-dose Interferon-alpha. Additionally, you will be given daily Leukine (sargramostim) cytokine injections usually beginning 3-5 days after receiving chemotherapy to help support the immune system by helping the body create more white blood cells. White blood cells are important to help your body fight infection.
After treatment, you will need a complete blood count with platelet and differential count each week. These lab studies can be done at your own doctor's office or hospital as long as you make sure that the results are faxed to us. They can also be done in our clinic. We will see you again in approximately three to four weeks and the treatment cycle will be repeated.
We always attempt to perform at least two thermo-chemotherapy cycles. After the second treatment, CT and/or MRI scans are repeated to see if your cancer is smaller. These scans, along with a physical examination and the lab studies, are used to determine if additional heat treatments will be performed. Additional treatments continue based on how well you respond to the treatment. There is no limit to the number of heat treatments a patient may have.
Ages Eligible for Study: | 18 Years and older |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Exclusion Criteria:
Contact: Joan M Bull, M.D. | 713-500-6820 | Joan.M.Bull@uth.tmc.edu |
Contact: Esperanza N. Fernandez | 713-500-6774 | Esperanza.N.Fernandez@uth.tmc.edu |
United States, Texas | |
Memorial Hermann Hospital | Recruiting |
Houston, Texas, United States, 77030 | |
Contact: Joan M Bull, M.D. 713-500-6815 Joan.M.Bull@uth.tmc.edu | |
Contact: Esperanza N. Fernandez, N/D 713-500-6774 Esperanza.N.Fernandez@uth.tmc.edu | |
Principal Investigator: Joan M. Bull, M.D. |
Principal Investigator: | Joan M Bull, M.D. | The University of Texas Health Science Center, Houston |
Responsible Party: | The University of Texas Health Science Center, Houston ( Joan M.C Bull, M.D. ) |
Study ID Numbers: | HSC-MS-02-117 |
Study First Received: | September 13, 2005 |
Last Updated: | December 16, 2008 |
ClinicalTrials.gov Identifier: | NCT00178763 |
Health Authority: | United States: Institutional Review Board |
Cancer Pancreatic Cancer Pancreas Neoplasms |
Interferon-alpha Interferon Type I, Recombinant Digestive System Neoplasms Pancreatic Neoplasms Interferons Benzocaine Endocrine System Diseases Pancrelipase Fever |
Digestive System Diseases Cisplatin Gastrointestinal Neoplasms Pancreatic Diseases Endocrinopathy Gemcitabine Interferon Alfa-2a Endocrine Gland Neoplasms |
Antimetabolites Anti-Infective Agents Antimetabolites, Antineoplastic Molecular Mechanisms of Pharmacological Action Immunologic Factors Antineoplastic Agents Growth Substances Physiological Effects of Drugs Enzyme Inhibitors Immunosuppressive Agents |
Antiviral Agents Angiogenesis Inhibitors Pharmacologic Actions Neoplasms Neoplasms by Site Radiation-Sensitizing Agents Therapeutic Uses Angiogenesis Modulating Agents Growth Inhibitors |