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Monoclonal Antibody RAV12 and Gemcitabine in Treating Patients With Metastatic Pancreatic Cancer

Primary Purpose

Pancreatic Cancer

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
RAV12 plus gemcitabine
Sponsored by
MacroGenics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pancreatic Cancer focused on measuring adenocarcinoma of the pancreas, stage IV pancreatic cancer, recurrent pancreatic cancer

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

DISEASE CHARACTERISTICS:

  • Histologically or cytologically confirmed adenocarcinoma of the pancreas

    • Metastatic disease

      • No prior therapy for metastatic disease (except prior adjuvant chemotherapy and/or radiotherapy)
  • At least 1 radiographically measurable site of disease ≥ 2 cm in the largest dimension by traditional CT technique or ≥ 1 cm by spiral CT scan (per RECIST)
  • No known history of current or prior central nervous system (CNS) metastatic disease

PATIENT CHARACTERISTICS:

  • Eastern Cooperative Oncology Group performance status 0-2
  • Absolute neutrophil count ≥ 1,500/mm³
  • Platelet count ≥ 100,000/mm³
  • Hemoglobin ≥ 9.0 g/dL
  • alanine aminotransferase and aspartate aminotransferase ≤ 2.5 times upper limit of normal (ULN)
  • Alkaline phosphatase and γ-glutamyltransferase ≤ 2.5 times ULN
  • Amylase and lipase ≤ 1.5 times ULN
  • Total bilirubin ≤ 1.5 times ULN
  • Creatinine < 1.5 mg/dL
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • Must be available for study-related treatments and assessments at the treating institution
  • No known hypersensitivity to any component of gemcitabine hydrochloride
  • No known hypersensitivity to murine or recombinant proteins, polysorbate 80, or any excipient contained in the drug formulation
  • No other primary malignancy that has been in remission for ≤ 3 years except treated nonmelanoma skin cancer, biopsy-confirmed carcinoma in situ of the cervix, squamous intraepithelial lesion on Papanicolaou smear, localized prostate cancer with Gleason score < 6, or resected melanoma in situ
  • No other primary malignancy that has a generally accepted recurrence risk ≥ 10%
  • No active viral, bacterial, or systemic fungal infection requiring parenteral treatment within 4 weeks of enrollment
  • No history of chronic or recurrent infections that require continuous use of antiviral, antifungal, or antibacterial agents
  • No serious underlying medical condition that would impair the patient's ability to receive or tolerate the planned treatment at the investigational site, including significant pulmonary compromise or heart disease of New York Heart Association class III or IV
  • No dementia or altered mental status that would preclude sufficient understanding to provide informed consent

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • More than 4 weeks since prior major surgery
  • More than 4 weeks since prior and no other concurrent investigational agents
  • More than 1 week since prior oral antiviral, antifungal, or antibacterial therapy
  • No concurrent immunosuppressive medications, steroids (except steroid inhaler, ophthalmic solution, nasal spray, or a stable dose of ≤ 10 mg/day of oral prednisone or equivalent), other antineoplastic therapy, or antitumor vaccinations
  • Monoclonal antibody treatment for non-cancer indications must be completed at least 3 half lives from study entry
  • No concurrent prophylactic hematologic growth factors
  • No concurrent megavitamin therapy
  • No concurrent bisphosphonates

Sites / Locations

  • MacroGenics, Incorporated
  • Fox Chase Cancer Center - Philadelphia

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

RAV12 plus gemcitabine

Arm Description

Outcomes

Primary Outcome Measures

Proportion of Patients Alive at 8 Months

Secondary Outcome Measures

Proportion of Patients Alive at 12 Months
Partial Response and Complete Response Rates
Based on Response Evaluation Criteria in Solid Tumors (RECIST) criteria 1.0; partial response = 30% decrease in sum of longest diameter. complete response = 100% decrease in sum of longest diameter. Rate of response = proportion of complete or partial responses based on number of patients evaluated.
Progression-free Survival
Overall Survival
Adverse Events
Frequency of adverse events and serious adverse events
Cmax
RAV12 and gemcitabine cmax

Full Information

First Posted
February 26, 2008
Last Updated
November 20, 2012
Sponsor
MacroGenics
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1. Study Identification

Unique Protocol Identification Number
NCT00625586
Brief Title
Monoclonal Antibody RAV12 and Gemcitabine in Treating Patients With Metastatic Pancreatic Cancer
Official Title
A Phase 2 Evaluation of the Monoclonal Antibody, RAV12, in Combination With Standard Gemcitabine in the Treatment of Patients With Metastatic Pancreatic Cancer Who Have Not Been Previously Treated for Metastatic Disease
Study Type
Interventional

2. Study Status

Record Verification Date
November 2012
Overall Recruitment Status
Terminated
Why Stopped
Corporate decision
Study Start Date
March 2008 (undefined)
Primary Completion Date
January 2009 (Actual)
Study Completion Date
March 2009 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
MacroGenics

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
RATIONALE: Monoclonal antibodies, such as RAV12, can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Drugs used in chemotherapy, such as gemcitabine, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving RAV12 together with gemcitabine may kill more tumor cells. PURPOSE: This phase II trial is studying the side effects and best dose of monoclonal antibody RAV12 when given together with gemcitabine in treating patients with metastatic pancreatic cancer.
Detailed Description
OBJECTIVES: To determine the maximum tolerated dose of monoclonal antibody RAV12 when administered with standard gemcitabine hydrochloride in patients with previously untreated metastatic pancreatic cancer. To determine the proportion of these patients surviving at 8 months after initiation of this regimen. To provide point estimates for response rate and duration of response in patients treated with this regimen. To define the toxicity profile of this drug in these patients when administered with standard gemcitabine hydrochloride. To estimate, preliminarily, the progression-free survival and overall survival of these patients after treatment with this regimen. To explore the utility of the tumor marker, carbohydrate antigen 19-9 (CA19-9), in the assessment of these patients. OUTLINE: This is a dose-escalation study of monoclonal antibody RAV12, followed by an efficacy study. The study is conducted in two segments. Segment 1 (dose escalation of RAV12): Patients receive gemcitabine hydrochloride IV over 30 minutes on days 1, 8, 15, and 22 of course 1 and on days 1, 8, and 15 of each subsequent course. Patients also receive RAV12 IV once weekly on days 1, 8, and 15 or twice weekly on days 1, 4 or 5, 8, 11 or 12, 15, and 18 or 19 until the maximum tolerated dose (MTD) is reached. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity. Segment 2 (efficacy): Once the MTD has been determined, patients receive RAV12 at the MTD and gemcitabine hydrochloride as in segment 1. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity. Blood samples are obtained for pharmacokinetic sampling during the dose-escalation segment of the study. Samples are analyzed to determine plasma concentrations of RAV12, gemcitabine hydrochloride, and difluorodeoxyuridine. Blood samples are also examined periodically for expression of serum biomarkers (i.e., CA19-9, RAAG12, and HACA) and for DNA analysis of Fc-gamma receptor polymorphisms. Archival paraffin blocks or slides from biopsy of primary or metastatic deposit or fresh/frozen tissue may be obtained at baseline for additional correlative studies. Samples are analyzed by immunohistochemistry (IHC) for expression of RAAG12 and for development of a companion RAAG12 diagnostic assay. After completion of study therapy, patients are followed every 8 weeks for up to 3 years. PROJECTED ACCRUAL: This study will accrue a total of 18 patients in the dose-escalation segment and 63 patients in the efficacy segment of the trial.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pancreatic Cancer
Keywords
adenocarcinoma of the pancreas, stage IV pancreatic cancer, recurrent pancreatic cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
2 (Actual)

8. Arms, Groups, and Interventions

Arm Title
RAV12 plus gemcitabine
Arm Type
Experimental
Intervention Type
Biological
Intervention Name(s)
RAV12 plus gemcitabine
Other Intervention Name(s)
gemcitabine: Gemzar
Intervention Description
Initial dose of gemcitabine plus RAV12 at 0.375 mg/kg qw escalated to 0.75 mg/kg qw. During the efficacy segment, 63 pts were to be treated with gemcitabine 1000 mg/m2 iv over 30 min., weekly days 1, 8, 15, 22 of the first cycle and 1000 mg/m2 iv over 30 min., weekly days 1, 8, and 15 of each subsequent cycle of 28 days plus RAV12 at Maximum Tolerated Dose (MTD) iv days 1; 4 or 5; 8, 11 or 12; and 15, 18 or 19 of each 28-day cycle until progression.
Primary Outcome Measure Information:
Title
Proportion of Patients Alive at 8 Months
Time Frame
8 months
Secondary Outcome Measure Information:
Title
Proportion of Patients Alive at 12 Months
Time Frame
12 months
Title
Partial Response and Complete Response Rates
Description
Based on Response Evaluation Criteria in Solid Tumors (RECIST) criteria 1.0; partial response = 30% decrease in sum of longest diameter. complete response = 100% decrease in sum of longest diameter. Rate of response = proportion of complete or partial responses based on number of patients evaluated.
Time Frame
8 months
Title
Progression-free Survival
Time Frame
time to progression or death, up to 3 years
Title
Overall Survival
Time Frame
three years
Title
Adverse Events
Description
Frequency of adverse events and serious adverse events
Time Frame
any timeframe following study drug up to 3 years
Title
Cmax
Description
RAV12 and gemcitabine cmax
Time Frame
29 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically or cytologically confirmed adenocarcinoma of the pancreas Metastatic disease No prior therapy for metastatic disease (except prior adjuvant chemotherapy and/or radiotherapy) At least 1 radiographically measurable site of disease ≥ 2 cm in the largest dimension by traditional CT technique or ≥ 1 cm by spiral CT scan (per RECIST) No known history of current or prior central nervous system (CNS) metastatic disease PATIENT CHARACTERISTICS: Eastern Cooperative Oncology Group performance status 0-2 Absolute neutrophil count ≥ 1,500/mm³ Platelet count ≥ 100,000/mm³ Hemoglobin ≥ 9.0 g/dL alanine aminotransferase and aspartate aminotransferase ≤ 2.5 times upper limit of normal (ULN) Alkaline phosphatase and γ-glutamyltransferase ≤ 2.5 times ULN Amylase and lipase ≤ 1.5 times ULN Total bilirubin ≤ 1.5 times ULN Creatinine < 1.5 mg/dL Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception Must be available for study-related treatments and assessments at the treating institution No known hypersensitivity to any component of gemcitabine hydrochloride No known hypersensitivity to murine or recombinant proteins, polysorbate 80, or any excipient contained in the drug formulation No other primary malignancy that has been in remission for ≤ 3 years except treated nonmelanoma skin cancer, biopsy-confirmed carcinoma in situ of the cervix, squamous intraepithelial lesion on Papanicolaou smear, localized prostate cancer with Gleason score < 6, or resected melanoma in situ No other primary malignancy that has a generally accepted recurrence risk ≥ 10% No active viral, bacterial, or systemic fungal infection requiring parenteral treatment within 4 weeks of enrollment No history of chronic or recurrent infections that require continuous use of antiviral, antifungal, or antibacterial agents No serious underlying medical condition that would impair the patient's ability to receive or tolerate the planned treatment at the investigational site, including significant pulmonary compromise or heart disease of New York Heart Association class III or IV No dementia or altered mental status that would preclude sufficient understanding to provide informed consent PRIOR CONCURRENT THERAPY: See Disease Characteristics More than 4 weeks since prior major surgery More than 4 weeks since prior and no other concurrent investigational agents More than 1 week since prior oral antiviral, antifungal, or antibacterial therapy No concurrent immunosuppressive medications, steroids (except steroid inhaler, ophthalmic solution, nasal spray, or a stable dose of ≤ 10 mg/day of oral prednisone or equivalent), other antineoplastic therapy, or antitumor vaccinations Monoclonal antibody treatment for non-cancer indications must be completed at least 3 half lives from study entry No concurrent prophylactic hematologic growth factors No concurrent megavitamin therapy No concurrent bisphosphonates
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Stanford Stewart, MD
Organizational Affiliation
MacroGenics, Incorporated
Official's Role
Study Chair
Facility Information:
Facility Name
MacroGenics, Incorporated
City
South San Francisco
State/Province
California
ZIP/Postal Code
94080
Country
United States
Facility Name
Fox Chase Cancer Center - Philadelphia
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19111-2497
Country
United States

12. IPD Sharing Statement

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Monoclonal Antibody RAV12 and Gemcitabine in Treating Patients With Metastatic Pancreatic Cancer

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