Pioglitazone as Second-Line in Patients With Metastatic Pancreatic Cancer After Treatment With Gemcitabine

The University of Texas System (UT)

Status and phase

Terminated

Early Phase 1

Conditions

Pancreatic Cancer

Treatments

Other: questionnaire administration

Other: laboratory biomarker analysis

Procedure: quality-of-life assessment

Drug: pioglitazone hydrochloride

Study type

Interventional

Funder types

Other

Identifiers

NCT00867126

SCCC-02208

CDR0000637622 (Registry Identifier)

NCI-2011-01036 (Registry Identifier)

Details and patient eligibility

About

RATIONALE: Pioglitazone may slow the growth of tumor cells and may be an effective treatment for pancreatic cancer.

PURPOSE: This phase I trial is studying how well pioglitazone works as second-line therapy in treating patients with metastatic pancreatic cancer that progressed after treatment with gemcitabine.

Full description

OBJECTIVES:

Primary

To describe changes in markers of insulin resistance, including serum adiponectin levels, standard glucose tolerance testing, and fasting serum glucose and insulin levels, in patients with previously treated metastatic adenocarcinoma of the pancreas treated with pioglitazone hydrochloride as second-line therapy.
To describe changes in weight in these patients.
To describe changes in ECOG performance status in these patients.
To describe changes in symptoms and quality of life of these patients using the validated FACT-Hep scale version 4 questionnaire.

Secondary

To determine the tumor response as measured by RECIST criteria in these patients.
To determine the time to disease progression in these patients.

OUTLINE: Patients receive oral pioglitazone hydrochloride once daily on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

Patients complete a quality-of-life questionnaire at baseline, every 4 weeks during therapy, and then at the completion of therapy.

Patients undergo blood sample collection at baseline, every 4 weeks during therapy, and then at the completion of therapy for laboratory biomarker studies. Samples are analyzed for levels of insulin resistance markers (adiponectin, glucose, and insulin).

After completion of study therapy, patients are followed monthly for 6 months and then every 3 months for 2 years.

Enrollment

6 patients

Sex

All

Ages

18 to 120 years old

Volunteers

No Healthy Volunteers

Inclusion and exclusion criteria

DISEASE CHARACTERISTICS:

Histologically or cytologically confirmed adenocarcinoma of the pancreas
- Metastatic disease
- Previously treated disease
Disease progression after first-line gemcitabine hydrochloride-based chemotherapy
Radiologically measurable disease

PATIENT CHARACTERISTICS:

ECOG performance status 0-2
ANC ≥ 1,500/mm^3
Platelet count ≥ 100,000/mm^3
Hemoglobin ≥ 9 g/dL
Serum creatinine < 1.5 times upper limit of normal (ULN) OR creatinine clearance > 45 mL/min
Total bilirubin ≤ 1.5 times ULN
AST and ALT ≤ 2.5 times ULN (5 times ULN if liver metastases are present)
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception during and for 3 months after completion of study treatment
No NYHA class III-IV congestive heart failure
No unstable angina
No second malignancy except for localized nonmelanoma skin cancer
No psychiatric or addictive disorders that would preclude giving informed consent

PRIOR CONCURRENT THERAPY:

Prior systemic therapy with fluorouracil, capecitabine, oxaliplatin, or erlotinib hydrochloride allowed
More than 12 months since prior and no other concurrent thiazolinediones
More than 6 months since prior treatment with immunosuppressive or immunomodulatory agents
No other concurrent anticancer therapy