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Study of CRS-207, Pembrolizumab, Ipilimumab, and Tadalafil in Metastatic Pancreatic Cancer

Primary Purpose

Pancreatic Cancer

Status
Recruiting
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Tadalafil
Pembrolizumab
Ipilimumab
CRS-207
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 Pancreatic Cancer focused on measuring Pancreatic cancer, Pembrolizumab, Ipilimumab, CRS-207, Tadalafil, Immunotherapy, Anti-PD-1, Anti-CTLA-4, Adenocarcinoma, Carcinoma

Eligibility Criteria

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

Inclusion Criteria:

  • Age ≥18 years.
  • Have histologically or cytologically proven adenocarcinoma of the pancreas.
  • Have previously treated metastatic disease.
  • Have radiographic disease progression.
  • Patients with the presence of at least one measurable tumor lesion.
  • Patient's acceptance to have a tumor biopsy at baseline and on
  • Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1
  • Patients must have adequate organ and marrow function defined by study-specified laboratory tests.
  • For both Women and Men, must use acceptable form of birth control while on study.
  • Ability to understand and willingness to sign a written informed consent document.

Exclusion Criteria:

  • Known history or evidence of brain metastases.
  • Had chemotherapy, radiation, or biological cancer therapy within the last 14 days.
  • Have received an investigational agent or device within the last 28 days.
  • Had surgery within the last 28 days.
  • Expected to require any other form of systemic or localized cancer therapy while on study.
  • Have received a vaccine within the last 14 days (7 days for the COVID vaccine) or received a live vaccine within the last 30 days.
  • Have received steroids within the last 14 days.
  • Use more than 4 g/day of acetaminophen.
  • Use of organic nitrates.
  • Use of guanylate cyclase (GC) stimulators such as riociguat.
  • Consumption of substantial amounts of alcohol (≥5 units/day)
  • Use of strong or moderate cytochrome P450 3A4 (CYP3A4) inhibitor or inducer.
  • Patients on immunosuppressive agents within the last 7 days
  • Known allergy to both penicillin and sulfa.
  • Severe hypersensitivity reaction to any monoclonal antibody.
  • History of severe hypersensitivity to tadalafil.
  • Have implant(s) or device(s) that has not and cannot be easily removed.
  • Have artificial joints or implanted medical devices that cannot be easily removed.
  • Have any evidence of clinical or radiographic ascites.
  • Have significant and/or malignant pleural effusion
  • Uncontrolled intercurrent illness.
  • Subjects with active, known or suspected autoimmune disease.
  • Have a tissue or organ allograft, including corneal allograft.
  • Have been diagnosed HIV, Hepatitis B or C positive.
  • Is on supplemental home oxygen.
  • Has an unhealed surgical wound or ulcer, or a bone fracture considered non-healing.
  • Has clinically significant heart disease
  • Prior history of non-arterial ischemic optic retinopathy.
  • History of significant hypotensive episode requiring hospitalization within 6 months.
  • Has insufficient peripheral vein access.
  • Is unwilling or unable to follow the study schedule for any reason.
  • Is pregnant or breastfeeding.

Sites / Locations

  • Sidney Kimmel Comprehensive Cancer CenterRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Arm A - Tadalafil, Pembrolizumab, Ipilimumab, CRS-207

Arm Description

Outcomes

Primary Outcome Measures

Objective response rate (irORR) using immune Response Evaluation Criteria for Solid Tumors (iRECIST)
irORR is defined as the number of patients achieving a complete response (irCR) or partial response (irPR) based on the immune Response Evaluation Criteria in Solid Tumors (iRECIST) at any time during the study. irCR = disappearance of all target lesions, irPR is =>30percent decrease in sum of diameters of target lesions, progressive disease (irPD) is >20percent increase in sum of diameters of target lesions, stable disease (irSD) is <30percent decrease or <20percent increase in sum of diameters of target lesions.

Secondary Outcome Measures

Number of participants experiencing grade 3 or above drug-related toxicities
When calculating the incidence of adverse event (AE)s, each AE (as defined by NCI CTCAE v5.0) will be counted only once for a given subject.

Full Information

First Posted
August 13, 2021
Last Updated
September 1, 2023
Sponsor
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Collaborators
Lustgarten Foundation, National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT05014776
Brief Title
Study of CRS-207, Pembrolizumab, Ipilimumab, and Tadalafil in Metastatic Pancreatic Cancer
Official Title
A Phase 2 Study of the Safety, Efficacy, and Immune Response of CRS-207, Pembrolizumab, Ipilimumab, and Tadalafil in Patients With Previously Treated Metastatic Pancreatic Adenocarcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Recruiting
Study Start Date
August 22, 2022 (Actual)
Primary Completion Date
December 1, 2024 (Anticipated)
Study Completion Date
December 1, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Collaborators
Lustgarten Foundation, 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
No

5. Study Description

Brief Summary
The purpose of this study is to evaluate the safety and clinical activity of tadalafil, pembrolizumab, ipilimumab, and CRS-207 in subjects with metastatic pancreatic adenocarcinoma who have progressed after at least 1 prior chemotherapy regimen.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pancreatic Cancer
Keywords
Pancreatic cancer, Pembrolizumab, Ipilimumab, CRS-207, Tadalafil, Immunotherapy, Anti-PD-1, Anti-CTLA-4, Adenocarcinoma, Carcinoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
20 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Arm A - Tadalafil, Pembrolizumab, Ipilimumab, CRS-207
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Tadalafil
Intervention Description
Patients will receive treatment every 3 weeks for 6 cycles of treatment within a course (total of 18 weeks). Tadalafil (20 mg) will be administered orally every day on days 3-21 for cycles 1-6.
Intervention Type
Drug
Intervention Name(s)
Pembrolizumab
Other Intervention Name(s)
KEYTRUDA®
Intervention Description
Patients will receive treatment every 3 weeks for 6 cycles of treatment within a course (total of 18 weeks). Pembrolizumab (200 mg) will be administered IV on Day 1 of cycles 1-6.
Intervention Type
Drug
Intervention Name(s)
Ipilimumab
Other Intervention Name(s)
YERVOY®
Intervention Description
Patients will receive treatment every 3 weeks for 6 cycles of treatment within a course (total of 18 weeks). Ipilimumab (50mg) will be administered IV on Day 1 of Cycles 1, 3, and 5.
Intervention Type
Drug
Intervention Name(s)
CRS-207
Intervention Description
Patients will receive treatment every 3 weeks for 6 cycles of treatment within a course (total of 18 weeks). CRS-207 [1 × 109 colony forming units (CFU) in 100ml NS] will be administered IV on Day 2 of Cycles 1-6.
Primary Outcome Measure Information:
Title
Objective response rate (irORR) using immune Response Evaluation Criteria for Solid Tumors (iRECIST)
Description
irORR is defined as the number of patients achieving a complete response (irCR) or partial response (irPR) based on the immune Response Evaluation Criteria in Solid Tumors (iRECIST) at any time during the study. irCR = disappearance of all target lesions, irPR is =>30percent decrease in sum of diameters of target lesions, progressive disease (irPD) is >20percent increase in sum of diameters of target lesions, stable disease (irSD) is <30percent decrease or <20percent increase in sum of diameters of target lesions.
Time Frame
4 years
Secondary Outcome Measure Information:
Title
Number of participants experiencing grade 3 or above drug-related toxicities
Description
When calculating the incidence of adverse event (AE)s, each AE (as defined by NCI CTCAE v5.0) will be counted only once for a given subject.
Time Frame
4 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age ≥18 years. Have histologically or cytologically proven adenocarcinoma of the pancreas. Have previously treated metastatic disease. Have radiographic disease progression. Patients with the presence of at least one measurable tumor lesion. Patient's acceptance to have a tumor biopsy at baseline and on Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1 Patients must have adequate organ and marrow function defined by study-specified laboratory tests. For both Women and Men, must use acceptable form of birth control while on study. Ability to understand and willingness to sign a written informed consent document. Exclusion Criteria: Known history or evidence of brain metastases. Had chemotherapy, radiation, or biological cancer therapy within the last 14 days. Have received an investigational agent or device within the last 28 days. Had surgery within the last 28 days. Expected to require any other form of systemic or localized cancer therapy while on study. Have received a vaccine within the last 14 days (7 days for the COVID vaccine) or received a live vaccine within the last 30 days. Have received steroids within the last 14 days. Use more than 4 g/day of acetaminophen. Use of organic nitrates. Use of guanylate cyclase (GC) stimulators such as riociguat. Consumption of substantial amounts of alcohol (≥5 units/day) Use of strong or moderate cytochrome P450 3A4 (CYP3A4) inhibitor or inducer. Patients on immunosuppressive agents within the last 7 days Known allergy to both penicillin and sulfa. Severe hypersensitivity reaction to any monoclonal antibody. History of severe hypersensitivity to tadalafil. Have implant(s) or device(s) that has not and cannot be easily removed. Have artificial joints or implanted medical devices that cannot be easily removed. Have any evidence of clinical or radiographic ascites. Have significant and/or malignant pleural effusion Uncontrolled intercurrent illness. Subjects with active, known or suspected autoimmune disease. Have a tissue or organ allograft, including corneal allograft. Have been diagnosed HIV, Hepatitis B or C positive. Is on supplemental home oxygen. Has an unhealed surgical wound or ulcer, or a bone fracture considered non-healing. Has clinically significant heart disease Prior history of non-arterial ischemic optic retinopathy. History of significant hypotensive episode requiring hospitalization within 6 months. Has insufficient peripheral vein access. Is unwilling or unable to follow the study schedule for any reason. Is pregnant or breastfeeding.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Colleen Apostal, RN
Phone
410-614-3644
Email
GIClinicalTrials@jhmi.edu
First Name & Middle Initial & Last Name or Official Title & Degree
Joann Santmyer, RN
Phone
410-614-3644
Email
GIClinicalTrials@jhmi.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Katherine Bever, MD
Organizational Affiliation
Sidney Kimmel Comprehensive Cancer Center at 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
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Trish Brothers, RN
Phone
410-614-3644
Email
GIClinicalTrials@jhmi.edu
First Name & Middle Initial & Last Name & Degree
Joann Santmyer, RN
Phone
410-614-3644
Email
GIClinicalTrials@jhmi.edu
First Name & Middle Initial & Last Name & Degree
Katherine Bever, MD

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Study of CRS-207, Pembrolizumab, Ipilimumab, and Tadalafil in Metastatic Pancreatic Cancer

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