S0809: Capecitabine, Gemcitabine, and RT in Patients w/Cholangiocarcinoma of the Gallbladder or Bile Duct
Condition: Extrahepatic Bile Duct Cancer; Gallbladder Cancer
MeSH terms: Cholangiocarcinoma; Gallbladder Neoplasms; Bile Duct Neoplasms
Study type: Interventional
Phase: Phase 2

Summary: 
      RATIONALE: Drugs used in chemotherapy, such as capecitabine and gemcitabine, work in
      different ways to stop the growth of tumor cells, either by killing the cells or by stopping
      them from dividing. Radiation therapy uses high-energy x-rays to kill tumor cells.
      Specialized radiation therapy that delivers a high dose of radiation directly to the tumor
      may kill more tumor cells and cause less damage to normal tissue. Giving more than one drug
      (combination chemotherapy) together with radiation therapy may kill more tumor cells.

      PURPOSE: This phase II trial is studying how well giving capecitabine together with
      gemcitabine followed by capecitabine and radiation therapy works in treating patients with
      cholangiocarcinoma of the gallbladder or bile duct.
    

Detailed description: 
      OBJECTIVES:

        -  To estimate the stratum-specific (R0 and R1) and overall 2-year survival probabilities
           of patients with extrahepatic cholangiocarcinoma treated with adjuvant chemotherapy
           comprising capecitabine and gemcitabine hydrochloride, followed by capecitabine and
           radiotherapy. (R0 stratum closed as of 12-15-11)

        -  To estimate the 2-year stratum-specific and overall disease-free survival and local
           disease-free survival of patients treated with this regimen.

        -  To assess the frequency and severity of toxicity in patients treated with this regimen.

      OUTLINE: This is a multicenter study. Patients are stratified according to margin of
      resection (negative [R0] vs microscopically positive [R1]). (R0 stratum closed as of
      12-15-11)

        -  Adjuvant chemotherapy: Patients receive oral capecitabine every 12 hours on days 1-14
           and gemcitabine hydrochloride IV over 30 minutes on days 1 and 8. Treatment repeats
           every 21 days for 4 courses in the absence of disease progression or unacceptable
           toxicity.

        -  Chemoradiotherapy: Beginning in week 13, patients receive oral capecitabine every 12
           hours on days 1-7. Patients also undergo concurrent three-dimensional or
           intensity-modulated radiotherapy on days 1-5. Treatment repeats weekly for 5-6 weeks in
           the absence of disease progression or unacceptable toxicity.

      After completion of study therapy patients are followed periodically for up to 5 years.
    

Intervention name(s): capecitabine; gemcitabine hydrochloride; 3-dimensional conformal radiation therapy; intensity-modulated radiation therapy
Intervention type(s): Drug; Drug; Radiation; Radiation
Intervention description(s): Adjuvant chemotherapy: 1500 mg/m^2/day, PO, Every 12 hrs on Days 1-14 of each cycle
Chemoradiotherapy: 1330 mg/m^2/day, PO, Every 12 hrs, 7 days per week beginning the first day of RT and finishing the last day of RT; 1000 mg/m^2, IV, Days 1 & 8 of each cycle; 4,500 cGy over 5 weeks (5 days/week) in 180 cGy/fraction + 900 cGy during week 1 in 180 cGy fractions.; 4,500 cGy over 5 weeks (5 days/week) in 180 cGy/fraction + 5,250 cGy in 210 cGy/fraction for a total of 25 fractions.
Other intervention name(s): Xeloda; NSC-712807; Gemzar; NSC-619927; 3D radiotherapy; IMRT
Intervention MeSH terms: Gemcitabine; Capecitabine
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: cholangiocarcinoma of the extrahepatic bile duct; cholangiocarcinoma of the gallbladder; localized extrahepatic bile duct cancer; localized gallbladder cancer; unresectable extrahepatic bile duct cancer; unresectable gallbladder cancer; metastatic extrahepatic bile duct cancer; metastatic gallbladder cancer