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A Trial Comparing Gemcitabine With and Without IMM-101 in Advanced Pancreatic Cancer

Primary Purpose

Advanced Pancreatic Cancer

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
IMM-101
Gemcitabine
Sponsored by
Immodulon Therapeutics Ltd
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Advanced Pancreatic Cancer

Eligibility Criteria

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

Inclusion Criteria:

  • Male or female; aged ≥18 years.
  • Histologically and/or cytologically confirmed inoperable ductal adenocarcinoma of the pancreas, including the mucinous variant. This will include locally advanced and metastatic disease (stage III/IV).
  • Presence of measurable lesions in at least one site which have not been previously irradiated (bone lesions, ascites and pleural effusions are not considered as measurable), described as any of the following:

    • Any primary tumour with at least bi-dimensionally measurable disease.
    • a) Palpable lymph nodes; b) Deep seated lymph nodes.
    • Liver metastases measurable by computerised tomography (CT) scan.
    • Deep seated soft tissue lesions measurable by CT scan.
  • World Health Organization (WHO) performance status of 0-2
  • Serum creatinine <140 μmol/L
  • White blood cell (WBC) count, including differential counts within the normal range or, if outside the normal range, considered by the Investigator not to be clinically significant.
  • Life expectancy of >3 months from randomisation.
  • Provided written informed consent to participate as shown by a signature and date on the patient's Informed Consent Form

Exclusion Criteria:

  • Acinar cell carcinoma, neuroendocrine tumours, lymphomas or squamous cell carcinomas.
  • Severe, active uncontrolled infection requiring systemic antibiotics, antiviral or antifungal treatments.
  • Any previous chemotherapy treatment for pancreatic cancer.
  • Eligible for resection of the pancreatic primary tumour but has either refused the operation or is considered to be medically unfit for the operation.
  • Clinical or CT evidence of central nervous system (CNS) metastases.
  • Any previous or concurrent malignancy, except adequately treated carcinoma in situ of the cervix, basal cell carcinoma of the skin and/or non-melanoma skin cancer, or if previous malignancy was more than 5 years earlier and there were no signs of recurrence.
  • Any previous treatment with IMM-101 or related mycobacterial immunotherapy.
  • Serum albumin < 26 g/L.
  • C-reactive protein (CRP) > 70 mg/L.
  • Radiotherapy in the 6 weeks prior to screening.
  • Depot corticosteroids in the 6 weeks prior to screening.
  • Chronic use of any systemic corticosteroids and/or immunosuppressant drugs within the 2-week period prior to the first administration of study drug.
  • Female patient of child-bearing potential who is not, in the opinion of the Investigator, using an approved method of birth control.
  • Female patient who were pregnant, breast feeding or planning a pregnancy during the course of the study. A pre-treatment serum pregnancy test measuring human chorionic gonadotrophin (hCG) had to be negative.
  • Had been administered any investigational product e.g. drug, vaccine or device, in the 3 months prior to screening.
  • Surgical or medical condition which, in the judgement of the Investigator, might interfere with the activity of IMM-101, or with the performance of this study.
  • Any uncontrolled concomitant disease (e.g. unstable angina pectoris, congestive heart failure, myocardial infarction, arrhythmias, and uncontrolled severe hypertension) which, in the judgement of the Investigator, might interfere with the activity of IMM 101, or with the performance of this study.
  • A history of serious adverse reaction or serious hypersensitivity to any drug.
  • Known to have a history of human immunodeficiency virus (HIV) or syphilis, current symptomatic Hepatitis B or C. Testing is not required in the absence of clinical signs and symptoms suggestive of infection with HIV.
  • Unable or unwilling to comply with the protocol.

Sites / Locations

  • Cyprus Oncology Centre
  • Adelaide, Meath & National Childrens Hospital,
  • St Vicents University Hospital
  • Azienda Ospedaliero-Universitaria di Bologna
  • A.O. Santa Croce e Carle, Struttura Complessa di Oncologia Medica
  • Azienda Ospedaliera San Gerardo Struttura Complessa Oncologia Medica
  • AOU Maggiore della Carità
  • Medical Oncology Department, Central University Hospital of Asturias
  • Hospital General de Alicante
  • Hospital Gregorio Marañon
  • Instituto Valenciano de Oncologia
  • Department of Medical Oncology, Hospital Universitari La Fe,
  • Hospital Miguel Servet
  • Airedale General Hospital
  • Royal Blackburn Hospital
  • Bradford Royal Infirmary
  • Velindre Cancer Centre
  • Ninewells Hospital,
  • Mount Vernon Cancer Centre
  • The London Clinic Cancer Centre
  • Peterbrough City Hospital, Haematology/Oncology Dept,

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Experimental

Arm Label

Gemcitabine chemotherapy

IMM-101 in addition to gemcitabine

Arm Description

Patients in the control arm will receive normal standard of care - up to 12 cycles of Gemcitabine. Dosing of Gemcitabine is as per the normal prescribing information for pancreatic cancer.

Patients in the experimental arm will receive IMM-101 in addition to the current standard of care, namely chemotherapy (Gemcitabine). The treatment regimen with IMM-101 will be every 2 weeks for the first 3 doses followed by a rest of 4 weeks then every 2 weeks for the next 3 doses followed by every 4 weeks thereafter. For patients in the active group, chemotherapy (Gemcitabine) will begin at least 14 days after first dose of IMM-101. Chemotherapy plus IMM-101 will be offered until intolerable toxicity or withdrawal from the study up to a maximum of 12 cycles (i.e. approximately 48 weeks). Patients who complete the Main Study and who provide informed consent are eligible to participate in a long term treatment Sub-Study (IMM-101-002A)

Outcomes

Primary Outcome Measures

Safety and Tolerability.
A clinically relevant deleterious effect of IMM-101 on safety and tolerability profiles was judged by: Local and systemic toxicities. Number, type and degree of toxicities as measured by the National Cancer Institute (NCI) Common Toxicity Criteria for Adverse Events (CTCAE) v4.0. Adverse events were collected from time of Informed Consent to 30 days post last dose of study medication IMM-101 does not appear to confer an incremental safety burden beyond that associated with chemotherapy and the disease itself. No new safety signals were identified from this study. The numbers of SAEs by preferred term were low, such that no trends could be inferred from these data and no significant SAEs attributable to IMM 101 were observed.

Secondary Outcome Measures

Survival
Overall and progression free survival
Overall Response Rate (ORR).
A clinically relevant improvement Overall Response Rate (ORR). Overall response rate was defined as the percentage of patients with a complete response or partial response as assessed by RECIST v1.1 criteria.
Overall Survival in Metastatic Patients Only
Overall and progression free survival in metastatic patients only

Full Information

First Posted
February 18, 2011
Last Updated
November 3, 2021
Sponsor
Immodulon Therapeutics Ltd
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1. Study Identification

Unique Protocol Identification Number
NCT01303172
Brief Title
A Trial Comparing Gemcitabine With and Without IMM-101 in Advanced Pancreatic Cancer
Official Title
A Randomised, Open-Label, Proof-of-Concept, Phase II Trial Comparing Gemcitabine With and Without IMM-101 in Advanced Pancreatic Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
November 2021
Overall Recruitment Status
Completed
Study Start Date
June 2011 (Actual)
Primary Completion Date
June 2014 (Actual)
Study Completion Date
January 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Immodulon Therapeutics Ltd

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
To compare, in patients with advanced pancreatic cancer, the effects of IMM-101 in combination with gemcitabine to gemcitabine alone on safety and tolerability (including QoL), clinical signs and symptoms of disease, selected markers of tumour burden and immunological status, and disease outcome.
Detailed Description
Patients in the IMM 101 treated group received an initial dose of IMM-101 followed by a maximum of 12 cycles of Gemcitabine (plus IMM-101); patients in the control group received Gemcitabine alone. All patients were to receive Gemcitabine once weekly for 3 consecutive weeks out of every 4 weeks. Patients in the IMM 101 treated group were to receive IMM 101 every 2 weeks for the first 3 doses, followed by a 4 week rest, then IMM-101 every 2 weeks for the next 3 doses. After this time, patients received doses every 4 weeks. Gemcitabine treatment began at least 14 days after the first dose of IMM-101 in the IMM 101 treated group. Patients who completed the Main Study and who provided informed consent were eligible to participate in a long term treatment Sub-Study. All patients received IMM-101 in the open-label, single arm, Sub-Study irrespective of whether they had been randomised to Gemcitabine or Gemcitabine plus IMM-101 in the main study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Advanced Pancreatic Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
110 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Gemcitabine chemotherapy
Arm Type
Active Comparator
Arm Description
Patients in the control arm will receive normal standard of care - up to 12 cycles of Gemcitabine. Dosing of Gemcitabine is as per the normal prescribing information for pancreatic cancer.
Arm Title
IMM-101 in addition to gemcitabine
Arm Type
Experimental
Arm Description
Patients in the experimental arm will receive IMM-101 in addition to the current standard of care, namely chemotherapy (Gemcitabine). The treatment regimen with IMM-101 will be every 2 weeks for the first 3 doses followed by a rest of 4 weeks then every 2 weeks for the next 3 doses followed by every 4 weeks thereafter. For patients in the active group, chemotherapy (Gemcitabine) will begin at least 14 days after first dose of IMM-101. Chemotherapy plus IMM-101 will be offered until intolerable toxicity or withdrawal from the study up to a maximum of 12 cycles (i.e. approximately 48 weeks). Patients who complete the Main Study and who provide informed consent are eligible to participate in a long term treatment Sub-Study (IMM-101-002A)
Intervention Type
Biological
Intervention Name(s)
IMM-101
Other Intervention Name(s)
Heat killed whole cell Mycobacterium obuense (M. obuense)
Intervention Description
IMM-101 is a suspension of heat-killed whole cell M. obuense in borate-buffered saline. A single 0.1 mL intradermal injection of IMM-101 (10 mg/mL) will be administered every 2 weeks for the first 3 doses followed by a rest of 4 weeks then every 2 weeks for the next 3 doses followed by every 4 weeks thereafter. Chemotherapy plus IMM-101 will be offered until intolerable toxicity or withdrawal from the study up to a maximum of 12 cycles of gemcitabine.
Intervention Type
Drug
Intervention Name(s)
Gemcitabine
Other Intervention Name(s)
Gemzar
Intervention Description
Gemcitabine will be administered intravenously at 1000 mg/m2 over 30 minutes once weekly for 3 consecutive weeks out of every 4 weeks. Chemotherapy will be offered until intolerable toxicity or withdrawal from the study up to a maximum of 12 cycles (i.e. approximately 48 weeks). Dosage reduction with each cycle or within each cycle may be applied based upon the grade of Gemcitabine-related toxicity experienced by the patient using centre's standard protocol.
Primary Outcome Measure Information:
Title
Safety and Tolerability.
Description
A clinically relevant deleterious effect of IMM-101 on safety and tolerability profiles was judged by: Local and systemic toxicities. Number, type and degree of toxicities as measured by the National Cancer Institute (NCI) Common Toxicity Criteria for Adverse Events (CTCAE) v4.0. Adverse events were collected from time of Informed Consent to 30 days post last dose of study medication IMM-101 does not appear to confer an incremental safety burden beyond that associated with chemotherapy and the disease itself. No new safety signals were identified from this study. The numbers of SAEs by preferred term were low, such that no trends could be inferred from these data and no significant SAEs attributable to IMM 101 were observed.
Time Frame
From time of Informed Consent to 30 days post last dose of study medication
Secondary Outcome Measure Information:
Title
Survival
Description
Overall and progression free survival
Time Frame
From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 1 year (or longer in the case of patients who entered the long term treatment sub-study, up to 5 years).
Title
Overall Response Rate (ORR).
Description
A clinically relevant improvement Overall Response Rate (ORR). Overall response rate was defined as the percentage of patients with a complete response or partial response as assessed by RECIST v1.1 criteria.
Time Frame
From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 1 year (or longer in the case of patients who entered the long term treatment sub-study).
Title
Overall Survival in Metastatic Patients Only
Description
Overall and progression free survival in metastatic patients only
Time Frame
From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 1 year (or longer in the case of patients who entered the long term treatment sub-study, up to 5 years).

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female; aged ≥18 years. Histologically and/or cytologically confirmed inoperable ductal adenocarcinoma of the pancreas, including the mucinous variant. This will include locally advanced and metastatic disease (stage III/IV). Presence of measurable lesions in at least one site which have not been previously irradiated (bone lesions, ascites and pleural effusions are not considered as measurable), described as any of the following: Any primary tumour with at least bi-dimensionally measurable disease. a) Palpable lymph nodes; b) Deep seated lymph nodes. Liver metastases measurable by computerised tomography (CT) scan. Deep seated soft tissue lesions measurable by CT scan. World Health Organization (WHO) performance status of 0-2 Serum creatinine <140 μmol/L White blood cell (WBC) count, including differential counts within the normal range or, if outside the normal range, considered by the Investigator not to be clinically significant. Life expectancy of >3 months from randomisation. Provided written informed consent to participate as shown by a signature and date on the patient's Informed Consent Form Exclusion Criteria: Acinar cell carcinoma, neuroendocrine tumours, lymphomas or squamous cell carcinomas. Severe, active uncontrolled infection requiring systemic antibiotics, antiviral or antifungal treatments. Any previous chemotherapy treatment for pancreatic cancer. Eligible for resection of the pancreatic primary tumour but has either refused the operation or is considered to be medically unfit for the operation. Clinical or CT evidence of central nervous system (CNS) metastases. Any previous or concurrent malignancy, except adequately treated carcinoma in situ of the cervix, basal cell carcinoma of the skin and/or non-melanoma skin cancer, or if previous malignancy was more than 5 years earlier and there were no signs of recurrence. Any previous treatment with IMM-101 or related mycobacterial immunotherapy. Serum albumin < 26 g/L. C-reactive protein (CRP) > 70 mg/L. Radiotherapy in the 6 weeks prior to screening. Depot corticosteroids in the 6 weeks prior to screening. Chronic use of any systemic corticosteroids and/or immunosuppressant drugs within the 2-week period prior to the first administration of study drug. Female patient of child-bearing potential who is not, in the opinion of the Investigator, using an approved method of birth control. Female patient who were pregnant, breast feeding or planning a pregnancy during the course of the study. A pre-treatment serum pregnancy test measuring human chorionic gonadotrophin (hCG) had to be negative. Had been administered any investigational product e.g. drug, vaccine or device, in the 3 months prior to screening. Surgical or medical condition which, in the judgement of the Investigator, might interfere with the activity of IMM-101, or with the performance of this study. Any uncontrolled concomitant disease (e.g. unstable angina pectoris, congestive heart failure, myocardial infarction, arrhythmias, and uncontrolled severe hypertension) which, in the judgement of the Investigator, might interfere with the activity of IMM 101, or with the performance of this study. A history of serious adverse reaction or serious hypersensitivity to any drug. Known to have a history of human immunodeficiency virus (HIV) or syphilis, current symptomatic Hepatitis B or C. Testing is not required in the absence of clinical signs and symptoms suggestive of infection with HIV. Unable or unwilling to comply with the protocol.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Angus Dalgleish, Professor
Organizational Affiliation
St George's, University of London
Official's Role
Principal Investigator
Facility Information:
Facility Name
Cyprus Oncology Centre
City
Nicosia
State/Province
Strovolos
ZIP/Postal Code
2006
Country
Cyprus
Facility Name
Adelaide, Meath & National Childrens Hospital,
City
Dublin
ZIP/Postal Code
Dublin 24
Country
Ireland
Facility Name
St Vicents University Hospital
City
Dublin
ZIP/Postal Code
Dublin 4
Country
Ireland
Facility Name
Azienda Ospedaliero-Universitaria di Bologna
City
Bologna
ZIP/Postal Code
40138
Country
Italy
Facility Name
A.O. Santa Croce e Carle, Struttura Complessa di Oncologia Medica
City
Cuneo
Country
Italy
Facility Name
Azienda Ospedaliera San Gerardo Struttura Complessa Oncologia Medica
City
Monza
ZIP/Postal Code
20900
Country
Italy
Facility Name
AOU Maggiore della Carità
City
Novara
Country
Italy
Facility Name
Medical Oncology Department, Central University Hospital of Asturias
City
Oviedo
State/Province
Asturias
Country
Spain
Facility Name
Hospital General de Alicante
City
Alicante
ZIP/Postal Code
03010
Country
Spain
Facility Name
Hospital Gregorio Marañon
City
Madrid
ZIP/Postal Code
28007
Country
Spain
Facility Name
Instituto Valenciano de Oncologia
City
Valencia
ZIP/Postal Code
46009
Country
Spain
Facility Name
Department of Medical Oncology, Hospital Universitari La Fe,
City
Valencia
ZIP/Postal Code
46026
Country
Spain
Facility Name
Hospital Miguel Servet
City
Zaragoza
ZIP/Postal Code
50009
Country
Spain
Facility Name
Airedale General Hospital
City
Skipton
State/Province
West Yorkshire
ZIP/Postal Code
BD20 6TD
Country
United Kingdom
Facility Name
Royal Blackburn Hospital
City
Blackburn
ZIP/Postal Code
BB2 3HH
Country
United Kingdom
Facility Name
Bradford Royal Infirmary
City
Bradford
ZIP/Postal Code
BD9 6RJ
Country
United Kingdom
Facility Name
Velindre Cancer Centre
City
Cardiff
ZIP/Postal Code
Velindre Cancer Centre
Country
United Kingdom
Facility Name
Ninewells Hospital,
City
Dundee
ZIP/Postal Code
DD1 9SY
Country
United Kingdom
Facility Name
Mount Vernon Cancer Centre
City
London
ZIP/Postal Code
HA6 2RN
Country
United Kingdom
Facility Name
The London Clinic Cancer Centre
City
London
ZIP/Postal Code
W1G 6BW
Country
United Kingdom
Facility Name
Peterbrough City Hospital, Haematology/Oncology Dept,
City
Peterborough
ZIP/Postal Code
PE3 9GZ
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
27599039
Citation
Dalgleish AG, Stebbing J, Adamson DJ, Arif SS, Bidoli P, Chang D, Cheeseman S, Diaz-Beveridge R, Fernandez-Martos C, Glynne-Jones R, Granetto C, Massuti B, McAdam K, McDermott R, Martin AJ, Papamichael D, Pazo-Cid R, Vieitez JM, Zaniboni A, Carroll KJ, Wagle S, Gaya A, Mudan SS. Randomised, open-label, phase II study of gemcitabine with and without IMM-101 for advanced pancreatic cancer. Br J Cancer. 2016 Sep 27;115(7):789-96. doi: 10.1038/bjc.2016.271. Epub 2016 Sep 6. Erratum In: Br J Cancer. 2016 Oct 25;115(9):e16.
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A Trial Comparing Gemcitabine With and Without IMM-101 in Advanced Pancreatic Cancer

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