Pilot Study With CY, Pembrolizumab, GVAX, and IMC-CS4 (LY3022855) in Patients With Borderline Resectable Adenocarcinoma of the Pancreas
Primary Purpose
Pancreatic Cancer
Status
Active
Phase
Early Phase 1
Locations
United States
Study Type
Interventional
Intervention
Cyclophosphamide
GVAX
Pembrolizumab
IMC-CS4
Sponsored by

About this trial
This is an interventional treatment trial for Pancreatic Cancer focused on measuring Pancreas vaccine, immunotherapy, antibody, PD-1, IMC-CS4, Pembrolizumab, GVAX, Borderline Resectable
Eligibility Criteria
Inclusion Criteria:
- Have histologically or cytologically proven adenocarcinoma of the pancreas.
- Patient's acceptance to have a core biopsy.
- Presence of at least one measurable lesion.
- Must not have metastatic disease.
- Patients must have measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded) as >20 mm with conventional techniques or as >10 mm with spiral CT scan. See Section 10.1.2 for the evaluation of measurable disease.
- Must have received last dose of stereotactic body radiotherapy no longer than 28 days prior to enrollment.
- Must have received last dose of chemotherapy at least 14 days or longer prior to entry into the study.
- Age >18 years.
- ECOG performance status 0-1.
- Patient's blood, kidney and liver function must within normal limits
- Must use an acceptable form of birth control while on study.
- Ability to understand and the willingness to sign a written informed consent document.
Exclusion Criteria:
- Currently is participating or has participated in a study using any investigational therapy within the past 28 days or is currently using an investigational device.
- Major surgery 28 days prior to study entry excluding minor procedures (dental work, skin biopsy, etc.), celiac plexus block, and biliary stent placement.
- Used any systemic steroids, immunosuppressant medications and anti-neoplastic treatment in the past 14 days.
- Prior treatment with immunotherapy agents (including, but not limited to: IL-2, interferon, anti-PD-1, anti-PD-L1, anti-PD-L2, anti-CD137, anti-OX-40, anti-CD40, or anti-CTLA-4 antibodies).
- Used any growth factors including, but not limited to, granulocyte-colony stimulating factor (G-CSF), GM-CSF, erythropoietin, within 14 days of study drug administration. Use of such agents while on study is also prohibited.
- Received any prophylactic vaccine within 14 days of first dose of study drug or received a live vaccine within 30 days of study treatment.
- Currently have or have history of certain study-specified heart, liver, kidney, lung, neurological, psychological, immune or other medical conditions.
- History of any autoimmune disease: inflammatory bowel disease, (including ulcerative colitis and Crohn's Disease), rheumatoid arthritis, systemic progressive sclerosis (scleroderma), systemic lupus erythematosus (SLE) autoimmune vasculitis (e.g., Wegener's Granulomatosis), CNS or motor neuropathy considered to be of autoimmune origin (e.g., Guillian-Barre Syndrome, Myasthenia Gravis, Multiple Sclerosis). Patients with thyroid disease will be allowed.
- Has history of (non-infectious) pneumonitis that required steroids, history or evidence of interstitial lung disease or active, non-infectious pneumonitis.
- Has a pulse oximetry < 92% on room air.
- Evidence of ascites on imaging.
- Requires the use of home oxygen.
- Have known history of infection with HIV, hepatitis B, or hepatitis C.
- Have been diagnosed with another cancer in the past 5 years (except for superficial bladder cancer, non-melanoma skin cancers, or a low grade prostate cancer not requiring therapy)
- History of severe hypersensitivity reaction to any monoclonal antibody.
- Known or suspected hypersensitivity to GM-CSF, hetastarch, corn, dimethyl sulfoxide, fetal bovine serum, trypsin (porcine origin), yeast or any other component of GVAX pancreas vaccine.
- Pregnant or breastfeeding women.
- Positive pregnancy test during the study.
- Women sexually active with a fertile man and of childbearing potential unwilling or unable to use an acceptable method to avoid pregnancy for the entire study and for up to 120 days after the last dose of study drug.
- Unwilling or unable to follow the study schedule for any reason.
Sites / Locations
- Sidney Kimmel Comprehensive Cancer Center
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Cyclophosphamide, GVAX, Pembrolizumab and IMC-CS4
Arm Description
Outcomes
Primary Outcome Measures
CD8 T cell density in the primary tumor after neoadjuvant administration of combination immunotherapy by immunohistochemistry (IHC)
Number of participants experiencing study drug-related toxicities
Secondary Outcome Measures
Overall survival (OS)
Disease free survival (DFS)
Objective response rate (ORR) by immune-related RECIST criteria (irRC)
Surgical resectability rate of borderline resectable pancreatic cancer (BRPC)
Pathologic response rate of patients with BRPC
Progression free survival (PFS)
Full Information
NCT ID
NCT03153410
First Posted
May 11, 2017
Last Updated
September 1, 2023
Sponsor
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Collaborators
Merck Sharp & Dohme LLC, Eli Lilly and Company
1. Study Identification
Unique Protocol Identification Number
NCT03153410
Brief Title
Pilot Study With CY, Pembrolizumab, GVAX, and IMC-CS4 (LY3022855) in Patients With Borderline Resectable Adenocarcinoma of the Pancreas
Official Title
A Pilot Study of a GVAX Pancreas Vaccine (With Cyclophosphamide) in Combination With a PD-1 Blockade Antibody (Pembrolizumab) and a Macrophage Targeting Agent (CSF1R Inhibitor) for the Treatment of Patients With Borderline Resectable Adenocarcinoma of the Pancreas
Study Type
Interventional
2. Study Status
Record Verification Date
September 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
September 27, 2018 (Actual)
Primary Completion Date
December 2023 (Anticipated)
Study Completion Date
December 2023 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Collaborators
Merck Sharp & Dohme LLC, Eli Lilly and Company
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This study will be looking at whether combining cyclophosphamide, pembrolizumab (an antibody that blocks negative signals to T cells), GVAX (pancreatic cancer vaccine), and IMC-CS4 (LY3022855) (an antibody that blocks a molecule called CSF1-R which prevents the bodies ability to fight cancer) is effective (anti-tumor activity) and safe in patients with borderline resectable pancreatic cancer.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pancreatic Cancer
Keywords
Pancreas vaccine, immunotherapy, antibody, PD-1, IMC-CS4, Pembrolizumab, GVAX, Borderline Resectable
7. Study Design
Primary Purpose
Treatment
Study Phase
Early Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
12 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Cyclophosphamide, GVAX, Pembrolizumab and IMC-CS4
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Cyclophosphamide
Other Intervention Name(s)
CY
Intervention Description
200 mg/m2 is to be administered as a 30 minute IV infusion one day prior to GVAX for a total of 8 doses.
Other Names:
Cytoxan CY
Intervention Type
Drug
Intervention Name(s)
GVAX
Other Intervention Name(s)
Panc 10.05 pcDNA1/GM-Neo, Panc 6.03 pcDNA1/GM-Neo
Intervention Description
5E8 cells is to be administered one day after CY, pembrolizumab, and IMC-CS4/ LY3022855 for a total of eight doses.
Other Names:
Pancreatic cancer vaccine Panc 10.05 pcDNA1/GM-Neo, Panc 6.03 pcDNA1/GM-Neo
Intervention Type
Drug
Intervention Name(s)
Pembrolizumab
Other Intervention Name(s)
MK-3475, KEYTRUDA®
Intervention Description
200 mg will be administered as a 30 minute IV infusion one day prior to the GVAX pancreas vaccine for a total of 18 doses.
Other Names:
MK-3475 KEYTRUDA
Intervention Type
Drug
Intervention Name(s)
IMC-CS4
Other Intervention Name(s)
LY3022855
Intervention Description
75 mg for dose level 1 and 100 mg at dose level 2 will be administered (Day 1, Day 8 and Day 15) as a 30 minute(s) IV infusion one day prior to GVAX pancreas vaccine for a total 18 doses.
Primary Outcome Measure Information:
Title
CD8 T cell density in the primary tumor after neoadjuvant administration of combination immunotherapy by immunohistochemistry (IHC)
Time Frame
2 years
Title
Number of participants experiencing study drug-related toxicities
Time Frame
2 years
Secondary Outcome Measure Information:
Title
Overall survival (OS)
Time Frame
2 years
Title
Disease free survival (DFS)
Time Frame
2 years
Title
Objective response rate (ORR) by immune-related RECIST criteria (irRC)
Time Frame
2 years
Title
Surgical resectability rate of borderline resectable pancreatic cancer (BRPC)
Time Frame
2 years
Title
Pathologic response rate of patients with BRPC
Time Frame
2 years
Title
Progression free survival (PFS)
Time Frame
2 years
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Have histologically or cytologically proven adenocarcinoma of the pancreas.
Patient's acceptance to have a core biopsy.
Presence of at least one measurable lesion.
Must not have metastatic disease.
Patients must have measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded) as >20 mm with conventional techniques or as >10 mm with spiral CT scan. See Section 10.1.2 for the evaluation of measurable disease.
Must have received last dose of stereotactic body radiotherapy no longer than 28 days prior to enrollment.
Must have received last dose of chemotherapy at least 14 days or longer prior to entry into the study.
Age >18 years.
ECOG performance status 0-1.
Patient's blood, kidney and liver function must within normal limits
Must use an acceptable form of birth control while on study.
Ability to understand and the willingness to sign a written informed consent document.
Exclusion Criteria:
Currently is participating or has participated in a study using any investigational therapy within the past 28 days or is currently using an investigational device.
Major surgery 28 days prior to study entry excluding minor procedures (dental work, skin biopsy, etc.), celiac plexus block, and biliary stent placement.
Used any systemic steroids, immunosuppressant medications and anti-neoplastic treatment in the past 14 days.
Prior treatment with immunotherapy agents (including, but not limited to: IL-2, interferon, anti-PD-1, anti-PD-L1, anti-PD-L2, anti-CD137, anti-OX-40, anti-CD40, or anti-CTLA-4 antibodies).
Used any growth factors including, but not limited to, granulocyte-colony stimulating factor (G-CSF), GM-CSF, erythropoietin, within 14 days of study drug administration. Use of such agents while on study is also prohibited.
Received any prophylactic vaccine within 14 days of first dose of study drug or received a live vaccine within 30 days of study treatment.
Currently have or have history of certain study-specified heart, liver, kidney, lung, neurological, psychological, immune or other medical conditions.
History of any autoimmune disease: inflammatory bowel disease, (including ulcerative colitis and Crohn's Disease), rheumatoid arthritis, systemic progressive sclerosis (scleroderma), systemic lupus erythematosus (SLE) autoimmune vasculitis (e.g., Wegener's Granulomatosis), CNS or motor neuropathy considered to be of autoimmune origin (e.g., Guillian-Barre Syndrome, Myasthenia Gravis, Multiple Sclerosis). Patients with thyroid disease will be allowed.
Has history of (non-infectious) pneumonitis that required steroids, history or evidence of interstitial lung disease or active, non-infectious pneumonitis.
Has a pulse oximetry < 92% on room air.
Evidence of ascites on imaging.
Requires the use of home oxygen.
Have known history of infection with HIV, hepatitis B, or hepatitis C.
Have been diagnosed with another cancer in the past 5 years (except for superficial bladder cancer, non-melanoma skin cancers, or a low grade prostate cancer not requiring therapy)
History of severe hypersensitivity reaction to any monoclonal antibody.
Known or suspected hypersensitivity to GM-CSF, hetastarch, corn, dimethyl sulfoxide, fetal bovine serum, trypsin (porcine origin), yeast or any other component of GVAX pancreas vaccine.
Pregnant or breastfeeding women.
Positive pregnancy test during the study.
Women sexually active with a fertile man and of childbearing potential unwilling or unable to use an acceptable method to avoid pregnancy for the entire study and for up to 120 days after the last dose of study drug.
Unwilling or unable to follow the study schedule for any reason.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ana DeJesus, MD
Organizational Affiliation
Johns Hopkins University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Sidney Kimmel Comprehensive Cancer Center
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21231
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
Undecided
Learn more about this trial
Pilot Study With CY, Pembrolizumab, GVAX, and IMC-CS4 (LY3022855) in Patients With Borderline Resectable Adenocarcinoma of the Pancreas
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