Durvalumab and SNDX-6532 Following Chemo or Radio-Embolization for Patients With Intrahepatic Cholangiocarcinoma
Primary Purpose
Unresectable Intrahepatic Cholangiocarcinoma
Status
Active
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Durvalumab
SNDX-6352
Sponsored by
About this trial
This is an interventional treatment trial for Unresectable Intrahepatic Cholangiocarcinoma focused on measuring colony stimulating factor -1 receptor (CSF-1R) inhibitor, Anti-PD-1 (receptor blocking antibody), Immunotherapy, Intra-arterial therapy, Y90 (yttrium-90 radioembolization), conventional transarterial chemoembolization (cTACE), Chemo-embolization, Radio-embolization, Biliary tract, Intrahepatic Cholangiocarcinoma, Monoclonal antibody
Eligibility Criteria
Inclusion Criteria:
- Have cytologically confirmed intrahepatic cholangiocarcinoma.
- All disease must be localized to the liver (locally advanced).
- Subjects must not be deemed surgical candidates.
- Must be a candidate for conventional transarterial chemoembolization or yttrium-90 radioembolization.
- Must have measureable disease be mRECIST. Measurable disease will be confirmed by radiological imaging (MRI, CT).
- Age ≥18 years
- Body weight > 30 kg
- Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1
- Life expectancy ≥12 weeks.
- Patient must have adequate organ function defined by the study-specified laboratory tests as per the protocol.
- Child Pugh Class A
- Measured creatinine clearance (CL) >40 mL/min or Calculated creatinine clearance CL>40 mL/min by the Cockcroft-Gault formula.
- Woman of childbearing potential must have a negative pregnancy test and follow contraceptive guidelines as defined per protocol.
- Must use acceptable form of birth control while on study.
- Men must use acceptable form of birth control while on study.
- Ability to understand and willingness to sign a written informed consent document.
- Willing and able to comply with the protocol for the duration of the study
Exclusion Criteria:
- Candidate for surgical resection
- Concurrent enrollment in another clinical study, unless it is an observational (non-interventional) clinical study or during the follow-up of an interventional study.
- Major surgery within 4 weeks prior to initiation of study treatment.
- Received the last dose of anticancer therapy ≤ 28 days prior to the first dose of study drug.
- All toxicities NCI CTCAE Grade ≥2 attributed to prior anti-cancer therapy other than alopecia, vitiligo, and neuropathy.
- Any concurrent chemotherapy, IP, biologic, or hormonal therapy for cancer treatment.
- History of allogenic organ transplantation.
- Active or prior documented autoimmune or inflammatory disorders (including inflammatory bowel disease [e.g., colitis or Crohn's disease], diverticulitis [with the exception of diverticulosis], systemic lupus erythematosus, Sarcoidosis syndrome, checkpoint inhibitor-induced immune mediated reaction or Wegener syndrome [granulomatosis with polyangiitis, Graves' disease, rheumatoid arthritis, hypophysitis, uveitis, etc.]).
- Patient with uncontrolled intercurrent illness including, but not limited to, uncontrolled infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, significant muscle disorders or psychiatric illness/social situations that would limit compliance with study requirements.
- History of known additional primary malignancies.
- History of leptomeningeal carcinomatosis.
- Brain metastases or spinal cord compression.
- History of active primary immunodeficiency.
- Infection with Tuberculosis, HIV or hepatitis B or C at screening.
- Current or prior use of immunosuppressive medication within 14 days before the first dose of treatment.
- Receipt of live attenuated vaccine within 30 days prior to the first dose of IP.
- Pregnant or breastfeeding women.
- Has a history of allergy to study treatments or any of its components of the study.
- Prior randomization or treatment in a previous durvalumab and/or SNDX-6532 clinical study regardless of treatment arm assignment.
- Patient has clinically significant heart disease.
- Any other sound medical, psychiatric, and/or social reason as determined by the Investigator.
- Unwilling or unable to follow the study schedule for any reason.
Sites / Locations
- Sidney Kimmel Comprehensive Cancer Center
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Durvalumab and SNDX-6352
Arm Description
Participants will receive Durvalumab and SNDX-6352.
Outcomes
Primary Outcome Measures
Objective Response Rate (ORR) Per mRECIST (Modified RECIST)
ORR is defined as the number of patients achieving a complete response (CR) or partial response (PR) based on the Response Evaluation Criteria in Solid Tumors (mRECIST) at any time during the study. CR = disappearance of all target lesions, PR is =>30% decrease in sum of diameters of target lesions, progressive disease (PD) is >20% increase in sum of diameters of target lesions, stable disease (SD) is <30% decrease or <20% increase in sum of diameters of target lesions. Estimation based on the Kaplan-Meier curve.
Number of Participants Experiencing Study Drug-related Toxicities
Number of participants who experience treatment related adverse events ≥ grade 3 as defined by CTCAE 5.0.
Secondary Outcome Measures
Overall Survival (OS)
OS will be measured from date of first dose until death or end of followup (OS will be censored on the date the subject was last known to be alive for subjects without documentation of death at the time of analysis). Estimation based on the Kaplan-Meier curve.
Progression-free Survival (PFS) Per mRECIST
PFS is defined as the number of months from the date of treatment to disease recurrence [disease recurrence (DR) progressive disease (PD) or relapse from complete response (CR) as assessed using mRECIST criteria] or death due to any cause. Per mRECIST criteria, CR = disappearance of all target lesions, Partial Response (PR) is =>30% decrease in sum of diameters of target lesions, Progressive Disease (PD) is >20% increase in sum of diameters of target lesions, Stable Disease (SD) is <30% decrease or <20% increase in sum of diameters of target lesions.
Duration of Response (DOR)
Number of weeks from the start date of PR or CR (whichever response is recorded first) and subsequently confirmed to the first date that recurrent or progressive disease or death is documented. Per mRECIST, CR = disappearance of any intratumoral arterial enhancement in all target lesions, PR is =>30% decrease in sum of diameters of target lesions.
Full Information
NCT ID
NCT04301778
First Posted
March 6, 2020
Last Updated
September 1, 2023
Sponsor
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Collaborators
Syndax Pharmaceuticals, AstraZeneca
1. Study Identification
Unique Protocol Identification Number
NCT04301778
Brief Title
Durvalumab and SNDX-6532 Following Chemo or Radio-Embolization for Patients With Intrahepatic Cholangiocarcinoma
Official Title
A Phase II Study of Durvalumab (MEDI4736) in Combination With a CSF-1R Inhibitor (SNDX-6532) Following Chemo or Radio-Embolization for Patients With Intrahepatic Cholangiocarcinoma.
Study Type
Interventional
2. Study Status
Record Verification Date
September 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
August 24, 2021 (Actual)
Primary Completion Date
November 4, 2022 (Actual)
Study Completion Date
September 1, 2025 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Collaborators
Syndax Pharmaceuticals, AstraZeneca
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
The purposed of this research is to study the safety and clinical activity of the combination of durvalumab and a CSF-1R inhibitor (SNDX-6352) in people with Intrahepatic Cholangiocarcinoma.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Unresectable Intrahepatic Cholangiocarcinoma
Keywords
colony stimulating factor -1 receptor (CSF-1R) inhibitor, Anti-PD-1 (receptor blocking antibody), Immunotherapy, Intra-arterial therapy, Y90 (yttrium-90 radioembolization), conventional transarterial chemoembolization (cTACE), Chemo-embolization, Radio-embolization, Biliary tract, Intrahepatic Cholangiocarcinoma, Monoclonal antibody
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
5 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Durvalumab and SNDX-6352
Arm Type
Experimental
Arm Description
Participants will receive Durvalumab and SNDX-6352.
Intervention Type
Drug
Intervention Name(s)
Durvalumab
Other Intervention Name(s)
MEDI4736
Intervention Description
Durvalumab - 1500 mg via IV infusion over 60 minutes (-5/+10 min) on day 1 of each 28-day cycle (every 4 weeks).
Drug - 1500mg IV
Intervention Type
Drug
Intervention Name(s)
SNDX-6352
Other Intervention Name(s)
UCB6352
Intervention Description
SNDX-6352 - 3mg/kg via IV infusion over 30 minutes (-5/+10 min) on days 1 and 15 of each 28-day cycle (every 2 weeks), starting with cycle 2 (not given during cycle 1).
Drug - 3mg/kg IV
Primary Outcome Measure Information:
Title
Objective Response Rate (ORR) Per mRECIST (Modified RECIST)
Description
ORR is defined as the number of patients achieving a complete response (CR) or partial response (PR) based on the Response Evaluation Criteria in Solid Tumors (mRECIST) at any time during the study. CR = disappearance of all target lesions, PR is =>30% decrease in sum of diameters of target lesions, progressive disease (PD) is >20% increase in sum of diameters of target lesions, stable disease (SD) is <30% decrease or <20% increase in sum of diameters of target lesions. Estimation based on the Kaplan-Meier curve.
Time Frame
8 months
Title
Number of Participants Experiencing Study Drug-related Toxicities
Description
Number of participants who experience treatment related adverse events ≥ grade 3 as defined by CTCAE 5.0.
Time Frame
up to 1 year
Secondary Outcome Measure Information:
Title
Overall Survival (OS)
Description
OS will be measured from date of first dose until death or end of followup (OS will be censored on the date the subject was last known to be alive for subjects without documentation of death at the time of analysis). Estimation based on the Kaplan-Meier curve.
Time Frame
4 years
Title
Progression-free Survival (PFS) Per mRECIST
Description
PFS is defined as the number of months from the date of treatment to disease recurrence [disease recurrence (DR) progressive disease (PD) or relapse from complete response (CR) as assessed using mRECIST criteria] or death due to any cause. Per mRECIST criteria, CR = disappearance of all target lesions, Partial Response (PR) is =>30% decrease in sum of diameters of target lesions, Progressive Disease (PD) is >20% increase in sum of diameters of target lesions, Stable Disease (SD) is <30% decrease or <20% increase in sum of diameters of target lesions.
Time Frame
4 years
Title
Duration of Response (DOR)
Description
Number of weeks from the start date of PR or CR (whichever response is recorded first) and subsequently confirmed to the first date that recurrent or progressive disease or death is documented. Per mRECIST, CR = disappearance of any intratumoral arterial enhancement in all target lesions, PR is =>30% decrease in sum of diameters of target lesions.
Time Frame
4 years
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Have cytologically confirmed intrahepatic cholangiocarcinoma.
All disease must be localized to the liver (locally advanced).
Subjects must not be deemed surgical candidates.
Must be a candidate for conventional transarterial chemoembolization or yttrium-90 radioembolization.
Must have measureable disease be mRECIST. Measurable disease will be confirmed by radiological imaging (MRI, CT).
Age ≥18 years
Body weight > 30 kg
Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1
Life expectancy ≥12 weeks.
Patient must have adequate organ function defined by the study-specified laboratory tests as per the protocol.
Child Pugh Class A
Measured creatinine clearance (CL) >40 mL/min or Calculated creatinine clearance CL>40 mL/min by the Cockcroft-Gault formula.
Woman of childbearing potential must have a negative pregnancy test and follow contraceptive guidelines as defined per protocol.
Must use acceptable form of birth control while on study.
Men must use acceptable form of birth control while on study.
Ability to understand and willingness to sign a written informed consent document.
Willing and able to comply with the protocol for the duration of the study
Exclusion Criteria:
Candidate for surgical resection
Concurrent enrollment in another clinical study, unless it is an observational (non-interventional) clinical study or during the follow-up of an interventional study.
Major surgery within 4 weeks prior to initiation of study treatment.
Received the last dose of anticancer therapy ≤ 28 days prior to the first dose of study drug.
All toxicities NCI CTCAE Grade ≥2 attributed to prior anti-cancer therapy other than alopecia, vitiligo, and neuropathy.
Any concurrent chemotherapy, IP, biologic, or hormonal therapy for cancer treatment.
History of allogenic organ transplantation.
Active or prior documented autoimmune or inflammatory disorders (including inflammatory bowel disease [e.g., colitis or Crohn's disease], diverticulitis [with the exception of diverticulosis], systemic lupus erythematosus, Sarcoidosis syndrome, checkpoint inhibitor-induced immune mediated reaction or Wegener syndrome [granulomatosis with polyangiitis, Graves' disease, rheumatoid arthritis, hypophysitis, uveitis, etc.]).
Patient with uncontrolled intercurrent illness including, but not limited to, uncontrolled infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, significant muscle disorders or psychiatric illness/social situations that would limit compliance with study requirements.
History of known additional primary malignancies.
History of leptomeningeal carcinomatosis.
Brain metastases or spinal cord compression.
History of active primary immunodeficiency.
Infection with Tuberculosis, HIV or hepatitis B or C at screening.
Current or prior use of immunosuppressive medication within 14 days before the first dose of treatment.
Receipt of live attenuated vaccine within 30 days prior to the first dose of IP.
Pregnant or breastfeeding women.
Has a history of allergy to study treatments or any of its components of the study.
Prior randomization or treatment in a previous durvalumab and/or SNDX-6532 clinical study regardless of treatment arm assignment.
Patient has clinically significant heart disease.
Any other sound medical, psychiatric, and/or social reason as determined by the Investigator.
Unwilling or unable to follow the study schedule for any reason.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Lei Zheng, MD
Organizational Affiliation
Sidney Kimmel Cancer Center at the Johns Hopkins Medical Institution
Official's Role
Principal Investigator
Facility Information:
Facility Name
Sidney Kimmel Comprehensive Cancer Center
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21231
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
Durvalumab and SNDX-6532 Following Chemo or Radio-Embolization for Patients With Intrahepatic Cholangiocarcinoma
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