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Gemcitabine With or Without WX-671 in Treating Patients With Locally Advanced Pancreatic Cancer That Cannot Be Removed By Surgery

Primary Purpose

Pancreatic Cancer

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
gemcitabine hydrochloride
Serine Proteinase Inhibitor WX-671
Serine Proteinase Inhibitor WX-671
Sponsored by
Heidelberg Pharma AG
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pancreatic Cancer focused on measuring recurrent pancreatic cancer, stage III pancreatic cancer, adenocarcinoma of the pancreas

Eligibility Criteria

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

DISEASE CHARACTERISTICS:

  • Inclusion criteria:

    • Locally advanced, unresectable, non-metastatic, histologically proven pancreatic adenocarcinoma (lymph nodes will not be considered metastases)
  • Exclusion criteria:

    • Any distant metastases

PATIENT CHARACTERISTICS:

  • Inclusion criteria:

    • ECOG performance status ≤ 1
    • Life expectancy > 12 weeks
    • Normal 12-lead ECG or only clinically insignificant abnormalities in the judgment of the investigator
    • Female patients of child-bearing potential will be required to use an effective method of birth control for the duration of the study to prevent pregnancy
    • ANC ≥ 1,500/mm³
    • Platelet count ≥ 100,000/mm³
    • Hemoglobin ≥ 9 g/dL
    • Total bilirubin ≤ 1.5 times ULN
    • AST and ALT ≤ 2.5 times ULN
    • Alkaline phosphatase ≤ 2.5 times ULN
    • Creatinine ≤ 2 times ULN or creatinine clearance > 45 mL/min
  • Exclusion criteria:

    • History of or current primary blood coagulation or bleeding disorders such as hemophilia
    • Any unrelated illness, e.g., active infection, inflammation, medical condition or laboratory abnormalities, which in the judgment of the investigator might significantly affect the patient's study participation
    • Any surgical or medical condition that might significantly alter the absorption, distribution, metabolism or excretion of any drug
    • Significant cardiac insufficiency (NYHA classification III or IV), presence of unstable angina or myocardial infarction within the previous 6 months, use of ongoing maintenance therapy for life threatening arrhythmia or known pulmonary hypertension
    • Any secondary malignancies within the last 5 years except for surgically cured non-melanoma skin cancer or cervical carcinoma in situ
    • Pregnancy (positive serum pregnancy test) or lactation
    • Known hepatitis B/C or HIV infection
    • Known hypersensitivity to any of the components in the anti-uPA serine protease inhibitor WX-671 capsules or gemcitabine hydrochloride infusion or other medical reasons for not being able to receive adequate pre-medication (for example, antihistamine or anti-inflammatory agents)

PRIOR CONCURRENT THERAPY:

  • Permitted:

    • Growth factors for treatment (not prophylaxis, i.e., epoetin alfa), analgesics, blood transfusions, antibiotics, bisphosphonates, other hormonal therapy for contraceptive practice, replacement therapy such as thyroid replacement or adrenal insufficiency as appropriate and medications for acute or chronic conditions not listed under the exclusion criteria
    • Embolization (i.e. for hematuria)
    • Subjects can receive blood transfusions as medically appropriate during the study

      • Subjects who require a blood transfusion during screening must have stable hemoglobin (≥9.0 g/dL [5.6 mmol/L]) without the need for further transfusions within 2 weeks before the first dose of anti-uPA serine protease inhibitor WX-671 to remain eligible
    • Prophylactic use of growth factors to support neutrophils
  • Prohibited:

    • Anticoagulant or thrombolytic therapy within four weeks prior to start of treatment (except low dose anticoagulant therapy with unfractionated heparin ≤ 15000 IU/d, low molecular weight heparin ≤ 5000 IE anti-Xa activity or acetyl salicylic acid ≤ 100 mg/d at the discretion of the investigator)
    • Anticancer therapies such as biologic therapy and chemotherapy (other than study drugs)
    • Radiation therapy (during the treatment phase of the protocol; increased bone pain not controlled by medication and requiring palliative therapy will be considered disease progression)
    • Laser treatment
    • Any other investigational agent
    • Thalidomide
    • Immunosuppressive therapies (inhaled or replacement dose corticosteroids are permitted).

Sites / Locations

  • Charite University Hospital - Campus Virchow Klinikum
  • Universitaetsklinikum Freiburg
  • Otto-Meyerhof-Zentrum Tagesklinik
  • Universitaetsklinkum Magdeburg der Otto-von-Guericke-Universitaet Magdeburg
  • Johannes Gutenberg University
  • III Medizinische Klinik Mannheim
  • Klinikum der Universitaet Muenchen - Grosshadern Campus
  • Klinikum Rechts Der Isar - Technische Universitaet Muenchen
  • Hospital Muenchen Bogenhausen
  • Szent Laszlo Korhaz
  • Debreceni Egyetem Onkologiai Tanzek
  • Petz Aladar County Hospital
  • University of Pecs Faculty of Medicine
  • Szeged University
  • Centro di Riferimento Oncologico - Aviano
  • Presidio Ospedaliero di Livorno
  • Azienda Ospedaliera di Rilievo Nazionale A.Cardarelli
  • Istituto Tumori/Fondazione Pascale
  • Ospedale San Filippo Neri
  • Altai Oncology Center
  • Moscow Oncology Hospital
  • Russian Academy of Medical Sciences Cancer Research Center
  • Central Clinical Hospital of the President of the Russian Federation
  • Rostov Research Institute of Oncology - Omsk
  • Saint Petersburg State Medical University
  • Pavlov State Medical University
  • Hospital de la Santa Cruz i Sant Pau
  • Vall d'Hebron University Hospital
  • Hospital Universitario de Elche
  • Hospital Virgen de las Nieves
  • Centro Oncologico M.D. Anderson International Espana
  • Cherkassy Regional Oncology Center
  • Bukovinian State Medical University
  • Dnipropetrovsk State Medical Academy
  • Donetsk Regional Antitumor Center
  • Ivano-Frankovsk Regional Oncology Center
  • Grigoriev Institute for Radiology Academy of Medical Science of Ukraine
  • Institute of Oncology
  • Ukrainian Medical Stomatological Academy

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Active Comparator

Experimental

Experimental

Arm Label

Gemcitabine

Gemcitabine plus 200 mg WX-671

Gemcitabine plus 400 mg WX-671

Arm Description

Outcomes

Primary Outcome Measures

Efficacy, in terms of response rate, progression-free survival, time to first metastasis, overall survival, and tumor and uPA system-related markers
Safety, in terms of vital signs, ECG, biochemistry, hematology (including coagulation), and adverse events

Secondary Outcome Measures

Full Information

First Posted
July 10, 2007
Last Updated
March 28, 2012
Sponsor
Heidelberg Pharma AG
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1. Study Identification

Unique Protocol Identification Number
NCT00499265
Brief Title
Gemcitabine With or Without WX-671 in Treating Patients With Locally Advanced Pancreatic Cancer That Cannot Be Removed By Surgery
Official Title
A Randomized, Open Label, Phase II Proof of Concept Study of WX-671 in Combination With Gemcitabine vs.Gemcitabine Alone in Patients With Locally Advanced, Non Resectable Pancreatic Cancer in Order to Evaluate the Anti-Tumor Activity of the Combination Therapy
Study Type
Interventional

2. Study Status

Record Verification Date
March 2012
Overall Recruitment Status
Completed
Study Start Date
April 2007 (undefined)
Primary Completion Date
May 2010 (Actual)
Study Completion Date
May 2010 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Heidelberg Pharma AG

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
RATIONALE: Drugs used in chemotherapy, such as gemcitabine, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. WX-671 may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Giving gemcitabine together with WX-671 may kill more tumor cells. PURPOSE: This randomized phase II trial is studying how well gemcitabine works when given together with WX-671 or when given alone in treating patients with locally advanced pancreatic cancer that cannot be removed by surgery.
Detailed Description
OBJECTIVES: Primary Assess the antitumor activity of two different doses of anti-uPA serine protease inhibitor WX-671 when given in combination with gemcitabine hydrochloride in patients with locally advanced unresectable pancreatic cancer. Compare the efficacy, in terms of response rate, progression-free survival, time to first metastasis, overall survival, and tumor and uPA system-related markers, of these regimens in these patients. Compare the safety, in terms of vital signs, ECG, biochemistry, hematology (including coagulation), and adverse events, of these regimens. OUTLINE: This is an open-label, randomized, multicenter study. Patients are randomized to 1 of 3 treatment arms. Arm I: Patients receive of oral anti-uPA serine protease inhibitor WX-671 once daily in weeks 1-8 (weeks 1-4 of each subsequent course) and gemcitabine hydrochloride IV over 30 minutes once weekly in weeks 1-7 (weeks 1-3 of each subsequent course) of course 1. All subsequent courses repeat every 4 weeks in the absence of disease progression or unacceptable toxicity. Arm II: Patients receive oral anti-uPA serine protease inhibitor WX-671 (at a lower dose than in arm I) once daily in weeks 1-8 (weeks 1-4 of each subsequent course) and gemcitabine hydrochloride IV over 30 minutes once weekly in weeks 1-7 (weeks 1-3 of each subsequent course) of course 1. All subsequent courses repeat every 4 weeks in the absence of disease progression or unacceptable toxicity. Arm III: Patients receive gemcitabine hydrochloride IV over 30 minutes once weekly in weeks 1-7 (weeks 1-3 of each subsequent course) of course 1. All subsequent courses repeat every 4 weeks in the absence of disease progression or unacceptable toxicity.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pancreatic Cancer
Keywords
recurrent pancreatic cancer, stage III pancreatic cancer, adenocarcinoma of the pancreas

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
95 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Gemcitabine
Arm Type
Active Comparator
Arm Title
Gemcitabine plus 200 mg WX-671
Arm Type
Experimental
Arm Title
Gemcitabine plus 400 mg WX-671
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
gemcitabine hydrochloride
Other Intervention Name(s)
GEMZAR
Intervention Description
1000 mg/m2 as 30 min i.v. infusion once weekly for 7/8 weeks and then every 3/4 weeks
Intervention Type
Drug
Intervention Name(s)
Serine Proteinase Inhibitor WX-671
Other Intervention Name(s)
MESUPRON
Intervention Description
oral, daily
Intervention Type
Drug
Intervention Name(s)
Serine Proteinase Inhibitor WX-671
Other Intervention Name(s)
MESUPRON
Intervention Description
oral, daily
Primary Outcome Measure Information:
Title
Efficacy, in terms of response rate, progression-free survival, time to first metastasis, overall survival, and tumor and uPA system-related markers
Time Frame
3 years
Title
Safety, in terms of vital signs, ECG, biochemistry, hematology (including coagulation), and adverse events
Time Frame
3 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Inclusion criteria: Locally advanced, unresectable, non-metastatic, histologically proven pancreatic adenocarcinoma (lymph nodes will not be considered metastases) Exclusion criteria: Any distant metastases PATIENT CHARACTERISTICS: Inclusion criteria: ECOG performance status ≤ 1 Life expectancy > 12 weeks Normal 12-lead ECG or only clinically insignificant abnormalities in the judgment of the investigator Female patients of child-bearing potential will be required to use an effective method of birth control for the duration of the study to prevent pregnancy ANC ≥ 1,500/mm³ Platelet count ≥ 100,000/mm³ Hemoglobin ≥ 9 g/dL Total bilirubin ≤ 1.5 times ULN AST and ALT ≤ 2.5 times ULN Alkaline phosphatase ≤ 2.5 times ULN Creatinine ≤ 2 times ULN or creatinine clearance > 45 mL/min Exclusion criteria: History of or current primary blood coagulation or bleeding disorders such as hemophilia Any unrelated illness, e.g., active infection, inflammation, medical condition or laboratory abnormalities, which in the judgment of the investigator might significantly affect the patient's study participation Any surgical or medical condition that might significantly alter the absorption, distribution, metabolism or excretion of any drug Significant cardiac insufficiency (NYHA classification III or IV), presence of unstable angina or myocardial infarction within the previous 6 months, use of ongoing maintenance therapy for life threatening arrhythmia or known pulmonary hypertension Any secondary malignancies within the last 5 years except for surgically cured non-melanoma skin cancer or cervical carcinoma in situ Pregnancy (positive serum pregnancy test) or lactation Known hepatitis B/C or HIV infection Known hypersensitivity to any of the components in the anti-uPA serine protease inhibitor WX-671 capsules or gemcitabine hydrochloride infusion or other medical reasons for not being able to receive adequate pre-medication (for example, antihistamine or anti-inflammatory agents) PRIOR CONCURRENT THERAPY: Permitted: Growth factors for treatment (not prophylaxis, i.e., epoetin alfa), analgesics, blood transfusions, antibiotics, bisphosphonates, other hormonal therapy for contraceptive practice, replacement therapy such as thyroid replacement or adrenal insufficiency as appropriate and medications for acute or chronic conditions not listed under the exclusion criteria Embolization (i.e. for hematuria) Subjects can receive blood transfusions as medically appropriate during the study Subjects who require a blood transfusion during screening must have stable hemoglobin (≥9.0 g/dL [5.6 mmol/L]) without the need for further transfusions within 2 weeks before the first dose of anti-uPA serine protease inhibitor WX-671 to remain eligible Prophylactic use of growth factors to support neutrophils Prohibited: Anticoagulant or thrombolytic therapy within four weeks prior to start of treatment (except low dose anticoagulant therapy with unfractionated heparin ≤ 15000 IU/d, low molecular weight heparin ≤ 5000 IE anti-Xa activity or acetyl salicylic acid ≤ 100 mg/d at the discretion of the investigator) Anticancer therapies such as biologic therapy and chemotherapy (other than study drugs) Radiation therapy (during the treatment phase of the protocol; increased bone pain not controlled by medication and requiring palliative therapy will be considered disease progression) Laser treatment Any other investigational agent Thalidomide Immunosuppressive therapies (inhaled or replacement dose corticosteroids are permitted).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Carola Mala, PhD
Organizational Affiliation
Heidelberg Pharma AG
Official's Role
Study Chair
Facility Information:
Facility Name
Charite University Hospital - Campus Virchow Klinikum
City
Berlin
ZIP/Postal Code
D-13353
Country
Germany
Facility Name
Universitaetsklinikum Freiburg
City
Freiburg
ZIP/Postal Code
D-79106
Country
Germany
Facility Name
Otto-Meyerhof-Zentrum Tagesklinik
City
Heidelberg
ZIP/Postal Code
69120
Country
Germany
Facility Name
Universitaetsklinkum Magdeburg der Otto-von-Guericke-Universitaet Magdeburg
City
Magdeburg
ZIP/Postal Code
D-39120
Country
Germany
Facility Name
Johannes Gutenberg University
City
Mainz
ZIP/Postal Code
D-55101
Country
Germany
Facility Name
III Medizinische Klinik Mannheim
City
Mannheim
ZIP/Postal Code
D-68305
Country
Germany
Facility Name
Klinikum der Universitaet Muenchen - Grosshadern Campus
City
Munich
ZIP/Postal Code
D-81377
Country
Germany
Facility Name
Klinikum Rechts Der Isar - Technische Universitaet Muenchen
City
Munich
ZIP/Postal Code
D-81675
Country
Germany
Facility Name
Hospital Muenchen Bogenhausen
City
Munich
ZIP/Postal Code
D-81925
Country
Germany
Facility Name
Szent Laszlo Korhaz
City
Budapest
ZIP/Postal Code
1097
Country
Hungary
Facility Name
Debreceni Egyetem Onkologiai Tanzek
City
Debrecen
ZIP/Postal Code
H-4012
Country
Hungary
Facility Name
Petz Aladar County Hospital
City
Gydr
ZIP/Postal Code
h-9024
Country
Hungary
Facility Name
University of Pecs Faculty of Medicine
City
Pecs
ZIP/Postal Code
H-7643
Country
Hungary
Facility Name
Szeged University
City
Szeged
ZIP/Postal Code
H-6720
Country
Hungary
Facility Name
Centro di Riferimento Oncologico - Aviano
City
Aviano
ZIP/Postal Code
33081
Country
Italy
Facility Name
Presidio Ospedaliero di Livorno
City
Livorno
ZIP/Postal Code
57100
Country
Italy
Facility Name
Azienda Ospedaliera di Rilievo Nazionale A.Cardarelli
City
Naples
ZIP/Postal Code
80131
Country
Italy
Facility Name
Istituto Tumori/Fondazione Pascale
City
Naples
ZIP/Postal Code
80131
Country
Italy
Facility Name
Ospedale San Filippo Neri
City
Rome
ZIP/Postal Code
00135
Country
Italy
Facility Name
Altai Oncology Center
City
Barnaul
ZIP/Postal Code
656049
Country
Russian Federation
Facility Name
Moscow Oncology Hospital
City
Moscow
ZIP/Postal Code
109033
Country
Russian Federation
Facility Name
Russian Academy of Medical Sciences Cancer Research Center
City
Moscow
ZIP/Postal Code
115478
Country
Russian Federation
Facility Name
Central Clinical Hospital of the President of the Russian Federation
City
Moscow
ZIP/Postal Code
121356
Country
Russian Federation
Facility Name
Rostov Research Institute of Oncology - Omsk
City
Omsk
ZIP/Postal Code
644013
Country
Russian Federation
Facility Name
Saint Petersburg State Medical University
City
Saint Petersburg
ZIP/Postal Code
197089
Country
Russian Federation
Facility Name
Pavlov State Medical University
City
St. Petersburg
ZIP/Postal Code
197089
Country
Russian Federation
Facility Name
Hospital de la Santa Cruz i Sant Pau
City
Barcelona
ZIP/Postal Code
08025
Country
Spain
Facility Name
Vall d'Hebron University Hospital
City
Barcelona
ZIP/Postal Code
08035
Country
Spain
Facility Name
Hospital Universitario de Elche
City
Elche
ZIP/Postal Code
03203
Country
Spain
Facility Name
Hospital Virgen de las Nieves
City
Granada
ZIP/Postal Code
18014
Country
Spain
Facility Name
Centro Oncologico M.D. Anderson International Espana
City
Madrid
ZIP/Postal Code
28033
Country
Spain
Facility Name
Cherkassy Regional Oncology Center
City
Cherkassy
ZIP/Postal Code
18009
Country
Ukraine
Facility Name
Bukovinian State Medical University
City
Chernivtsy
ZIP/Postal Code
58002
Country
Ukraine
Facility Name
Dnipropetrovsk State Medical Academy
City
Dnipropetrovsk
ZIP/Postal Code
49600
Country
Ukraine
Facility Name
Donetsk Regional Antitumor Center
City
Donetsk
ZIP/Postal Code
83092
Country
Ukraine
Facility Name
Ivano-Frankovsk Regional Oncology Center
City
Ivano-Frankovsk
ZIP/Postal Code
76018
Country
Ukraine
Facility Name
Grigoriev Institute for Radiology Academy of Medical Science of Ukraine
City
Kharkiv
ZIP/Postal Code
61024
Country
Ukraine
Facility Name
Institute of Oncology
City
Kiev
ZIP/Postal Code
03022
Country
Ukraine
Facility Name
Ukrainian Medical Stomatological Academy
City
Poltava
ZIP/Postal Code
36024
Country
Ukraine

12. IPD Sharing Statement

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Gemcitabine With or Without WX-671 in Treating Patients With Locally Advanced Pancreatic Cancer That Cannot Be Removed By Surgery

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