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RESEARCH PRODUCT

Modified FOLFIRINOX versus CisGem first-line chemotherapy for locally advanced non resectable or metastatic biliary tract cancer (AMEBICA)-PRODIGE 38: Study protocol for a randomized controlled multicenter phase II/III study

Sylvain ManfrediProdige InvestigatorsPierre MichelJérôme DesraméJulien EdelineJean-frédéric BlancCindy NeuzilletJean-marc PhelipVincent BourgeoisDavid MalkaEmilie Barbier

subject

Malemedicine.medical_specialtyFOLFIRINOXmedicine.medical_treatmentModified folfirinoxLeucovorinAntineoplastic Agents[SDV.CAN]Life Sciences [q-bio]/CancerAdvanced biliary cancerIrinotecanDeoxycytidineGastroenterology03 medical and health sciences0302 clinical medicineInternal medicineAntineoplastic Combined Chemotherapy ProtocolsCarcinomaHumansMedicineNeoplasm InvasivenessNeoplasm StagingChemotherapyHepatologybusiness.industryGallbladderCarcinomaGastroenterologyMetastatic Pancreatic Adenocarcinomamedicine.diseaseGemcitabinePrimary tumorGemcitabine3. Good healthOxaliplatinmedicine.anatomical_structureBile Duct NeoplasmsBiliary tract030220 oncology & carcinogenesisFemale030211 gastroenterology & hepatologyFluorouracilFranceCisplatinDrug Monitoringbusinessmedicine.drug

description

IF 3.287 (2017); International audience; IntroductionCombination of cisplatine and Gemcitabine (CisGem) is the reference 1st line Chemotherapy in patients with advanced biliary cancer. FOLFIRINOX demonstrated an overall survival superiority when compared to gemcitabine in 1st line for patients with metastatic pancreatic adenocarcinoma. Because of similarities between pancreatic and biliary cancers, we proposed a randomized trial comparing mFOLFIRINOX and CisGEm.AimPRODIGE38-AMEBICA is a phase II/III trial evaluating efficacy of modifed FOLFIRINOX (D1 bolus removed) or CisGEm on patients with locally advanced non resectable or metastatic biliary tract cancer.Patients and methodsMain inclusion criteria are histologically or cytologically proven biliary tract tumor (intra or extra hepatic or hilar or gallbladder carcinoma), measurable disease (metastases and/or primary tumor), Bilirubin <1,5 N and transaminases <5 N. The randomization (ratio 1:1) will be stratified on center, stage of the disease, tumor localization and previous adjuvant treatment. The Phase II trial has an objective of 73% patients alive and without progression at 6 months for Folfirinox (versus 59% for Gemcis). 128 additional patients should be added in the phase III trial with an objective of overall survival improvement of 4 months in favor of mFOLFIRINOX.ConclusionThe study is opened in France (EudraCT no.: 2015-002282-35). All the patients (188) of the phase II part are currently randomized.

10.1016/j.dld.2018.11.018https://hal-univ-bourgogne.archives-ouvertes.fr/hal-01980019