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Study of Ruxolitinib in Pancreatic Cancer Patients (Janus 1)

Primary Purpose

Pancreatic Cancer

Status
Terminated
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Ruxolitinib
Placebo
Capecitabine
Sponsored by
Incyte Corporation
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pancreatic Cancer focused on measuring Metastatic pancreatic cancer, Metastatic pancreatic adenocarcinoma that is recurrent

Eligibility Criteria

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

Inclusion Criteria:

  • Histologically or cytologically confirmed adenocarcinoma of the pancreas.
  • Advanced adenocarcinoma of the pancreas that is inoperable or metastatic.
  • Eastern Cooperative Oncology Group (ECOG) performance status 0 to 2
  • Received 1 prior chemotherapy regimen for advanced or metastatic disease (not including neoadjuvant and/or adjuvant therapy).
  • ≥ 2 weeks elapsed from the completion of previous treatment regimen and participants must have recovered or be at a new stable baseline from any related toxicities.
  • Radiographically measurable or evaluable disease
  • Modified Glasgow Prognostic Score (mGPS) of 1 or 2 as defined below:

    1. mGPS of 1: C-reactive protein >10 mg/L and albumin ≥35 g/L
    2. mGPS of 2: C-reactive protein >10 mg/L and albumin <35 g/L

Exclusion Criteria:

  • Received more than 1 prior regimen for advanced or metastatic disease.
  • Ongoing radiation therapy, radiation therapy administered within 30 days of enrollment.
  • Concurrent anticancer therapy (eg, chemotherapy, radiation therapy, surgery, immunotherapy, biologic therapy, hormonal therapy, investigational therapy, or tumor embolization).
  • Prior severe reaction to fluoropyrimidines, known dihydropyrimidine dehydrogenase deficiency (DPD), or other known hypersensitivity to active substances, including fluorouracil (5-FU), or ruxolitinib, or any of their excipients.
  • Prior treatment with a JAK inhibitor for any indication.

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Ruxolitinib plus capecitabine

Placebo plus capecitabine

Arm Description

Outcomes

Primary Outcome Measures

Overall Survival (OS)
Overall survival is reported here based on the number of deaths from randomization up to 6-months or to the data cutoff 11FEB2016.

Secondary Outcome Measures

Progression-free Survival (PFS)
Progressive Disease (PD) is defined using Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 at least a 20% increase in the sum of the LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions, unequivocal progression of non-target lesions, or the appearance of new lesions.
Percentage of Participants Achieving Progression Free Survival (PFS)
PFS is defined as the time from randomization until the earliest date of disease progression determined by investigator assessment of objective radiographic disease assessments per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1, or death due to any cause if sooner. Progressive Disease (PD) is defined using Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 at least a 20% increase in the sum of the LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions, unequivocal progression of non-target lesions, or the appearance of new lesions.
Objective Response Rate (ORR)
Objective response rate determined by radiographic disease assessments per RECIST (v1.1), by investigator assessment and was defined as the percentage of participants with Complete Response (CR) or Partial Response (PR) by Response Evaluation Criteria in Solid Tumours (RECIST) at any post baseline visit. Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST) for target lesions and assessed by computed tomography (CT) and/or magnetic resonance imaging (MRI) : Complete Response (CR), Disappearance of all target and non-target lesions; Partial Response (PR), >=30% decrease in the sum of the longest diameter of target lesions with no worsening of non-target lesions and no new lesions; Overall Response (OR) = CR + PR.
Duration of Response
Duration of overall response was defined as the time in months from Complete Response (CR) or Partial Response (PR) by Response Evaluation Criteria in Solid Tumours (RECIST v1.1) until the first date Progressive Disease (PD) was objectively documented or until the date of death.
Participants With Treatment-Emergent Adverse Events (TEAEs)
A treatment-emergent AE was defined as an event occurring after exposure to at least 1 dose of study drug (ruxolitinib or placebo). A treatment-related AE was defined as an event with a definite, probable, or possible causality to study medication. A serious AE is an event resulting in death, hospitalization, persistent or significant disability/incapacity, or is life threatening, a congenital anomaly/birth defect or requires medical or surgical intervention to prevent 1 of the outcomes above. The intensity of an AE was graded according to the National Cancer Institute common terminology criteria for adverse events (NCI-CTCAE) version 4.03: Grade 1 (Mild); Grade 2 (Moderate); Grade 3 (Severe); Grade 4 (life-threatening).

Full Information

First Posted
April 16, 2014
Last Updated
March 14, 2019
Sponsor
Incyte Corporation
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1. Study Identification

Unique Protocol Identification Number
NCT02117479
Brief Title
Study of Ruxolitinib in Pancreatic Cancer Patients (Janus 1)
Official Title
A Randomized, Double-Blind, Phase 3 Study of the JAK1/2 Inhibitor, Ruxolitinib or Placebo in Combination With Capecitabine in Subjects With Advanced or Metastatic Adenocarcinoma of the Pancreas Who Have Failed or Are Intolerant to First-Line Chemotherapy (The JANUS 1 Study)
Study Type
Interventional

2. Study Status

Record Verification Date
March 2019
Overall Recruitment Status
Terminated
Why Stopped
The study was terminated early based on the results of the planned interim analysis.
Study Start Date
March 2014 (Actual)
Primary Completion Date
February 2016 (Actual)
Study Completion Date
December 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Incyte Corporation

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Determining the efficacy, based upon overall survival, of ruxolitinib added to capecitabine for the treatment of advanced or metastatic pancreatic cancer.
Detailed Description
This was a randomized, double-blinded, placebo-controlled, Phase 3 study, in which approximately 310 participants with advanced or metastatic adenocarcinoma of the pancreas who have failed, or were intolerant to first-line chemotherapy, were to be randomized (1:1) to one of the following treatment groups: Treatment A (N = 155): Capecitabine + ruxolitinib Treatment B (N = 155): Capecitabine + placebo Treatment consisted of repeating 21-day cycles. Capecitabine was self-administered for the first 14 days of each cycle, and ruxolitinib/placebo was self-administered daily for each cycle. Treatment for all participants continued as long as the regimen was tolerated, and the participant did not meet discontinuation criteria. Participants who discontinued study treatment before study termination were monitored for safety up to 30-35 days from the end of treatment. All participants were followed for survival until study termination or the safety follow-up visit.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pancreatic Cancer
Keywords
Metastatic pancreatic cancer, Metastatic pancreatic adenocarcinoma that is recurrent

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
321 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Ruxolitinib plus capecitabine
Arm Type
Experimental
Arm Title
Placebo plus capecitabine
Arm Type
Active Comparator
Intervention Type
Drug
Intervention Name(s)
Ruxolitinib
Other Intervention Name(s)
Jakafi ®, Jakavi ®
Intervention Description
5 mg tablets to be administered by mouth twice daily (BID)
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
5 mg tablets to be administered by mouth twice daily (BID)
Intervention Type
Drug
Intervention Name(s)
Capecitabine
Intervention Description
150 and 500 mg tablets to be administered by mouth twice daily (BID)
Primary Outcome Measure Information:
Title
Overall Survival (OS)
Description
Overall survival is reported here based on the number of deaths from randomization up to 6-months or to the data cutoff 11FEB2016.
Time Frame
Randomization until death due to any cause; up to the data cutoff 11FEB2016.
Secondary Outcome Measure Information:
Title
Progression-free Survival (PFS)
Description
Progressive Disease (PD) is defined using Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 at least a 20% increase in the sum of the LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions, unequivocal progression of non-target lesions, or the appearance of new lesions.
Time Frame
Randomization to disease progression, or death due to any cause if sooner; up to 6-months or to the data cutoff 11FEB2016.
Title
Percentage of Participants Achieving Progression Free Survival (PFS)
Description
PFS is defined as the time from randomization until the earliest date of disease progression determined by investigator assessment of objective radiographic disease assessments per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1, or death due to any cause if sooner. Progressive Disease (PD) is defined using Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 at least a 20% increase in the sum of the LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions, unequivocal progression of non-target lesions, or the appearance of new lesions.
Time Frame
Randomization to disease progression, or death due to any cause if sooner; up to 6-months or to the data cutoff 11FEB2016.
Title
Objective Response Rate (ORR)
Description
Objective response rate determined by radiographic disease assessments per RECIST (v1.1), by investigator assessment and was defined as the percentage of participants with Complete Response (CR) or Partial Response (PR) by Response Evaluation Criteria in Solid Tumours (RECIST) at any post baseline visit. Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST) for target lesions and assessed by computed tomography (CT) and/or magnetic resonance imaging (MRI) : Complete Response (CR), Disappearance of all target and non-target lesions; Partial Response (PR), >=30% decrease in the sum of the longest diameter of target lesions with no worsening of non-target lesions and no new lesions; Overall Response (OR) = CR + PR.
Time Frame
Baseline through end of study; up to 6-months or to the data cutoff 11FEB2016.
Title
Duration of Response
Description
Duration of overall response was defined as the time in months from Complete Response (CR) or Partial Response (PR) by Response Evaluation Criteria in Solid Tumours (RECIST v1.1) until the first date Progressive Disease (PD) was objectively documented or until the date of death.
Time Frame
Baseline through end of study; up to 6-months or to the data cutoff 11FEB2016.
Title
Participants With Treatment-Emergent Adverse Events (TEAEs)
Description
A treatment-emergent AE was defined as an event occurring after exposure to at least 1 dose of study drug (ruxolitinib or placebo). A treatment-related AE was defined as an event with a definite, probable, or possible causality to study medication. A serious AE is an event resulting in death, hospitalization, persistent or significant disability/incapacity, or is life threatening, a congenital anomaly/birth defect or requires medical or surgical intervention to prevent 1 of the outcomes above. The intensity of an AE was graded according to the National Cancer Institute common terminology criteria for adverse events (NCI-CTCAE) version 4.03: Grade 1 (Mild); Grade 2 (Moderate); Grade 3 (Severe); Grade 4 (life-threatening).
Time Frame
Baseline through approximately 30 days post treatment discontinuation; up to 6-months or to the data cutoff 11FEB2016.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically or cytologically confirmed adenocarcinoma of the pancreas. Advanced adenocarcinoma of the pancreas that is inoperable or metastatic. Eastern Cooperative Oncology Group (ECOG) performance status 0 to 2 Received 1 prior chemotherapy regimen for advanced or metastatic disease (not including neoadjuvant and/or adjuvant therapy). ≥ 2 weeks elapsed from the completion of previous treatment regimen and participants must have recovered or be at a new stable baseline from any related toxicities. Radiographically measurable or evaluable disease Modified Glasgow Prognostic Score (mGPS) of 1 or 2 as defined below: mGPS of 1: C-reactive protein >10 mg/L and albumin ≥35 g/L mGPS of 2: C-reactive protein >10 mg/L and albumin <35 g/L Exclusion Criteria: Received more than 1 prior regimen for advanced or metastatic disease. Ongoing radiation therapy, radiation therapy administered within 30 days of enrollment. Concurrent anticancer therapy (eg, chemotherapy, radiation therapy, surgery, immunotherapy, biologic therapy, hormonal therapy, investigational therapy, or tumor embolization). Prior severe reaction to fluoropyrimidines, known dihydropyrimidine dehydrogenase deficiency (DPD), or other known hypersensitivity to active substances, including fluorouracil (5-FU), or ruxolitinib, or any of their excipients. Prior treatment with a JAK inhibitor for any indication.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Fitzroy Dawkins, M.D.
Organizational Affiliation
Incyte Corporation
Official's Role
Study Director
Facility Information:
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Avondale
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Chandler
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Gilbert
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Marietta
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Newnan
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Rome
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Detroit
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Papillion
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Lebanon
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Farmington
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Binghamton
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Bronx
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Fresh Meadows
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Hudson
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Johnson City
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New York
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Nyack
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Rochester
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Durham
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Wake Forest
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Winston-Salem
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Columbus
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Toledo
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Eugene
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Portland
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Springfield
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Tualatin
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Philadelphia
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Charleston
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Seneca
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Spartanburg
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Chattanooga
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Knoxville
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Memphis
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Nashville
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Arlington
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Austin
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Beaumont
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Bedford
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Cedar Park
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Dallas
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Denton
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El Paso
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Fort Worth
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Houston
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Plano
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Round Rock
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San Antonio
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Temple
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Tyler
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Waco
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Ogden
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Salt Lake City
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Blacksburg
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Virginia
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Richmond
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Roanoke
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Salem
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Wytheville
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Seattle
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Vancouver
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Madison
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Wisconsin
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Australian Capital Territory
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Australia
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New South Wales
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Australia
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South Australia
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Australia
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Victoria
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Australia
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Aalst
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Belgium
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Brugge
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Belgium
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Bruxelles
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Belgium
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Edegem
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Belgium
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Gent
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Belgium
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Gilly
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Belgium
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Kortrijk
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Belgium
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Leuven
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Belgium
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Calgary
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Alberta
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Canada
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Oshawa
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Ontario
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Canada
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Sault Ste. Marie
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Ontario
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Canada
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Toronto
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Ontario
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Canada
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Greenfield Park
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Quebec
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Canada
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Laval
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Quebec
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Canada
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Montreal
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Quebec
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Canada
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Aschaffenburg
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Germany
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Berlin
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Germany
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Bochum
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Germany
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Essen
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Germany
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Frankford
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Germany
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Koeln
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Germany
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Velbert
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Germany
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Aviano
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Italy
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Bari
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Italy
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Bergamo
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Italy
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Brescia
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Italy
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Cremona
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Italy
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Firenze
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Italy
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Genova
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Italy
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Lido di Camaiore
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Italy
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Milano
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Italy
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Napoli
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Italy
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Pisa
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Italy
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Rimini
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Italy
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Roma
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Italy
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Hwasun-gun
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Korea, Republic of
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Seongnam-si
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Korea, Republic of
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Seoul
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Korea, Republic of
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Auckland
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New Zealand
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Christchurch
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New Zealand
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Hamilton
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New Zealand
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Badajoz
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Spain
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Barcelona
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Spain
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Madrid
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Spain
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Malaga
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Spain
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Seville
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Spain
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Taichung
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Taiwan
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Tainan
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Taiwan
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Taipei
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Taiwan
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Patumwan
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Thailand
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Ratchathewi
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Thailand
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Seetatarom
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Thailand
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Aberdeen
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United Kingdom
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Bangor
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United Kingdom
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Birmingham
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United Kingdom
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Boston
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Bristol
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Cardiff
Country
United Kingdom
City
Glasgow
Country
United Kingdom
City
Guildford
Country
United Kingdom
City
Harlow
Country
United Kingdom
City
Huddersfield
Country
United Kingdom
City
Lancaster
Country
United Kingdom
City
Leeds
Country
United Kingdom
City
London
Country
United Kingdom
City
Manchester
Country
United Kingdom
City
Newcastle upon Tyne
Country
United Kingdom
City
Nottingham
Country
United Kingdom
City
Plymouth
Country
United Kingdom
City
Southampton
Country
United Kingdom
City
Sutton
Country
United Kingdom
City
Welwyn Garden City
Country
United Kingdom
City
Wirral
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
29508247
Citation
Hurwitz H, Van Cutsem E, Bendell J, Hidalgo M, Li CP, Salvo MG, Macarulla T, Sahai V, Sama A, Greeno E, Yu KH, Verslype C, Dawkins F, Walker C, Clark J, O'Reilly EM. Ruxolitinib + capecitabine in advanced/metastatic pancreatic cancer after disease progression/intolerance to first-line therapy: JANUS 1 and 2 randomized phase III studies. Invest New Drugs. 2018 Aug;36(4):683-695. doi: 10.1007/s10637-018-0580-2. Epub 2018 Mar 6.
Results Reference
derived

Learn more about this trial

Study of Ruxolitinib in Pancreatic Cancer Patients (Janus 1)

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