Gemcitabine With or Without Cisplatin in Treating Patients With Unresectable Locally Advanced or Metastatic Cholangiocarcinoma or Other Biliary Tract Tumors

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Basic Trial Information

PhaseTypeStatusAgeSponsorProtocol IDs
Phase IIITreatmentCompleted16 and overOtherCDR0000455013
CRUK-ABC-02, EU-205103, ISRCTN82956140, EUDRACT-2004-004882-14, CTA-21266/0005/001, NCT00262769

Trial Description


RATIONALE: Drugs used in chemotherapy, such as gemcitabine and cisplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more tumor cells. It is not yet known whether gemcitabine is more effective with or without cisplatin in treating cholangiocarcinoma or biliary tract tumors.

PURPOSE: This randomized phase III trial is studying gemcitabine and cisplatin to see how well they work compared to gemcitabine alone in treating patients with unresectable locally advanced or metastatic cholangiocarcinoma or other biliary tract tumors.

Further Study Information



  • Compare the overall survival of patients with unresectable locally advanced or metastatic cholangiocarcinoma or other biliary tract tumors treated with gemcitabine hydrochloride with vs without cisplatin.


  • Compare the progression-free survival of patients treated with these regimens.
  • Compare the toxic effects of these regimens in these patients.
  • Compare quality of life of patients treated with these regimens.

OUTLINE: This is a randomized, multicenter study. Patients are stratified according to participating center, primary site of disease (gallbladder vs bile ducts vs ampulla), prior therapy (photodynamic therapy [PDT] vs non-PDT therapy vs none), ECOG performance status (0 vs 1 vs 2), and disease status (locally advanced vs metastatic). Patients are randomized to 1 of 2 treatment arms.

  • Arm I: Patients receive gemcitabine hydrochloride IV over 30 minutes on days 1, 8, and 15. Treatment repeats every 28 days for 6 courses in the absence of disease progression or unacceptable toxicity.
  • Arm II: Patients receive gemcitabine hydrochloride IV over 30 minutes and cisplatin IV over 1½ hours on days 1 and 8. Treatment repeats every 21 days for 8 courses in the absence of disease progression or unacceptable toxicity.

Quality of life is assessed at baseline, 12 weeks, and after finishing treatment.

After completion of study treatment, patients are followed periodically for at least 3 years.

Peer Reviewed and Funded or Endorsed by Cancer Research UK

PROJECTED ACCRUAL: A total of 400 patients will be accrued for this study.

Eligibility Criteria


  • Histologically or cytologically confirmed biliary tract, gallbladder, or ampullary carcinoma
  • Intra- or extra-hepatic disease allowed
  • Unresectable locally advanced, recurrent, or metastatic disease
  • No brain metastases


Performance status

  • ECOG 0-2

Life expectancy

  • At least 3 months


  • Absolute neutrophil count ≥ 1,500/mm^3
  • Platelet count ≥ 100,000/mm^3
  • Hemoglobin ≥ 10 g/dL (transfusion allowed)
  • WBC ≥ 3,000/mm^3


  • AST and ALT ≤ 3 times upper limit of normal (ULN) (5 times ULN if liver metastases are present)
  • Bilirubin ≤ 1.5 times ULN
  • Alkaline phosphatase ≤ 3 times ULN (5 times ULN if liver metastases are present)
  • Adequate biliary drainage
  • No unresolved biliary tract obstruction


  • Creatinine < 1.5 times ULN
  • Urea < 1.5 times ULN
  • Glomerular filtration rate (GFR) ≥ 45 mL/min
  • If GFR < 60 mL/min, isotope EDTA confirmation of adequate renal function is required


  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception during and for 3 months after study participation
  • No active, uncontrolled infection
  • No other severe or uncontrolled systemic disease
  • No other malignancy within the past 5 years except nonmetastatic basal cell or squamous cell skin cancer or carcinoma in situ of the cervix treated by cone-biopsy or resection
  • No psychiatric disorder that would preclude giving informed consent



  • At least 6 months since prior adjuvant chemotherapy
  • No prior gemcitabine hydrochloride
  • No prior cisplatin
  • No prior systemic chemotherapy for locally advanced or metastatic disease except low-dose radiosensitizing chemotherapy in conjunction with radiotherapy


  • Prior radiotherapy for localized disease allowed provided there is clear evidence of disease progression afterwards


  • Prior curative surgery allowed provided there is evidence of nonresectable disease relapse requiring systemic chemotherapy


  • Recovered from all prior therapies
  • Prior photodynamic therapy (PDT) allowed provided it was given for localized disease only (with no evidence of metastatic disease) and resulted in subsequent disease progression after completion of therapy OR to relieve biliary obstruction in the presence of metastatic disease
  • PDT must have been completed ≥ 4 weeks ago
  • At least 4 weeks since prior investigational agents
  • No other concurrent, curative anticancer therapy

Trial Contact Information

Trial Lead Organizations/Sponsors

University College Hospital - London

  • Eli Lilly and Company
John A. Bridgewater, Study Chair

Link to the current record.
NLM Identifier NCT00262769 processed this data on April 09, 2015

Note: Information about this trial is from the database. The versions designated for health professionals and patients contain the same text. Minor changes may be made to the record to standardize the names of study sponsors, sites, and contacts. only lists sites that are recruiting patients for active trials, whereas lists all sites for all trials. Questions and comments regarding the presented information should be directed to