Hepatic Arterial Infusion (HAI) With Floxuridine (FUDR) and Dexamethasone (Dex) Combined With Systemic Gemcitabine and Oxaliplatin in Patients With Unresectable Intrahepatic Cholangiocarcinoma (ICC)

Description

The purpose of this study is to use both, liver pump treatment and systemic chemotherapy, to assess the effects this type of treatment has on the patient and the tumor. Liver pump treatment uses a metal pump that is surgically placed in the abdomen and gives chemotherapy directly to the liver. Systemic chemotherapy gives chemotherapy through a vein [intravenously (IV)] and treats the whole body. This type of treatment has been done before and had shown that people with both pump and systemic chemotherapy had improved results. The investigators hope that this combination of treatments improves the response to chemotherapy and reduces the spread of the disease. Another purpose of this study is to learn the clinical importance of a specific type of MRI scan. The investigators would like to see if this type of MRI will help predict the response to the treatment and see if they could help the physician with their treatment plan. These scans will be done at specific time points. The last purpose of this study is to learn more about how the tumor interacts with the chemotherapy. This will be done through a biopsy taken during surgery and blood draws at specific time points.

Study Start Date

May 2013

Estimated Completion Date

May 2017

Interventions

  • Other: Research blood draws
  • Drug: Floxuridine (FUDR)
  • Drug: Gemcitabine
  • Drug: Oxaliplatin
  • Other: MRI
  • Drug: dexamethasone

Specialties

  • Gastroenterology: Biliary System/Pancreas,GI Oncology
  • Oncology: Hepatobiliary/Pancreas,Pharmacology/Therapy,Radiation Oncology
  • Radiology: MRI
  • Pharmacy: Chemotherapy/Oncology

MeSH Terms

  • Cholangiocarcinoma
  • Liver Neoplasms

Study ID

Memorial Sloan-Kettering Cancer Center -- 13-066

Status

Unknown

Trial ID

NCT01862315

Study Type

Interventional

Trial Phase

Phase 2

Enrollment Quota

86

Sponsor

Memorial Sloan-Kettering Cancer Center

Inclusion Criteria

  • Age ? 21 years
  • Histologically confirmed intrahepatic cholangiocarcinoma (also variously reported as peripheral cholangiocarcinoma, cholangiolar carcinoma or cholangiocellular carcinoma) (ICC). Confirmation of the diagnosis at MSKCC must be obtained.
  • Clinical or radiographic evidence of metastatic disease to regional lymph nodes will be allowed, provided it is amenable to resection.
  • Radiographically measurable disease. Measurable disease is defined as disease that can be assessed with 2-dimensional measurements on a cross-sectional imaging. Minimum lesion size is 2cm in greatest diameter as per RECIST criteria.
  • Disease must be considered unresectable at the time of preoperative evaluation.
  • Presence of less than 70% liver involvement by cancer.
  • Patients may have failed ablative therapy
  • Patient previously treated with systemic chemotherapy will be eligible
  • KPS ? 60% and be considered candidates for general anesthesia, abdominal exploration and hepatic artery pump placement
  • Patients with chronic hepatitis and/or cirrhosis are eligible, but must be Child-Pugh class A
  • Patients must be able to read, understand and sign informed consent
  • WBC ? 3,000 cells/mm3
  • Platelet count ? 100,000/mm3
  • Creatinine ? 1.8 mg/dl
  • Total bilirubin < 1.6 mg/dl

Exclusion Criteria

  • Presence of distant metastatic disease. Patients will undergo radiographic evaluation to exclude the possibility of distant metastatic disease. For patients who have undergone preor postoperative biopsies that definitively diagnose ICC, the diagnostic studies may be modified at the discretion of the Principal Investigator. Clinical or radiographic evidence of metastatic disease to regional lymph nodes will be allowed, provided it is amenable to resection.
  • Prior treatment with FUDR
  • Prior external beam radiation therapy to the liver
  • Diagnosis of sclerosing cholangitis
  • Clinical evidence or portal hypertension (ascites, gastroesophageal varices, or portal vein thrombosis)
  • Active infection
  • Pregnant or lactating women
  • History of other malignancy within the past 5 years (except non-melanoma skin cancer)
  • Life expectancy less than 12 weeks
  • Inability to comply with study and/or followup procedures
  • History of peripheral neuropathy
  • History of disease progression on gemcitabine and oxaliplatin

Gender

Both

Ages

21 Years and older

Accepts Healthy Volunteers

No

Study Locations and Contact Information (4)

Study Location Distance Name Phone Email
Memorial Sloan Kettering Cancer Center Suffolk - Commack, New York 26.2 miles William Jarnagin MD 212-639-7601 None
Memorial Sloan Kettering West Harrison - West Harrison, New York 28.7 miles William Jarnagin MD 212-639-7601 None
Memoral Sloan Kettering Cancer Center at Phelps - Sleepy Hollow, New York 33.0 miles William Jarnagin MD 212-639-7601 None
Memorial Sloan Kettering Cancer Center - New York, New York 50.7 miles William R Jarnagin MD 212-639-7601 None

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