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A New Clinical Pathway for Personalized Management of Borderline Resectable and Locally Advanced Pancreatic Cancer


2024-12-03


2028-12-31


2028-12-31


400

Study Overview

A New Clinical Pathway for Personalized Management of Borderline Resectable and Locally Advanced Pancreatic Cancer

NORPACT-3 is a nationwide, Norwegian single arm prospective study that evaluates the resectability rates and survival in patients with borderline resectable and locally advanced pancreatic cancer who received primary chemotherapy. Eligible patients are treated with primary chemotherapy possibly followed by surgical exploration and resection. All Norwegian centres performing pancreatic surgery have agreed to collaborate in this trial. The assignment of the medical intervention is not at the discretion of the investigator, but follow the national Norwegian guidelines regarding diagnostic work up, oncological and surgical treatment and follow up. The primary aim is a national resection rate of 50% in BRPC and 15% in LAPC in patients initiating primary chemotherapy, with adequate overall survival and morbidity/mortality (after resection median overall survival of 24 months, 1 year survival 80%, and 5 year survival >20% + 90 day postoperative mortality ≤5%, 90-day postoperative major morbidity (Clavien Dindo grade 3) ≤40%).

N/A

  • Locally Advanced Pancreatic Cancer
  • Borderline Resectable Pancreatic Cancer
  • Pancreatectomy
  • Chemotherapy Effect
  • DRUG: Chemotherapy
  • DIAGNOSTIC_TEST: Radiology
  • PROCEDURE: Pancreatectomy
  • PROCEDURE: Endoscopy
  • REK sør-øst D 733339
  • 2023010 (OTHER_GRANT Identifier) (OTHER_GRANT: Southern and Eastern Norway Regional Health Authority)
  • 279530-2023 (OTHER_GRANT Identifier) (OTHER_GRANT: Norwegian Cancer Society)

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates Results Reporting Dates Study Record Updates

2025-01-17  

N/A  

2025-04-17  

2025-04-17  

N/A  

2025-04-25  

2025-04-25  

N/A  

2025-04  

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

Design Details

Primary Purpose:
N/A


Allocation:
N/A


Interventional Model:
N/A


Masking:
N/A


Arms and Interventions

Participant Group/ArmIntervention/Treatment
Primary Outcome MeasuresMeasure DescriptionTime Frame
Resection rate (of the pancreatic tumour)Resection rate: National target of 50% in BRPC and 15% in LAPC in patients initiating primary chemotherapy.From November 2024-December 2027
Secondary Outcome MeasuresMeasure DescriptionTime Frame
Overall survivalAfter resection, median overall survival of 24 months, 1 year survival 80%, and 5 year survival >20%.From November 2024-December 2027
Mortality after surgical resection90-day postoperative mortality ≤5%From November 2024-December 2027
Morbidity after surgical resection90-day postoperative major morbidity (Clavien-Dindo ≥ grade3) of ≤40%From November 2024-December 2027
Number of patients evaluated at national MDT undergoing resectionFrom November 2024-December 2027
Adverse eventsAdverse events during primary chemotherapyFrom November 2023-December 2027
R0 resection rateR0 (microscopic radical resection >1mm) versus R1 (microscopic residual tumor ≤1mm).From November 2023-December 2027
Quality of life EORTC QLQ-C30Outcome measures will be calculated, according to the validated questionnaire manuals.Measured at baseline, 3, 6, and 12 months from diagnosis, followed by yearly measurements.]
Quality of life EORTC QLQ-PAN26Outcome measures will be calculated, according to the validated questionnaire manuals.Measured at baseline, 3, 6, and 12 months from diagnosis, followed by yearly measurements.
Quality of life EQ-5D-5LOutcome measures will be calculated, according to the validated questionnaire manuals.Measured at baseline, 3, 6, and 12 months from diagnosis, followed by yearly measurements.

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Name: Knut Jørgen Labori, MD PhD

Phone Number: +4723070000

Email: uxknab@ous-hf.no

Study Contact Backup

Name: Jacob Ghotbi, MD

Phone Number: +4723070000

Email: Jacob.Ghotbi@ous-hf.no

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person’s general health condition or prior treatments.

Ages Eligible for Study:
ALL

Sexes Eligible for Study:
18 Years

Accepts Healthy Volunteers:

    Inclusion Criteria:

  • Borderline resectable or locally advanced adenocarcinoma of the pancreas (NCCN, version 2, 2021) (Appendix 3)
  • Nx, M0 (UICC 8th version, 2016)
  • Cytological or histological confirmation of adenocarcinoma
  • Age >18 year
  • Considered able to receive primary chemotherapy and possible surgery
  • Written informed consent

  • Exclusion Criteria:

  • Co-morbidity or performance status precluding primary chemotherapy
  • Co-morbidity or performance status precluding pancreatectomy
  • Female patients in child-bearing age not using adequate contraception, pregnant or lactating women
  • Mental or physical disorders that could interfere with treatment of with the provision of informed consent
  • Any reason why, in the opinion of the investigator, the patient should not participate

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

  • University Hospital of North Norway
  • Haukeland University Hospital
  • Helse Stavanger HF
  • St.Olavs Hospital, Trondheim University Hospital, Norway

  • : ,

Publications

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

  • Boggi U, Kauffmann EF, Napoli N, Barreto SG, Besselink MG, Fusai GK, Hackert T, Hilal MA, Marchegiani G, Salvia R, Shrikhande SV, Truty M, Werner J, Wolfgang C, Bannone E, Capretti G, Cattelani A, Coppola A, Cucchetti A, De Sio D, Di Dato A, Di Meo G, Fiorillo C, Gianfaldoni C, Ginesini M, Hidalgo Salinas C, Lai Q, Miccoli M, Montorsi R, Pagnanelli M, Poli A, Ricci C, Sucameli F, Tamburrino D, Viti V, Cameron J, Clavien PA, Asbun HJ; REDISCOVER guidelines group. REDISCOVER guidelines for borderline-resectable and locally advanced pancreatic cancer: management algorithm, unanswered questions, and future perspectives. Updates Surg. 2024 Sep;76(5):1573-1591. doi: 10.1007/s13304-024-01860-0. Epub 2024 Apr 29.
  • Springfeld C, Ferrone CR, Katz MHG, Philip PA, Hong TS, Hackert T, Buchler MW, Neoptolemos J. Neoadjuvant therapy for pancreatic cancer. Nat Rev Clin Oncol. 2023 May;20(5):318-337. doi: 10.1038/s41571-023-00746-1. Epub 2023 Mar 17.
  • Stoop TF, Theijse RT, Seelen LWF, Groot Koerkamp B, van Eijck CHJ, Wolfgang CL, van Tienhoven G, van Santvoort HC, Molenaar IQ, Wilmink JW, Del Chiaro M, Katz MHG, Hackert T, Besselink MG; International Collaborative Group on Locally Advanced Pancreatic Cancer. Preoperative chemotherapy, radiotherapy and surgical decision-making in patients with borderline resectable and locally advanced pancreatic cancer. Nat Rev Gastroenterol Hepatol. 2024 Feb;21(2):101-124. doi: 10.1038/s41575-023-00856-2. Epub 2023 Nov 30.
  • Farnes I, Kleive D, Verbeke CS, Aabakken L, Issa-Epe A, Smastuen MC, Fosby BV, Dueland S, Line PD, Labori KJ. Resection rates and intention-to-treat outcomes in borderline and locally advanced pancreatic cancer: real-world data from a population-based, prospective cohort study (NORPACT-2). BJS Open. 2023 Nov 1;7(6):zrad137. doi: 10.1093/bjsopen/zrad137.