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Pembrolizumab Plus Chemotherapy in 1st Line Treatment of Pancreatic Cancer

Primary Purpose

Pancreatic Cancer, Chemotherapy Effect

Status
Active
Phase
Phase 2
Locations
Korea, Republic of
Study Type
Interventional
Intervention
Gemcitabine
Nab-paclitaxel
Pembrolizumab
Oxaliplatin
Leucovorin
Irinotecan
5FU
Sponsored by
Seoul National University Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pancreatic Cancer

Eligibility Criteria

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

Inclusion Criteria:

  1. Male/female participants who are at least 18 years of age on the day of signing informed consent
  2. Histologically confirmed diagnosis of unresectable, recurrent, or metastatic pancreatic cancer
  3. Not pregnant, not breasfeeding, and agree to use proper contraception,
  4. Chemotherapy-naïve for advanced pancreatic cancer (previous adjuvant chemotherapy is allowed)
  5. Have measurable disease based on RECIST 1.1.
  6. Have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1.
  7. Have adequate organ function

    • Haemoglobin ≥ 9.0 g/dL
    • Absolute neutrophil count (ANC) 1.5 (or 1.0) x (> 1500 per mm3)
    • Platelet count ≥ 100 x 109/L (>75,000 per mm3)
    • Serum creatinine CL>30 mL/min by the Cockcroft-Gault formula or serum creatinine ≤1.5 × ULN
    • Serum bilirubin ≤ 1.5 x ULN
    • AST (SGOT)/ALT (SGPT) ≤ 2.5 x ULN unless liver metastases are present, in which case it must be ≤ 5x ULN
    • International normalized ratio (INR) or Prothrombin time (PT), activated partial thromboplastin time (aPTT) ≤1.5 × ULN unless participant is receiving anticoagulant therapy

Exclusion Criteria:

  1. A WOCBP who has a positive urine pregnancy test within 72 hours prior to allocation
  2. Has received prior therapy with an anti-PD-1, anti-PD-L1, or anti PD L2 agent or with an agent directed to another stimulatory or co-inhibitory T-cell receptor (eg, CTLA-4, OX 40, CD137).
  3. Has received prior systemic anti-cancer therapy including investigational agents within 4 weeks
  4. Has received prior radiotherapy within 2 weeks of start of study treatment.
  5. Has received a live vaccine within 30 days prior to the first dose of study drug.
  6. Is currently participating in or has participated in a study of an investigational agent or has used an investigational device
  7. Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy (in dosing exceeding 10 mg daily of prednisone equivalent) or any other form of immunosuppressive therapy within 7 days prior to the first dose of study drug.
  8. Has a known additional malignancy that is progressing or has required active treatment within the past 3 years.
  9. Has known active CNS metastases and/or carcinomatous meningitis.
  10. Has severe hypersensitivity (≥Grade 3) to pembrolizumab and/or any of its excipients.
  11. Has active autoimmune disease that has required systemic treatment in the past 2 years
  12. Has a history of (non-infectious) pneumonitis that required steroids or has current pneumonitis.
  13. Has an active infection requiring systemic therapy.
  14. Has a known history of Human Immunodeficiency Virus (HIV).
  15. Has a known history of Hepatitis B (defined as Hepatitis B surface antigen [HBsAg] reactive) or known active Hepatitis C virus (defined as HCV RNA [qualitative] is detected) infection.
  16. Has a known history of active TB (Bacillus Tuberculosis).
  17. Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the study, interfere with the subject's participation for the full duration of the study, or is not in the best interest of the subject to participate, in the opinion of the treating investigator.
  18. Has known psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the trial.
  19. Is pregnant or breastfeeding, or expecting to conceive or father children within the projected duration of the study, starting with the screening visit through 120 days after the last dose of trial treatment.

Sites / Locations

  • Seoul National University Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Gemcitabine/Nab-paclitaxel

FOLFIRINOX

Arm Description

Gemcitabine/Nab-paclitaxel + pembrolizumab

FOLFIRINOX + pembrolizumab

Outcomes

Primary Outcome Measures

Objective Response Rate
The percentage of patients whose optimal response achieves CR or PR between the initial response assessment and the time between treatment termination or intermediate dropout due to any cause

Secondary Outcome Measures

Progression-free survival
Time from enroll until disease progression or death
Duration of response
Time from enroll untill disease progression or death in patients whose optimal response achieves CR or PR
Disease control rate
The percentage of patients who have achieved complete response, partial response and stable disease
Overall survival
Time from enroll until death from any cause
Immune-related response
RECIST 1.1, ir response

Full Information

First Posted
June 23, 2020
Last Updated
April 10, 2023
Sponsor
Seoul National University Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT04447092
Brief Title
Pembrolizumab Plus Chemotherapy in 1st Line Treatment of Pancreatic Cancer
Official Title
Biomarker-oriented Study of Pembrolizumab in Combination With Chemotherapy in Chemotherapy -naïve Advanced Pancreatic Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
April 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
July 1, 2020 (Actual)
Primary Completion Date
December 31, 2023 (Anticipated)
Study Completion Date
December 31, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Seoul National University Hospital

4. Oversight

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

5. Study Description

Brief Summary
This is an open-label, phase 2 study of Pembrolizumab in combination with chemotherapy in chemotherapy-naïve advanced pancreatic cancer
Detailed Description
In unresectable advanced pancreatic cancer, palliative chemotherapy (mainly Gemcitabine/nab-Paclitaxel or FOLFIRINOX) is the mainstay of treatment. Regardless of the choice of first-line therapy, more than half of the patients with advanced/metastatic disease will progress within six months and will not survive more than one year. Immune cells (IC) are a significant part of the pancreatic tumor-associated stroma and play a fundamental part in maintaining a non-immunogenic and immuno-suppressive environment. IO (Immuno-Oncology drug) monotherapy is not effective in advanced pancreatic cancer; therefore, we need more active combination regimens including IO/IO or IO/chemotherapy, etc. Furthermore, we need biomarker study to uncover which population is an optimal target for this IO-based treatment strategy. Based on these rationale, we plan to conduct an open-label, phase 2 study to explore biomarkers and evaluate the safety and efficacy of the pembrolizumab/chemotherapy combination in an advanced pancreatic cancer primary environment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pancreatic Cancer, Chemotherapy Effect

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Gemcitabine/Nab-paclitaxel
Arm Type
Experimental
Arm Description
Gemcitabine/Nab-paclitaxel + pembrolizumab
Arm Title
FOLFIRINOX
Arm Type
Experimental
Arm Description
FOLFIRINOX + pembrolizumab
Intervention Type
Drug
Intervention Name(s)
Gemcitabine
Intervention Description
Gemcitabine 1000 mg/m2 iv D1, 8, 15 (every 4 weeks)
Intervention Type
Drug
Intervention Name(s)
Nab-paclitaxel
Intervention Description
Nab-paclitaxel 125 mg/m2 iv D1, 8, 15 (every 4 weeks)
Intervention Type
Drug
Intervention Name(s)
Pembrolizumab
Intervention Description
Pembrolizumab ( 200 ) mg iv D1 (every 3 weeks)
Intervention Type
Drug
Intervention Name(s)
Oxaliplatin
Intervention Description
Oxaliplatin 65 mg/m2 iv over 2 hours D1 (every 2 weeks)
Intervention Type
Drug
Intervention Name(s)
Leucovorin
Intervention Description
Leucovorin 400 mg/m2 iv D1 (every 2 weeks)
Intervention Type
Drug
Intervention Name(s)
Irinotecan
Intervention Description
Irinotecan 140 mg/m2 iv over 1.5 hours D1 (every 2 weeks)
Intervention Type
Drug
Intervention Name(s)
5FU
Intervention Description
5-FU 2400 mg/m2 iv over 46 hours D1 (every 2 weeks)
Primary Outcome Measure Information:
Title
Objective Response Rate
Description
The percentage of patients whose optimal response achieves CR or PR between the initial response assessment and the time between treatment termination or intermediate dropout due to any cause
Time Frame
8 weeks
Secondary Outcome Measure Information:
Title
Progression-free survival
Description
Time from enroll until disease progression or death
Time Frame
8 weeks
Title
Duration of response
Description
Time from enroll untill disease progression or death in patients whose optimal response achieves CR or PR
Time Frame
8 weeks
Title
Disease control rate
Description
The percentage of patients who have achieved complete response, partial response and stable disease
Time Frame
8 weeks
Title
Overall survival
Description
Time from enroll until death from any cause
Time Frame
8 weeks
Title
Immune-related response
Description
RECIST 1.1, ir response
Time Frame
8 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male/female participants who are at least 18 years of age on the day of signing informed consent Histologically confirmed diagnosis of unresectable, recurrent, or metastatic pancreatic cancer Not pregnant, not breasfeeding, and agree to use proper contraception, Chemotherapy-naïve for advanced pancreatic cancer (previous adjuvant chemotherapy is allowed) Have measurable disease based on RECIST 1.1. Have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1. Have adequate organ function Haemoglobin ≥ 9.0 g/dL Absolute neutrophil count (ANC) 1.5 (or 1.0) x (> 1500 per mm3) Platelet count ≥ 100 x 109/L (>75,000 per mm3) Serum creatinine CL>30 mL/min by the Cockcroft-Gault formula or serum creatinine ≤1.5 × ULN Serum bilirubin ≤ 1.5 x ULN AST (SGOT)/ALT (SGPT) ≤ 2.5 x ULN unless liver metastases are present, in which case it must be ≤ 5x ULN International normalized ratio (INR) or Prothrombin time (PT), activated partial thromboplastin time (aPTT) ≤1.5 × ULN unless participant is receiving anticoagulant therapy Exclusion Criteria: A WOCBP who has a positive urine pregnancy test within 72 hours prior to allocation Has received prior therapy with an anti-PD-1, anti-PD-L1, or anti PD L2 agent or with an agent directed to another stimulatory or co-inhibitory T-cell receptor (eg, CTLA-4, OX 40, CD137). Has received prior systemic anti-cancer therapy including investigational agents within 4 weeks Has received prior radiotherapy within 2 weeks of start of study treatment. Has received a live vaccine within 30 days prior to the first dose of study drug. Is currently participating in or has participated in a study of an investigational agent or has used an investigational device Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy (in dosing exceeding 10 mg daily of prednisone equivalent) or any other form of immunosuppressive therapy within 7 days prior to the first dose of study drug. Has a known additional malignancy that is progressing or has required active treatment within the past 3 years. Has known active CNS metastases and/or carcinomatous meningitis. Has severe hypersensitivity (≥Grade 3) to pembrolizumab and/or any of its excipients. Has active autoimmune disease that has required systemic treatment in the past 2 years Has a history of (non-infectious) pneumonitis that required steroids or has current pneumonitis. Has an active infection requiring systemic therapy. Has a known history of Human Immunodeficiency Virus (HIV). Has a known history of Hepatitis B (defined as Hepatitis B surface antigen [HBsAg] reactive) or known active Hepatitis C virus (defined as HCV RNA [qualitative] is detected) infection. Has a known history of active TB (Bacillus Tuberculosis). Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the study, interfere with the subject's participation for the full duration of the study, or is not in the best interest of the subject to participate, in the opinion of the treating investigator. Has known psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the trial. Is pregnant or breastfeeding, or expecting to conceive or father children within the projected duration of the study, starting with the screening visit through 120 days after the last dose of trial treatment.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Do-Youn Oh, M.D., PhD.
Organizational Affiliation
Seoul National University Hospital
Official's Role
Study Director
Facility Information:
Facility Name
Seoul National University Hospital
City
Seoul
ZIP/Postal Code
110-744
Country
Korea, Republic of

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Pembrolizumab Plus Chemotherapy in 1st Line Treatment of Pancreatic Cancer

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