Phase II Study of NGC-Triple Regimen in Potentially Resectable Pancreatic Cancer Patients

This is a phase II multi-center study of nab-paclitaxel, gemcitabine and cisplatin (NGC triple regimen) as preoperative therapy in potentially resectable pancreatic cancer patients. DISEASE STATE * Potentially operable or borderline resectable pancreatic adenocarcinoma as assessed by standard CT criteria and histologically confirmed. * Staging by pancreatic protocol, helical abdominal computed tomography (with contrast) or MRI (with contrast) required (endoscopic ultrasound is not required). * No evidence of metastatic disease. Lymphadenopathy (defined as nodes measuring \>1 cm in short axis) outside the surgical basin (i.e., para-aortic, peri-caval, celiac axis, or distant nodes) is considered M1 (unless nodes are biopsied and are negative, then enrollment can be considered after review with the study PI). Potentially Resectable Pancreatic Cancer * No involvement of the celiac artery, common hepatic artery, and superior mesenteric artery (SMA) and, if present, replaced right hepatic artery. * No involvement or \<180° interface between tumor and vessel wall of the portal vein and/or superior mesenteric vein (SMV-PV) and patent portal vein/splenic vein confluence. * For tumors of the body and tail of the pancreas, involvement of the splenic artery and vein of any degree is considered resectable disease. Borderline Resectable Pancreatic Cancer * Tumor-vessel interface ≥180° of vessel wall circumference, and/or reconstructible occlusion of the SMV-PV. * Tumor-vessel interface \<180° of the circumference of the SMA. * Tumor-vessel interface \<180° of the circumference of the celiac artery. * Reconstructible short-segment interface of any degree between tumor and hepatic artery.

Sex

All

Minimum age

18 Years

Maximum age

75 Years

Major Inclusion Criteria for the Study Include the Following:

* Patient has an ECOG performance status PS 0-1. No prior chemotherapy or radiation for pancreatic cancer and no prior exposure to gemcitabine and/or nab-paclitaxel

Patient has the following blood counts at baseline:

* ANC ≥1.5 × 109/L (1500 /mm3)
* Platelets ≥100 × 109/L; (100,000/mm3)
* Hgb ≥10 g/dL

Patient has the following blood chemistry levels at baseline:

* AST (SGOT), ALT (SGPT) ≤ 3.0 × upper limit of normal (ULN)
* Alkaline phosphatase (AP) ≤3.0 X ULN
* Total bilirubin ≤1.5 or ≤ULN
* Serum creatinine ≤1.5mg/dL or calculated clearance ≥50 mL/min/1.73 m2 for patients with serum creatinine levels \>1.5 mg/dL
* Patient has acceptable coagulation status as indicated by a PT within normal limits (± 15%) and PTT within normal limits (± 15%)

Major Exclusion Criteria include the Following:

1. Patient has locally advanced unresectable pancreatic cancer.
2. Patients aged \>75.
3. Histologies other than adenocarcinoma, or any mixed histologies, will NOT be eligible.
4. Patient uses therapeutic Coumadin for a history of pulmonary emboli or DVT.
5. Patient has active, uncontrolled bacterial, viral, or fungal infection(s) requiring systemic therapy.
6. Patient has known infection with HIV, hepatitis B, or hepatitis C.
7. Patient has undergone major surgery, other than diagnostic surgery (i.e. surgery done to obtain a biopsy for diagnosis without removal of an organ) within 4 weeks prior to Day 1 of treatment in this study.
8. Prior chemotherapy or radiation for pancreatic cancer. Prior exposure to gemcitabine and/or nab-paclitaxel.
9. Patient has a history of allergy or hypersensitivity to the study drugs.

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