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A multicenter phase 4 geriatric assessment directed trial to evaluate gemcitabine +/− nab-paclitaxel in elderly pancreatic cancer patients (GrantPax)

Betge, Johannes ; Chi-Kern, Jing ; Schulte, Nadine ; Belle, Sebastian ; Gutting, Tobias ; Burgermeister, Elke ; Jesenofsky, Ralf ; Maenz, Martin ; Wedding, Ulrich ; Ebert, Matthias P. ; Haertel, Nicolai

In: BMC Cancer, 18 (2018), Nr. 747. pp. 1-7. ISSN 1471-2407

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Download (778kB) | Lizenz: Creative Commons LizenzvertragA multicenter phase 4 geriatric assessment directed trial to evaluate gemcitabine +/− nab-paclitaxel in elderly pancreatic cancer patients (GrantPax) by Betge, Johannes ; Chi-Kern, Jing ; Schulte, Nadine ; Belle, Sebastian ; Gutting, Tobias ; Burgermeister, Elke ; Jesenofsky, Ralf ; Maenz, Martin ; Wedding, Ulrich ; Ebert, Matthias P. ; Haertel, Nicolai underlies the terms of Creative Commons Attribution 3.0 Germany

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Abstract

Background: In the group of elderly patients (≥70 years) with metastatic pancreatic ductal adenocarcinoma (mPDAC), it is not known who benefits from intensive 1st line nab-paclitaxel/gemcitabine (nab-p/gem) combination chemotherapy or who would rather suffer from increased toxicity. We aim to determine whether treatment individualization by comprehensive geriatric assessments (CGAs) improves functional outcome of the patients.

Methods/Design: GrantPax is a multicenter, open label phase 4 interventional trial. We use a CGA to stratify elderly patients into three parallel treatment groups (n = 45 per arm): 1) GOGO (nab-p/gem), 2) SLOWGO (gem mono) or 3) FRAIL (best supportive care). After the 1st cycle of chemotherapy (or 4 weeks in FRAIL group) another CGA and safety assessment is performed. CGA-stratified patients may not decline in their CGA performance in response to the first cycle of chemotherapy (primary objective), measured as a loss of 5 points or less in Barthels activities of daily living. Based on the second CGA, patients are re-assigned to their definite treatment arm and undergo further CGAs to monitor the course of treatment. Secondary endpoints include CGA scores during the course of therapy (CGA1–4), response rates, safety and survival rates.

Discussion: GrantPax is the first trial implementing a CGA-driven treatment to personalize therapy for elderly patients with pancreatic cancer. This may lead to standardization of therapy decisions for elderly patients and may optimize standard of care for this increasing group of patients.

Trial registration: NCT02812992 , registered 24.06.2016.

Item Type: Article
Journal or Publication Title: BMC Cancer
Volume: 18
Number: 747
Publisher: BioMed Central : Springer
Place of Publication: London ; Berlin ; Heidelberg
Date Deposited: 23 Jul 2018 08:48
Date: 2018
ISSN: 1471-2407
Page Range: pp. 1-7
Faculties / Institutes: Medizinische Fakultät Mannheim > Medizinische Klinik - Lehrstuhl für Innere Medizin II
Subjects: 610 Medical sciences Medicine
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