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CEND-1 in Combination With Neoadjuvant FOLFIRINOX With or Without Panitumumab (CENDIFOX)

Primary Purpose

Colon Cancer, Pancreas Cancer, Digestive Cancer

Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
CEND-1
Panitumumab
Folfirinox
Sponsored by
Anup Kasi
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Colon Cancer

Eligibility Criteria

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

Inclusion Criteria:

  • Ability of participant OR Legally Authorized Representative (LAR) to understand this study, and participant or LAR willingness to sign a written informed consent
  • Eastern Cooperative Oncology Group (ECOG) Performance Status 0 - 1
  • One or more lesions evaluable on MRI, positive emission tomography (PET)/CT, or dedicated CT scan according to RECIST v1.1
  • Patients with histologically confirmed pancreatic ductal adenocarcinomas, colorectal and appendiceal adenocarcinomas
  • For cohort 1: Resectable Pancreatic Cancer: No evidence of distant metastasis and tumor mass showing no extension to superior mesenteric artery (SMA) and hepatic artery. There must be clear fat plane between SMA and celiac axis. Patent superior mesenteric vein (SMV/portal vein (PV) with no distortion of venous architecture. Please refer to 2021 NCCN PDAC Guidelines
  • For cohort 1: Borderline Resectable Pancreatic Cancer: defined as localized cancer with 1 or more of the following features: "a) an interface between the primary tumor and superior mesenteric vein (SMV)-portal vein (PV) measuring 180o or greater of the circumference of the vein wall, and/or b) short-segment occlusion of the SMV-PV with normal vein above and below the level of obstruction that is amenable to resection and venous reconstruction and/or c) short segment interface of any degree between tumor and hepatic artery with normal artery proximal and distal to the interface that is amenable to resection and arterial reconstruction and/or d) an interface between the tumor and SMA or celiac trunk measuring less than 180o of the circumference of the artery wall. Please refer to 2021 National Comprehensive Cancer Network (NCCN) Pancreatic Ductal Adenocarcinoma (PDAC) Guidelines
  • For cohort 2: Peritoneal Metastases due to Colorectal Cancer or Invasive Adenocarcinoma of the Appendix
  • For cohort 3: Oligometastatic colorectal cancer: resectable metastases as determined by multidisciplinary evaluation. Patients with bilobar liver metastases or oligometastatic liver and lung metastases that requires resection of one or more metastases are also allowed
  • Eligible for treatment with FOLFIRINOX with or without panitumumab
  • Life expectancy of at least 3 months
  • Adequate archival tissue from prior biopsy for biomarker evaluation or willingness to undergo biopsy before treatment starts and on treatment
  • Medically fit to undergo complex major abdominal surgery at end of study treatment
  • Women of childbearing potential must have a negative serum pregnancy test within 72 hours prior to enrollment
  • Adequate organ function

Exclusion Criteria:

  • Simultaneously enrolled in any therapeutic clinical trial
  • Concurrent use of any other anti-cancer therapy, including chemotherapy, targeted therapy, immunotherapy, or biological agents
  • Prior chemotherapy or any other investigational agents for the treatment of cancer within 2 years prior to enrollment on this study
  • Diagnosed with a psychiatric illness or is in a social situation that would limit compliance with study requirements
  • Is pregnant or breastfeeding
  • Has a known allergic reaction to any excipient contained in the study drug formulation
  • Active Grade 3 (per the NCI CTCAE, Version 5.0) or higher viral, bacterial, or fungal infection within 2 weeks prior to the first dose of study treatment
  • New York Heart Association Class III or IV, cardiac disease, myocardial infarction within the past 6 months, unstable arrhythmia, or evidence of ischemia on ECG
  • Known infection with HIV, hepatitis B, or hepatitis C
  • Serious nonmalignant disease (e.g., hydronephrosis, liver failure, or other conditions) that could compromise protocol objectives in the opinion of the investigator
  • Participants with known brain metastases. Screening for brain metastases with head imaging is not required
  • History of prior or current synchronous malignancy, except:

    • Malignancy that was treated with curative intent and for which there has been no known active disease for >3 years prior to enrollment
    • Curatively treated non-melanoma skin cancer, cervical cancer in situ, or prostatic intraepithelial neoplasia, without evidence of prostate cancer

Sites / Locations

  • The University of Kansas Cancer Center (KUCC)Recruiting
  • The University of Kansas Cancer Center, Westwood CampusRecruiting
  • The University of Kansas Medical CenterRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

Cohort 1 Pancreatic Cancer

Cohort 2 Peritoneal Mets

Cohort 3 Oligomets Colon Cancer

Arm Description

Biopsy for tissue immune profile if archived tissue not available. Folfirinox infusion for 3 cycles followed by a repeat biopsy for a second tissue immune profiling. Folfirinox plus CEND1 infusion for 3 cycles. Seventy-two hours after last infusion participant will have surgery.

Biopsy for tissue immune profile if archived tissue not available. Folfirinox plus Panitumumab (if RAS/BRAF) infusion for 3 cycles followed by a repeat biopsy for a second tissue immune profiling. Folfirinox plus Panitumumab (if RAS/BRAF positive) and CEND1 infusion for 3 cycles. Seventy-two hours after last infusion participant will have surgery.

Biopsy for tissue immune profile if archived tissue not available. Folfirinox plus Panitumumab (if RAS/BRAF) infusion for 3 cycles followed by a repeat biopsy for a second tissue immune profiling. Folfirinox plus Panitumumab (if RAS/BRAF positive) and CEND1 infusion for 3 cycles. Seventy-two hours after last infusion participant will have surgery.

Outcomes

Primary Outcome Measures

Drug Safety: Number of participants with treatment-related adverse events as assessed by CTCAE v5.0
Adverse Events : Counts and proportions of grade 3 -5 Adverse Events

Secondary Outcome Measures

Overall survival (OS)
Overall survival (OS) will be reported using median survival time along with a 90% confidence interval
Disease-free survival (DFS)
Disease-free survival (DFS) will be reported using median survival time along with a 90% confidence interval
Overall response rate (ORR)
Overall response rate (ORR) will be reported as a proportion with 90% confidence interval.
RO resection rate (RORR)
RO resection rate (RORR) will be reported as a proportion with 90% confidence interval.
Pathological response rate (PCR) .
Pathological response rate (PCR) will be reported as a proportion with 90% confidence interval.

Full Information

First Posted
October 19, 2021
Last Updated
November 16, 2021
Sponsor
Anup Kasi
Collaborators
Cend Therapeutics Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT05121038
Brief Title
CEND-1 in Combination With Neoadjuvant FOLFIRINOX With or Without Panitumumab
Acronym
CENDIFOX
Official Title
A Phase 1B/2A Trial Of CEND-1 In Combination With Neoadjuvant FOLFIRINOX Based Therapies In Pancreatic, Colon And Appendiceal Cancers (CENDIFOX)
Study Type
Interventional

2. Study Status

Record Verification Date
November 2021
Overall Recruitment Status
Recruiting
Study Start Date
October 20, 2021 (Actual)
Primary Completion Date
September 2023 (Anticipated)
Study Completion Date
September 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Anup Kasi
Collaborators
Cend Therapeutics Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a phase IB/IIA trial to ensure the safety of CEND-1 in combination with with Folfirinox with or without Panitumumab for treatment of pancreatic, colon and appendiceal cancers

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Colon Cancer, Pancreas Cancer, Digestive Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
50 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Cohort 1 Pancreatic Cancer
Arm Type
Experimental
Arm Description
Biopsy for tissue immune profile if archived tissue not available. Folfirinox infusion for 3 cycles followed by a repeat biopsy for a second tissue immune profiling. Folfirinox plus CEND1 infusion for 3 cycles. Seventy-two hours after last infusion participant will have surgery.
Arm Title
Cohort 2 Peritoneal Mets
Arm Type
Experimental
Arm Description
Biopsy for tissue immune profile if archived tissue not available. Folfirinox plus Panitumumab (if RAS/BRAF) infusion for 3 cycles followed by a repeat biopsy for a second tissue immune profiling. Folfirinox plus Panitumumab (if RAS/BRAF positive) and CEND1 infusion for 3 cycles. Seventy-two hours after last infusion participant will have surgery.
Arm Title
Cohort 3 Oligomets Colon Cancer
Arm Type
Experimental
Arm Description
Biopsy for tissue immune profile if archived tissue not available. Folfirinox plus Panitumumab (if RAS/BRAF) infusion for 3 cycles followed by a repeat biopsy for a second tissue immune profiling. Folfirinox plus Panitumumab (if RAS/BRAF positive) and CEND1 infusion for 3 cycles. Seventy-two hours after last infusion participant will have surgery.
Intervention Type
Drug
Intervention Name(s)
CEND-1
Intervention Description
The treatment with CEND-1 will be given as an intravenous (IV) infusion (through a needle in a vein) at the clinic once every 14 days (or Day 1 of every 14-day cycle starting in Cycle 4).
Intervention Type
Drug
Intervention Name(s)
Panitumumab
Intervention Description
Up to ten (10) participants with cancer that has spread to certain areas of the body and who have a certain gene in the tumor called "RAS/BRAF wild type" will receive another drug called panitumumab in addition to CEND-1 and FOLFIRINOX.
Intervention Type
Drug
Intervention Name(s)
Folfirinox
Other Intervention Name(s)
Oxaliplatin,Leucovorin,Irinotecan,Fluorouracil
Intervention Description
FOLFIRINOX is a name for a chemotherapy treatment regimen that includes several different drugs that are given in a certain order. All of these drugs are given as an intravenous (IV) infusion (through a needle in a vein) at the clinic once every 14 days (or Day 1 of every 14-day cycle). Oxaliplatin - dose is 85 mg / m2 the infusion takes about 2 hours. then Leucovorin - dose is 400 mg / m2 - this is given at same time with irinotecan (below) and the infusion takes about 1.5 hours. Irinotecan - dose is 180 mg / m2 - this is given at same time with leucovorin (above), and the infusion takes about 1.5 hours. then • Fluorouracil - dose is 2400 mg / m2 - this infusion takes 46 to 48 hours (2 days) with an IV pump done at home.
Primary Outcome Measure Information:
Title
Drug Safety: Number of participants with treatment-related adverse events as assessed by CTCAE v5.0
Description
Adverse Events : Counts and proportions of grade 3 -5 Adverse Events
Time Frame
24 months
Secondary Outcome Measure Information:
Title
Overall survival (OS)
Description
Overall survival (OS) will be reported using median survival time along with a 90% confidence interval
Time Frame
48 months
Title
Disease-free survival (DFS)
Description
Disease-free survival (DFS) will be reported using median survival time along with a 90% confidence interval
Time Frame
48 months
Title
Overall response rate (ORR)
Description
Overall response rate (ORR) will be reported as a proportion with 90% confidence interval.
Time Frame
24 months
Title
RO resection rate (RORR)
Description
RO resection rate (RORR) will be reported as a proportion with 90% confidence interval.
Time Frame
24 months
Title
Pathological response rate (PCR) .
Description
Pathological response rate (PCR) will be reported as a proportion with 90% confidence interval.
Time Frame
24 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Ability of participant OR Legally Authorized Representative (LAR) to understand this study, and participant or LAR willingness to sign a written informed consent Eastern Cooperative Oncology Group (ECOG) Performance Status 0 - 1 One or more lesions evaluable on MRI, positive emission tomography (PET)/CT, or dedicated CT scan according to RECIST v1.1 Patients with histologically confirmed pancreatic ductal adenocarcinomas, colorectal and appendiceal adenocarcinomas For cohort 1: Resectable Pancreatic Cancer: No evidence of distant metastasis and tumor mass showing no extension to superior mesenteric artery (SMA) and hepatic artery. There must be clear fat plane between SMA and celiac axis. Patent superior mesenteric vein (SMV/portal vein (PV) with no distortion of venous architecture. Please refer to 2021 NCCN PDAC Guidelines For cohort 1: Borderline Resectable Pancreatic Cancer: defined as localized cancer with 1 or more of the following features: "a) an interface between the primary tumor and superior mesenteric vein (SMV)-portal vein (PV) measuring 180o or greater of the circumference of the vein wall, and/or b) short-segment occlusion of the SMV-PV with normal vein above and below the level of obstruction that is amenable to resection and venous reconstruction and/or c) short segment interface of any degree between tumor and hepatic artery with normal artery proximal and distal to the interface that is amenable to resection and arterial reconstruction and/or d) an interface between the tumor and SMA or celiac trunk measuring less than 180o of the circumference of the artery wall. Please refer to 2021 National Comprehensive Cancer Network (NCCN) Pancreatic Ductal Adenocarcinoma (PDAC) Guidelines For cohort 2: Peritoneal Metastases due to Colorectal Cancer or Invasive Adenocarcinoma of the Appendix For cohort 3: Oligometastatic colorectal cancer: resectable metastases as determined by multidisciplinary evaluation. Patients with bilobar liver metastases or oligometastatic liver and lung metastases that requires resection of one or more metastases are also allowed Eligible for treatment with FOLFIRINOX with or without panitumumab Life expectancy of at least 3 months Adequate archival tissue from prior biopsy for biomarker evaluation or willingness to undergo biopsy before treatment starts and on treatment Medically fit to undergo complex major abdominal surgery at end of study treatment Women of childbearing potential must have a negative serum pregnancy test within 72 hours prior to enrollment Adequate organ function Exclusion Criteria: Simultaneously enrolled in any therapeutic clinical trial Concurrent use of any other anti-cancer therapy, including chemotherapy, targeted therapy, immunotherapy, or biological agents Prior chemotherapy or any other investigational agents for the treatment of cancer within 2 years prior to enrollment on this study Diagnosed with a psychiatric illness or is in a social situation that would limit compliance with study requirements Is pregnant or breastfeeding Has a known allergic reaction to any excipient contained in the study drug formulation Active Grade 3 (per the NCI CTCAE, Version 5.0) or higher viral, bacterial, or fungal infection within 2 weeks prior to the first dose of study treatment New York Heart Association Class III or IV, cardiac disease, myocardial infarction within the past 6 months, unstable arrhythmia, or evidence of ischemia on ECG Known infection with HIV, hepatitis B, or hepatitis C Serious nonmalignant disease (e.g., hydronephrosis, liver failure, or other conditions) that could compromise protocol objectives in the opinion of the investigator Participants with known brain metastases. Screening for brain metastases with head imaging is not required History of prior or current synchronous malignancy, except: Malignancy that was treated with curative intent and for which there has been no known active disease for >3 years prior to enrollment Curatively treated non-melanoma skin cancer, cervical cancer in situ, or prostatic intraepithelial neoplasia, without evidence of prostate cancer
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
KUCC Navigation
Phone
9135883671
Email
kucc_navigation@kumc.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Anup Kasi, MD
Organizational Affiliation
University of Kansas Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
The University of Kansas Cancer Center (KUCC)
City
Fairway
State/Province
Kansas
ZIP/Postal Code
66205
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
KUCC Navigator
Phone
913-588-3671
Email
kucc_navigation@kumc.edu
Facility Name
The University of Kansas Cancer Center, Westwood Campus
City
Kansas City
State/Province
Kansas
ZIP/Postal Code
66205
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
KUCC Navigation
Phone
913-588-3671
Email
kucc_navigation@kumc.edu
Facility Name
The University of Kansas Medical Center
City
North Kansas City
State/Province
Missouri
ZIP/Postal Code
64116
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Nurse Navigator
Phone
913-945-7552
Email
ctnursenav@kumc.edu

12. IPD Sharing Statement

Plan to Share IPD
Undecided

Learn more about this trial

CEND-1 in Combination With Neoadjuvant FOLFIRINOX With or Without Panitumumab

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