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A Study to Evaluate the Safety and Efficacy of PRRT With 177Lu-EB-FAPI in Patients With Advanced Cholopancreatic Tumors (CISPD-5)

Primary Purpose

Advanced Pancreatic Cancer and Cholangiocarcinoma

Status
Recruiting
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
PRRT with 177Lu-EB-FAPI
Sponsored by
Zhejiang University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Advanced Pancreatic Cancer and Cholangiocarcinoma

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Signed the informed consent form; Age: 18-75 years old (when signing the informed consent form); Received 68 Ga-FAPI 46 PET imaging positive before treatment; Phase Ia requires patients who have previously failed at least 2 lines of systemic chemotherapy or who the investigator considers unsuitable to receive systemic chemotherapy; Phase Ib Cohort 1, enrollment of patients with hist-or cytologically confirmed metastatic pancreatic cancer; Phase Ib Cohort 2, enrollment of patients with hist-or cytologically confirmed metastatic cholangiocarcinoma; Phase Ia requires at least one evaluable lesion confirmed per RECIST 1.1 criteria; Phase Ib requires at least one measurable lesion confirmed per RECIST 1.1 criteria; ECOG score 0-1, expected survival greater than 3 months; Major organs function well; Patients must have reliable contraception during the study and within 6 months after the study period; negative serum pregnancy / urine pregnancy test within 7 days before study enrollment and must be non-lactating subjects; male subjects should agree to have contraception during the study and within 6 months after the end of the study period. Exclusion Criteria: Prior treatment before the first dose included chemotherapy and targeted therapy with any associated toxicity (CTCAE v5.0) of> 1 N. A., excluding alopecia; Severe organ failure, such as respiratory failure, uncontrolled thyroid dysfunction including hyperthyroidism and hypothyroidism, or uncorrection of K +, Na +, Ca 2 + electrolyte disorders; Within 5 years, the patient had previous or both other malignant tumors (except for cured skin basal cell carcinoma and cervical carcinoma in situ); had other malignant tumors, but the following two conditions can be enrolled: other malignant tumors treated with single surgery with R0 resection and no recurrence and metastasis; cured cervical carcinoma in situ, skin basal cell carcinoma, nasopharyngeal carcinoma and superficial bladder tumor [Ta (non-invasive tumor), Tis (carcinoma in situ) and T1 (tumor infiltrating basement membrane)]; Major surgical treatment with significant traumatic injury within 28 days prior to the first medication; Long-term non-healed wound or fracture; Active bleeding or high risk of bleeding considered by the investigator, such as gastric fundus varices, hemoptysis, etc.; Motor / venous thrombosis events, such as cerebrovascular accidents (including temporary ischemic attack, cerebral hemorrhage, cerebral infarction), deep vein thrombosis and pulmonary embolism, occurred within 6 months before the first medication; Patients with a history of psychiatric substance abuse and unable to quit or with mental disorders; Symptomatic interstitial lung disease, and conditions that may cause drug pulmonary toxicity or associated pneumonia; Patients with any severe and / or uncontrolled disease. Previous history of severe allergy to macromolecular drugs, or allergy to the known component of 177Lu-EB-FAPI injection; Claustrophobic or radiologically phobic patients, or patients with mental disorders or primary affective disorders; According to the discretion of the investigator, subjects with a serious hazard to subject safety or concomitant illness affecting the study or other reasons for enrollment.

Sites / Locations

  • First Affiliated Hospital of Zhejiang UniversityRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

Phase Ia: Dose escalation

Phase Ib: Dose expansion-pancreatic cancer cohort

Phase Ib: Dose expansion-cholangiocarcinoma cohort

Arm Description

To determine the therapeutic dose of 177Lu-EB-FAPI using a 3 + 3 dose-escalation mode

In pancreatic cancer cohort, patients will receive the first phase determined dose of 177Lu-EB-FAPI every 4 weeks, and each patient will receive no more than 4 cycles.

In cholangiocarcinoma cohort, patients will receive the first phase determined dose of 177Lu-EB-FAPI every 4 weeks, and each patient will receive no more than 4 cycles.

Outcomes

Primary Outcome Measures

Safety of treatment:hematotoxicity
Safety evaluation,Complete Blood Count was done continuously during treatment by using CTCAE 5.0 during study
Objective reponse rate (ORR)
The proportion of patients who had tumor evaluated as PR according to RECIST1.1 criteria during phase Ib
Safety of treatment:Hepatotoxicity
Safety evaluation,liver function lab test was done continuously during treatment and the level of serum ALT, AST, and total bilirubin will be evaluated by using CTCAE 5.0 during study.
Safety of treatment:renal toxicity
Safety evaluation,renal function lab test was done continuously during treatment and the level of serum creatinine will be evaluated by using CTCAE 5.0 during study.

Secondary Outcome Measures

Disease control rate (DCR)
The proportion of patients who had tumor evaluated as PR or SD according to RECIST1.1 criteria during phase Ib
Duration of remission (DoR)
The time from the first assessment of the tumor as CR or PR to the first assessment of PD or death from any cause during phase Ib
Progression-free survival (PFS)
The time from enrolled to disease pregression or death from any cause during phase Ib
Overall survival (OS)
The time from enrolled to death from any cause during phase Ib

Full Information

First Posted
June 12, 2023
Last Updated
October 10, 2023
Sponsor
Zhejiang University
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1. Study Identification

Unique Protocol Identification Number
NCT06081322
Brief Title
A Study to Evaluate the Safety and Efficacy of PRRT With 177Lu-EB-FAPI in Patients With Advanced Cholopancreatic Tumors
Acronym
CISPD-5
Official Title
An Exploratory Study to Evaluate the Safety and Efficacy of Peptide Receptor Radionuclide Therapy With 177Lu-EB-FAPI in Patients With Advanced Cholopancreatic Tumors
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Recruiting
Study Start Date
September 1, 2023 (Actual)
Primary Completion Date
June 30, 2024 (Anticipated)
Study Completion Date
June 30, 2025 (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
Data Monitoring Committee
No

5. Study Description

Brief Summary
This study is a prospective, single-center, open, single-arm, exploratory study to evaluate the safety and efficacy of 177Lu-EB-FAPI PRRT, and to explore 177Lu-EB-FAPI in patients with advanced pancreatic cancer and cholangiocarcinoma. Eligible patients with advanced pancreatic cancer or cholangiocarcinoma were screened and enrolled after signing the informed consent forms. In the first stage of the enrolled patients, the 177Lu-EB-FAPI treatment dose was determined using a 3 + 3 dose escalation mode. Patients enrolled in the second phase, divided into pancreatic cancer cohort and cholangiocarcinoma based on pathology, will receive the first phase determined dose of 177Lu-EB-FAPI every 4 weeks, and each patient will receive no more than 4 cycles. The aim of the study is to evaluate the safety and efficacy of the 177Lu-EB-FAPI treatment.
Detailed Description
This study is a prospective, single-center, open, single-arm, exploratory study to evaluate the safety and efficacy of 177Lu-EB-FAPI PRRT, and to explore 177Lu-EB-FAPI in patients with advanced pancreatic cancer and cholangiocarcinoma. Eligible patients with advanced pancreatic cancer or cholangiocarcinoma were screened and enrolled after signing the informed consent forms. In the first stage of the enrolled patients, the 177Lu-EB-FAPI treatment dose was determined using a 3 + 3 dose escalation mode. Patients enrolled in the second phase, divided into pancreatic cancer cohort and cholangiocarcinoma based on pathology, will receive the first phase determined dose of 177Lu-EB-FAPI every 4 weeks, and each patient will receive no more than 4 cycles. The aim of the study is to evaluate the safety and efficacy of the 177Lu-EB-FAPI treatment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Advanced Pancreatic Cancer and Cholangiocarcinoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
29 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Phase Ia: Dose escalation
Arm Type
Experimental
Arm Description
To determine the therapeutic dose of 177Lu-EB-FAPI using a 3 + 3 dose-escalation mode
Arm Title
Phase Ib: Dose expansion-pancreatic cancer cohort
Arm Type
Experimental
Arm Description
In pancreatic cancer cohort, patients will receive the first phase determined dose of 177Lu-EB-FAPI every 4 weeks, and each patient will receive no more than 4 cycles.
Arm Title
Phase Ib: Dose expansion-cholangiocarcinoma cohort
Arm Type
Experimental
Arm Description
In cholangiocarcinoma cohort, patients will receive the first phase determined dose of 177Lu-EB-FAPI every 4 weeks, and each patient will receive no more than 4 cycles.
Intervention Type
Drug
Intervention Name(s)
PRRT with 177Lu-EB-FAPI
Intervention Description
PRRT with 177Lu-Fibroblast activation protein inhibitor and modified by Evans blue
Primary Outcome Measure Information:
Title
Safety of treatment:hematotoxicity
Description
Safety evaluation,Complete Blood Count was done continuously during treatment by using CTCAE 5.0 during study
Time Frame
Up to 2 years.
Title
Objective reponse rate (ORR)
Description
The proportion of patients who had tumor evaluated as PR according to RECIST1.1 criteria during phase Ib
Time Frame
Up to 2 years
Title
Safety of treatment:Hepatotoxicity
Description
Safety evaluation,liver function lab test was done continuously during treatment and the level of serum ALT, AST, and total bilirubin will be evaluated by using CTCAE 5.0 during study.
Time Frame
Up to 2 years.
Title
Safety of treatment:renal toxicity
Description
Safety evaluation,renal function lab test was done continuously during treatment and the level of serum creatinine will be evaluated by using CTCAE 5.0 during study.
Time Frame
Up to 2 years.
Secondary Outcome Measure Information:
Title
Disease control rate (DCR)
Description
The proportion of patients who had tumor evaluated as PR or SD according to RECIST1.1 criteria during phase Ib
Time Frame
Up to 2 years
Title
Duration of remission (DoR)
Description
The time from the first assessment of the tumor as CR or PR to the first assessment of PD or death from any cause during phase Ib
Time Frame
Up to 2 years
Title
Progression-free survival (PFS)
Description
The time from enrolled to disease pregression or death from any cause during phase Ib
Time Frame
Up to 2 years
Title
Overall survival (OS)
Description
The time from enrolled to death from any cause during phase Ib
Time Frame
Up to 2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Signed the informed consent form; Age: 18-75 years old (when signing the informed consent form); Received 68 Ga-FAPI 46 PET imaging positive before treatment; Phase Ia requires patients who have previously failed at least 2 lines of systemic chemotherapy or who the investigator considers unsuitable to receive systemic chemotherapy; Phase Ib Cohort 1, enrollment of patients with hist-or cytologically confirmed metastatic pancreatic cancer; Phase Ib Cohort 2, enrollment of patients with hist-or cytologically confirmed metastatic cholangiocarcinoma; Phase Ia requires at least one evaluable lesion confirmed per RECIST 1.1 criteria; Phase Ib requires at least one measurable lesion confirmed per RECIST 1.1 criteria; ECOG score 0-1, expected survival greater than 3 months; Major organs function well; Patients must have reliable contraception during the study and within 6 months after the study period; negative serum pregnancy / urine pregnancy test within 7 days before study enrollment and must be non-lactating subjects; male subjects should agree to have contraception during the study and within 6 months after the end of the study period. Exclusion Criteria: Prior treatment before the first dose included chemotherapy and targeted therapy with any associated toxicity (CTCAE v5.0) of> 1 N. A., excluding alopecia; Severe organ failure, such as respiratory failure, uncontrolled thyroid dysfunction including hyperthyroidism and hypothyroidism, or uncorrection of K +, Na +, Ca 2 + electrolyte disorders; Within 5 years, the patient had previous or both other malignant tumors (except for cured skin basal cell carcinoma and cervical carcinoma in situ); had other malignant tumors, but the following two conditions can be enrolled: other malignant tumors treated with single surgery with R0 resection and no recurrence and metastasis; cured cervical carcinoma in situ, skin basal cell carcinoma, nasopharyngeal carcinoma and superficial bladder tumor [Ta (non-invasive tumor), Tis (carcinoma in situ) and T1 (tumor infiltrating basement membrane)]; Major surgical treatment with significant traumatic injury within 28 days prior to the first medication; Long-term non-healed wound or fracture; Active bleeding or high risk of bleeding considered by the investigator, such as gastric fundus varices, hemoptysis, etc.; Motor / venous thrombosis events, such as cerebrovascular accidents (including temporary ischemic attack, cerebral hemorrhage, cerebral infarction), deep vein thrombosis and pulmonary embolism, occurred within 6 months before the first medication; Patients with a history of psychiatric substance abuse and unable to quit or with mental disorders; Symptomatic interstitial lung disease, and conditions that may cause drug pulmonary toxicity or associated pneumonia; Patients with any severe and / or uncontrolled disease. Previous history of severe allergy to macromolecular drugs, or allergy to the known component of 177Lu-EB-FAPI injection; Claustrophobic or radiologically phobic patients, or patients with mental disorders or primary affective disorders; According to the discretion of the investigator, subjects with a serious hazard to subject safety or concomitant illness affecting the study or other reasons for enrollment.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Tingbo Liang, PhD
Phone
+86 19941463683
Email
liangtingbo@zju.edu.cn
First Name & Middle Initial & Last Name or Official Title & Degree
Yiwen Chen, MD
Phone
+86 15088682641
Email
cherry0705@zju.edu.cn
Facility Information:
Facility Name
First Affiliated Hospital of Zhejiang University
City
Hangzhou
State/Province
Zhejiang
ZIP/Postal Code
310000
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yiwen Chen, MD
Phone
19941463683

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Study to Evaluate the Safety and Efficacy of PRRT With 177Lu-EB-FAPI in Patients With Advanced Cholopancreatic Tumors

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