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Combination Therapy With NC-6004 and Gemcitabine Versus Gemcitabine Alone in Pancreatic Cancer

Primary Purpose

Pancreatic Neoplasms

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
NC-6004
Gemcitabine
Sponsored by
Orient Europharma Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pancreatic Neoplasms focused on measuring Pancreatic cancer, Platinum, Micelle

Eligibility Criteria

20 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion criteria:

  1. Male or female aged between 20 to 80 years (inclusive)
  2. Unresectable, histologically or cytologically confirmed, locally advanced or metastatic pancreatic cancer (adenocarcinoma, adenosquamous carcinoma or poorly differentiated carcinoma)
  3. Presence of at least one measurable tumor lesion (longest diameter ≥ 10 mm)
  4. No prior systemic anti-cancer therapy* and radiotherapy** for advanced pancreatic cancer

    * Patients with post-operative adjuvant chemotherapy other than platinum products (e.g. cisplatin, carboplatin and oxaliplatin, etc.) or radiotherapy or chemo-radiotherapy completed more than 6 months before recurrence will be eligible.

    ** Patients with prior palliative radiotherapy of < 20% bone marrow involvement prior to 6 months from screening will be eligible.

  5. Eastern Cooperative Oncology Group (ECOG) performance status of ≤ 1
  6. Adequate organ function defined as:

    • 3,000 cells/μL ≤ WBC ≤ 12,000 cells/μL
    • Absolute neutrophils count (ANC) ≥ 1,500 cells/μL
    • Platelets ≥ 100,000 cells/μL
    • Hemoglobin (Hb) ≥ 9.0 g/dL
    • Alanine amino transferase (ALT) and aspartate amino transferase (AST) ≤ 2.5 times the upper limit of normal (ULN) in patients with no demonstrable hepatic metastasis, or ≤ 5 x ULN in patients with hepatic metastasis
    • Serum bilirubin ≤ 1.5 x ULN in patients with no demonstrable hepatic metastasis and obstructive jaundice, or ≤ 2.5 x ULN in patients with hepatic metastasis or obstructive jaundice
    • Serum creatinine (SCr) ≤ 1.5 mg/dL and creatinine clearance (CrCl) ≥ 60 mL/min (from 24-hour urine test or Cockcroft-Gault formula)
    • Corrected serum calcium ≤ ULN
  7. If fertile*, willing to use barrier contraception till 6 months after the end of treatment

    * With the following exceptions: 1) pre-menopausal females with bilateral tubal ligation, bilateral oophorectomy or hysterectomy; 2) post-menopausal women, defined as 12 months of spontaneous amenorrhea; 3) males with vasectomy.

  8. Willing and able to comply with study procedures and provide written informed consent

Exclusion criteria:

  1. Pregnancy or breastfeeding
  2. Active concomitant malignancy or history of other cancer except carcinoma in situ of cervical squamous cell carcinoma, stage I colon cancer or other malignance that has remained disease-free for more than 3 years after curative intervention
  3. Metastasis to the central nervous system or brain
  4. Evidence of hearing impaired ≥ Grade 2 as assessed by pure tone audiometry or other neurotoxicity ≥ Grade 2

    * Patients with age-associated hearing loss at the high frequencies that, in the judgment of the investigator, would not interfere significantly with patient's safety or study assessments will be eligible to enroll.

  5. Patient with pulmonary fibrosis or interstitial pneumonia
  6. Marked pleural effusion or ascites above Grade 2
  7. Patient with known HIV infection
  8. Patient with active hepatitis B, hepatitis C or any other ongoing severe infections
  9. Patient with severe mental disorder
  10. As judged by the investigator, any evidence of significant laboratory findings or severe/uncontrolled clinical disorders (e.g. dementia, myocardial infarction within 6 months prior to enrollment, New York Heart Association (NYHA) Class III or IV heart failure, unstable angina, active cardiomyopathy, unstable arrhythmia, and other unstable or uncompensated respiratory, cardiac, hepatic, renal and/or infectious disease)
  11. Patient with known hypersensitivity to Pt compounds
  12. Known severe drug hypersensitivity
  13. Treatment with a non-approved or investigational product within 30 days before Day 1 of study treatment
  14. Alcoholic liver disease* or liver disease with obvious clinical symptom or sign

    * the investigator should judge from medical examination by interview and laboratory test including γ-GTP, AST and ALT

  15. Daily Alcohol consumption within 6 months before the screening as an average weekly intake of >21 units (168 g of pure alcohol) or an average daily intake of >3 units (24 g of pure alcohol) for males / an average weekly intake of >14 units (112 g of pure alcohol) or an average daily intake of >2 units (16 g of pure alcohol) for females.

    Kind of Alcohol Alcohol Percentage mL per 1 unit =8 g of pure alcohol

    Beer 5 % 200 mL

    Whiskey/Brandy 40 % 25 mL

    Wine 12 % approx. 83 mL

    Sake 15 % approx. 67 mL

    Distilled spirit 25 % 40 mL

    Kaoliang 50 % 20 mL

  16. Patient with uncontrolled diabetes
  17. Radiotherapy within 6 months before screening
  18. Experienced Abdominal Radiotherapy
  19. Experienced treatment of Gemtuzumab ozogamicin
  20. Patient with autoimmune hepatitis or idiopathic thrombocytopenic purpura (ITP)
  21. Observation of "attenuated or reversed hepatic venous portal blood flow*" was confirmed by doppler ultrasonography or CT (recommend evaluation in arterial phase, portal-venous phase and equilibrium phase) of the liver * On doppler ultrasonography of right and left branch of portal vein, blood flow is measured as about 0 mL/min or between plus and minus, which indicate obvious blood flow obstruction

Sites / Locations

  • Prince of Wales Hospital
  • Queen Mary Hospital
  • Aichi Cancer Center
  • Chiba Cancer Center
  • National Hospital Organization Kyushu Cancer Center
  • Hokkaido University Hospital
  • National Hospital Organization Osaka National Hospital
  • Osaka Medical Center for Cancer and Cardiovascular Diseases
  • Saitama Cancer Center
  • National Hospital Organization Shikoku Cancer Center
  • Shizuoka Cancer Center
  • Center Hospital of the National Center for Global Health and Medicine
  • Kyorin university Hospital
  • National Cancer Center Hospital East
  • National Cancer Center Hospital
  • The Cancer Institute Hospital of JFCR
  • The University of Tokyo Hospital
  • Kanagawa Cancer Center
  • Ajou University Hospital (AUH)
  • Samsung Medical Center (SMC)
  • The Catholic University of Korea, Seoul St. Mary's Hospital (CUK SSMH)
  • Korea University Guro Hospital (KUGH)
  • Yonsei University Health System, Severance Hospital
  • Hospital Sultan Ismail
  • Hospital Kuala Lumpur
  • Makati Medical Center
  • National Cancer Centre
  • Chiayi Chang Gung Memorial Hospital
  • Kaohsiung Medical University Hospital
  • Chang Gung Memorial Hospital, Kaohsiung Branch
  • China Medical University Hospital
  • Taichung Veterans General Hospital
  • National Cheng Kung University Hospital
  • Chi Mei Hospital
  • Mackay Memorial Hospital
  • National Taiwan University Hospital
  • Taipei Medical University Hospital
  • Koo Foundation Sun Yat-Sen Cancer Center
  • Taipei Veterans General Hospital
  • Tri-Service General Hospital
  • Taipei Medical University-Shuang-Ho Hospital, Ministry of Health and Welfare
  • Chang Gung Memorial Hospital, Linkou Branch
  • Chi Mei Medical Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

NC-6004 and Gemcitabine combination

Gemcitabine monotherapy

Arm Description

NC-6004 90mg/m2 i.v. on Day 1 and Gemcitabine 1000mg/m2 i.v. on Day 1 and Day 8 respectively

Gemcitabine 1000mg/m2 i.v. on Day 1 ,8 and 15

Outcomes

Primary Outcome Measures

Overall survival (OS)
Overall survival is defined as the time from the treatment initiation until death from any cause, and censored at the last follow up time.

Secondary Outcome Measures

Progression free survival (PFS)
Progression free survival is defined as the time from the treatment initiation until progression or death, and censored at the last follow up time.
Response rate (RR) and disease control rate (DCR) according to Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 criteria
Response rate is defined as counts and proportions of patients responding complete response or partial response within the duration of the study. Disease control rate is defined as counts and proportions of patients responding complete response, partial response or progressive disease within the duration of the study.
Duration of response
Duration of overall response (DOR) will be measured from the time of initial response (CR or PR) until documented progression or death, and censored at last follow up time. Duration of stable disease (DSD) will be measured from the time of initial stable disease (SD) until documented progression or death, and censored at last follow up time.
CA19-9
CA19-9 values and changes from baseline will be summarized.
Quality of life (QoL) using EORTC QLQ-C30
Quality of life (QoL) values and changes from baseline will be summarized.

Full Information

First Posted
January 14, 2014
Last Updated
April 14, 2020
Sponsor
Orient Europharma Co., Ltd.
Collaborators
NanoCarrier Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT02043288
Brief Title
Combination Therapy With NC-6004 and Gemcitabine Versus Gemcitabine Alone in Pancreatic Cancer
Official Title
A Phase III, Open-label, Randomized Study of the Combination Therapy With NC-6004 and Gemcitabine Versus Gemcitabine Alone in Patients With Locally Advanced or Metastatic Pancreatic Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
April 2020
Overall Recruitment Status
Completed
Study Start Date
January 2014 (Actual)
Primary Completion Date
December 2019 (Actual)
Study Completion Date
December 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Orient Europharma Co., Ltd.
Collaborators
NanoCarrier Co., Ltd.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This clinical trial is designed to evaluate the impact of the addition of NC-6004 to gemcitabine in the treatment of patients with locally advanced or metastatic pancreatic cancer in Asian countries.
Detailed Description
Pancreatic cancer is one of the most deadly cancers because of the predominately late diagnosis. Gemcitabine (GEM) is the standard treatment for advanced and metastatic pancreatic cancer. According to preclinical data and few early phase studies, a combined use of gemcitabine and cisplatin (CDDP) showed synergistic efficacy against pancreatic cancer. NC-6004, a novel micellar cisplatin formulation, retains the activity but avoids the renal toxicity and neurotoxicity caused by the high peak Cmax concentrations of cisplatin. This trial is designed to evaluate the impact of the addition of NC-6004 to gemcitabine in the treatment of patients with locally advanced or metastatic pancreatic cancer. The main hypothesis of this study is that NC-6004 plus gemcitabine combination is superior to gemcitabine alone in terms of overall survival in locally advanced or metastatic pancreatic cancer patients

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pancreatic Neoplasms
Keywords
Pancreatic cancer, Platinum, Micelle

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
310 (Actual)

8. Arms, Groups, and Interventions

Arm Title
NC-6004 and Gemcitabine combination
Arm Type
Experimental
Arm Description
NC-6004 90mg/m2 i.v. on Day 1 and Gemcitabine 1000mg/m2 i.v. on Day 1 and Day 8 respectively
Arm Title
Gemcitabine monotherapy
Arm Type
Active Comparator
Arm Description
Gemcitabine 1000mg/m2 i.v. on Day 1 ,8 and 15
Intervention Type
Drug
Intervention Name(s)
NC-6004
Other Intervention Name(s)
Micelplatin
Intervention Description
Study group (3 week/cycle): NC-6004 90 mg/m2 i.v. inf. over 60 min on Day 1
Intervention Type
Drug
Intervention Name(s)
Gemcitabine
Other Intervention Name(s)
Gemzar
Intervention Description
Study group (3 week/cycle): Gemcitabine 1000 mg/m2 i.v. inf. over 30 min on Day 1 and Day 8 (follow by administration of NC-6004) Control group (4 week/cycle): Gemcitabine 1000 mg/m2 i.v. inf. over 30 min on Day 1, Day 8 and Day 15
Primary Outcome Measure Information:
Title
Overall survival (OS)
Description
Overall survival is defined as the time from the treatment initiation until death from any cause, and censored at the last follow up time.
Time Frame
3.5 years
Secondary Outcome Measure Information:
Title
Progression free survival (PFS)
Description
Progression free survival is defined as the time from the treatment initiation until progression or death, and censored at the last follow up time.
Time Frame
3.5 years
Title
Response rate (RR) and disease control rate (DCR) according to Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 criteria
Description
Response rate is defined as counts and proportions of patients responding complete response or partial response within the duration of the study. Disease control rate is defined as counts and proportions of patients responding complete response, partial response or progressive disease within the duration of the study.
Time Frame
3.5 years
Title
Duration of response
Description
Duration of overall response (DOR) will be measured from the time of initial response (CR or PR) until documented progression or death, and censored at last follow up time. Duration of stable disease (DSD) will be measured from the time of initial stable disease (SD) until documented progression or death, and censored at last follow up time.
Time Frame
3.5 years
Title
CA19-9
Description
CA19-9 values and changes from baseline will be summarized.
Time Frame
3.5 years
Title
Quality of life (QoL) using EORTC QLQ-C30
Description
Quality of life (QoL) values and changes from baseline will be summarized.
Time Frame
3.5 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
20 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion criteria: Male or female aged between 20 to 80 years (inclusive) Unresectable, histologically or cytologically confirmed, locally advanced or metastatic pancreatic cancer (adenocarcinoma, adenosquamous carcinoma or poorly differentiated carcinoma) Presence of at least one measurable tumor lesion (longest diameter ≥ 10 mm) No prior systemic anti-cancer therapy* and radiotherapy** for advanced pancreatic cancer * Patients with post-operative adjuvant chemotherapy other than platinum products (e.g. cisplatin, carboplatin and oxaliplatin, etc.) or radiotherapy or chemo-radiotherapy completed more than 6 months before recurrence will be eligible. ** Patients with prior palliative radiotherapy of < 20% bone marrow involvement prior to 6 months from screening will be eligible. Eastern Cooperative Oncology Group (ECOG) performance status of ≤ 1 Adequate organ function defined as: 3,000 cells/μL ≤ WBC ≤ 12,000 cells/μL Absolute neutrophils count (ANC) ≥ 1,500 cells/μL Platelets ≥ 100,000 cells/μL Hemoglobin (Hb) ≥ 9.0 g/dL Alanine amino transferase (ALT) and aspartate amino transferase (AST) ≤ 2.5 times the upper limit of normal (ULN) in patients with no demonstrable hepatic metastasis, or ≤ 5 x ULN in patients with hepatic metastasis Serum bilirubin ≤ 1.5 x ULN in patients with no demonstrable hepatic metastasis and obstructive jaundice, or ≤ 2.5 x ULN in patients with hepatic metastasis or obstructive jaundice Serum creatinine (SCr) ≤ 1.5 mg/dL and creatinine clearance (CrCl) ≥ 60 mL/min (from 24-hour urine test or Cockcroft-Gault formula) Corrected serum calcium ≤ ULN If fertile*, willing to use barrier contraception till 6 months after the end of treatment * With the following exceptions: 1) pre-menopausal females with bilateral tubal ligation, bilateral oophorectomy or hysterectomy; 2) post-menopausal women, defined as 12 months of spontaneous amenorrhea; 3) males with vasectomy. Willing and able to comply with study procedures and provide written informed consent Exclusion criteria: Pregnancy or breastfeeding Active concomitant malignancy or history of other cancer except carcinoma in situ of cervical squamous cell carcinoma, stage I colon cancer or other malignance that has remained disease-free for more than 3 years after curative intervention Metastasis to the central nervous system or brain Evidence of hearing impaired ≥ Grade 2 as assessed by pure tone audiometry or other neurotoxicity ≥ Grade 2 * Patients with age-associated hearing loss at the high frequencies that, in the judgment of the investigator, would not interfere significantly with patient's safety or study assessments will be eligible to enroll. Patient with pulmonary fibrosis or interstitial pneumonia Marked pleural effusion or ascites above Grade 2 Patient with known HIV infection Patient with active hepatitis B, hepatitis C or any other ongoing severe infections Patient with severe mental disorder As judged by the investigator, any evidence of significant laboratory findings or severe/uncontrolled clinical disorders (e.g. dementia, myocardial infarction within 6 months prior to enrollment, New York Heart Association (NYHA) Class III or IV heart failure, unstable angina, active cardiomyopathy, unstable arrhythmia, and other unstable or uncompensated respiratory, cardiac, hepatic, renal and/or infectious disease) Patient with known hypersensitivity to Pt compounds Known severe drug hypersensitivity Treatment with a non-approved or investigational product within 30 days before Day 1 of study treatment Alcoholic liver disease* or liver disease with obvious clinical symptom or sign * the investigator should judge from medical examination by interview and laboratory test including γ-GTP, AST and ALT Daily Alcohol consumption within 6 months before the screening as an average weekly intake of >21 units (168 g of pure alcohol) or an average daily intake of >3 units (24 g of pure alcohol) for males / an average weekly intake of >14 units (112 g of pure alcohol) or an average daily intake of >2 units (16 g of pure alcohol) for females. Kind of Alcohol Alcohol Percentage mL per 1 unit =8 g of pure alcohol Beer 5 % 200 mL Whiskey/Brandy 40 % 25 mL Wine 12 % approx. 83 mL Sake 15 % approx. 67 mL Distilled spirit 25 % 40 mL Kaoliang 50 % 20 mL Patient with uncontrolled diabetes Radiotherapy within 6 months before screening Experienced Abdominal Radiotherapy Experienced treatment of Gemtuzumab ozogamicin Patient with autoimmune hepatitis or idiopathic thrombocytopenic purpura (ITP) Observation of "attenuated or reversed hepatic venous portal blood flow*" was confirmed by doppler ultrasonography or CT (recommend evaluation in arterial phase, portal-venous phase and equilibrium phase) of the liver * On doppler ultrasonography of right and left branch of portal vein, blood flow is measured as about 0 mL/min or between plus and minus, which indicate obvious blood flow obstruction
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Li-Tzong Chen, M.D., Ph. D.
Organizational Affiliation
National Institute of Cancer Research, National Health Research Institutes
Official's Role
Principal Investigator
Facility Information:
Facility Name
Prince of Wales Hospital
City
Hong Kong
Country
Hong Kong
Facility Name
Queen Mary Hospital
City
Hong Kong
Country
Hong Kong
Facility Name
Aichi Cancer Center
City
Aichi
Country
Japan
Facility Name
Chiba Cancer Center
City
Chiba
Country
Japan
Facility Name
National Hospital Organization Kyushu Cancer Center
City
Fukuoka
Country
Japan
Facility Name
Hokkaido University Hospital
City
Hokkaido
Country
Japan
Facility Name
National Hospital Organization Osaka National Hospital
City
Osaka
Country
Japan
Facility Name
Osaka Medical Center for Cancer and Cardiovascular Diseases
City
Osaka
Country
Japan
Facility Name
Saitama Cancer Center
City
Saitama
Country
Japan
Facility Name
National Hospital Organization Shikoku Cancer Center
City
Shikokuchūō
Country
Japan
Facility Name
Shizuoka Cancer Center
City
Shizuoka
Country
Japan
Facility Name
Center Hospital of the National Center for Global Health and Medicine
City
Tokyo
Country
Japan
Facility Name
Kyorin university Hospital
City
Tokyo
Country
Japan
Facility Name
National Cancer Center Hospital East
City
Tokyo
Country
Japan
Facility Name
National Cancer Center Hospital
City
Tokyo
Country
Japan
Facility Name
The Cancer Institute Hospital of JFCR
City
Tokyo
Country
Japan
Facility Name
The University of Tokyo Hospital
City
Tokyo
Country
Japan
Facility Name
Kanagawa Cancer Center
City
Yokohama
Country
Japan
Facility Name
Ajou University Hospital (AUH)
City
Gyeonggi-do
ZIP/Postal Code
443-380
Country
Korea, Republic of
Facility Name
Samsung Medical Center (SMC)
City
Seoul
ZIP/Postal Code
135-710
Country
Korea, Republic of
Facility Name
The Catholic University of Korea, Seoul St. Mary's Hospital (CUK SSMH)
City
Seoul
ZIP/Postal Code
137-701
Country
Korea, Republic of
Facility Name
Korea University Guro Hospital (KUGH)
City
Seoul
ZIP/Postal Code
152-703
Country
Korea, Republic of
Facility Name
Yonsei University Health System, Severance Hospital
City
Seoul
ZIP/Postal Code
50-1
Country
Korea, Republic of
Facility Name
Hospital Sultan Ismail
City
Johor Bahru
Country
Malaysia
Facility Name
Hospital Kuala Lumpur
City
Kuala Lumpur
Country
Malaysia
Facility Name
Makati Medical Center
City
Makati
ZIP/Postal Code
1229
Country
Philippines
Facility Name
National Cancer Centre
City
Singapore
ZIP/Postal Code
169610
Country
Singapore
Facility Name
Chiayi Chang Gung Memorial Hospital
City
Chiayi City
ZIP/Postal Code
61363
Country
Taiwan
Facility Name
Kaohsiung Medical University Hospital
City
Kaohsiung
ZIP/Postal Code
80756
Country
Taiwan
Facility Name
Chang Gung Memorial Hospital, Kaohsiung Branch
City
Kaohsiung
ZIP/Postal Code
833
Country
Taiwan
Facility Name
China Medical University Hospital
City
Taichung
ZIP/Postal Code
404
Country
Taiwan
Facility Name
Taichung Veterans General Hospital
City
Taichung
ZIP/Postal Code
40750
Country
Taiwan
Facility Name
National Cheng Kung University Hospital
City
Tainan
ZIP/Postal Code
704
Country
Taiwan
Facility Name
Chi Mei Hospital
City
Tainan
ZIP/Postal Code
710
Country
Taiwan
Facility Name
Mackay Memorial Hospital
City
Taipei
ZIP/Postal Code
104
Country
Taiwan
Facility Name
National Taiwan University Hospital
City
Taipei
ZIP/Postal Code
106
Country
Taiwan
Facility Name
Taipei Medical University Hospital
City
Taipei
ZIP/Postal Code
110
Country
Taiwan
Facility Name
Koo Foundation Sun Yat-Sen Cancer Center
City
Taipei
ZIP/Postal Code
112
Country
Taiwan
Facility Name
Taipei Veterans General Hospital
City
Taipei
ZIP/Postal Code
112
Country
Taiwan
Facility Name
Tri-Service General Hospital
City
Taipei
ZIP/Postal Code
114
Country
Taiwan
Facility Name
Taipei Medical University-Shuang-Ho Hospital, Ministry of Health and Welfare
City
Taipei
ZIP/Postal Code
235
Country
Taiwan
Facility Name
Chang Gung Memorial Hospital, Linkou Branch
City
Taipei
ZIP/Postal Code
333
Country
Taiwan
Facility Name
Chi Mei Medical Center
City
Yongkang
ZIP/Postal Code
710
Country
Taiwan

12. IPD Sharing Statement

Plan to Share IPD
No

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Combination Therapy With NC-6004 and Gemcitabine Versus Gemcitabine Alone in Pancreatic Cancer

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