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A Trial of PEGPH20 in Combination With Avelumab in Chemotherapy Resistant Pancreatic Cancer

Primary Purpose

Pancreatic Ductal Adenocarcinoma, Pancreatic Cancer

Status
Terminated
Phase
Early Phase 1
Locations
Spain
Study Type
Interventional
Intervention
PEGylated Recombinant Human Hyaluronidase (PEGPH20)
Avelumab
Sponsored by
PH Research, S.L.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pancreatic Ductal Adenocarcinoma focused on measuring pancreatic cancer, inmunotherapy

Eligibility Criteria

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

Key Inclusion Criteria:

  • Signed, written IRB/IEC-approved Informed Consent Form
  • Histologically or cytologically-confirmed pancreatic ductal adenocarcinoma (PDAC).
  • Accessible tumor for two repeated tumor biopsies.
  • Progression to first line treatment for locally advanced or advanced disease. Prior adjuvant chemotherapy or chemoradiation therapy for early disease is allowed.
  • Age ≥18 years.
  • Radiologically measurable disease per RECIST v1.1.
  • Performance-status ECOG 0 -2.
  • Life expectancy ≥ 3 months.
  • Resolved acute effects of any prior therapy to baseline or Grade ≤1 severity
  • Screening laboratory:

    1. Hematologic: ANC ≥ 1.5 × 109/L, platelet count ≥ 100 × 109/L, and hemoglobin ≥ 9 g/dL
    2. Hepatic: Total bilirubin level ≤ 1.5 × the ULN range and AST and ALT levels ≤ 2.5 × ULN or AST and ALT levels ≤ 5 X ULN (for subjects with documented metastatic disease to the liver)
    3. Renal: Estimated creatinine clearance ≥ 30 mL/min according to the Cockcroft-Gault formula or serum creatinine ≤ 2.0 mg/dL.
    4. Albumin ≥2.5 g/dL.
    5. Coagulation: PT time and INR within normal limits (+/-15%). PTT within normal limits (+/-15%).
  • If a subject requires anticoagulation, treatment must be modified to enoxaparin.
  • Negative serum pregnancy test if female subject is of childbearing potential.
  • Patients who are willing and able to comply with scheduled visits, treatment plans, laboratory tests, biopsies when required, and other procedures.

Exclusion Criteria:

  • Clinical evidence of DVT, PE, prior history of CVA or history of TIA within 12 months or other known TE event present during the screening period
  • Current use of megestrol acetate (use within 10 days of Day 1).
  • Contraindication to heparin as per institutional guidelines.
  • Another primary cancer within the last 3 years currently requiring antineoplastic treatment within the exception of non-melanoma skin cancer, early-stage prostate cancer, or curatively treated cervical carcinoma in-situ.
  • Current use of immunosuppressive medication within 2 weeks of study participation, EXCEPT for those listed in protocol
  • Active autoimmune disease that might deteriorate when receiving an immuno-stimulatory agent: Patients with diabetes type I, vitiligo, psoriasis, or hypo- or hyperthyroid diseases not requiring immunosuppressive treatment are eligible.
  • Prior organ transplantation including allogenic stem-cell transplantation.
  • Active infection requiring systemic therapy.
  • Known infection with human immunodeficiency virus, Hepatitis B, or Hepatitis C
  • Known prior severe hypersensitivity to investigational product, hyaluronidase, or any component in its formulations, including known severe hypersensitivity reactions to monoclonal antibodies (NCI CTCAE v4.03 Grade ≥ 3).
  • Any history of anaphylaxis or uncontrolled asthma (that is, 3 or more features of partially controlled asthma).
  • Clinically significant (i.e., active) cardiovascular disease: myocardial infarction (< 6 months prior to enrollment), unstable angina, congestive heart failure (≥ New York Heart Association Classification Class II), or serious cardiac arrhythmia requiring medication.
  • Prior cerebrovascular accident/stroke.
  • Clinically significant carotid artery disease (e.g. prior carotid surgery, symptomatic and/or requires treatment)
  • Inability to comply with study and follow-up procedures as judged by the Investigator.
  • Known alcohol or drug abuse.

Sites / Locations

  • Hospital Universitario Fuenlabrada
  • Hospital Universitario La Paz
  • Hospital Ramon y Cajal

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

PEGPH20 + Avelumab

Arm Description

PEGPH20, a multi-site PEGylated enzyme generated by conjugating N-hydroxysuccinimidyl ester of methoxypoly(ethylene glycol)-butanoic acid (MSBA30K/B or PEG) and recombinant human hyaluronidase (rHuPH20). PEGPH20 has a half-life of approximately 2 days, thereby enabling systemic activity and sustained duration of action to degrade HA. In many different tumor types tested in murine xenograft models, response to PEGPH20 has been shown to be more robust for tumors characterized by higher HA expression.

Outcomes

Primary Outcome Measures

Determine ORR as per RECIST v1.1 criteria
Determine ORR as per RECIST v1.1 criteria
To assess the safety of this combination in patients with PDAC.
graded by National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 4.03

Secondary Outcome Measures

Determine OS (OVERALL SURVIVAL)
The length of time from either the date of diagnosis or the start of treatment for a disease, such as cancer, that patients diagnosed with the disease are still alive
Determine PFS (PROGRESSION FREE SURVIVAL)
The length of time during and after the treatment of a disease, such as cancer, that a patient lives with the disease but it does not get worse.
Changes in CA 19,9 leves
Measured in UI/ML

Full Information

First Posted
February 10, 2018
Last Updated
August 20, 2019
Sponsor
PH Research, S.L.
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1. Study Identification

Unique Protocol Identification Number
NCT03481920
Brief Title
A Trial of PEGPH20 in Combination With Avelumab in Chemotherapy Resistant Pancreatic Cancer
Official Title
A Pilot Trial of PEGPH20 (Pegylated Hyaluronidase) in Combination With Avelumab (Anti-PD-L1 MSB0010718C) in Chemotherapy Resistant Pancreatic Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
January 2019
Overall Recruitment Status
Terminated
Why Stopped
Stopped Enrollment
Study Start Date
January 10, 2018 (Actual)
Primary Completion Date
January 10, 2019 (Actual)
Study Completion Date
June 10, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
PH Research, S.L.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
The purpose of this study is to evaluate the pharmacodynamics, safety and efficacy of PEGPH20 in combination with Avelumab in adult patients with chemotherapy resistant advanced or locally advanced pancreatic ductal adenocarcinoma (PDAC). This is a multi-center, open-label, non-randomized trial.
Detailed Description
The reported response rate with check-point inhibitors in PDAC is 0 %. This study tests the hypothesis that elimination of HA in pancreas tumor microenvironment mediated by PEG PH20 will result in increased tumor vascularization and vessel patency as well as stromal remodeling with increase immune infiltrate. These effects may facilitate the activity of check-point inhibitors like avelumab by at least two mechanisms including increase in drug delivery and increasing immune infiltrate. The purpose of this study is to evaluate the pharmacodynamics, safety and efficacy of PEGPH20 in combination with Avelumab in adult patients with chemotherapy resistant advanced or locally advanced pancreatic ductal adenocarcinoma (PDAC). This is a multi-center, open-label, non-randomized trial.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pancreatic Ductal Adenocarcinoma, Pancreatic Cancer
Keywords
pancreatic cancer, inmunotherapy

7. Study Design

Primary Purpose
Treatment
Study Phase
Early Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
7 (Actual)

8. Arms, Groups, and Interventions

Arm Title
PEGPH20 + Avelumab
Arm Type
Experimental
Arm Description
PEGPH20, a multi-site PEGylated enzyme generated by conjugating N-hydroxysuccinimidyl ester of methoxypoly(ethylene glycol)-butanoic acid (MSBA30K/B or PEG) and recombinant human hyaluronidase (rHuPH20). PEGPH20 has a half-life of approximately 2 days, thereby enabling systemic activity and sustained duration of action to degrade HA. In many different tumor types tested in murine xenograft models, response to PEGPH20 has been shown to be more robust for tumors characterized by higher HA expression.
Intervention Type
Drug
Intervention Name(s)
PEGylated Recombinant Human Hyaluronidase (PEGPH20)
Intervention Description
PEGPH20 will be administered at a dose of 3.0 micrograms per kilogram (μg/kg) as an intravenous (IV) infusion.
Intervention Type
Drug
Intervention Name(s)
Avelumab
Other Intervention Name(s)
MSB0010718C
Intervention Description
Avelumab will be administered as at a dose of 10 milligrams per kilogram (mg/kg) as an intravenous (IV) infusion once every 2 weeks.
Primary Outcome Measure Information:
Title
Determine ORR as per RECIST v1.1 criteria
Description
Determine ORR as per RECIST v1.1 criteria
Time Frame
6 months from trial treatment initiation cycle 1/day 1. Each treatment cycle is 14 days
Title
To assess the safety of this combination in patients with PDAC.
Description
graded by National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 4.03
Time Frame
Initiation of trial treatment cycle 1/day 1 through 30 days after last dose of trial treatment
Secondary Outcome Measure Information:
Title
Determine OS (OVERALL SURVIVAL)
Description
The length of time from either the date of diagnosis or the start of treatment for a disease, such as cancer, that patients diagnosed with the disease are still alive
Time Frame
From date of treatment initiation cycle 1/day 1 until death from any cause, assessed up to 36 months
Title
Determine PFS (PROGRESSION FREE SURVIVAL)
Description
The length of time during and after the treatment of a disease, such as cancer, that a patient lives with the disease but it does not get worse.
Time Frame
From date of treatment initiation cycle 1/day 1 until progression, assessed up to 24 months
Title
Changes in CA 19,9 leves
Description
Measured in UI/ML
Time Frame
Up to 4 weeks
Other Pre-specified Outcome Measures:
Title
The effect of PEGPH20 in tumor hyaluronic acid (HA) content in plasma and paired tumor biopsies of patients with PDAC treated with this regimen
Description
Hyaluronan concentrations will be analyzed in blood plasma samples by total HA disaccharides using liquid chromatography-tandem mass spectrometry (LC-MS-MS) . Hyaluronan concentrations will be analyzed in tumor tissue samples using an immunohistochemical method used exclusively in research.
Time Frame
tumor assessments performed every 8 +/- 1 week while on treatment, up to 24 months
Title
Collagen content
Description
Collagen type I will be determine in tumor samples
Time Frame
tumor assessments performed every 8 +/- 1 week while on treatment, up to 24 months
Title
Cancer associated fibroblasts (CAF) in tumor samples.
Description
Activated fibroblasts will be determined with double staining using vimentin as a fibroblast total marker and smooth muscle actin (SMA) as an activated fibroblast marker.
Time Frame
tumor assessments performed every 8 +/- 1 week while on treatment, up to 24 months
Title
Immune infiltrate.
Description
CD4 and CD8 surface markers will be used to determine the immune infiltrate in tumor samples.
Time Frame
tumor assessments performed every 8 +/- 1 week while on treatment, up to 24 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Key Inclusion Criteria: Signed, written IRB/IEC-approved Informed Consent Form Histologically or cytologically-confirmed pancreatic ductal adenocarcinoma (PDAC). Accessible tumor for two repeated tumor biopsies. Progression to first line treatment for locally advanced or advanced disease. Prior adjuvant chemotherapy or chemoradiation therapy for early disease is allowed. Age ≥18 years. Radiologically measurable disease per RECIST v1.1. Performance-status ECOG 0 -2. Life expectancy ≥ 3 months. Resolved acute effects of any prior therapy to baseline or Grade ≤1 severity Screening laboratory: Hematologic: ANC ≥ 1.5 × 109/L, platelet count ≥ 100 × 109/L, and hemoglobin ≥ 9 g/dL Hepatic: Total bilirubin level ≤ 1.5 × the ULN range and AST and ALT levels ≤ 2.5 × ULN or AST and ALT levels ≤ 5 X ULN (for subjects with documented metastatic disease to the liver) Renal: Estimated creatinine clearance ≥ 30 mL/min according to the Cockcroft-Gault formula or serum creatinine ≤ 2.0 mg/dL. Albumin ≥2.5 g/dL. Coagulation: PT time and INR within normal limits (+/-15%). PTT within normal limits (+/-15%). If a subject requires anticoagulation, treatment must be modified to enoxaparin. Negative serum pregnancy test if female subject is of childbearing potential. Patients who are willing and able to comply with scheduled visits, treatment plans, laboratory tests, biopsies when required, and other procedures. Exclusion Criteria: Clinical evidence of DVT, PE, prior history of CVA or history of TIA within 12 months or other known TE event present during the screening period Current use of megestrol acetate (use within 10 days of Day 1). Contraindication to heparin as per institutional guidelines. Another primary cancer within the last 3 years currently requiring antineoplastic treatment within the exception of non-melanoma skin cancer, early-stage prostate cancer, or curatively treated cervical carcinoma in-situ. Current use of immunosuppressive medication within 2 weeks of study participation, EXCEPT for those listed in protocol Active autoimmune disease that might deteriorate when receiving an immuno-stimulatory agent: Patients with diabetes type I, vitiligo, psoriasis, or hypo- or hyperthyroid diseases not requiring immunosuppressive treatment are eligible. Prior organ transplantation including allogenic stem-cell transplantation. Active infection requiring systemic therapy. Known infection with human immunodeficiency virus, Hepatitis B, or Hepatitis C Known prior severe hypersensitivity to investigational product, hyaluronidase, or any component in its formulations, including known severe hypersensitivity reactions to monoclonal antibodies (NCI CTCAE v4.03 Grade ≥ 3). Any history of anaphylaxis or uncontrolled asthma (that is, 3 or more features of partially controlled asthma). Clinically significant (i.e., active) cardiovascular disease: myocardial infarction (< 6 months prior to enrollment), unstable angina, congestive heart failure (≥ New York Heart Association Classification Class II), or serious cardiac arrhythmia requiring medication. Prior cerebrovascular accident/stroke. Clinically significant carotid artery disease (e.g. prior carotid surgery, symptomatic and/or requires treatment) Inability to comply with study and follow-up procedures as judged by the Investigator. Known alcohol or drug abuse.
Facility Information:
Facility Name
Hospital Universitario Fuenlabrada
City
Fuenlabrada
State/Province
Madrid
Country
Spain
Facility Name
Hospital Universitario La Paz
City
Madrid
ZIP/Postal Code
28046
Country
Spain
Facility Name
Hospital Ramon y Cajal
City
Madrid
Country
Spain

12. IPD Sharing Statement

Learn more about this trial

A Trial of PEGPH20 in Combination With Avelumab in Chemotherapy Resistant Pancreatic Cancer

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