Capecitabine or Observation After Surgery in Treating Patients With Biliary Tract Cancer

Last updated: August 23, 2013
Sponsor: University Hospital Southampton NHS Foundation Trust
Overall Status: Completed

Phase

3

Condition

Liver Cancer

Liver Disease

Gall Bladder Cancer

Treatment

N/A

Clinical Study ID

NCT00363584
CDR0000492266
EUDRACT-2005-003318-13
ISRCTN72785446
CRUK-BIBF1120
EU-20629
CRUK-HE3002
CRUK-BILCAP
  • Ages > 18
  • All Genders

Study Summary

RATIONALE: Drugs used in chemotherapy, such as capecitabine, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving capecitabine after surgery may kill any tumor cells that remain after surgery. Sometimes, after surgery, the tumor may not need more treatment until it progresses. In this case, observation may be sufficient. It is not yet known whether capecitabine is more effective than observation in treating biliary tract cancer.

PURPOSE: This randomized phase III trial is studying capecitabine to see how well it works compared with observation in treating patients with biliary tract cancer.

Eligibility Criteria

Inclusion

DISEASE CHARACTERISTICS:

  • Histologically confirmed biliary tract cancer (including intrahepatic or extrahepatic/hilar cholangiocarcinoma or muscle invasive gallbladder cancer or cancer of the distal bile duct)

  • Must have undergone a radical surgical approach which includes liver resection, pancreatic resection, or less commonly both

  • Patients with pathological evidence of microscopic involvement of the margins of the excised specimen are eligible as long as resection is macroscopically complete

  • Must be able to start treatment within 12 weeks of surgery

  • No pancreatic or periampullary cancer

  • No mucosal gallbladder cancer

PATIENT CHARACTERISTICS:

  • ECOG performance status 0-2

  • Urea < 1.5 times upper limit of normal (ULN)

  • Creatinine < 1.5 times ULN

  • Glomerular filtration rate ≥ 60 mL/min (if < 60 mL/min, adequate renal function for capecitabine must be confirmed by isotope EDTA)

  • Hemoglobin ≥ 10 g/dL

  • WBC ≥ 3,000/mm³

  • Absolute neutrophil count ≥ 1,500/mm³

  • Platelet count ≥ 100,000/mm³

  • Bilirubin ≤ 3 times ULN

  • ALT and AST ≤ 5 times ULN

  • Adequate surgical biliary drainage with no evidence of infection

  • Not pregnant or nursing

  • Negative pregnancy test for women of childbearing age and childbearing potential

  • Fertile patients must use effective contraception during study treatment and for at least 3 months after study treatment has ended

  • Must provide written informed consent

  • No history of other malignant diseases within the past 5 years other than adequately treated nonmelanoma skin cancer or in situ carcinoma of the uterine cervix

  • No serious co-existing medical condition likely to interfere with protocol treatment, including a potential serious infection

  • No evidence of significant clinical disorder or laboratory finding that makes it undesirable for the patient to participate in the trial

  • No psychological, familial, sociological, or geographical factors considered likely to preclude study compliance

  • No other serious uncontrolled medical conditions

  • No unresolved biliary tree obstruction

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics

  • Completely recovered from prior surgery

  • No use of other investigational agents within 28 days prior to and during study treatment

  • No prior chemotherapy or radiotherapy for biliary tract cancer

  • No other concurrent anticancer chemotherapy, radiotherapy, or investigational agent

Study Design

Total Participants: 360
Study Start date:
March 01, 2006
Estimated Completion Date:

Study Description

OBJECTIVES:

Primary

  • To determine whether adjuvant chemotherapy with capecitabine has any effect on 2-year survival compared to expectant treatment alone (observation) in patients who have undergone a macroscopically complete surgical resection of a biliary tract cancer.

Secondary

  • To compare capecitabine versus observation in terms of 5-year survival, relapse-free survival, toxicity, quality of life, and health economics.

OUTLINE: This is a multicenter, prospective, randomized study. Patients are stratified according to surgical center, disease site (hilar/extrahepatic cholangiocarcinoma vs intrahepatic cholangiocarcinoma vs gallbladder vs intrapancreatic/common bile duct), type of resection (R0 vs R1), and ECOG performance status (0 vs 1 vs 2). Patients are randomized to 1 of 2 treatment arms.

  • Arm I: Patients receive oral capecitabine twice a day on days 1-14. Treatment repeats every 3 weeks for 8 courses in the absence of disease progression or unacceptable toxicity.

  • Arm II: Patients undergo expectant treatment (observation). Quality of life is assessed at baseline, every 3 months for 1 year, and then every 6 months for 1 year.

All patients are followed for up to 5 years post-randomization.

Peer Reviewed and Funded or Endorsed by Cancer Research UK

PROJECTED ACCRUAL: A total of 360 patients will be accrued for this study.

Connect with a study center

  • Basildon University Hospital

    Basildon, England SS16 5NL
    United Kingdom

    Site Not Available

  • Basingstoke and North Hampshire NHS Foundation Trust

    Basingstoke, England RG24 9NA
    United Kingdom

    Site Not Available

  • Cancer Research UK Clinical Trials Unit - Birmingham

    Birmingham, England B15 2TT
    United Kingdom

    Site Not Available

  • Royal Bournemouth Hospital

    Bournemouth, England BH7 7DW
    United Kingdom

    Site Not Available

  • Bristol Haematology and Oncology Centre

    Bristol, England BS2 8ED
    United Kingdom

    Site Not Available

  • Addenbrooke's Hospital

    Cambridge, England CB2 2QQ
    United Kingdom

    Site Not Available

  • Walsgrave Hospital

    Coventry, England CV2 2DX
    United Kingdom

    Site Not Available

  • Princess Alexandra Hospital

    Essex, England CM20 1QX
    United Kingdom

    Site Not Available

  • St. Luke's Cancer Centre at Royal Surrey County Hospital

    Guildford, England GU2 7XX
    United Kingdom

    Site Not Available

  • Calderdale Royal Hospital

    Halifax, England HX3 0PW
    United Kingdom

    Site Not Available

  • Huddersfield Royal Infirmary

    Huddersfield, West Yorks, England HD3 3EA
    United Kingdom

    Site Not Available

  • Cancer Research UK Clinical Centre at St. James's University Hospital

    Leeds, England LS16 6QB
    United Kingdom

    Site Not Available

  • Leicester General Hospital

    Leicester, England LE5 4PW
    United Kingdom

    Site Not Available

  • Leicester Royal Infirmary

    Leicester, England LE1 5WW
    United Kingdom

    Site Not Available

  • Aintree University Hospital

    Liverpool, England L9 7AL
    United Kingdom

    Site Not Available

  • Royal Liverpool University Hospital

    Liverpool, England L7 8XP
    United Kingdom

    Site Not Available

  • Hammersmith Hospital

    London, England W12 OHS
    United Kingdom

    Site Not Available

  • Helen Rollason Cancer Care Centre at North Middlesex Hospital

    London, England N18 1QX
    United Kingdom

    Site Not Available

  • King's College Hospital

    London, England SE5 9RS
    United Kingdom

    Site Not Available

  • Royal Marsden - London

    London, England SW3 6JJ
    United Kingdom

    Site Not Available

  • Saint Bartholomew's Hospital

    London, England EC1A 7BE
    United Kingdom

    Site Not Available

  • St. Thomas' Hospital

    London, England SE1 7EH
    United Kingdom

    Site Not Available

  • UCL Cancer Institute

    London, England NW3 2QG
    United Kingdom

    Site Not Available

  • University College of London Hospitals

    London, England WIT 3AA
    United Kingdom

    Site Not Available

  • Maidstone Hospital

    Maidstone, England ME16 9QQ
    United Kingdom

    Site Not Available

  • Christie Hospital

    Manchester, England M20 4BX
    United Kingdom

    Site Not Available

  • North Manchester General Hospital - Penine Actute Hospitals Trust

    Manchester, England M8 6RB
    United Kingdom

    Site Not Available

  • Clatterbridge Centre for Oncology

    Merseyside, England CH63 4JY
    United Kingdom

    Site Not Available

  • Freeman Hospital

    Newcastle-Upon-Tyne, England NE7 7DN
    United Kingdom

    Site Not Available

  • Northern Centre for Cancer Treatment at Newcastle General Hospital

    Newcastle-Upon-Tyne, England NE4 6BE
    United Kingdom

    Site Not Available

  • St. Mary's Hospital

    Newport, England PO30 5TG
    United Kingdom

    Site Not Available

  • Nottingham City Hospital

    Nottingham, England NG5 1PB
    United Kingdom

    Site Not Available

  • Derriford Hospital

    Plymouth, England PL6 8DH
    United Kingdom

    Site Not Available

  • Portsmouth Oncology Centre at Saint Mary's Hospital

    Portsmouth Hants, England PO3 6AD
    United Kingdom

    Site Not Available

  • Alexandra Healthcare NHS

    Redditch, Worcestershire, England B98 7UB
    United Kingdom

    Site Not Available

  • Salisbury District Hospital

    Salisbury, England SP2 8BJ
    United Kingdom

    Site Not Available

  • Cancer Research Centre at Weston Park Hospital

    Sheffield, England S1O 2SJ
    United Kingdom

    Site Not Available

  • Southampton General Hospital

    Southampton, England SO16 6YD
    United Kingdom

    Site Not Available

  • Royal Marsden - Surrey

    Sutton, England SM2 5PT
    United Kingdom

    Site Not Available

  • Southend University Hospital NHS Foundation Trust

    Westcliff-On-Sea, England SS0 0RY
    United Kingdom

    Site Not Available

  • Yeovil District Hospital

    Yeovil, England BA21 4AT
    United Kingdom

    Site Not Available

  • Ninewells Hospital

    Dundee, Scotland DD1 9SY
    United Kingdom

    Site Not Available

  • Edinburgh Cancer Centre at Western General Hospital

    Edinburgh, Scotland EH4 2XU
    United Kingdom

    Site Not Available

  • Beatson West of Scotland Cancer Centre

    Glasgow, Scotland G12 0YN
    United Kingdom

    Site Not Available

  • Perth Royal Infirmary

    Perth, Scotland PH1 1NX
    United Kingdom

    Site Not Available

  • Velindre Cancer Center at Velindre Hospital

    Cardiff, Wales CF14 2TL
    United Kingdom

    Site Not Available

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