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Epacadostat, Pembrolizumab, and CRS-207, With or Without CY/GVAX Pancreas in Patients With Metastatic Pancreas Cancer

Primary Purpose

Metastatic Pancreatic Adenocarcinoma

Status
Active
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Epacadostat
Pembrolizumab
CRS-207
CY
GVAX
Sponsored by
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Metastatic Pancreatic Adenocarcinoma focused on measuring pancreatic cancer, vaccine, immunotherapy, MK-3475, PD-1, IDO

Eligibility Criteria

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

Inclusion Criteria (abbreviated):

  • Documented adenocarcinoma of the pancreas
  • Have disease progression after prior chemotherapy for metastatic pancreas cancer (or adjuvant or neoadjuvant if progression occurred within 6 months of completing this regimen)
  • Presence of at least one measurable lesion
  • Patient acceptance to have a tumor biopsy of an accessible lesion at 2 time points (baseline and on study)
  • ECOG performance status of 0 or 1
  • Life expectancy of greater than 3 months
  • Adequate organ and marrow function defined by study-specified laboratory tests

Exclusion Criteria (abbreviated):

  • Brain metastases
  • Clinical or radiographic ascites (some trace amount may be allowed)
  • Rapidly progressing disease
  • Live vaccine within 30 days of study treatment (flu vaccine allowed)
  • Surgery within 28 days of study treatment (some exceptions for minor procedures)
  • Use of an investigational agent or device within 28 days of study treatment.
  • Chemotherapy, radiation, or biological cancer therapy within 14 days of study treatment.
  • Prior treatment with anti-CTLA-4, anti-PD-1, anti-PD-L1, or anti PD-L2, or with IDO inhibitor.
  • Use of growth factors within 14 days of study treatment
  • Use of any systemic steroids within 14 days of study treatment or other immunosuppressive agents within 7 days of study treatment.
  • Use of more than 2 g/day of acetaminophen
  • Use of any UGT1A9 inhibitor
  • Use of warfarin
  • Use of MAOIs or drugs with significant MAOI activity within the 21 days of screening
  • History of Seratonin Syndome
  • Known allergy to both penicillin and sulfa
  • Known or suspected hypersensitivity to any monoclonal antibody or any study drug component
  • Have artificial joints or implants that cannot be easily removed or a history of infection associated with an implant
  • Significant or malignant pleural effusion
  • New pulmonary embolism, extremity deep venous thromboembolism, or portal vein thrombosis within 2 months of study enrollment
  • History of autoimmune disease (exceptions for Graves or Hashimoto's disease, vitiligo, and type I diabetes mellitus)
  • Gastrointestinal condition that may affect drug absorption
  • Significant heart disease or heart disease requiring antibiotic for prevention of endocarditis
  • History of abnormal electrocardiogram (ECG) that is deemed meaningful by the investigator
  • History of (non-infectious) pneumonitis that required steroids, evidence of interstitial lung disease or active, non-infectious pneumonitis
  • Pulse oximetry of < 92% on room air or the need for supplemental home oxygen
  • Infection with HIV, hepatitis B or hepatitis C
  • Other conditions, including alcohol or drug dependence, intercurrent illness, or lack of sufficient peripheral venous access that would affect the patient's ability to comply with study visits and procedures
  • Pregnant or breastfeeding women
  • Unwillingness or inability to follow the study schedule for any reason

Sites / Locations

  • The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Epacadostat/Pembrolizumab/CY/GVAX/CRS-207

Epacadostat/Pembrolizumab/CRS-207

Arm Description

Outcomes

Primary Outcome Measures

Recommended Dose of Epacadostat
Evaluate 4 dose levels of epacadostat, in order to determine recommended dose for use in combination with pembrolizumab, CY, GVAX, and CRS-207
6 Month Survival
Proportion of subjects who are alive 6 months or longer after the date of randomization

Secondary Outcome Measures

Number of participants experiencing drug-related adverse events (AEs) requiring treatment discontinuation

Full Information

First Posted
December 28, 2016
Last Updated
September 5, 2023
Sponsor
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Collaborators
Merck Sharp & Dohme LLC, National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT03006302
Brief Title
Epacadostat, Pembrolizumab, and CRS-207, With or Without CY/GVAX Pancreas in Patients With Metastatic Pancreas Cancer
Official Title
Phase 2 Study of Epacadostat, Pembrolizumab, and CRS-207, With or Without Cyclophosphamide and GVAX Pancreas Vaccine in Patients With Metastatic Pancreas Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
January 31, 2018 (Actual)
Primary Completion Date
August 22, 2023 (Actual)
Study Completion Date
December 1, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Collaborators
Merck Sharp & Dohme LLC, National Cancer Institute (NCI)

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study will enroll patients who have metastatic pancreatic cancer and have progressed on prior chemotherapy. Part 1 (dose escalation) participants will receive epacadostat/pembrolizumab/cyclophosphamide(CY)/GVAX pancreas vaccine followed by epacadostat/pembrolizumab/CRS-207, Part 1X (dose escalation) participants will receive epacadostat/pembrolizumab/CRS-207. Part 2X (dose expansion) participants will receive epacadostat/pembrolizumab/CRS-207. The primary objectives of this study are to determine the recommended dose of epacadostat in this combination and assess survival of subjects in both treatment groups.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metastatic Pancreatic Adenocarcinoma
Keywords
pancreatic cancer, vaccine, immunotherapy, MK-3475, PD-1, IDO

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
40 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Epacadostat/Pembrolizumab/CY/GVAX/CRS-207
Arm Type
Experimental
Arm Title
Epacadostat/Pembrolizumab/CRS-207
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Epacadostat
Other Intervention Name(s)
INCB024360
Intervention Description
50, 100, 300, or 600 mg taken by mouth twice a day, every day of each cycle
Intervention Type
Drug
Intervention Name(s)
Pembrolizumab
Other Intervention Name(s)
MK-3475, anti-PD-1 mAb
Intervention Description
200 mg IV on Day 1 of each cycle
Intervention Type
Biological
Intervention Name(s)
CRS-207
Intervention Description
1x10^9 CFU given IV on Day 2 of Cycles 3-6 (Arm A) or Day 2 of Cycles 1-6 (Arm B)
Intervention Type
Drug
Intervention Name(s)
CY
Other Intervention Name(s)
cyclophosphamide, cytoxan
Intervention Description
200 mg/m^2 given IV on Day 1 of Cycles 1-2 (Arm A only)
Intervention Type
Biological
Intervention Name(s)
GVAX
Other Intervention Name(s)
GVAX Pancreas Vaccine, Panc 10.05 pcDNA-1/GM-Neo, Panc 6.03 pcDNA-1/GM-Neo
Intervention Description
5x10^8 cells given as 6 intradermal injections on Day 2 of Cycles 1-2 (Arm A only)
Primary Outcome Measure Information:
Title
Recommended Dose of Epacadostat
Description
Evaluate 4 dose levels of epacadostat, in order to determine recommended dose for use in combination with pembrolizumab, CY, GVAX, and CRS-207
Time Frame
1 year
Title
6 Month Survival
Description
Proportion of subjects who are alive 6 months or longer after the date of randomization
Time Frame
4 years
Secondary Outcome Measure Information:
Title
Number of participants experiencing drug-related adverse events (AEs) requiring treatment discontinuation
Time Frame
4 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria (abbreviated): Documented adenocarcinoma of the pancreas Have disease progression after prior chemotherapy for metastatic pancreas cancer (or adjuvant or neoadjuvant if progression occurred within 6 months of completing this regimen) Presence of at least one measurable lesion Patient acceptance to have a tumor biopsy of an accessible lesion at 2 time points (baseline and on study) ECOG performance status of 0 or 1 Life expectancy of greater than 3 months Adequate organ and marrow function defined by study-specified laboratory tests Exclusion Criteria (abbreviated): Brain metastases Clinical or radiographic ascites (some trace amount may be allowed) Rapidly progressing disease Live vaccine within 30 days of study treatment (flu vaccine allowed) Surgery within 28 days of study treatment (some exceptions for minor procedures) Use of an investigational agent or device within 28 days of study treatment. Chemotherapy, radiation, or biological cancer therapy within 14 days of study treatment. Prior treatment with anti-CTLA-4, anti-PD-1, anti-PD-L1, or anti PD-L2, or with IDO inhibitor. Use of growth factors within 14 days of study treatment Use of any systemic steroids within 14 days of study treatment or other immunosuppressive agents within 7 days of study treatment. Use of more than 2 g/day of acetaminophen Use of any UGT1A9 inhibitor Use of warfarin Use of MAOIs or drugs with significant MAOI activity within the 21 days of screening History of Seratonin Syndome Known allergy to both penicillin and sulfa Known or suspected hypersensitivity to any monoclonal antibody or any study drug component Have artificial joints or implants that cannot be easily removed or a history of infection associated with an implant Significant or malignant pleural effusion New pulmonary embolism, extremity deep venous thromboembolism, or portal vein thrombosis within 2 months of study enrollment History of autoimmune disease (exceptions for Graves or Hashimoto's disease, vitiligo, and type I diabetes mellitus) Gastrointestinal condition that may affect drug absorption Significant heart disease or heart disease requiring antibiotic for prevention of endocarditis History of abnormal electrocardiogram (ECG) that is deemed meaningful by the investigator History of (non-infectious) pneumonitis that required steroids, evidence of interstitial lung disease or active, non-infectious pneumonitis Pulse oximetry of < 92% on room air or the need for supplemental home oxygen Infection with HIV, hepatitis B or hepatitis C Other conditions, including alcohol or drug dependence, intercurrent illness, or lack of sufficient peripheral venous access that would affect the patient's ability to comply with study visits and procedures Pregnant or breastfeeding women Unwillingness or inability to follow the study schedule for any reason
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Dung Le, M.D.
Organizational Affiliation
The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Official's Role
Principal Investigator
Facility Information:
Facility Name
The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21287
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Epacadostat, Pembrolizumab, and CRS-207, With or Without CY/GVAX Pancreas in Patients With Metastatic Pancreas Cancer

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