NaliCap (Irinotecan Liposome (Nal-IRI)/Capecitabine) vs. NAPOLI (Nal-IRI/5-FU/LV) ) in Advanced Pancreatic Cancer (NaliCap)
Primary Purpose
Pancreatic Cancer
Status
Recruiting
Phase
Phase 2
Locations
Korea, Republic of
Study Type
Interventional
Intervention
Irinotecan Liposomal Injection [Onivyde]
Capecitabine
5-fluorouracil
Leucovorin
Sponsored by
About this trial
This is an interventional treatment trial for Pancreatic Cancer
Eligibility Criteria
Inclusion Criteria:
- Signed informed consent
- Age>20 years at time of study entry
- Histologically confirmed pancreatic ductal adenocarcinoma
- Advanced stage (unresectable, recurrent)
- Gemcitabine-pretreated for advanced pancreatic cancer
- Eastern Cooperative Oncology Group(ECOG) performance status 0, 1
- Adequate organ function
- Evidence of post-menopausal status or negative urinary or serum pregnancy test for female pre-menopausal subjects.
- Subject is willing and able to comply with the protocol for the duration of the study including undergoing treatment and scheduled visits and examinations including follow up.
Exclusion Criteria:
- Participation in another clinical study with an investigational product (IP) during the last 3 weeks
- Concurrent enrolment in another clinical study, unless it is an observational (non-interventional) clinical study or during the follow-up period of an interventional study
- Receipt of the last dose of anti-cancer therapy (chemotherapy, immunotherapy, endocrine therapy, targeted therapy, biologic therapy, tumor embolization, monoclonal antibodies, other investigational agent) 28 days prior to the first dose of study drug
- Major surgical procedure (as defined by the Investigator) within 28 days prior to the first dose of IP. Note: Local surgery of isolated lesions for palliative intent is acceptable.
- Known brain metastasis or spinal cord compression.
- History of allogenic organ transplantation
- Cardiac event during past 6 months
- Uncontrolled intercurrent illness, including but not limited to, ongoing or active infection, symptomatic congestive heart failure, uncontrolled hypertension, unstable angina pectoris, cardiac arrhythmia, interstitial lung disease, serious chronic gastrointestinal conditions associated with diarrhea, or psychiatric illness/social situations that would limit compliance with study requirement, substantially increase risk of incurring AEs or compromise the ability of the patient to give written informed consent
- Active infection including tuberculosis (TB) (clinical evaluation that includes clinical history, physical examination and radiographic findings, and TB testing in line with local practice), hepatitis B (known positive hepatitis B virus (HBV) surface antigen (HBsAg) result), hepatitis C, or human immunodeficiency virus (positive HIV 1/2 antibodies). Subjects with a past or resolved HBV infection (defined as the presence of hepatitis B core antibody [anti-HBc (hepatitis B core antigen)] and absence of HBsAg) are eligible. Subjects positive for hepatitis C (HCV) antibody are eligible only if polymerase chain reaction is negative for HCV RNA.
- Female subjects who are pregnant or breastfeeding or male or female subjects of reproductive potential who are not willing to employ effective birth control from screening to 90 days after the last dose of IP.
- Known allergy or hypersensitivity to any of the study drugs or any of the study drug excipients.
- Judgment by the investigator that the patient is unsuitable to participate in the study and the patient is unlikely to comply with study procedures, restrictions and requirements.
Sites / Locations
- Seoul National University Bundang HospitalRecruiting
- Seoul National University HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Active Comparator
Arm Label
NaliCap
NAPOLI
Arm Description
nal-IRI/Capecitabine
nal-IRI/5-FU/LV
Outcomes
Primary Outcome Measures
Progression-free survival
Progression-free survival was defined as the duration between randomization and disease progression, any cause of death before disease progression, or the last follow-up.The event was defined as disease progression and any cause of death.
Secondary Outcome Measures
Objective response rate
Partial response and complete response
Overall survival
Overall survival was measured from the randomization to the last follow-up or any cause of death. The event was defined as any cause of death.
Adverse events
Common Terminology Criteria for Adverse Events (CTCAE)_ver 5.0 will be used.
QOL: eortc qlq-c30
eortc qlq-c30 will be used.
Full Information
NCT ID
NCT04371224
First Posted
April 26, 2020
Last Updated
April 10, 2023
Sponsor
Seoul National University Hospital
1. Study Identification
Unique Protocol Identification Number
NCT04371224
Brief Title
NaliCap (Irinotecan Liposome (Nal-IRI)/Capecitabine) vs. NAPOLI (Nal-IRI/5-FU/LV) ) in Advanced Pancreatic Cancer
Acronym
NaliCap
Official Title
Randomized Phase II Study of NaliCap (Irinotecan Liposome/Capecitabine) Compared to NAPOLI (Irinotecan Liposome/5-fluorouracil/Leucovorin) in Gemcitabine-pretreated Advanced Pancreatic Cancer
Study Type
Interventional
2. Study Status
Record Verification Date
April 2023
Overall Recruitment Status
Recruiting
Study Start Date
June 23, 2020 (Actual)
Primary Completion Date
June 30, 2023 (Anticipated)
Study Completion Date
December 31, 2023 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Seoul National University Hospital
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
This is an open label, randomized phase 2 study of NaliCap (irinotecan liposome/Capecitabine) compared to NAPOLI (irinotecan liposome/5-FU/LV) in gemcitabine-pretreated advanced pancreatic cancer patients.
Detailed Description
At the time of initial diagnosis of pancreatic cancer, resectable pancreatic cancer is around 20%, locally-advanced pancreatic cancer is around 25-30%, and the remaining is metastatic pancreatic cancer.
In metastatic pancreatic cancer, Gemcitabine/Abraxane or FOLFIRINOX 5-fluorouracil/leucovorin/irinotecan/oxaliplatin (FOLFIRINOX) is most commonly used regimen as a palliative 1st-line chemotherapy. In gemcitabine-pretreated pancreatic cancer, irinotecan liposome(nal-IRI)/5-fluorouracil(5FU)/leucovorin(LV)(NAPOLI regimen) improved overall survival of patients compared to 5FU/LV. Now, NAPOLI is standard of care in gemcitabine-pretreated pancreatic cancer.
Oral 5-FU such as TS-1 is used in gemcitabine pretreated pancreatic cancer patients or 1st-line treatment in gemcitabine-intolerable patients.
Capecitabine is oral 5-FU, which is commonly used in GI cancers, usually replacing intravenous infusion of 5-FU. It improves patient's convenience not requiring vascular access or hospital admission.
In NAPOLI regimen, iv 5-FU/LV could be replaced with capecitabine. So far, nal-IRI/Capecitabine combination has not yet been tested.
Based on these rationale, we plan to conduct the open-label, randomized phase 2 study to assess the safety and efficacy of NaliCap (nal-IRI/Capecitabine) compared to NAPOLI (nal-IRI/5-FU/LV) in patients with gemcitabine-pretreated advanced pancreatic cancer.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pancreatic Cancer
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
randomized phase 2 study
Masking
None (Open Label)
Allocation
Randomized
Enrollment
200 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
NaliCap
Arm Type
Experimental
Arm Description
nal-IRI/Capecitabine
Arm Title
NAPOLI
Arm Type
Active Comparator
Arm Description
nal-IRI/5-FU/LV
Intervention Type
Drug
Intervention Name(s)
Irinotecan Liposomal Injection [Onivyde]
Other Intervention Name(s)
nal-IRI
Intervention Description
both arm
Intervention Type
Drug
Intervention Name(s)
Capecitabine
Other Intervention Name(s)
xeloda
Intervention Description
NaliCap
Intervention Type
Drug
Intervention Name(s)
5-fluorouracil
Other Intervention Name(s)
5FU
Intervention Description
NAPOLI
Intervention Type
Drug
Intervention Name(s)
Leucovorin
Other Intervention Name(s)
LV
Intervention Description
NAPOLI
Primary Outcome Measure Information:
Title
Progression-free survival
Description
Progression-free survival was defined as the duration between randomization and disease progression, any cause of death before disease progression, or the last follow-up.The event was defined as disease progression and any cause of death.
Time Frame
From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 12 months
Secondary Outcome Measure Information:
Title
Objective response rate
Description
Partial response and complete response
Time Frame
through study completion, an average of 1 year
Title
Overall survival
Description
Overall survival was measured from the randomization to the last follow-up or any cause of death. The event was defined as any cause of death.
Time Frame
From date of randomization until the date of first documented date of death from any cause, whichever came first, assessed up to 12 months
Title
Adverse events
Description
Common Terminology Criteria for Adverse Events (CTCAE)_ver 5.0 will be used.
Time Frame
through study completion, an average of 1 year
Title
QOL: eortc qlq-c30
Description
eortc qlq-c30 will be used.
Time Frame
through study completion, an average of 1 year
10. Eligibility
Sex
All
Minimum Age & Unit of Time
20 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Signed informed consent
Age>20 years at time of study entry
Histologically confirmed pancreatic ductal adenocarcinoma
Advanced stage (unresectable, recurrent)
Gemcitabine-pretreated for advanced pancreatic cancer
Eastern Cooperative Oncology Group(ECOG) performance status 0, 1
Adequate organ function
Evidence of post-menopausal status or negative urinary or serum pregnancy test for female pre-menopausal subjects.
Subject is willing and able to comply with the protocol for the duration of the study including undergoing treatment and scheduled visits and examinations including follow up.
Exclusion Criteria:
Participation in another clinical study with an investigational product (IP) during the last 3 weeks
Concurrent enrolment in another clinical study, unless it is an observational (non-interventional) clinical study or during the follow-up period of an interventional study
Receipt of the last dose of anti-cancer therapy (chemotherapy, immunotherapy, endocrine therapy, targeted therapy, biologic therapy, tumor embolization, monoclonal antibodies, other investigational agent) 28 days prior to the first dose of study drug
Major surgical procedure (as defined by the Investigator) within 28 days prior to the first dose of IP. Note: Local surgery of isolated lesions for palliative intent is acceptable.
Known brain metastasis or spinal cord compression.
History of allogenic organ transplantation
Cardiac event during past 6 months
Uncontrolled intercurrent illness, including but not limited to, ongoing or active infection, symptomatic congestive heart failure, uncontrolled hypertension, unstable angina pectoris, cardiac arrhythmia, interstitial lung disease, serious chronic gastrointestinal conditions associated with diarrhea, or psychiatric illness/social situations that would limit compliance with study requirement, substantially increase risk of incurring AEs or compromise the ability of the patient to give written informed consent
Active infection including tuberculosis (TB) (clinical evaluation that includes clinical history, physical examination and radiographic findings, and TB testing in line with local practice), hepatitis B (known positive hepatitis B virus (HBV) surface antigen (HBsAg) result), hepatitis C, or human immunodeficiency virus (positive HIV 1/2 antibodies). Subjects with a past or resolved HBV infection (defined as the presence of hepatitis B core antibody [anti-HBc (hepatitis B core antigen)] and absence of HBsAg) are eligible. Subjects positive for hepatitis C (HCV) antibody are eligible only if polymerase chain reaction is negative for HCV RNA.
Female subjects who are pregnant or breastfeeding or male or female subjects of reproductive potential who are not willing to employ effective birth control from screening to 90 days after the last dose of IP.
Known allergy or hypersensitivity to any of the study drugs or any of the study drug excipients.
Judgment by the investigator that the patient is unsuitable to participate in the study and the patient is unlikely to comply with study procedures, restrictions and requirements.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Do-Youn Oh, M.D., PhD.
Phone
+82-2-2072-0701
Email
ohdoyoun@snu.ac.kr
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Do-Youn Oh, M.D., PhD.
Organizational Affiliation
Seoul National University Hospital
Official's Role
Study Director
Facility Information:
Facility Name
Seoul National University Bundang Hospital
City
Seongnam-si
ZIP/Postal Code
13620
Country
Korea, Republic of
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jin Won Kim, MD
Phone
82 31 787 7053
Email
jwkim@snubh.org
First Name & Middle Initial & Last Name & Degree
Kim
Facility Name
Seoul National University Hospital
City
Seoul
ZIP/Postal Code
110-744
Country
Korea, Republic of
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Do-Youn Oh, MD
Phone
+82-2-2072-0701
Email
ohdoyoun@snu.ac.kr
12. IPD Sharing Statement
Plan to Share IPD
No
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NaliCap (Irinotecan Liposome (Nal-IRI)/Capecitabine) vs. NAPOLI (Nal-IRI/5-FU/LV) ) in Advanced Pancreatic Cancer
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