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A Study of Live Biotherapeutic Product MRx0518 With Hypofractionated Radiation Therapy in Resectable Pancreatic Cancer

Primary Purpose

Pancreatic Cancer

Status
Terminated
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
MRx0518
Hypofractionated Preoperative Radiation
Sponsored by
4D pharma plc
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pancreatic Cancer

Eligibility Criteria

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

Inclusion Criteria:

  • Patient has signed informed consent and is willing to comply with the protocol
  • Cytologic or biopsy confirmed adenocarcinoma of the pancreas
  • TNM stage: Tx, T1-4, N0-1 or Nx, M0
  • Potentially resectable pancreatic cancer defined as no extra-pancreatic disease, no evidence of tumor extension to the celiac axis, common hepatic artery and superior mesenteric artery, and no evidence of deformity of the superior mesenteric vein or superior mesenteric portal vein confluence
  • No evidence of distant metastases either prior to or after induction chemotherapy
  • Able to comply with instructions required for radiation therapy
  • Age 18 years or older
  • Completion of 2-6 months of standard induction chemotherapy (mFOLFIRINOX, gemcitabine and nab-paclitaxel or other)
  • Eastern Cooperative Oncology Group Score 0, 1 or 2
  • Adequate haematologic function (absolute neutrophil count ≥1500mm3; haemoglobin ≥8.0 g/dL; platelet count ≥50000mm3)
  • Adequate renal and liver function (creatinine ≤ 1.5 x upper limit of normal; total bilirubin ≤ 1.5 x upper limit of normal; aspartate aminotransferase and alanine aminotransferase ≤ 2.5 x upper limit of normal; alkaline phosphatase ≤ 2.5 x upper limit of normal

Exclusion Criteria:

  • Prior radiation therapy to the abdomen that would overlap with the treatment field
  • Prior surgical resection of pancreatic tumor
  • Receiving any approved or investigational anti-cancer agent other than those provided for in this study
  • Uncontrolled or active gastric or duodenal ulcer disease within 30 days of dosing
  • Residual or ongoing ≥Grade 3 toxicity from chemotherapy
  • Contraindication to IV contrast that can't be managed with pre-medication
  • Concurrent participation in another interventional clinical trial or use of another investigational agent within 30 days of consent (concurrent non-interventional trials are eligible)
  • Uncontrolled intercurrent illness including but not limited to, symptomatic congestive heart failure, unstable angina pectoris, renal failure, cardiac arrhythmia, stroke, or psychiatric illness that would limit compliance with treatment
  • Second primary malignancy within the last 5 years, unless treated definitively and/or low risk in the judgement of the treating investigator
  • Known history of HIV or active hepatitis B/C (patients who have been vaccinated for hepatitis B and do not have history of infection are eligible)
  • Known intolerance or hypersensitivity to study drug
  • Subjects who are allergic to amoxicillin/clavulanic acid, erythromycin and imipenem
  • Female subjects who are breastfeeding
  • Women of child-bearing potential who are unwilling or unable to use an acceptable method of birth control for the entire study and for 30 days after last dose of MRx0518. A negative pregnancy test must be obtained within 14 days prior to start of treatment
  • Male subjects who are unwilling or unable to use an acceptable method of birth control for the entire study period and for 30 days after last dose of MRx0518
  • Serious infection requiring systemic therapy
  • Use of systemic antibiotics within 2 weeks of start of study treatment
  • Has a known inability for intake of oral capsules

Sites / Locations

  • MD Anderson Cancer Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

MRx0518 with hypofractionated preoperative radiation

Arm Description

Subjects will take one capsule of MRx0518 twice daily from one week prior to radiation therapy until surgical resection (6 to 9 weeks approx.) Radiation therapy will be delivered as 30Gy/10 fractions over 2 weeks.

Outcomes

Primary Outcome Measures

To assess the safety of MRx0518 in combination with hypofractionated preoperative radiation through the collection of adverse events
Adverse events will be assessed as per CTCAE v5.0

Secondary Outcome Measures

Major pathologic response
Major pathologic response is defined as <5% viable cells in resected tumour specimen
Tumour infiltrating lymphocytes (TILs)
Changes in TILs from optional baseline biopsy to resected tumour specimen will be assessed.
Overall Survival (OS)
OS is defined as the duration from the start of study treatment until death due to any cause
Progression Free Survival (PFS)
PFS is defined as the duration from the start of study treatment until disease progression or death
Local Control
Local control is defined as absence of progression at the primary site and will be assessed with imaging
Distant Control
Distant control is defined as absence of progression at any site other than the primary site and will be assessed with imaging
Margin status
The margin status of the tumour at the time of surgery will be assessed

Full Information

First Posted
November 12, 2019
Last Updated
June 1, 2023
Sponsor
4D pharma plc
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1. Study Identification

Unique Protocol Identification Number
NCT04193904
Brief Title
A Study of Live Biotherapeutic Product MRx0518 With Hypofractionated Radiation Therapy in Resectable Pancreatic Cancer
Official Title
A Safety and Preliminary Efficacy Study of the Oral Live Biotherapeutic MRx0518 With Hypofractionated Preoperative Radiation for Resectable Pancreatic Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Terminated
Why Stopped
Sponsor insolvency
Study Start Date
December 20, 2019 (Actual)
Primary Completion Date
May 8, 2023 (Actual)
Study Completion Date
May 8, 2023 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
4D pharma plc

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
This is a single center, open-label, phase I study to evaluate the safety and preliminary efficacy of MRx0518 with preoperative hypofractionated radiation in 15 patients with resectable pancreatic cancer. Subjects will take MRx0518 daily for one week prior to the start of radiation therapy, throughout radiation and until surgical resection of the tumour.

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 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
13 (Actual)

8. Arms, Groups, and Interventions

Arm Title
MRx0518 with hypofractionated preoperative radiation
Arm Type
Experimental
Arm Description
Subjects will take one capsule of MRx0518 twice daily from one week prior to radiation therapy until surgical resection (6 to 9 weeks approx.) Radiation therapy will be delivered as 30Gy/10 fractions over 2 weeks.
Intervention Type
Drug
Intervention Name(s)
MRx0518
Intervention Description
MRx0518 is a live biotherapeutic product consisting of a lyophilised formulation of a proprietary strain of bacterium. The study dosing regimen is one capsule two times per day for the duration of the treatment period.
Intervention Type
Radiation
Intervention Name(s)
Hypofractionated Preoperative Radiation
Intervention Description
Radiation will be delivered as 30Gy/10 fractions over two weeks.
Primary Outcome Measure Information:
Title
To assess the safety of MRx0518 in combination with hypofractionated preoperative radiation through the collection of adverse events
Description
Adverse events will be assessed as per CTCAE v5.0
Time Frame
Up to 1 year post completion of radiation
Secondary Outcome Measure Information:
Title
Major pathologic response
Description
Major pathologic response is defined as <5% viable cells in resected tumour specimen
Time Frame
At time of surgery
Title
Tumour infiltrating lymphocytes (TILs)
Description
Changes in TILs from optional baseline biopsy to resected tumour specimen will be assessed.
Time Frame
Baseline to Surgery
Title
Overall Survival (OS)
Description
OS is defined as the duration from the start of study treatment until death due to any cause
Time Frame
12 months post radiation
Title
Progression Free Survival (PFS)
Description
PFS is defined as the duration from the start of study treatment until disease progression or death
Time Frame
12 months post radiation
Title
Local Control
Description
Local control is defined as absence of progression at the primary site and will be assessed with imaging
Time Frame
6 months post radiation
Title
Distant Control
Description
Distant control is defined as absence of progression at any site other than the primary site and will be assessed with imaging
Time Frame
6 months post radiation
Title
Margin status
Description
The margin status of the tumour at the time of surgery will be assessed
Time Frame
At time of surgery
Other Pre-specified Outcome Measures:
Title
Changes to microbiome
Description
The microbiome profile of faecal, urine, tumour and duodenum samples will be analysed for changes using the MicroDx platform
Time Frame
Baseline to 6 months post completion of radiation
Title
Tumour immune infiltration
Description
Optional biopsies and resection specimens will be assessed for changes in tumour immune infiltrates
Time Frame
Baseline to Surgery
Title
Landscape of immune and stromal cells
Description
Optional biopsy and resection specimens will be catalogued for the landscape of immune and stromal cells
Time Frame
Baseline to Surgery
Title
Changes in Circulating Tumour Cells
Description
Blood samples will be assessed for presence of circulating tumour cells, circulating tumour DNA and/or circulating immune cells
Time Frame
Baseline to 6 months post completion of radiation
Title
Genomic changes
Description
Whole exome sequencing and transcriptome sequencing from tumour and blood samples will be performed
Time Frame
Baseline to 6 months post completion of radiation

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patient has signed informed consent and is willing to comply with the protocol Cytologic or biopsy confirmed adenocarcinoma of the pancreas TNM stage: Tx, T1-4, N0-1 or Nx, M0 Potentially resectable pancreatic cancer defined as no extra-pancreatic disease, no evidence of tumor extension to the celiac axis, common hepatic artery and superior mesenteric artery, and no evidence of deformity of the superior mesenteric vein or superior mesenteric portal vein confluence No evidence of distant metastases either prior to or after induction chemotherapy Able to comply with instructions required for radiation therapy Age 18 years or older Completion of 2-6 months of standard induction chemotherapy (mFOLFIRINOX, gemcitabine and nab-paclitaxel or other) Eastern Cooperative Oncology Group Score 0, 1 or 2 Adequate haematologic function (absolute neutrophil count ≥1500mm3; haemoglobin ≥8.0 g/dL; platelet count ≥50000mm3) Adequate renal and liver function (creatinine ≤ 1.5 x upper limit of normal; total bilirubin ≤ 1.5 x upper limit of normal; aspartate aminotransferase and alanine aminotransferase ≤ 2.5 x upper limit of normal; alkaline phosphatase ≤ 2.5 x upper limit of normal Exclusion Criteria: Prior radiation therapy to the abdomen that would overlap with the treatment field Prior surgical resection of pancreatic tumor Receiving any approved or investigational anti-cancer agent other than those provided for in this study Uncontrolled or active gastric or duodenal ulcer disease within 30 days of dosing Residual or ongoing ≥Grade 3 toxicity from chemotherapy Contraindication to IV contrast that can't be managed with pre-medication Concurrent participation in another interventional clinical trial or use of another investigational agent within 30 days of consent (concurrent non-interventional trials are eligible) Uncontrolled intercurrent illness including but not limited to, symptomatic congestive heart failure, unstable angina pectoris, renal failure, cardiac arrhythmia, stroke, or psychiatric illness that would limit compliance with treatment Second primary malignancy within the last 5 years, unless treated definitively and/or low risk in the judgement of the treating investigator Known history of HIV or active hepatitis B/C (patients who have been vaccinated for hepatitis B and do not have history of infection are eligible) Known intolerance or hypersensitivity to study drug Subjects who are allergic to amoxicillin/clavulanic acid, erythromycin and imipenem Female subjects who are breastfeeding Women of child-bearing potential who are unwilling or unable to use an acceptable method of birth control for the entire study and for 30 days after last dose of MRx0518. A negative pregnancy test must be obtained within 14 days prior to start of treatment Male subjects who are unwilling or unable to use an acceptable method of birth control for the entire study period and for 30 days after last dose of MRx0518 Serious infection requiring systemic therapy Use of systemic antibiotics within 2 weeks of start of study treatment Has a known inability for intake of oral capsules
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Cullen M Taniguchi, MD
Organizational Affiliation
M.D. Anderson Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
MD Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Study of Live Biotherapeutic Product MRx0518 With Hypofractionated Radiation Therapy in Resectable Pancreatic Cancer

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