Gemcitabine, Nab-paclitaxel and KPT-330 in Advanced Pancreatic Cancer
Acinar Cell Adenocarcinoma of the Pancreas, Duct Cell Adenocarcinoma of the Pancreas, Stage IV Pancreatic Cancer
About this trial
This is an interventional treatment trial for Acinar Cell Adenocarcinoma of the Pancreas
Eligibility Criteria
Inclusion Criteria:
- Written informed consent in accordance with federal, local, and institutional guidelines
- Patients with metastatic pancreatic adenocarcinoma not treated with chemotherapy for metastatic disease
- Eastern Cooperative Oncology Group (ECOG) performance status of 0-1
- Absolute neutrophil count (ANC) >= 1500/mm^3
- Platelet count >= 100,000/mm^3
- Bilirubin < 2 times the upper limit of normal (ULN) (except patients with Gilbert's syndrome who must have a total bilirubin of < 3 times ULN)
- Alanine aminotransferase (ALT) < 2.5 times ULN
- Serum creatinine =< 1.5 mg/dL
- Serum albumin >= 3.0 g/dL
- Female patients of child-bearing potential must agree to use dual methods of contraception and have a negative serum pregnancy test at screening, and male patients must use an effective barrier method of contraception if sexually active with a female of child-bearing potential; acceptable methods of contraception are condoms with contraceptive foam, oral, implantable or injectable contraceptives, contraceptive patch, intrauterine device, diaphragm with spermicidal gel, or a sexual partner who is surgically sterilized or post-menopausal; for both male and female patients, effective methods of contraception must be used throughout the study and for three months following the last dose
- Patients with history of previously treated malignancies who have no evidence of disease for last five years are allowed to participate
Exclusion Criteria:
- Patients who are pregnant or lactating
- Radiation, chemotherapy, or immunotherapy or any other anticancer therapy =< 3 weeks prior to cycle 1 day 1; mitomycin C or radio-immunotherapy 6 weeks prior to cycle 1 day 1
- Major surgery within four weeks before cycle 1 day 1
Unstable cardiovascular function:
- Symptomatic ischemia, or
- Uncontrolled clinically significant conduction abnormalities (e.g.: ventricular tachycardia on antiarrhythmics are excluded and 1st degree atrioventricular [AV] block or asymptomatic left anterior fascicular block [LAFB]/right bundle branch block [RBBB] will not be excluded), or
- Congestive heart failure (CHF) of New York Heart Association (NYHA) class >= 3, or
- Myocardial infarction (MI) within 3 months of cycle 1 day 1 dose
- Uncontrolled active infection requiring parenteral antibiotics, antivirals, or antifungals within one week prior to first dose
- Known to be HIV seropositive who are on anti-HIV drugs because of the unknown interactions between these drugs and the study agents
- Known active hepatitis A, B, or C infection; or known to be positive for hepatitis C virus (HCV) ribonucleic acid (RNA) or HBsAg (hepatitis B virus [HBV] surface antigen)
- Patients with active central nervous system (CNS) malignancy; asymptomatic small lesions are not considered active; treated lesions may be considered inactive if they are stable for at least 3 months
- Patients with significantly diseased or obstructed gastrointestinal tract or uncontrolled vomiting or diarrhea
- Grade >= 2 peripheral neuropathy within 14 days prior to cycle 1 day 1
- History of seizures, movement disorders or cerebrovascular accident within the past 5 years prior to cycle 1 day 1
- Patients with muscular degeneration, uncontrolled glaucoma, or markedly decreased visual acuity based on physician's assessment
- Serious psychiatric or medical conditions that could interfere with treatment
- Participation in an investigational anti-cancer study within 3 weeks prior to cycle 1 day 1
- Concurrent therapy with approved or investigational anticancer therapeutic
- Presence of clinically significant ascites
Sites / Locations
- Barbara Ann Karmanos Cancer Institute
- Stony Brook University Cancer Center
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Experimental
Experimental
Group I: Phase Ib (gemcitabine, nab-paclitaxel, selinexor)
Group II: Phase II Group I (gemcitabine, selinexor)
GroupIII: Phase II Group II (gemcitabine, selinexor)
Patients receive gemcitabine hydrochloride IV, nab-paclitaxel IV, and selinexor PO on days 1, 8, and 15. Cycles repeat every 4 weeks in the absence of disease progression or unacceptable toxicity.
Patients receive gemcitabine hydrochloride IV on days 1, 8, and 15. Patients also receive selinexor PO on days 3, 8, and 15 of cycle 1 and on days 1, 8, and 15 for the subsequent cycles. Cycles repeat every 4 weeks in the absence of disease progression or unacceptable toxicity
Patients receive gemcitabine hydrochloride IV and selinexor PO on days 1, 8, and 15. Cycles repeat every 4 weeks in the absence of disease progression or unacceptable toxicity.