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Combination Therapy for Patients With Untreated Metastatic Pancreatic Ductal Adenocarcinoma

Primary Purpose

Untreated Metastatic Pancreatic Ductal Adenocarcinoma

Status
Active
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Nivolumab
Albumin-bound paclitaxel
Paricalcitol
Cisplatin
Gemcitabine
Sponsored by
HonorHealth Research Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Untreated Metastatic Pancreatic Ductal Adenocarcinoma

Eligibility Criteria

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

Inclusion Criteria:

  1. Age ≥18 years of age .
  2. Histologically or cytologically confirmed metastatic pancreatic ductal adenocarcinoma.
  3. Capable of providing informed consent and complying with Trial procedures.
  4. Karnofsky Performance Status (KPS) of ≥ 70%.
  5. Life expectancy ≥ 12 weeks.
  6. Measurable tumor lesions according to RECIST 1.1 criteria.
  7. Women must not be able to become pregnant (e.g. post-menopausal for at least 1 year, surgically sterile, or practicing adequate birth control methods) for the duration of the study. Women of child bearing potential must have a negative serum or urine pregnancy test at the Screening Visit and be non-lactating. Both male and female patients of reproductive potential must agree to use a reliable method of birth control during the study.

Exclusion Criteria:

  1. Patients must have received no previous radiotherapy, surgery, chemotherapy or investigational therapy for the treatment of metastatic disease. Prior treatments in the adjuvant setting with gemcitabine and/or 5-FU or gemcitabine administered as a radiation sensitizer are allowed, provided at least 6 months have elapsed since completion of the last dose and no lingering toxicities are present.
  2. Palliative surgery and/or radiation treatment less than 4 weeks prior to initiation of study treatment.
  3. Exposure to any investigational agent within 4 weeks prior to initiation of study treatment.
  4. Evidence of central nervous system (CNS) metastasis (negative imaging study, if clinically indicated, within 4 weeks of Screening Visit).
  5. History of other malignancies (except cured basal cell carcinoma, superficial bladder cancer or carcinoma in situ of the cervix) unless documented free of cancer for ≥5 years.
  6. Laboratory values: Screening serum creatinine > upper limit of normal (ULN); total bilirubin > (ULN); alanine aminotransferase (ALT) and AST ≥ 2.5 ULN or ≥ 5.0×ULN if liver metastases are present; absolute neutrophil count <1,500/mm3, platelet concentration <100,000/mm3, hematocrit level <27% for females or <30% for males, or coagulation tests (prothrombin time [PT], partial thromboplastin time [PTT], International Normalized Ratio [INR]) >1.5×ULN unless on therapeutic doses of warfarin.
  7. Current, serious, clinically significant cardiac arrhythmias as determined by the investigator.
  8. History of HIV infection or active or chronic hepatitis B or C.
  9. Active, clinically significant serious infection requiring treatment with antibiotics, anti-virals or anti-fungals.
  10. Major surgery within 4 weeks prior to initiation of study treatment.
  11. Any condition that might interfere with the patient's participation in the study or in the evaluation of the study results.
  12. Any condition that is unstable and could jeopardize the patient's participation in the study.
  13. Patient has a transplanted organ.
  14. Patients with a history of autoimmune disease.
  15. Prior PD-1 or PD-L1 therapy.
  16. Patients taking any chemo or immunosuppressive steroids (equivalent to > 20 mg hydrocortisone per day).
  17. Patients cannot have > Grade 1 pre-existing peripheral neuropathy (per CTCAE).

Sites / Locations

  • Clinical Trials Nurse Navigator

Arms of the Study

Arm 1

Arm Type

Other

Arm Label

single arm

Arm Description

open label using combination therapy

Outcomes

Primary Outcome Measures

Complete response rate
Complete response rate as defined by CT scan using RECIST 1.1 criteria and CA 19-9 (or CA 125, or CEA if not expressers of CA 19-9) down to normal limits.When a complete response is documented, a PET scan will be obtained to confirm.

Secondary Outcome Measures

Number of participants with treatment-related adverse events as assessed by CTCAE v4.0
Patients will be followed throughout their study participation and every 12 weeks following last dose of treatment until reported date of death.

Full Information

First Posted
April 19, 2016
Last Updated
August 14, 2023
Sponsor
HonorHealth Research Institute
Collaborators
Translational Genomics Research Institute, Bristol-Myers Squibb, Lustgarten Foundation
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1. Study Identification

Unique Protocol Identification Number
NCT02754726
Brief Title
Combination Therapy for Patients With Untreated Metastatic Pancreatic Ductal Adenocarcinoma
Official Title
A Phase II Pilot Trial of Nivolumab + Albumin-Bound Paclitaxel + Paricalcitol + Cisplatin + Gemcitabine (NAPPCG) In Patients With Previously Untreated Metastatic Pancreatic Ductal Adenocarcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
April 2016 (Actual)
Primary Completion Date
April 11, 2023 (Actual)
Study Completion Date
December 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
HonorHealth Research Institute
Collaborators
Translational Genomics Research Institute, Bristol-Myers Squibb, Lustgarten Foundation

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to find out if the study drugs nivolumab, albumin- bound paclitaxel, paricalcitol, cisplatin, and gemcitabine given together are safe and effective when combined to treat advanced pancreatic cancer.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Untreated Metastatic Pancreatic Ductal Adenocarcinoma

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
single arm
Arm Type
Other
Arm Description
open label using combination therapy
Intervention Type
Drug
Intervention Name(s)
Nivolumab
Other Intervention Name(s)
Opdivo
Intervention Description
Nivolumab 240mg 240 mg as a 60 minute infusion on days 1, 15, 29 per 42 day cycle
Intervention Type
Drug
Intervention Name(s)
Albumin-bound paclitaxel
Other Intervention Name(s)
Abraxane
Intervention Description
125 mg/m2 over 30 minutes IV infusion on days 1, 8 and 22, 29 per 42 day cycle
Intervention Type
Drug
Intervention Name(s)
Paricalcitol
Other Intervention Name(s)
Zemplar
Intervention Description
25 micrograms IV on days 1,4,8,12,15,18,22,26,29,32,36,39 (+/-1 day allowed for dosing per 42 day cycle
Intervention Type
Drug
Intervention Name(s)
Cisplatin
Other Intervention Name(s)
Platinol
Intervention Description
25 mg/m2 over 60 minutes IV infusion on days 1, 8 and 22, 29 per 42 day cycle
Intervention Type
Drug
Intervention Name(s)
Gemcitabine
Other Intervention Name(s)
Gemzar
Intervention Description
1000 mg/m2 over 30 minutes IV infusion on days 1, 8 and 22, 29 per 42 day cycle
Primary Outcome Measure Information:
Title
Complete response rate
Description
Complete response rate as defined by CT scan using RECIST 1.1 criteria and CA 19-9 (or CA 125, or CEA if not expressers of CA 19-9) down to normal limits.When a complete response is documented, a PET scan will be obtained to confirm.
Time Frame
From date of enrollment until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 100 months
Secondary Outcome Measure Information:
Title
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0
Description
Patients will be followed throughout their study participation and every 12 weeks following last dose of treatment until reported date of death.
Time Frame
From date of enrollment until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 100 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age ≥18 years of age . Histologically or cytologically confirmed metastatic pancreatic ductal adenocarcinoma. Capable of providing informed consent and complying with Trial procedures. Karnofsky Performance Status (KPS) of ≥ 70%. Life expectancy ≥ 12 weeks. Measurable tumor lesions according to RECIST 1.1 criteria. Women must not be able to become pregnant (e.g. post-menopausal for at least 1 year, surgically sterile, or practicing adequate birth control methods) for the duration of the study. Women of child bearing potential must have a negative serum or urine pregnancy test at the Screening Visit and be non-lactating. Both male and female patients of reproductive potential must agree to use a reliable method of birth control during the study. Exclusion Criteria: Patients must have received no previous radiotherapy, surgery, chemotherapy or investigational therapy for the treatment of metastatic disease. Prior treatments in the adjuvant setting with gemcitabine and/or 5-FU or gemcitabine administered as a radiation sensitizer are allowed, provided at least 6 months have elapsed since completion of the last dose and no lingering toxicities are present. Palliative surgery and/or radiation treatment less than 4 weeks prior to initiation of study treatment. Exposure to any investigational agent within 4 weeks prior to initiation of study treatment. Evidence of central nervous system (CNS) metastasis (negative imaging study, if clinically indicated, within 4 weeks of Screening Visit). History of other malignancies (except cured basal cell carcinoma, superficial bladder cancer or carcinoma in situ of the cervix) unless documented free of cancer for ≥5 years. Laboratory values: Screening serum creatinine > upper limit of normal (ULN); total bilirubin > (ULN); alanine aminotransferase (ALT) and AST ≥ 2.5 ULN or ≥ 5.0×ULN if liver metastases are present; absolute neutrophil count <1,500/mm3, platelet concentration <100,000/mm3, hematocrit level <27% for females or <30% for males, or coagulation tests (prothrombin time [PT], partial thromboplastin time [PTT], International Normalized Ratio [INR]) >1.5×ULN unless on therapeutic doses of warfarin. Current, serious, clinically significant cardiac arrhythmias as determined by the investigator. History of HIV infection or active or chronic hepatitis B or C. Active, clinically significant serious infection requiring treatment with antibiotics, anti-virals or anti-fungals. Major surgery within 4 weeks prior to initiation of study treatment. Any condition that might interfere with the patient's participation in the study or in the evaluation of the study results. Any condition that is unstable and could jeopardize the patient's participation in the study. Patient has a transplanted organ. Patients with a history of autoimmune disease. Prior PD-1 or PD-L1 therapy. Patients taking any chemo or immunosuppressive steroids (equivalent to > 20 mg hydrocortisone per day). Patients cannot have > Grade 1 pre-existing peripheral neuropathy (per CTCAE).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Erkut Borazanci, MD
Organizational Affiliation
HonorHealth Research Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
Clinical Trials Nurse Navigator
City
Scottsdale
State/Province
Arizona
ZIP/Postal Code
85258
Country
United States

12. IPD Sharing Statement

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Combination Therapy for Patients With Untreated Metastatic Pancreatic Ductal Adenocarcinoma

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