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Combination of Anti-PD-1 Antibody and Chemotherapy in Pancreatic Cancer

Primary Purpose

Pancreatic Cancer

Status
Recruiting
Phase
Phase 3
Locations
China
Study Type
Interventional
Intervention
Anti-PD-1 monoclonal antibody
Sponsored by
Zhejiang University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pancreatic Cancer focused on measuring Pancreatic cancer, PD-1, FOLFIRINOX, combination therapy

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Pathologically (histologically or cytologically) confirmed pancreatic ductal adenocarcinoma (PDAC).
  • No evidence of distant metastasis (such as liver, peritoneum, lung) evaluated by abdominal contrast-enhanced CT, MRI, and chest CT. PET/CT or other imaging examinations would be used if necessary.
  • Initial assessment for definitive borderline resectable or locally advanced tumors (resectability judgment is based on CT enhanced scan or magnetic resonance imaging, NCCN2019 first edition standard).
  • ECOG score 0 or 1.
  • Serum creatinine level is normal, and serum total bilirubin level is less than 1.5 x ULN.
  • ALT and AST are less than 2 x ULN.
  • If biliary obstruction is observed, biliary decompression should be performed when the patient is randomly assigned to receive neoadjuvant chemotherapy.
  • Leukocyte count (> 3.5 x 10^6 /mL), neutrophil count (> 1.5 x 10^6 /mL), platelet count (> 80 x 10^6 /mL), hemoglobin (> 9 g/dL).
  • Signed informed consent.

Exclusion Criteria:

  • History of malignance treatment in the past, excluding basal and cutaneous squamous cell carcinoma, cervical carcinoma in situ, papillary thyroid carcinoma
  • History of participation of other clinical trails within 4 weeks
  • History of immunotherapy within 4 weeks
  • History of receiving chemotherapy, radiotherapy and molecular target therapy within 2 weeks
  • Tumor is a local recurrent lesion.
  • Imaging confirmed severe portal hypertension / cavernous transformation.
  • Ascites
  • Gastric outlet obstruction
  • Respiratory failure requires supplementation of oxygen.
  • Immune deficiency syndrome, such as active tuberculosis and HIV infection.
  • Hematological precancerous diseases, such as myelodysplastic syndromes.
  • Major cardiovascular diseases (including myocardial infarction, unstable angina, congestive heart failure, severe uncontrolled arrhythmia) during the past six months of enrollment.
  • Evidence of clinical-related or previous interstitial lung disease, such as noninfectious pneumonia or pulmonary fibrosis, or baseline chest CT scan or chest X-ray findings
  • Previous or physical findings of central nervous system disease, except for adequately treated (e.g. primary brain tumors, uncontrolled seizures or strokes with standard medications)
  • Preexisting neuropathy > 1 (NCI CTCAE).
  • Allograft requires immunosuppressive therapy or other major immunosuppressive therapies.
  • Severe serious wounds, ulcers or fractures.
  • Confirmed coagulant disease.
  • Clinical evaluation is unacceptable.

Sites / Locations

  • the First Affiliated Hospital, School of Medicine, Zhejiang UniversityRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

No Intervention

Experimental

Arm Label

Chemotherapy group

Combination group

Arm Description

Treatment with modified-FOLFIRINOX Folic acid 400mg/m^2, 5- fluorouracil 2400mg/m^2 for 46h, irinotecan 135mg/m^2 and oxaliplatin 68mg/m^2

Treatment with modified-FOLFIRINOX and Anti-PD-1 antibody Folic acid 400mg/m^2, 5- fluorouracil 2400mg/m^2 for 46h, irinotecan 135mg/m^2 and oxaliplatin 68mg/m^2, Anti-PD-1 antibody 3mg/kg

Outcomes

Primary Outcome Measures

Progression-free survival
The time of treatment until documented tumor progreesion.

Secondary Outcome Measures

Resection rate
The proportion of patients with surgeical treatment after treatment
R0 rate
The proportion of patients with completely tumor resection after treatment
Objective response rate
The proportion of patients with tumor size reduction of a predefined amount and for a minimum time period
Disease control rate
The proportion of patients with tumor size reduction or stable
Overall survival
The time of treatment until death.
EORTC QLQ - PAN26 score
QLQ score assessed by the European Organization for Research and Treatment of Cancer Quality of Life scale for pancreatic cancer
Adverse effects
The most common hematologic and non-hemotologic adverse events
Carbohydrate antigen 19-9
Carbohydrate antigen 19-9 level

Full Information

First Posted
June 5, 2019
Last Updated
June 12, 2023
Sponsor
Zhejiang University
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1. Study Identification

Unique Protocol Identification Number
NCT03983057
Brief Title
Combination of Anti-PD-1 Antibody and Chemotherapy in Pancreatic Cancer
Official Title
Study on Therapeutic Effect of Combination of Anti-PD-1 Antibody and Chemotherapy in Locally Advanced or Borderline Resectable Pancreatic Cancer Patients: A Randomized Clinical Trial
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Recruiting
Study Start Date
April 1, 2019 (Actual)
Primary Completion Date
December 1, 2023 (Anticipated)
Study Completion Date
December 1, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Zhejiang University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
The prognosis of pancreatic cancer is extremely poor. Current guidelines recommend FOLFIRINOX or modified-FOLFIRINOX as the first-line chemotherapeutic regimen. Studies have shown that immunotherapy with Anti-PD-1 antibody can effectively increase the response rate and prolong patient survival in a number of cancer diseases. Here investigators intend to compare the therapeutic effects of modified-FOLFIRINOX alone and the combination of modified-FOLFIRINOX and Anti-PD-1 antibody in patients with borderline resectable and locally advanced pancreatic cancer.
Detailed Description
Investigators chose borderline resectable and locally advanced pancreatic cancer patients. The planned treatment was given to the participants after randomization. Response rate, recurrence-free survival, overall survival, drugs related side effects and other endpoints events were recorded and analyzed, to assess the combination treatment with modified-FOLFIRINOX and Anti-PD-1 antibody could or couldn't benefit the patients with borderline resectable and locally advanced pancreatic cancer.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pancreatic Cancer
Keywords
Pancreatic cancer, PD-1, FOLFIRINOX, combination therapy

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
830 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Chemotherapy group
Arm Type
No Intervention
Arm Description
Treatment with modified-FOLFIRINOX Folic acid 400mg/m^2, 5- fluorouracil 2400mg/m^2 for 46h, irinotecan 135mg/m^2 and oxaliplatin 68mg/m^2
Arm Title
Combination group
Arm Type
Experimental
Arm Description
Treatment with modified-FOLFIRINOX and Anti-PD-1 antibody Folic acid 400mg/m^2, 5- fluorouracil 2400mg/m^2 for 46h, irinotecan 135mg/m^2 and oxaliplatin 68mg/m^2, Anti-PD-1 antibody 3mg/kg
Intervention Type
Drug
Intervention Name(s)
Anti-PD-1 monoclonal antibody
Intervention Description
Accompanying with modified-FOLFIRINOX, Anti-PD-1 antibody was applied biweekly.
Primary Outcome Measure Information:
Title
Progression-free survival
Description
The time of treatment until documented tumor progreesion.
Time Frame
Through the study peirod, for 3 years
Secondary Outcome Measure Information:
Title
Resection rate
Description
The proportion of patients with surgeical treatment after treatment
Time Frame
Through the study peirod, for 3 years
Title
R0 rate
Description
The proportion of patients with completely tumor resection after treatment
Time Frame
Through the study peirod, for 3 years
Title
Objective response rate
Description
The proportion of patients with tumor size reduction of a predefined amount and for a minimum time period
Time Frame
Through the study peirod, for 3 years
Title
Disease control rate
Description
The proportion of patients with tumor size reduction or stable
Time Frame
Through the study peirod, for 3 years
Title
Overall survival
Description
The time of treatment until death.
Time Frame
Through the study peirod, for 3 years
Title
EORTC QLQ - PAN26 score
Description
QLQ score assessed by the European Organization for Research and Treatment of Cancer Quality of Life scale for pancreatic cancer
Time Frame
Through the study peirod, for 3 years
Title
Adverse effects
Description
The most common hematologic and non-hemotologic adverse events
Time Frame
Through the study peirod, for 3 years
Title
Carbohydrate antigen 19-9
Description
Carbohydrate antigen 19-9 level
Time Frame
Through the study peirod, for 3 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Pathologically (histologically or cytologically) confirmed pancreatic ductal adenocarcinoma (PDAC). No evidence of distant metastasis (such as liver, peritoneum, lung) evaluated by abdominal contrast-enhanced CT, MRI, and chest CT. PET/CT or other imaging examinations would be used if necessary. Initial assessment for definitive borderline resectable or locally advanced tumors (resectability judgment is based on CT enhanced scan or magnetic resonance imaging, NCCN2019 first edition standard). ECOG score 0 or 1. Serum creatinine level is normal, and serum total bilirubin level is less than 1.5 x ULN. ALT and AST are less than 2 x ULN. If biliary obstruction is observed, biliary decompression should be performed when the patient is randomly assigned to receive neoadjuvant chemotherapy. Leukocyte count (> 3.5 x 10^6 /mL), neutrophil count (> 1.5 x 10^6 /mL), platelet count (> 80 x 10^6 /mL), hemoglobin (> 9 g/dL). Signed informed consent. Exclusion Criteria: History of malignance treatment in the past, excluding basal and cutaneous squamous cell carcinoma, cervical carcinoma in situ, papillary thyroid carcinoma History of participation of other clinical trails within 4 weeks History of immunotherapy within 4 weeks History of receiving chemotherapy, radiotherapy and molecular target therapy within 2 weeks Tumor is a local recurrent lesion. Imaging confirmed severe portal hypertension / cavernous transformation. Ascites Gastric outlet obstruction Respiratory failure requires supplementation of oxygen. Immune deficiency syndrome, such as active tuberculosis and HIV infection. Hematological precancerous diseases, such as myelodysplastic syndromes. Major cardiovascular diseases (including myocardial infarction, unstable angina, congestive heart failure, severe uncontrolled arrhythmia) during the past six months of enrollment. Evidence of clinical-related or previous interstitial lung disease, such as noninfectious pneumonia or pulmonary fibrosis, or baseline chest CT scan or chest X-ray findings Previous or physical findings of central nervous system disease, except for adequately treated (e.g. primary brain tumors, uncontrolled seizures or strokes with standard medications) Preexisting neuropathy > 1 (NCI CTCAE). Allograft requires immunosuppressive therapy or other major immunosuppressive therapies. Severe serious wounds, ulcers or fractures. Confirmed coagulant disease. Clinical evaluation is unacceptable.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Tingbo Liang, MD PhD
Phone
8613666676128
Email
liangtingbo@zju.edu.cn
Facility Information:
Facility Name
the First Affiliated Hospital, School of Medicine, Zhejiang University
City
Hangzhou
State/Province
Zhejiang
ZIP/Postal Code
310003
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Liang TingBo, MD, PHD
Phone
086-571-87236688
Email
liangtingbo@zju.edu.cn

12. IPD Sharing Statement

Plan to Share IPD
No

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Combination of Anti-PD-1 Antibody and Chemotherapy in Pancreatic Cancer

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