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QUILT-3.088: NANT Pancreatic Cancer Vaccine

Primary Purpose

Metastatic Pancreatic Cancer

Status
Withdrawn
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Gemcitabine
Nab-paclitaxel
Aldoxorubicin HCl
ALT-803
ETBX-011
ETBX-021
ETBX-051
ETBX-061
GI-4000
GI-6207
GI-6301
haNK
Avelumab
Bevacizumab
Capecitabine
Cyclophosphamide
5-Fluorouracil
Leucovorin
Oxaliplatin
Sponsored by
ImmunityBio, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Metastatic Pancreatic Cancer

Eligibility Criteria

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

Inclusion Criteria:

  1. Age ≥ 18 years old.
  2. Able to understand and provide a signed informed consent that fulfills the relevant IRB or Independent Ethics Committee (IEC) guidelines.
  3. Histologically-confirmed metastatic pancreatic adenocarcinoma that has not been previously treated with chemotherapy.
  4. ECOG performance status of 0-2.
  5. Have at least 1 measurable lesion of ≥ 1.0 cm.
  6. If available, must be willing to release a recent formalin-fixed, paraffin-embedded (FFPE) tumor biopsy specimen for prospective and exploratory tumor molecular profiling. If an historic specimen is not available, the subject must be willing to undergo a biopsy during the screening period, if considered safe by the Investigator.
  7. Must be willing to provide blood samples prior to the start of treatment on this study for prospective tumor molecular profiling and exploratory analyses.
  8. Must be willing to provide a tumor biopsy specimen 8 weeks after the start of treatment for exploratory analyses, if considered safe by the Investigator.
  9. Ability to attend required study visits and return for adequate follow-up, as required by this protocol.
  10. Agreement to practice effective contraception for female subjects of child-bearing potential and non-sterile males. Female subjects of child-bearing potential must agree to use effective contraception for up to 1 year after completion of therapy, and non-sterile male subjects must agree to use a condom for up to 4 months after treatment. Effective contraception includes surgical sterilization (eg, vasectomy, tubal ligation), two forms of barrier methods (eg, condom, diaphragm) used with spermicide, intrauterine devices (IUDs), and abstinence.

Exclusion Criteria:

  1. Serious uncontrolled concomitant disease that would contraindicate the use of the investigational drug used in this study or that would put the subject at high risk for treatment-related complications.
  2. Systemic autoimmune disease (eg, lupus erythematosus, rheumatoid arthritis, Addison's disease, autoimmune disease associated with lymphoma).
  3. History of organ transplant requiring immunosuppression.
  4. History of or active inflammatory bowel disease (eg, Crohn's disease, ulcerative colitis).
  5. Inadequate organ function, evidenced by the following laboratory results:

    1. Absolute neutrophil count (ANC) < 1,000 cells/mm^3.
    2. Platelet count < 75,000 cells/mm^3.
    3. Total bilirubin greater than the upper limit of normal (ULN; unless the subject has documented Gilbert's syndrome).
    4. Aspartate aminotransferase (AST [SGOT]) or alanine aminotransferase (ALT [SGPT]) > 2.5 × ULN (> 5 × ULN in subjects with liver metastases).
    5. Alkaline phosphatase levels (ALP) > 2.5 × ULN (> 5 × ULN in subjects with liver metastases, or >10 × ULN in subjects with bone metastases).
    6. Serum creatinine > 2.0 mg/dL or 177 μmol/L.
    7. Serum anion gap > 16 mEq/L or arterial blood with pH < 7.3.
    8. Medically uncorrectable grade 3 anemia (hemoglobin < 8 g/dL).
  6. Uncontrolled hypertension (systolic > 160 mm Hg and/or diastolic > 110 mm Hg) or clinically significant (ie, active) cardiovascular disease, cerebrovascular accident/stroke, or myocardial infarction within 6 months prior to first study medication; unstable angina; congestive heart failure of New York Heart Association grade 2 or higher; or serious cardiac arrhythmia requiring medication. Subjects with uncontrolled hypertension should be medically managed on a stable regimen to control hypertension prior to study entry.
  7. Serious myocardial dysfunction defined by echocardiogram (ECHO) as absolute left ventricular ejection fraction (LVEF) 10% below the institution's lower limit of predicted normal.
  8. Dyspnea at rest due to complications of advanced malignancy or other disease requiring continuous oxygen therapy.
  9. Positive results of screening test for human immunodeficiency virus (HIV).
  10. Current chronic daily treatment (continuous for > 3 months) with systemic corticosteroids (dose equivalent to or greater than 10 mg/day methylprednisolone), excluding inhaled steroids. Short-term steroid use to prevent IV contrast allergic reaction or anaphylaxis in subjects who have known contrast allergies is allowed.
  11. Known hypersensitivity to any component of the study medication(s).
  12. Subjects taking any medication(s) (herbal or prescribed) known to have an adverse drug reaction with any of the study medications.
  13. Concurrent or prior use of a strong cytochrome P450 (CYP)3A4 inhibitor (including ketoconazole, itraconazole, posaconazole, clarithromycin, indinavir, nefazodone, nelfinavir, ritonavir, saquinavir, telithromycin, voriconazole, and grapefruit products) or strong CYP3A4 inducers (including phenytoin, carbamazepine, rifampin, rifabutin, rifapentin, phenobarbital, and St John's Wort) within 14 days before study day 1.
  14. Concurrent or prior use of a strong CYP2C8 inhibitor (gemfibrozil) or moderate CYP2C8 inducer (rifampin) within 14 days before study day 1.
  15. History of receiving any investigational treatment for metastatic pancreatic cancer, or participation in an investigational drug study within 30 days prior to screening for this study, except for testosterone-lowering therapy in men with prostate cancer.
  16. Assessed by the Investigator to be unable or unwilling to comply with the requirements of the protocol.
  17. Concurrent participation in any interventional clinical trial.
  18. Pregnant and nursing women.

Sites / Locations

  • Chan Soon-Shiong Institute for Medicine

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Active Comparator

Active Comparator

Arm Label

NANT Pancreatic Cancer Vaccine

Gemcitabine and Nab-paclitaxel

Gemcitabine

Arm Description

in subjects with ECOG=2 or subjects with ECOG=0 or 1 A combination of agents will be administered to subjects in this study: cyclophosphamide, bevacizumab, oxaliplatin, capecitabine, 5-fluorouracil, leucovorin, nab-paclitaxel, aldoxorubicin HCl, avelumab, ALT-803, haNK, GI-4000, GI-6207, GI-6301, ETBX-011, ETBX-021, ETBX-051, ETBX-061.

Gemcitabine plus Nab-paclitaxel will be administered to subjects with ECOG=2

Gemcitabine will be administered to subjects with ECOG=0 or 1

Outcomes

Primary Outcome Measures

Progression-Free Survival
Compare the efficacy of the NANT Pancreatic Cancer Vaccine regimen vs standard-of-care (SoC) therapy as first-line treatment for patients with metastatic pancreatic cancer as assessed by progression-free survival (PFS) using RECIST Version 1.1

Secondary Outcome Measures

Overall Survival
Overall Survival from first treatment to date of death (any cause)
Overall Response Rate
Overall Response Rate, as determined by the percentage of patients achieving Partial or Complete response per RECIST 1.1 and irRC
Duration of Response
Duration of Response from date of first response to date of disease progression or death (any cause), per RECIST 1.1 and irRC
Disease Control Rate
Disease Control Rate: the number of patients with a CR, PR or SD lasting at least 2 months per RECIST 1.1 and irRC
Quality of Life by Patient-Reported Outcomes
Quality of Life as assessed by Patient Reported Outcomes using the FACT-C questionnaire
Progression Free Survival
Progression Free Survival from baseline to progression per irRC
Evaluation of safety as determined by incidence or treatment-emergent adverse events
Incidence of treatment -emergent adverse events using NCI CTCAE Version 4.03

Full Information

First Posted
May 25, 2018
Last Updated
March 17, 2021
Sponsor
ImmunityBio, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT03563144
Brief Title
QUILT-3.088: NANT Pancreatic Cancer Vaccine
Official Title
QUILT-3.088 NANT Pancreatic Cancer Vaccine: Phase II Randomized Trial of the NANT Pancreatic Cancer Vaccine vs. Standard-of-Care as First- Line Treatment for Patients With Metastatic Pancreatic Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
August 2018
Overall Recruitment Status
Withdrawn
Why Stopped
Trial not initiated
Study Start Date
August 2018 (Anticipated)
Primary Completion Date
December 30, 2019 (Anticipated)
Study Completion Date
December 30, 2019 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
ImmunityBio, Inc.

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
QUILT-3.088 NANT Pancreatic Cancer Vaccine: Phase II Randomized Trial of the NANT Pancreatic Cancer Vaccine vs. Standard-of-Care as First- Line Treatment for Patients with Metastatic Pancreatic Cancer.
Detailed Description
This is a two-cohort, open-label, randomized phase 2 study to evaluate the safety and efficacy (as assessed by PFS) of the NANT Pancreatic Cancer Vaccine regimen (experimental arms) vs SoC therapy (control arms) as first-line treatment for subjects with metastatic pancreatic cancer. Subjects will be enrolled into two independent cohorts based on ECOG status. Subjects with ECOG 0-1 will be randomized 1:1 to receive the NANT Pancreatic Cancer Vaccine regimen (experimental arm) or gemcitabine in combination with nab-paclitaxel (control arm), while subjects with ECOG 2 will be randomized 1:1 to receive the NANT Pancreatic Cancer Vaccine regimen (experimental arm) or gemcitabine monotherapy (control arm). The experimental arms will be administered in two phases, an induction and a subsequent maintenance phase. The treatment regimen administered in the experimental arms will be identical for all subjects, independent of ECOG status. Subjects may continue induction treatment for up to 1 year. Those who have a complete response (CR) in the induction phase will enter the maintenance phase of the study. Subjects who experience ongoing stable disease (SD) or an ongoing partial response (PR) after 1 year of induction phase treatment may enter the maintenance phase at the Investigator's discretion. Subjects may remain on the maintenance phase of the study for up to 1 year. Treatment in the study will be discontinued if the subject experiences confirmed PD or unacceptable toxicity, withdraws consent, or if the Investigator feels it is no longer in the subject's best interest to continue treatment. Subjects receiving treatment in the control arms may cross over to treatment in the induction phase of the experimental arms after experiencing PD. Subjects receiving treatment in the experimental arms with an initial assessment of PD per RECIST 1.1 may, at the discretion of the Investigator, continue to receive study treatment until PD is confirmed. The maximum time on study treatment is 2 years.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Model Description
This is a randomized parallel group study comparing the NANT Pancreatic Cancer Vaccine and standard therapy with respect to efficacy and safety in treatment naïve patients with pancreatic cancer. Patients will be stratified by ECOG status and then randomized 1:1 to receive either the NANT Pancreatic Vaccine (n~532) or standard therapy with gemcitabine alone (ECOG 2; n~266) or combined with nab-paclitaxel (ECOG 0-1; n~266). Treatment may continue for up to 2 years or until documented progression (RECIST v 1.1) or unacceptable toxicity. Patients on standard therapy who progress or experience unacceptable toxicity may crossover to receive NANT Pancreatic Vaccine.
Masking
None (Open Label)
Allocation
Randomized
Enrollment
0 (Actual)

8. Arms, Groups, and Interventions

Arm Title
NANT Pancreatic Cancer Vaccine
Arm Type
Experimental
Arm Description
in subjects with ECOG=2 or subjects with ECOG=0 or 1 A combination of agents will be administered to subjects in this study: cyclophosphamide, bevacizumab, oxaliplatin, capecitabine, 5-fluorouracil, leucovorin, nab-paclitaxel, aldoxorubicin HCl, avelumab, ALT-803, haNK, GI-4000, GI-6207, GI-6301, ETBX-011, ETBX-021, ETBX-051, ETBX-061.
Arm Title
Gemcitabine and Nab-paclitaxel
Arm Type
Active Comparator
Arm Description
Gemcitabine plus Nab-paclitaxel will be administered to subjects with ECOG=2
Arm Title
Gemcitabine
Arm Type
Active Comparator
Arm Description
Gemcitabine will be administered to subjects with ECOG=0 or 1
Intervention Type
Drug
Intervention Name(s)
Gemcitabine
Intervention Description
Gemcitabine is a type of chemotherapy medication used to interfere with the cancer cells' ability to grow and divide.
Intervention Type
Drug
Intervention Name(s)
Nab-paclitaxel
Intervention Description
NAB-paclitaxel is a type of chemotherapy called a microtubule inhibitor. Microtubule inhibitors interfere with a cancer cell's ability to grow and divide.
Intervention Type
Drug
Intervention Name(s)
Aldoxorubicin HCl
Intervention Description
Albumin-binding prodrug of doxorubicin HCl
Intervention Type
Biological
Intervention Name(s)
ALT-803
Intervention Description
Recombinant human super agonist interleukin-15 (IL-15) complex
Intervention Type
Biological
Intervention Name(s)
ETBX-011
Intervention Description
Ad5 [E1-, E2b-]-CEA
Intervention Type
Biological
Intervention Name(s)
ETBX-021
Intervention Description
Ad5 [E1-, E2b-]-human epidermal growth factor receptor 2 [HER2] vaccine
Intervention Type
Biological
Intervention Name(s)
ETBX-051
Intervention Description
Ad5 [E1-, E2b-]-Brachyury vaccine
Intervention Type
Biological
Intervention Name(s)
ETBX-061
Intervention Description
Ad5 [E1-, E2b-]-mucin 1[MUC1]
Intervention Type
Biological
Intervention Name(s)
GI-4000
Intervention Description
Vaccine derived from recombinant Saccharomyces cerevisiae yeast expressing mutant Ras proteins
Intervention Type
Biological
Intervention Name(s)
GI-6207
Intervention Description
CEA yeast vaccine
Intervention Type
Biological
Intervention Name(s)
GI-6301
Intervention Description
Brachyury yeast vaccine
Intervention Type
Biological
Intervention Name(s)
haNK
Intervention Description
NK-92 [CD16.158V, ER IL-2]
Intervention Type
Drug
Intervention Name(s)
Avelumab
Intervention Description
Avelumab
Intervention Type
Drug
Intervention Name(s)
Bevacizumab
Intervention Description
Bevacizumab
Intervention Type
Drug
Intervention Name(s)
Capecitabine
Intervention Description
Capecitabine
Intervention Type
Drug
Intervention Name(s)
Cyclophosphamide
Intervention Description
2-[bis(2-chloroethyl)amino]tetrahydro-2H-1,3,2-oxazaphosphorine 2-oxide monohydrate
Intervention Type
Drug
Intervention Name(s)
5-Fluorouracil
Intervention Description
5-fluoro-2,4 (1H,3H)-pyrimidinedione
Intervention Type
Drug
Intervention Name(s)
Leucovorin
Intervention Description
L-Glutamic acid, N-[4-[[(2-amino-5-formyl-1,4,5,6,7,8-hexahydro-4-oxo-6-pteridinyl)methyl]amino]benzoyl]-, calcium salt
Intervention Type
Drug
Intervention Name(s)
Oxaliplatin
Intervention Description
Oxaliplatin
Primary Outcome Measure Information:
Title
Progression-Free Survival
Description
Compare the efficacy of the NANT Pancreatic Cancer Vaccine regimen vs standard-of-care (SoC) therapy as first-line treatment for patients with metastatic pancreatic cancer as assessed by progression-free survival (PFS) using RECIST Version 1.1
Time Frame
12 mths
Secondary Outcome Measure Information:
Title
Overall Survival
Description
Overall Survival from first treatment to date of death (any cause)
Time Frame
24 months
Title
Overall Response Rate
Description
Overall Response Rate, as determined by the percentage of patients achieving Partial or Complete response per RECIST 1.1 and irRC
Time Frame
19 months
Title
Duration of Response
Description
Duration of Response from date of first response to date of disease progression or death (any cause), per RECIST 1.1 and irRC
Time Frame
19 months
Title
Disease Control Rate
Description
Disease Control Rate: the number of patients with a CR, PR or SD lasting at least 2 months per RECIST 1.1 and irRC
Time Frame
19 months
Title
Quality of Life by Patient-Reported Outcomes
Description
Quality of Life as assessed by Patient Reported Outcomes using the FACT-C questionnaire
Time Frame
19 months
Title
Progression Free Survival
Description
Progression Free Survival from baseline to progression per irRC
Time Frame
12 months
Title
Evaluation of safety as determined by incidence or treatment-emergent adverse events
Description
Incidence of treatment -emergent adverse events using NCI CTCAE Version 4.03
Time Frame
19 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age ≥ 18 years old. Able to understand and provide a signed informed consent that fulfills the relevant IRB or Independent Ethics Committee (IEC) guidelines. Histologically-confirmed metastatic pancreatic adenocarcinoma that has not been previously treated with chemotherapy. ECOG performance status of 0-2. Have at least 1 measurable lesion of ≥ 1.0 cm. If available, must be willing to release a recent formalin-fixed, paraffin-embedded (FFPE) tumor biopsy specimen for prospective and exploratory tumor molecular profiling. If an historic specimen is not available, the subject must be willing to undergo a biopsy during the screening period, if considered safe by the Investigator. Must be willing to provide blood samples prior to the start of treatment on this study for prospective tumor molecular profiling and exploratory analyses. Must be willing to provide a tumor biopsy specimen 8 weeks after the start of treatment for exploratory analyses, if considered safe by the Investigator. Ability to attend required study visits and return for adequate follow-up, as required by this protocol. Agreement to practice effective contraception for female subjects of child-bearing potential and non-sterile males. Female subjects of child-bearing potential must agree to use effective contraception for up to 1 year after completion of therapy, and non-sterile male subjects must agree to use a condom for up to 4 months after treatment. Effective contraception includes surgical sterilization (eg, vasectomy, tubal ligation), two forms of barrier methods (eg, condom, diaphragm) used with spermicide, intrauterine devices (IUDs), and abstinence. Exclusion Criteria: Serious uncontrolled concomitant disease that would contraindicate the use of the investigational drug used in this study or that would put the subject at high risk for treatment-related complications. Systemic autoimmune disease (eg, lupus erythematosus, rheumatoid arthritis, Addison's disease, autoimmune disease associated with lymphoma). History of organ transplant requiring immunosuppression. History of or active inflammatory bowel disease (eg, Crohn's disease, ulcerative colitis). Inadequate organ function, evidenced by the following laboratory results: Absolute neutrophil count (ANC) < 1,000 cells/mm^3. Platelet count < 75,000 cells/mm^3. Total bilirubin greater than the upper limit of normal (ULN; unless the subject has documented Gilbert's syndrome). Aspartate aminotransferase (AST [SGOT]) or alanine aminotransferase (ALT [SGPT]) > 2.5 × ULN (> 5 × ULN in subjects with liver metastases). Alkaline phosphatase levels (ALP) > 2.5 × ULN (> 5 × ULN in subjects with liver metastases, or >10 × ULN in subjects with bone metastases). Serum creatinine > 2.0 mg/dL or 177 μmol/L. Serum anion gap > 16 mEq/L or arterial blood with pH < 7.3. Medically uncorrectable grade 3 anemia (hemoglobin < 8 g/dL). Uncontrolled hypertension (systolic > 160 mm Hg and/or diastolic > 110 mm Hg) or clinically significant (ie, active) cardiovascular disease, cerebrovascular accident/stroke, or myocardial infarction within 6 months prior to first study medication; unstable angina; congestive heart failure of New York Heart Association grade 2 or higher; or serious cardiac arrhythmia requiring medication. Subjects with uncontrolled hypertension should be medically managed on a stable regimen to control hypertension prior to study entry. Serious myocardial dysfunction defined by echocardiogram (ECHO) as absolute left ventricular ejection fraction (LVEF) 10% below the institution's lower limit of predicted normal. Dyspnea at rest due to complications of advanced malignancy or other disease requiring continuous oxygen therapy. Positive results of screening test for human immunodeficiency virus (HIV). Current chronic daily treatment (continuous for > 3 months) with systemic corticosteroids (dose equivalent to or greater than 10 mg/day methylprednisolone), excluding inhaled steroids. Short-term steroid use to prevent IV contrast allergic reaction or anaphylaxis in subjects who have known contrast allergies is allowed. Known hypersensitivity to any component of the study medication(s). Subjects taking any medication(s) (herbal or prescribed) known to have an adverse drug reaction with any of the study medications. Concurrent or prior use of a strong cytochrome P450 (CYP)3A4 inhibitor (including ketoconazole, itraconazole, posaconazole, clarithromycin, indinavir, nefazodone, nelfinavir, ritonavir, saquinavir, telithromycin, voriconazole, and grapefruit products) or strong CYP3A4 inducers (including phenytoin, carbamazepine, rifampin, rifabutin, rifapentin, phenobarbital, and St John's Wort) within 14 days before study day 1. Concurrent or prior use of a strong CYP2C8 inhibitor (gemfibrozil) or moderate CYP2C8 inducer (rifampin) within 14 days before study day 1. History of receiving any investigational treatment for metastatic pancreatic cancer, or participation in an investigational drug study within 30 days prior to screening for this study, except for testosterone-lowering therapy in men with prostate cancer. Assessed by the Investigator to be unable or unwilling to comply with the requirements of the protocol. Concurrent participation in any interventional clinical trial. Pregnant and nursing women.
Facility Information:
Facility Name
Chan Soon-Shiong Institute for Medicine
City
El Segundo
State/Province
California
ZIP/Postal Code
90245
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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QUILT-3.088: NANT Pancreatic Cancer Vaccine

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