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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT04089150
Registration number
NCT04089150
Ethics application status
Date submitted
4/02/2019
Date registered
13/09/2019
Titles & IDs
Public title
MFOLFIRINOX And Stereotactic Radiotherapy (SBRT) for Pancreatic Cancer With High Risk and Locally Advanced Disease
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Scientific title
MASTERPLAN: A Randomised Phase II Study of MFOLFIRINOX And Stereotactic Radiotherapy (SBRT) for Pancreatic Cancer With High Risk and Locally Advanced Disease
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Secondary ID [1]
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CTC 0245/AGITG AG0118PS
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Universal Trial Number (UTN)
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Trial acronym
MASTERPLAN
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Pancreatic Cancer
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Condition category
Condition code
Cancer
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Pancreatic
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Other - Stereotactic Radiotherapy (SBRT)
Treatment: Drugs - mFOLFIRINOX
Treatment: Drugs - Gemcitabine + Nab-paclitaxel
Treatment: Drugs - Gemcitabine + Capecitabine
Treatment: Surgery - Pancreatoduodenectomy (Whipple procedure)
Active comparator: Arm A - * Option 1: fluorouracil(5-FU)/leucovorin/irinotecan/oxaliplatin (mFOLFIRINOX) (6 cycles)
* Option 2: gemcitabine + nab-paclitaxel (3 cycles)
* Resectable patients receive surgery 6 weeks post completion of initial chemotherapy
* Unresectable patients continue with ongoing chemotherapy (option 1 or option 2)
* Unresectable patients with locoregional progression or metastatic disease, chemotherapy treatment at the discretion of treating medical oncologist
* Adjuvant chemotherapy for resectable patients to begin within 8 weeks after surgery
* For patients who received option 1 chemotherapy: 12 weeks of mFOLFIRINOX
* For patients who received option 2 chemotherapy: 12 weeks of mFOLFIRINOX or 12 additional weeks of gemcitabine/capecitabine
Experimental: Arm B - * Option 1: fluorouracil(5-FU)/leucovorin/irinotecan/oxaliplatin (mFOLFIRINOX) (6 cycles)
* Option 2: gemcitabine + nab-paclitaxel (3 cycles)
* Stereotactic Radiotherapy (SBRT) to commence within 3 weeks of completing initial chemotherapy: 40 Gray (Gy) in 5 fractions over 2 weeks
* Resectable patients receive surgery 6 weeks post completion of initial chemotherapy
* Unresectable patients continue with ongoing chemotherapy (option 1 or option 2)
* Unresectable patients with locoregional progression or metastatic disease, chemotherapy treatment at the discretion of treating medical oncologist
* Adjuvant chemotherapy for resectable patients to begin within 8 weeks after surgery
* For patients who received option 1 chemotherapy: 12 weeks of mFOLFIRINOX
* For patients who received option 2 chemotherapy: 12 weeks of mFOLFIRINOX or 12 additional weeks of gemcitabine/capecitabine
Treatment: Other: Stereotactic Radiotherapy (SBRT)
40 Gray (Gy) in 5 fractions, 2-3 fractions per week over two weeks, 8 Gy per fraction
Treatment: Drugs: mFOLFIRINOX
* Day 1: oxaliplatin 85mg/m2 + irinotecan 150mg/m2 + leucovorin 50mg
* 5-FU 2400mg/m2 continuous IV infusion, 46 hour continuous infusion
* 14-day cycle, 6 cycles
Treatment: Drugs: Gemcitabine + Nab-paclitaxel
* Day 1, Day 8 and Day 15 gemcitabine 1000mg/m2 + nab-paclitaxel 125mg/m2
* 28-day cycle, 3 cycles
Treatment: Drugs: Gemcitabine + Capecitabine
* Week 1, 2 and 3, qw: 1000 mg/m2 gemcitabine
* 21 days continuous: 830 mg/m2 oral capecitabine + 7 days rest
* 28-day cycle, 3 cycles
Treatment: Surgery: Pancreatoduodenectomy (Whipple procedure)
R0 resection. When the tumour is within the head of the pancreas, a standard Whipple's procedure and level 2/3 dissection with modification to obtain margin clearance will be offered. For lesions in the tail, a standard modular resection will be offered.
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Intervention code [1]
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Treatment: Other
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Intervention code [2]
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Treatment: Drugs
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Intervention code [3]
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Treatment: Surgery
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Locoregional control (Locoregional Response Rate LRR)
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Assessment method [1]
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To determine if the addition of SBRT to chemotherapy improves locoregional control;
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Timepoint [1]
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Within 12 months of randomisation;
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Secondary outcome [1]
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Safety (NCI CTCAE v5.0)
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Assessment method [1]
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Compare acute and late side effects from chemotherapy +/- SBRT
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Timepoint [1]
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Safety Assessment before each cycle of chemotherapy, post chemotherapy treatment, following SBRT and surgery (if applicable) then at 3, 6, 9 and 12 months post-randomisation and 6 monthly during year 2, 3 and 4
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Secondary outcome [2]
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Surgical morbidity/mortality (Clavien grading system)
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Assessment method [2]
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Length of stay, death within 30 days, frequency and severity of adverse events. Hospital admission during surgery will be calculated from day of surgery to date of discharge from acute care hospitalisation. The length of stay in acute hospital care will include intensive care admissions.
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Timepoint [2]
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At discharge post-surgery, 30 days and 90 days post surgery, up to 4 years
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Secondary outcome [3]
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Radiological response rates (RECIST v1.1)
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Assessment method [3]
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Compare radiologic response rates for chemotherapy +/- SBRT
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Timepoint [3]
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at baseline. In SBRT arm, post-initial chemotherapy (prior to SBRT). In both arms, 4-6 weeks post completion of initial treatment (prior to surgery), 3 ,6, 9 and 12 monthly during year 2, 3 and 4.
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Secondary outcome [4]
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Progression Free Survival (PFS) (RECIST v1.1)
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Assessment method [4]
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Compare 12-month progression free survival
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Timepoint [4]
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From randomisation to the time of first documented clinical or imaging relapse or date of death from any cause, whichever occurs first; up to 4 years
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Secondary outcome [5]
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Pathological response rates (College of American Pathology Tumour Regression Grade TRG)
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Assessment method [5]
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Compare pathologic response rates of chemotherapy +/- SBRT
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Timepoint [5]
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At SRBT/surgery compared to baseline;
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Secondary outcome [6]
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Surgical resection rates (Guidelines for the Evaluation of Resectability and Histology)
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Assessment method [6]
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Compare rates of surgical resection
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Timepoint [6]
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At surgery
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Secondary outcome [7]
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R0 resection rates (>1mm) (Synoptic PC histology reporting as outlined in Royal College of Pathologists of Australasia (RCPA)
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Assessment method [7]
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Compare R0 resection rates (\>1 mm)
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Timepoint [7]
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At surgery
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Secondary outcome [8]
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Quality of Life (EORTC QLQ C30 and PAN26 QOL)
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Assessment method [8]
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To assess the impact of the regimens on quality of life of patients
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Timepoint [8]
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Baseline, Day 1 of each cycle of chemotherapy, prior to SBRT, post initial chemotherapy +/- SBRT, prior to surgery, 30 days post end of treatment, at months 3, 6,9 and 12 post randomisation 6 monthly in years 2, 3 and 4.
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Secondary outcome [9]
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Deterioration-Free Survival (DFS) (EORTC QLQ C30)
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Assessment method [9]
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To assess overall net clinical benefit of treatment
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Timepoint [9]
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The time until the first of the following events: a 10-point deterioration in health status from baseline, disease progression, death, or treatment discontinuation;up to 4 years
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Secondary outcome [10]
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Overall Survival (OS)
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Assessment method [10]
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OS is defined as the interval from the date of randomisation to date of death from any cause, or the date of last known alive. Participants will be censored at the date of commencement of the subsequent anti-cancer therapy.
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Timepoint [10]
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From the date of randomisation to date of death from any cause, or the date of last known alive; up to 4 years
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Eligibility
Key inclusion criteria
* Adults, aged between 18-75 years, with histological confirmation of pancreatic adenocarcinoma
* Any of the following
1. T3 (tumour >4 cm)
2. Extrapancreatic extension
3. Node positive (stage IIB)
4. Borderline resectable pancreatic cancer, locally advanced pancreatic cancer
* Measurable disease according to RECIST v1.1
* ECOG performance status 0-1
* Adequate renal and haematological function
* Adequate hepatic function. Defined as bilirubin <1.5 X ULN (Upper Limit of Normal), AST + ALT <3.0 X ULN. In patients who have had a recent biliary drainage and whose bilirubin is descending, a value of = 3 X N is acceptable
* Study treatment planned to start within 14 days of registration
* Willing and able to comply with all study requirements, including treatment, timing and/or nature of required assessments
* Signed, written informed consent
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Minimum age
18
Years
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Maximum age
75
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Tumour size greater than 70mm
* Prior abdominal radiotherapy
* Evidence of metastatic disease on baseline radiologic investigations
* History of another malignancy within 2 years prior to randomisation, except adequately treated carcinoma-in-situ, basal cell carcinoma of the skin, squamous cell carcinoma of the skin, superficial transitional cell carcinoma of the bladder, or any Stage 1 endometrial carcinoma. Patients with a history of other malignancies are eligible if they have been continuously disease free for at least 2 years after definitive primary treatment
* Concurrent illness, including severe infection that may jeopardise the ability of the patient to undergo the procedures outlined in this protocol with reasonable safety
* Neuroendocrine pancreatic carcinoma
* Life expectancy of less than 3 months
* Pregnancy, lactation, or inadequate contraception. Women must be post-menopausal, infertile, or use a reliable means of contraception. Women of childbearing potential must have a negative pregnancy test done within 7 days prior to registration. Men must use a reliable means of contraception
* Serious medical or psychiatric conditions that might limit the ability of the patient to comply with the protocol
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
UNKNOWN
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
1/10/2019
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
30/08/2023
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Actual
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Sample size
Target
120
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW,QLD,SA,VIC
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Recruitment hospital [1]
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Chris O'Brien Lifehouse - Camperdown
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Recruitment hospital [2]
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St George Hospital - Kogarah
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Recruitment hospital [3]
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Prince of Wales Hospital - Randwick
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Recruitment hospital [4]
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Royal North Shore Hospital - St Leonards
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Recruitment hospital [5]
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Calvary Mater Newcastle - Waratah
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Recruitment hospital [6]
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Westmead Hospital - Westmead
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Recruitment hospital [7]
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ICON Cancer Centre, Gold Coast University Hospital - Southport
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Recruitment hospital [8]
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Princess Alexandra Hospital - Woolloongabba
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Recruitment hospital [9]
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Royal Adelaide Hospital - Adelaide
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Recruitment hospital [10]
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Peter MacCallum Cancer Centre - Melbourne
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Recruitment hospital [11]
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The Alfred Hospital - Melbourne
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Recruitment postcode(s) [1]
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2050 - Camperdown
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Recruitment postcode(s) [2]
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2217 - Kogarah
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Recruitment postcode(s) [3]
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2031 - Randwick
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Recruitment postcode(s) [4]
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2065 - St Leonards
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Recruitment postcode(s) [5]
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2298 - Waratah
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Recruitment postcode(s) [6]
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2145 - Westmead
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Recruitment postcode(s) [7]
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4215 - Southport
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Recruitment postcode(s) [8]
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4102 - Woolloongabba
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Recruitment postcode(s) [9]
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5000 - Adelaide
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Recruitment postcode(s) [10]
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3000 - Melbourne
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Recruitment postcode(s) [11]
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3004 - Melbourne
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Funding & Sponsors
Primary sponsor type
Other
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Name
Australasian Gastro-Intestinal Trials Group
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Address
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Other collaborator category [1]
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Other
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Name [1]
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Trans Tasman Radiation Oncology Group
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Address [1]
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Country [1]
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Other collaborator category [2]
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Government body
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Name [2]
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Australian Government Department of Health and Ageing
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Address [2]
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Country [2]
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Ethics approval
Ethics application status
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Summary
Brief summary
This is a prospective, multicentre randomised, phase II clinical trial, with randomisation 2:1 by minimisation and stratification by tumour stage, planned chemotherapy and institution.
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Trial website
https://clinicaltrials.gov/study/NCT04089150
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Andrew Oar
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Address
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ICON Gold Coast University Hospital, Southport, Queensland, AUS
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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NHMRC CTC
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Address
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Country
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Phone
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+61 (0) 2 9562 5000
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
The study will be conducted in accordance with applicable Privacy Acts and Regulations. All data generated in this study will remain confidential. All information will be stored securely at the NHMRC CTC, University of Sydney and will only be available to people directly involved with the study.
Personal data identifying trial participants will be held securely at the NHMRC CTC for the purpose of follow up if the patient is unable to/wishes to discontinue clinic based follow-up.
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT04089150