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RecruitingNCT05241249Updated Jun 5, 2025

Stimulation With Bethanechol in Combination With Gemcitabine and Nab-paclitaxel in Pancreatic Adenocarcinoma

A Phase 2 interventional study of Bethanechol and Gemcitabine in Pancreas Cancer, sponsored by Susan E. Bates. Recruiting at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-06-05.

Sponsored by Susan E. Bates · Phase 2, Interventional, and Other

Phase
Phase 2
Study type
Interventional
Enrollment
37
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

The primary objective of this study is to assess the impact of bethanechol therapy on R0 resection rates. The safety objective will be assessment of the safety and tolerability of bethanechol in combination with gemcitabine and nab-paclitaxel. The exploratory objective will be to evaluate genomic biomarkers associated with parasympathetic stimulation in pancreatic cancer, and the ability to reduce tumor growth rate.

Read the detailed description

The purpose of this study is to determine whether the drug, bethanechol, could potentially be used in combination with chemotherapy regimen gemcitabine and nab-paclitaxel and surgery to decrease the chance of the cancer coming back after it is removed. Animal models have shown that treatment with bethanechol can inhibit cancer growth and spread. The chemotherapy regimen nab-paclitaxel for use in combination with gemcitabine to treat patients with metastatic pancreatic cancer is FDA approved. Although bethanechol is FDA approved, in this study its use is experimental. The aim of the study is to show that the medication is easy to tolerate and that it shows signs of slowing cancer cell growth. The investigators hypothesize that treatment with bethanechol will alter nerve conduction within tumors by stimulating the parasympathetic nervous system and reduce tumor proliferation, decrease CD44+ expression in cancer cells, decrease tumor growth rate resulting in an improved R0 resection rate.

02

Conditions studied

  • Pancreas Cancer

Keywords

  • Pancreas
  • pancreatic adenocarcinoma
  • adenocarcinoma
  • bethanechol
  • parasympathetic
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Pancreatic Ductal Adenocarcinoma
  • Plan for neoadjuvant chemotherapy
  • Available diagnostic tissue adequate for biomarker analysis
  • Ability to tolerate PO meds and comply with study procedures

Exclusion criteria

Exclusion Criteria:

  • Metastatic disease
  • Evidence of GI obstruction
  • Baseline bradycardia (HR\<55) or hypotension (systolic blood pressure\<90)
  • Use of acetylcholinesterase inhibitors
  • Medical conditions including: hyperthyroidism, active/symptomatic coronary artery disease, seizure disorder, peptic ulcer disease.
04

Study design

Phase
Phase 2
Primary purpose
Other
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
37 participants (estimated)

Study arms

  • Experimental
    Bethanechol

    Patients with borderline resectable pancreatic cancer and no contraindication to bethanechol therapy will receive bethanechol on day 1 and continue until 2 days prior to scheduled surgery for a minimum of 2 months.

    Drug: Bethanechol · Drug: Gemcitabine · Drug: nab-paclitaxel

Interventions

  • DrugBethanechol

    Study Drug: Bethanechol (generic), supplied as 50mg oral tablets. Subjects will take 2 tablets (100mg) twice daily. Medication should be taken 1 hour before meals in AM and PM. Medication will be purchased commercially and dispensed at the research pharmacy.

    Also known as: Bethanechol chloride tablet

  • DrugGemcitabine

    Non-experimental. Chemotherapy will be administered on a day 1, 8 and 15 schedule with gemcitabine at a dose of 1000 mg/m2

  • Drugnab-paclitaxel

    Non-experimental. Chemotherapy will be administered on a day 1, 8 and 15 schedule with nab-paclitaxel dose at 125 mg/m2

05

What researchers measure

Primary outcomes

  1. R0 resection rate

    This rate will be analyzed in patients treated with bethanechol in combination with gemcitabine and nab-paclitaxel compared to historical R0 resection rates.

    Time frame: 36 months

Secondary outcomes

  1. Ki-67 expression in tumor cells

    This is to measure cell proliferation by Ki-67 expression in tumor cells, to quantify the change in tumor growth and alterations in inflammatory cytokines and immune profiles.

    Time frame: 36 months

06

Study locations

1 of 1 sites recruiting
  • Columbia University Medical Center
    New York, New York 10032, United States
    • Susan E Bates, MD · Principal investigator
    Recruiting
07

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT05241249
Lead sponsor
Susan E. Bates
Responsible party
Susan E. Bates (Associate Professor of Medicine, Columbia University) — Sponsor-investigator
First posted
Feb 15, 2022
Start date
Feb 1, 2022
Primary completion
Jan 2026 (estimated)
Completion
Jan 2026 (estimated)
Last update
Jun 5, 2025

Study contacts

Research Nurse Navigator
Contact
cancerclinicaltrials@cumc.columbia.edu
212-342-5162
Susan E Bates, MD
Contact
seb2227@cumc.columbia.edu
Susan E Bates, MD
principal investigator · Columbia University

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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