Evidence map›Paper›PMID 39833722›Full record

ArticleBMC cancer2025

Study protocol: multi-centre, randomised controlled clinical trial exploring stromal targeting in locally advanced pancreatic cancer; STARPAC2.

Hemant M Kocher, BCI-STARPAC2 team, BPTB team, Precision-Panc team, Peter Sasieni, Pippa Corrie, Mairéad G McNamara, Debashis Sarker, Fieke E M Froeling, Alan Christie and 3 more

Registry-linked trialAbstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04241276 (Phase IIb Randomised Clinical Trial Repurposing ATRA as a Stromal Targeting Agent in a Novel Drug Combination for Pancreatic Cancer), which is not on this map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04241276 phase2active not recruitingnot on this map

Phase IIb Randomised Clinical Trial Repurposing ATRA as a Stromal Targeting Agent in a Novel Drug Combination for Pancreatic Cancer

TypeinterventionalSponsorQueen Mary University of LondonRan2020 to 2029Enrolled170ConditionsPancreatic CancerArmsATRA, Gemcitabine, nab-paclitaxel
3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Review
  2. Review
  3. Review
  4. Pancreatic cancer in 2025: Have we found a solution?World journal of gastroenterology · 2025
    Review
  5. Article
  6. Review
  7. Article
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Hemant M KocherBarts Cancer Institute and Wolfson Institute of Public Health, Mary University of London, John Vane Science Centre, Charterhouse Square, London, Queen, EC1M 6BQ, UK. h.kocher@qmul.ac.uk.ORCID http://orcid.org/0000-0001-6771-1905
BCI-STARPAC2 team
BPTB team
Precision-Panc team
Peter SasieniBarts Cancer Institute and Wolfson Institute of Public Health, Mary University of London, John Vane Science Centre, Charterhouse Square, London, Queen, EC1M 6BQ, UK.ORCID http://orcid.org/0000-0003-1509-8744
Pippa CorrieCambridge University Hospitals NHS Foundation Trust, Cambridge, UK.ORCID http://orcid.org/0000-0003-4875-7021
Mairéad G McNamaraDivision of Cancer Sciences, Department of Medical Oncology, University of Manchester &, The Christie NHS Foundation Trust, Manchester, UK.ORCID http://orcid.org/0000-0002-2272-3678
Debashis SarkerGuy's and St Thomas' NHS Foundation Trust, London, UK.ORCID http://orcid.org/0000-0001-6948-2974
Fieke E M FroelingUniversity of Glasgowand, NHS Greater Glasgow and Clyde , Glasgow, UK.ORCID http://orcid.org/0000-0002-8653-8164
Alan ChristieEdinburgh Cancer Centre, NHS Lothian, Edinburgh, UK.ORCID http://orcid.org/0000-0002-0220-4643
Roopinder GillmoreRoyal Free London NHS Foundation Trust, London, UK.ORCID http://orcid.org/0000-0001-8620-3885
Khurum KhanUniversity College London Hospitals NHS Foundation Trust, London, UK.ORCID http://orcid.org/0000-0001-9364-6182
David PropperBarts Cancer Institute and Wolfson Institute of Public Health, Mary University of London, John Vane Science Centre, Charterhouse Square, London, Queen, EC1M 6BQ, UK.ORCID http://orcid.org/0000-0002-4274-5460

Funding

Medical Research Council MR/S036601/1Pancreatic Cancer Research Fund PCRFTB
6 · The paper itself

Abstract

backgroundPancreatic cancer (PDAC: pancreatic ductal adenocarcinoma, the commonest form), a lethal disease, is best treated with surgical excision but is feasible in less than a fifth of patients. Around a third of patients presentlocally advanced, inoperable, non-metastatic (laPDAC), whose stadrd of care is palliative chemotherapy; a small minority are down-sized sufficiently to enable surgical excision. We propose a phase II clinical trial to test whether a combination of standard chemotherapy (gemcitabine & nab-Paclitaxel: GEM-NABP) and repurposing All Trans Retinoic Acid (ATRA) to target the stroma may extend progression-free survival and enable successful surgical resection for patients with laPDAC, since data from phase IB clinical trial demonstrate safety of GEM-NABP-ATRA combination to patients with advanced PDAC with potential therapeutic benefit.

methodsPatients with laPDAC will receive at least six cycles of GEM-NABP with 1:1 randomisation to receive this with or without ATRA to assess response, until progression or intolerance. Those with stable/responding disease may undergo surgical resection. Primary endpoint is progression free survival (PFS) defined as the time from the date of randomisation to the date of first documented tumour progression (response evaluation criteria in solid tumours [RECIST] v1.1) or death from any cause, whichever occurs first. Secondary endpoints include objective response rate (ORR), overall survival (OS), safety and tolerability, surgical resection rate, R0 surgical resection rate and patient reported outcome measures (PROMS) as measured by questionnaire EQ-5D-5L. Exploratory endpoints include a decrease or increase in CA19-9 and serum Vitamin A over time correlated with ORR, PFS, and OS. DISCUSSION: STARPAC2 aims to assess the role of stromal targeting in laPDAC.

trial registrationEudraCT: 2019-004231-23; NCT04241276; ISRCTN11503604.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsCarcinoma, Pancreatic DuctalPancreatic NeoplasmsAlbuminsClinical Trials, Phase II as TopicDeoxycytidineGemcitabineHumansMaleMulticenter Studies as TopicPaclitaxelRandomized Controlled Trials as TopicStromal CellsTretinoin130-nm albumin-bound paclitaxelAlbuminsDeoxycytidineGemcitabinePaclitaxelTretinoinAll-trans-retinoic acid (ATRA)ChemotherapyGemcitabine and nab-paclitaxel (GEM-NABP)Locally advanced pancreatic ductal adenocarcinoma (laPDAC)ProgressionStroma

Identifiers

PMID39833722
PMCPMC11748870

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.