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QUILT-2.001: ALT-803 in Patients With Advanced Pancreatic Cancer in Conjunction With Gemcitabine and Nab-Paclitaxel

Primary Purpose

Advanced Pancreatic Cancer

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Gemcitabine
Nab-paclitaxel
ALT-803
Sponsored by
Altor BioScience
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Advanced Pancreatic Cancer focused on measuring Pancreas, Pancreatic, Cancer, Advanced Pancreatic Cancer, Immunotherapy, Immunotherapeutic, Interleukin-15, Gemcitabine, Nab-paclitaxel, Solid Tumor, Metastatic Disease, Combination Immunotherapy

Eligibility Criteria

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

DISEASE CHARACTERISTICS:

Inclusion Criteria:

  • Histologically or cytologically confirmed diagnosis of pancreatic cancer.

    • For dose escalation phase (Phase Ib) distant metastatic disease or unresectable disease and not a candidate for down staging to resection.
    • For expansion phase (Phase II) distant metastatic disease only.
  • For dose escalation phase (Phase Ib) 0 or 1 prior lines of chemotherapy for advanced pancreatic cancer. Prior gemcitabine is allowed, however prior nab-paclitaxel is not allowed.
  • For expansion phase (Phase II) no prior therapy for pancreatic cancer is allowed except for adjuvant therapy as long as it was completed ≥ 6 months prior to study treatment start
  • Have at least one untreated and progressing tumor lesion that can be accurately measured according to Response Evaluation Criteria in Solid Tumor
  • Prior radiation is allowed if the index lesion(s) remains outside of the treatment field or has progressed since prior treatment. Radiation therapy must have been completed at least 4 weeks prior to the baseline scan
  • Resolved acute effects of any prior therapy to baseline or Grade ≤1
  • The Eastern Cooperative Oncology Group (ECOG) Performance Status 0, 1 or 2
  • Life expectancy ≥12 weeks
  • Glomerular Filtration Rate (GFR) > 40mL (milliliter)/min; Creatinine ≤ 1.5 x ULN (Upper limit of Normal)
  • Platelets ≥100,000/uL (microliter)
  • Hemoglobin ≥ 9g/dL
  • Absolute Lymphocytes ≥800/uL
  • Absolute neutrophil count/absolute granulocyte count ≥1500/uL
  • Total bilirubin ≤ 2.0 X ULN, or ≤ 3.0 X ULN (for patients with Gilbert's Syndrome)
  • aspartate aminotransferase, alanine aminotransferase ≤ 2.5 X ULN, or ≤ 5.0 X ULN (if liver metastasis present)
  • Normal clinical assessment of pulmonary function
  • Negative serum pregnancy test if female and of childbearing potential
  • Subjects, both females and males, with reproductive potential must agree to use effective contraceptive measures for the duration of the study
  • Must provide informed consent and HIPPA authorization and agree to comply with all protocol-specified procedures and follow-up evaluations

Exclusion Criteria:

  • No women who are pregnant or nursing
  • No known hypersensitivity to gemcitabine or nab-paclitaxel
  • No concurrent herbal or unconventional therapy
  • No prior therapy with IL-15 or IL-15 analog
  • No ongoing toxicity from prior anti-cancer treatment that may interfere with study treatment. All toxicities attributed to prior anti-cancer therapy other than alopecia and fatigue must resolve to grade 1 or baseline before administration of the study treatment.
  • No positive Hep C serology or active Hep B infection
  • No congestive heart failure < 6 months
  • No unstable angina pectoris < 6 months
  • No myocardial infarction < 6 months
  • No history of ventricular arrhythmias or severe cardiac dysfunction
  • No history of uncontrollable supraventricular arrhythmias
  • No New York Heart Association Class > II congestive heart failure
  • No marked baseline prolongation of QT/QTc interval
  • No known autoimmune disease requiring active treatment. Subjects with a condition requiring systemic treatment with either corticosteroids (>10 mg daily prednisone equivalent) or other immunosuppressive medications within 14 days of enrollment. Inhaled or topical steroids, and adrenal replacement steroid doses ≤ 10 mg daily prednisone equivalent, are permitted in the absence of active autoimmune disease
  • No known prior organ allograft or allogeneic transplantation
  • No known HIV-positive or AIDS unless patient is on a stable highly active antiretroviral therapy (HAART) regimen, have CD4 (cluster of differentiation 4) counts >350, with no detectable viral load on quantitative polymerase chain reaction test
  • No untreated central nervous system metastases, or if treated must be neurologically stable for at least 2 weeks prior to enrollment
  • No corticosteroids, or on a stable or decreasing dose of ≤ 10 mg daily prednisone (or equivalent)
  • No psychiatric illness/social situation that would limit compliance
  • No other illness that in the opinion of the investigator would exclude the subject from participating in the study
  • No active systemic infection requiring parenteral antibiotic therapy
  • No anti-cancer treatment including surgery, radiotherapy, chemotherapy, other immunotherapy, or investigational therapy within 14 days before treatment start
  • No disease requiring systemic immunosuppressive therapy
  • No other prior malignancy is allowed except for the following: adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer, adequately treated Stage I or II cancer from which the patient is currently in complete remission, or any other cancer from which the patient has been disease-free for 3 years after surgical treatment.

Sites / Locations

  • University of Hawaii Cancer Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Phase Ib/II ALT-803 w/ gemcitabine and nab-paclitaxel

Arm Description

Outcomes

Primary Outcome Measures

Determination of MTD; Phase Ib
Determine the maximum tolerated dose (MTD) level and designate the recommended dose level for phase II.
Safety Profile (Number and severity of treatment related AEs); Phase Ib and II
Number and severity of treatment related adverse events (AEs) that occur or worsen after the first dose of study treatment
Overall Survival; Phase II
Determine the 8.5 month overall survival of treated patients

Secondary Outcome Measures

Objective response rate
Evaluate objective response rate in treated patients.
Duration of response
Evaluate duration of response in treated patients.
Time to progression
Evaluate time to progression in treated patients.
Progression-free survival
Evaluate progression-free survival in treated patients.
Biomarkers; Phase Ib
Measure the serum levels of the following including but not limited to Interleukin-2 (IL-2), Interleukin-4 (IL-4), Interleukin-6 (IL-6), Interleukin-10 (IL-10), Interferon-gamma (IFN-ɣ), Tumor necrosis factor-alpha (TNF-α) and Monocyte chemoattractant protein-1 (MCP-1)
Determine the level of anti-ALT-803 antibodies in patient serum
Determine the level of anti-ALT-803 antibodies in patient serum
Area under the plasma concentration-time curve from time zero to infinity (AUC); Phase Ib
Area under the plasma concentration-time curve from time zero to infinity (AUC)
Correlation between the level of circulating cell free DNA in patient plasma and response to study treatment
Correlation between the level of circulating cell free DNA in patient plasma and response to study treatment
Correlation between the level of tumor DNA in patient plasma and response to study treatment
Correlation between the level of tumor DNA in patient plasma and response to study treatment

Full Information

First Posted
September 23, 2015
Last Updated
January 24, 2020
Sponsor
Altor BioScience
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1. Study Identification

Unique Protocol Identification Number
NCT02559674
Brief Title
QUILT-2.001: ALT-803 in Patients With Advanced Pancreatic Cancer in Conjunction With Gemcitabine and Nab-Paclitaxel
Official Title
Phase Ib/II Study of ALT-803 in Combination With Gemcitabine and Nab-paclitaxel in Patients With Advanced Pancreatic Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
January 2020
Overall Recruitment Status
Completed
Study Start Date
July 2016 (undefined)
Primary Completion Date
February 21, 2018 (Actual)
Study Completion Date
February 21, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Altor BioScience

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a Phase Ib/II, open-label, multi-center, competitive enrollment and dose escalation study of ALT-803 in combination with gemcitabine and nab-paclitaxel in patients with advanced pancreatic cancer in conjunction with gemcitabine and nab-paclitaxel.
Detailed Description
The purpose of this study is to evaluate the safety and tolerability of escalating doses, to identify the Maximum Tolerated Dose (MTD) and designate a dose level for Phase II study (RP2D) of ALT-803 administered in combination with gemcitabine and nab-paclitaxel in patients with advanced pancreatic cancer. To access the anti-tumor activity of ALT-803 administered in combination with gemcitabine and nab-paclitaxel as measured by objective response rate, overall survival, progression-free survival, time to progression, and duration of response in patients with advanced pancreatic cancer. To Characterize the pharmacokinetic, immunogenicity, and serum cytokine profile of ALT-803 in combination with gemcitabine and nab-paclitaxel in treated patients. To correlate circulating cell free DNA and circulating tumor DNA with clinical outcomes of the study in treated patients.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Advanced Pancreatic Cancer
Keywords
Pancreas, Pancreatic, Cancer, Advanced Pancreatic Cancer, Immunotherapy, Immunotherapeutic, Interleukin-15, Gemcitabine, Nab-paclitaxel, Solid Tumor, Metastatic Disease, Combination Immunotherapy

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
8 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Phase Ib/II ALT-803 w/ gemcitabine and nab-paclitaxel
Arm Type
Experimental
Intervention Type
Biological
Intervention Name(s)
Gemcitabine
Other Intervention Name(s)
Gemzar
Intervention Description
Intravenous Infusion; Patients will receive two 4-week treatment cycles consisting of gemcitabine given on Day 1, 8, 15, 29, 36, and 43. Eligible patients may receive up to 10 additional treatment cycles.
Intervention Type
Biological
Intervention Name(s)
Nab-paclitaxel
Other Intervention Name(s)
Abraxane
Intervention Description
Intravenous Infusion; Patients will receive two 4-week treatment cycles consisting of nab-paclitaxel given on Day 1, 8, 15, 29, 36, and 43. Eligible patients may receive up to 10 additional treatment cycles.
Intervention Type
Biological
Intervention Name(s)
ALT-803
Intervention Description
Subcutaneous Injection; Patients will receive two 4-week cycles consisting of ALT-803 given on Day 2, 9, 16, 30, 37, and 44. Eligible patients may receive up to 10 additional treatment cycles.
Primary Outcome Measure Information:
Title
Determination of MTD; Phase Ib
Description
Determine the maximum tolerated dose (MTD) level and designate the recommended dose level for phase II.
Time Frame
9 Months
Title
Safety Profile (Number and severity of treatment related AEs); Phase Ib and II
Description
Number and severity of treatment related adverse events (AEs) that occur or worsen after the first dose of study treatment
Time Frame
48 Months
Title
Overall Survival; Phase II
Description
Determine the 8.5 month overall survival of treated patients
Time Frame
8.5 Months
Secondary Outcome Measure Information:
Title
Objective response rate
Description
Evaluate objective response rate in treated patients.
Time Frame
72 Months
Title
Duration of response
Description
Evaluate duration of response in treated patients.
Time Frame
72 Months
Title
Time to progression
Description
Evaluate time to progression in treated patients.
Time Frame
72 Months
Title
Progression-free survival
Description
Evaluate progression-free survival in treated patients.
Time Frame
72 Months
Title
Biomarkers; Phase Ib
Description
Measure the serum levels of the following including but not limited to Interleukin-2 (IL-2), Interleukin-4 (IL-4), Interleukin-6 (IL-6), Interleukin-10 (IL-10), Interferon-gamma (IFN-ɣ), Tumor necrosis factor-alpha (TNF-α) and Monocyte chemoattractant protein-1 (MCP-1)
Time Frame
36 Months
Title
Determine the level of anti-ALT-803 antibodies in patient serum
Description
Determine the level of anti-ALT-803 antibodies in patient serum
Time Frame
36 Months
Title
Area under the plasma concentration-time curve from time zero to infinity (AUC); Phase Ib
Description
Area under the plasma concentration-time curve from time zero to infinity (AUC)
Time Frame
36 Months
Title
Correlation between the level of circulating cell free DNA in patient plasma and response to study treatment
Description
Correlation between the level of circulating cell free DNA in patient plasma and response to study treatment
Time Frame
36 Months
Title
Correlation between the level of tumor DNA in patient plasma and response to study treatment
Description
Correlation between the level of tumor DNA in patient plasma and response to study treatment
Time Frame
36 Months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Inclusion Criteria: Histologically or cytologically confirmed diagnosis of pancreatic cancer. For dose escalation phase (Phase Ib) distant metastatic disease or unresectable disease and not a candidate for down staging to resection. For expansion phase (Phase II) distant metastatic disease only. For dose escalation phase (Phase Ib) 0 or 1 prior lines of chemotherapy for advanced pancreatic cancer. Prior gemcitabine is allowed, however prior nab-paclitaxel is not allowed. For expansion phase (Phase II) no prior therapy for pancreatic cancer is allowed except for adjuvant therapy as long as it was completed ≥ 6 months prior to study treatment start Have at least one untreated and progressing tumor lesion that can be accurately measured according to Response Evaluation Criteria in Solid Tumor Prior radiation is allowed if the index lesion(s) remains outside of the treatment field or has progressed since prior treatment. Radiation therapy must have been completed at least 4 weeks prior to the baseline scan Resolved acute effects of any prior therapy to baseline or Grade ≤1 The Eastern Cooperative Oncology Group (ECOG) Performance Status 0, 1 or 2 Life expectancy ≥12 weeks Glomerular Filtration Rate (GFR) > 40mL (milliliter)/min; Creatinine ≤ 1.5 x ULN (Upper limit of Normal) Platelets ≥100,000/uL (microliter) Hemoglobin ≥ 9g/dL Absolute Lymphocytes ≥800/uL Absolute neutrophil count/absolute granulocyte count ≥1500/uL Total bilirubin ≤ 2.0 X ULN, or ≤ 3.0 X ULN (for patients with Gilbert's Syndrome) aspartate aminotransferase, alanine aminotransferase ≤ 2.5 X ULN, or ≤ 5.0 X ULN (if liver metastasis present) Normal clinical assessment of pulmonary function Negative serum pregnancy test if female and of childbearing potential Subjects, both females and males, with reproductive potential must agree to use effective contraceptive measures for the duration of the study Must provide informed consent and HIPPA authorization and agree to comply with all protocol-specified procedures and follow-up evaluations Exclusion Criteria: No women who are pregnant or nursing No known hypersensitivity to gemcitabine or nab-paclitaxel No concurrent herbal or unconventional therapy No prior therapy with IL-15 or IL-15 analog No ongoing toxicity from prior anti-cancer treatment that may interfere with study treatment. All toxicities attributed to prior anti-cancer therapy other than alopecia and fatigue must resolve to grade 1 or baseline before administration of the study treatment. No positive Hep C serology or active Hep B infection No congestive heart failure < 6 months No unstable angina pectoris < 6 months No myocardial infarction < 6 months No history of ventricular arrhythmias or severe cardiac dysfunction No history of uncontrollable supraventricular arrhythmias No New York Heart Association Class > II congestive heart failure No marked baseline prolongation of QT/QTc interval No known autoimmune disease requiring active treatment. Subjects with a condition requiring systemic treatment with either corticosteroids (>10 mg daily prednisone equivalent) or other immunosuppressive medications within 14 days of enrollment. Inhaled or topical steroids, and adrenal replacement steroid doses ≤ 10 mg daily prednisone equivalent, are permitted in the absence of active autoimmune disease No known prior organ allograft or allogeneic transplantation No known HIV-positive or AIDS unless patient is on a stable highly active antiretroviral therapy (HAART) regimen, have CD4 (cluster of differentiation 4) counts >350, with no detectable viral load on quantitative polymerase chain reaction test No untreated central nervous system metastases, or if treated must be neurologically stable for at least 2 weeks prior to enrollment No corticosteroids, or on a stable or decreasing dose of ≤ 10 mg daily prednisone (or equivalent) No psychiatric illness/social situation that would limit compliance No other illness that in the opinion of the investigator would exclude the subject from participating in the study No active systemic infection requiring parenteral antibiotic therapy No anti-cancer treatment including surgery, radiotherapy, chemotherapy, other immunotherapy, or investigational therapy within 14 days before treatment start No disease requiring systemic immunosuppressive therapy No other prior malignancy is allowed except for the following: adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer, adequately treated Stage I or II cancer from which the patient is currently in complete remission, or any other cancer from which the patient has been disease-free for 3 years after surgical treatment.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Hing C. Wong, Ph.D.
Organizational Affiliation
Altor BioScience
Official's Role
Study Chair
Facility Information:
Facility Name
University of Hawaii Cancer Center
City
Honolulu
State/Province
Hawaii
ZIP/Postal Code
96813
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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QUILT-2.001: ALT-803 in Patients With Advanced Pancreatic Cancer in Conjunction With Gemcitabine and Nab-Paclitaxel

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