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RO4929097 Before Surgery in Treating Patients With Pancreatic Cancer

Primary Purpose

Adenocarcinoma of the Pancreas, Stage IA Pancreatic Cancer, Stage IB Pancreatic Cancer

Status
Terminated
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
gamma-secretase/Notch signalling pathway inhibitor RO4929097
laboratory biomarker analysis
pharmacological study
neoadjuvant therapy
therapeutic conventional surgery
Sponsored by
National Cancer Institute (NCI)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Adenocarcinoma of the Pancreas

Eligibility Criteria

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

Inclusion Criteria:

  • Histologically or cytologically confirmed pancreatic adenocarcinoma

    • T1-3, N0-1, and M0 disease
  • Surgically resectable disease confirmed by a surgeon experienced in pancreatic surgery

    • No borderline resectable disease defined as any of the following:

      • Tumors with severe unilateral or bilateral SMV/portal involvement impingement
      • Abutment (or) encasement of hepatic artery
      • SMA or celiac encasement (or) presence of SMV occlusion by tumor
  • No metastatic disease
  • ECOG performance status 0-1
  • Life expectancy > 6 months
  • WBC ≥ 3,000/mm³
  • ANC ≥ 1,500/mm³
  • Platelet count ≥ 100,000/mm³
  • Hemoglobin ≥ 9 g/dL
  • Total bilirubin ≤ 2 mg/dL
  • AST and ALT ≤ 2.5 times upper limit of normal
  • Creatinine ≤ 2 mg/dL
  • Calcium, magnesium, phosphorous, and potassium normal
  • Negative pregnancy test
  • Not pregnant or nursing
  • Fertile patients must use effective barrier-method contraception 4 weeks before, during, and for ≥ 12 months after completion of treatment
  • Able to swallow tablets
  • No malabsorption syndrome or other condition that would interfere with intestinal absorption
  • No history of allergic reactions attributed to compounds of similar chemical or biologic composition to gamma-secretase inhibitor RO4929097 or other agents used in the study
  • No uncontrolled hypocalcemia, hypomagnesemia, hyponatremia, hypophosphatemia, or hypokalemia despite adequate electrolyte supplementation

    • Grade 1 hyponatremia with sodium ≤ 131 mg/dL is permissible
  • No uncontrolled intercurrent illness including, but not limited to, any of the following:

    • Ongoing or active infection
    • Symptomatic congestive heart failure
    • Unstable angina pectoris
    • Cardiac arrhythmia other than chronic
    • Stable atrial fibrillation
    • Psychiatric illness/social situations that would limit compliance with study requirements
  • No baseline QTcF > 450 msec (male) or QTcF > 470 msec (female)
  • Patients with a prior cancer with evidence of active cancer are excluded from this study

    • Patients with a prior cancer are permitted to enter this study as long as there is no documented evidence of active malignancy
  • No uncontrolled electrolyte abnormalities including hypocalcemia, hypomagnesemia, and hypokalemia
  • No symptomatic congestive heart failure, unstable angina pectoris, and a history of torsades de pointes or other significant cardiac arrhythmias
  • No requirement for antiarrhythmics or other medications known to prolong QTc
  • No other concurrent anticancer agents or therapies
  • Recovered to < grade 2 toxicity related to prior therapy
  • No prior chemotherapy or radiotherapy for pancreatic cancer
  • No other concurrent investigational agents
  • No concurrent medications with narrow therapeutic indices that are metabolized by cytochrome P450 (CYP450), including warfarin sodium (Coumadin®), ketoconazole, or grapefruit juice
  • No concurrent strong inducers or inhibitors of CYP3A4
  • No concurrent combination antiretroviral therapy for HIV-positive patients

Sites / Locations

  • Tower Cancer Research Foundation
  • City of Hope Medical Center
  • University of Chicago Comprehensive Cancer Center
  • Illinois CancerCare-Peoria
  • Central Illinois Hematology Oncology Center
  • Fort Wayne Medical Oncology and Hematology Inc - State Boulevard

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Arm I

Arm Description

Patients receive oral gamma-secretase inhibitor RO4929097 on days 1-3 and 8-10 in the absence of disease progression or unacceptable toxicity. Beginning 7 days after completion of gamma-secretase inhibitor RO4929097, patients undergo complete resection comprising pancreaticoduodenectomy, distal pancreatectomy, or total pancreatectomy based on the anatomic location of the cancer. Tumor tissue from biopsy and surgery and blood samples are collected periodically for pharmacodynamic studies.

Outcomes

Primary Outcome Measures

Notch activity (expression of Hes-1)
Summarized as a binary endpoint for both the RO4929097 population and the stage-matched controls by the proportion and 95% exact binomial confidence interval.
Frequency and severity of adverse events as measured by the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE)
Toxicity will be determined with a 95% exact binomial confidence interval.

Secondary Outcome Measures

Proportion of cancer stem cells (CD44+, CD24+, ESA+ population of cells) self-renewal and tumorigenesis as measured by FACS

Full Information

First Posted
August 31, 2010
Last Updated
September 27, 2013
Sponsor
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT01192763
Brief Title
RO4929097 Before Surgery in Treating Patients With Pancreatic Cancer
Official Title
A Neoadjuvant Pharmacodynamic Study Of RO4929097 (RO) in Pancreas Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
September 2013
Overall Recruitment Status
Terminated
Study Start Date
August 2010 (undefined)
Primary Completion Date
January 2012 (Actual)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
This phase I trial is studying the side effects of RO4929097 before surgery in treating patients with pancreatic cancer. RO4929097 may stop the growth of tumor cells by blocking some enzymes needed for cell growth. Giving RO4929097 before surgery may make the tumor smaller and reduce the amount of normal tissue that needs to be removed.
Detailed Description
PRIMARY OBJECTIVES: I. To evaluate the effects of neoadjuvant gamma-secretase inhibitor RO4929097 on Notch inhibition via interrogation of Hes-1 expression in patients with pancreatic cancer. SECONDARY OBJECTIVES: I. To evaluate the effects of this regimen on pancreatic cancer stem cell self-renewal and tumorigenesis as compared to pancreatic stem cells from controls (patients who do not receive treatment). II. To evaluate the safety of this regimen in these patients. OUTLINE: This is a multicenter study. Patients receive oral gamma-secretase inhibitor RO4929097 on days 1-3 and 8-10 in the absence of disease progression or unacceptable toxicity. Beginning 7 days after completion of gamma-secretase inhibitor RO4929097, patients undergo complete resection comprising pancreaticoduodenectomy, distal pancreatectomy, or total pancreatectomy based on the anatomic location of the cancer. Tumor tissue from biopsy and surgery and blood samples are collected periodically for pharmacodynamic studies. After completion of study therapy, patients are followed up every 6 months for 1 year.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Adenocarcinoma of the Pancreas, Stage IA Pancreatic Cancer, Stage IB Pancreatic Cancer, Stage IIA Pancreatic Cancer, Stage IIB Pancreatic Cancer

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Arm I
Arm Type
Experimental
Arm Description
Patients receive oral gamma-secretase inhibitor RO4929097 on days 1-3 and 8-10 in the absence of disease progression or unacceptable toxicity. Beginning 7 days after completion of gamma-secretase inhibitor RO4929097, patients undergo complete resection comprising pancreaticoduodenectomy, distal pancreatectomy, or total pancreatectomy based on the anatomic location of the cancer. Tumor tissue from biopsy and surgery and blood samples are collected periodically for pharmacodynamic studies.
Intervention Type
Drug
Intervention Name(s)
gamma-secretase/Notch signalling pathway inhibitor RO4929097
Other Intervention Name(s)
R4733, RO4929097
Intervention Description
Given orally
Intervention Type
Other
Intervention Name(s)
laboratory biomarker analysis
Intervention Description
Correlative studies
Intervention Type
Other
Intervention Name(s)
pharmacological study
Other Intervention Name(s)
pharmacological studies
Intervention Description
Correlative studies
Intervention Type
Procedure
Intervention Name(s)
neoadjuvant therapy
Intervention Type
Procedure
Intervention Name(s)
therapeutic conventional surgery
Primary Outcome Measure Information:
Title
Notch activity (expression of Hes-1)
Description
Summarized as a binary endpoint for both the RO4929097 population and the stage-matched controls by the proportion and 95% exact binomial confidence interval.
Time Frame
Up to day 3 (of course 1)
Title
Frequency and severity of adverse events as measured by the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE)
Description
Toxicity will be determined with a 95% exact binomial confidence interval.
Time Frame
Up to 1 year
Secondary Outcome Measure Information:
Title
Proportion of cancer stem cells (CD44+, CD24+, ESA+ population of cells) self-renewal and tumorigenesis as measured by FACS
Time Frame
Up to day 3 (of course 1)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically or cytologically confirmed pancreatic adenocarcinoma T1-3, N0-1, and M0 disease Surgically resectable disease confirmed by a surgeon experienced in pancreatic surgery No borderline resectable disease defined as any of the following: Tumors with severe unilateral or bilateral SMV/portal involvement impingement Abutment (or) encasement of hepatic artery SMA or celiac encasement (or) presence of SMV occlusion by tumor No metastatic disease ECOG performance status 0-1 Life expectancy > 6 months WBC ≥ 3,000/mm³ ANC ≥ 1,500/mm³ Platelet count ≥ 100,000/mm³ Hemoglobin ≥ 9 g/dL Total bilirubin ≤ 2 mg/dL AST and ALT ≤ 2.5 times upper limit of normal Creatinine ≤ 2 mg/dL Calcium, magnesium, phosphorous, and potassium normal Negative pregnancy test Not pregnant or nursing Fertile patients must use effective barrier-method contraception 4 weeks before, during, and for ≥ 12 months after completion of treatment Able to swallow tablets No malabsorption syndrome or other condition that would interfere with intestinal absorption No history of allergic reactions attributed to compounds of similar chemical or biologic composition to gamma-secretase inhibitor RO4929097 or other agents used in the study No uncontrolled hypocalcemia, hypomagnesemia, hyponatremia, hypophosphatemia, or hypokalemia despite adequate electrolyte supplementation Grade 1 hyponatremia with sodium ≤ 131 mg/dL is permissible No uncontrolled intercurrent illness including, but not limited to, any of the following: Ongoing or active infection Symptomatic congestive heart failure Unstable angina pectoris Cardiac arrhythmia other than chronic Stable atrial fibrillation Psychiatric illness/social situations that would limit compliance with study requirements No baseline QTcF > 450 msec (male) or QTcF > 470 msec (female) Patients with a prior cancer with evidence of active cancer are excluded from this study Patients with a prior cancer are permitted to enter this study as long as there is no documented evidence of active malignancy No uncontrolled electrolyte abnormalities including hypocalcemia, hypomagnesemia, and hypokalemia No symptomatic congestive heart failure, unstable angina pectoris, and a history of torsades de pointes or other significant cardiac arrhythmias No requirement for antiarrhythmics or other medications known to prolong QTc No other concurrent anticancer agents or therapies Recovered to < grade 2 toxicity related to prior therapy No prior chemotherapy or radiotherapy for pancreatic cancer No other concurrent investigational agents No concurrent medications with narrow therapeutic indices that are metabolized by cytochrome P450 (CYP450), including warfarin sodium (Coumadin®), ketoconazole, or grapefruit juice No concurrent strong inducers or inhibitors of CYP3A4 No concurrent combination antiretroviral therapy for HIV-positive patients
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Edward Kim
Organizational Affiliation
University of Chicago Comprehensive Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Tower Cancer Research Foundation
City
Beverly Hills
State/Province
California
ZIP/Postal Code
90211-1850
Country
United States
Facility Name
City of Hope Medical Center
City
Duarte
State/Province
California
ZIP/Postal Code
91010
Country
United States
Facility Name
University of Chicago Comprehensive Cancer Center
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60637-1470
Country
United States
Facility Name
Illinois CancerCare-Peoria
City
Peoria
State/Province
Illinois
ZIP/Postal Code
61615
Country
United States
Facility Name
Central Illinois Hematology Oncology Center
City
Springfield
State/Province
Illinois
ZIP/Postal Code
60702
Country
United States
Facility Name
Fort Wayne Medical Oncology and Hematology Inc - State Boulevard
City
Fort Wayne
State/Province
Indiana
ZIP/Postal Code
46845
Country
United States

12. IPD Sharing Statement

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RO4929097 Before Surgery in Treating Patients With Pancreatic Cancer

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