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Study of Combined SGT-53 Plus Gemcitabine/Nab-Paclitaxel for Metastatic Pancreatic Cancer

Primary Purpose

Metastatic Pancreatic Cancer

Status
Recruiting
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
SGT-53
nab-paclitaxel
Gemcitabine
Sponsored by
SynerGene Therapeutics, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Metastatic Pancreatic Cancer

Eligibility Criteria

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

Inclusion Criteria:

  • Patients with histologic or cytologic diagnosis of stage IV metastatic pancreatic adenocarcinoma.
  • One or more tumors measurable on CT scan.
  • Eastern Cooperative Oncology Group (ECOG) performance status ≤ 1.
  • Life expectancy of at least 3 months.
  • Age ≥ 18 years.
  • Signed, written IRB-approved informed consent.
  • A negative pregnancy test (if female and of child-bearing potential).
  • Acceptable liver function:

    • Bilirubin ≤ 1.5 times upper limit of normal
    • AST (SGOT), ALT (SGPT) ≤ 3.0 x ULN
    • Serum creatinine ≤ 1.5 X ULN
  • Acceptable hematologic status:

    • Absolute neutrophil count ≥ 1500 cells/mm³
    • Platelet count ≥ 100,000 (plt/mm³)
    • Hemoglobin ≥ 10 g/dL
  • Acceptable blood sugar control

    *Fasting glucose value ≤ 160 mg/dL

  • Urinalysis: No clinically significant abnormalities.
  • PT and PTT ≤ 1.5 X ULN
  • For men and women of child-producing potential, willingness to use of effective contraceptive methods during the study.
  • NOT have received any prior cytotoxic chemotherapy or investigational therapy. However, this study may be used as 2nd line treatment of patients who progressed on or were intolerant of 1st line FOLFIRINOX for the primary or metastatic disease. Prior treatment with gemcitabine administered as radiation sensitizer in the adjuvant setting is allowed, provided at least 6 months have elapsed since completion of the last dose and no lingering toxicities are present.
  • They also must NOT have received chemotherapy, radiotherapy, surgery or investigational therapy for the treatment of metastatic disease.
  • Organ function characterized by ≤ Grade 1.

Exclusion Criteria:

  • Patient has received any prior cytotoxic chemotherapy for pancreatic cancer with the exception of patients who progressed on or were intolerant of 1st line FOLFIRINOX in primary or metastatic disease. Prior treatment with gemcitabine administered as a radiation sensitizer in the adjuvant setting is allowed, provided at least 6 months have elapsed since completion of the last dose and no lingering toxicities are present. Patients who previously had and were treated with standard therapy for non-pancreatic cancer will be evaluated for entry into the trial on a case-by-case basis.
  • New York Heart Association Class III or IV, cardiac disease, myocardial infarction within the past 6 months, unstable arrhythmia, unstable angina (chest pain greater than three times weekly while on therapy), evidence of ischemia on ECG, or abnormal stress echocardiogram with evidence of ischemia, or LVEF < 50%.
  • Active, uncontrolled bacterial, viral, or fungal infections, requiring systemic therapy.
  • Treated with antibiotics for infection within one week prior to study entry.
  • Fever (> 38.1°C)
  • Have hematological malignancy
  • Have diastolic blood pressure of > 90 mm Hg resting at baseline despite medication.
  • Pregnant or nursing women.
  • Treatment with surgery, or investigational therapy within 28 days prior to study entry or radiation therapy within 6 months prior to study entry.
  • Have received chemotherapy, radiotherapy, surgery or investigational therapy for the treatment of metastatic disease.
  • Unwillingness or inability to comply with procedures required in this protocol.
  • Known infection with HIV, Hepatitis B, or Hepatitis C.
  • Serious nonmalignant disease that could compromise protocol objectives in the opinion of the Investigator and/or the Sponsor.
  • Patients who are currently receiving any other investigational agent.
  • Patients who are currently taking Coumadin or Coumadin derivatives other than to maintain patency of venous access lines.
  • Receiving systemic steroids or other chronic immunosuppressive medications within 30 days prior to study entry
  • Receiving hematopoietic growth factors on a regular basis
  • Had within six months prior to enrollment any of the following:

    • Cerebrovascular accident
    • Uncontrolled congestive heart failure
  • Have significant baseline neuropathies
  • Requires renal dialysis
  • Had prior exposure to gene vector delivery products
  • Had previously experienced a severe hypersensitivity reaction to gemcitabine or nab-paclitaxel

Sites / Locations

  • Mary Crowley Cancer Research CenterRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

SGT-53 with gemcitabine/nab-paclitaxel

Arm Description

A course of therapy will include 7 weeks of treatment. SGT-53, at 3.6 mg DNA/infusion, will be administered bi-weekly on days 1 and 5 in weeks 1-3, weekly on day 3 in week 4, and weekly on day 1 in weeks 5-7. Patients who are responding to treatment may receive two additional courses (7 weeks) of SGT-53/gemcitabine/nab-paclitaxel therapy at investigator discretion. If still responding to treatment, they may continue on SGT-53/gemcitabine/nab-paclitaxel at investigator discretion with the approval of the sponsor.

Outcomes

Primary Outcome Measures

Progression free survival (PFS) at 5.5 months
PFS5.5mos will be assessed by objective radiographic assessment
Objective response rate (ORR)
ORR will be assessed by objective radiographic assessment using RECIST 1.1 criteria

Secondary Outcome Measures

Progression free survival (PFS)
Progression free survival (PFS) will be defined as the time from registration until confirmed tumor progression or death, whichever occurs first.
Overall survival (OS)
Survival will be defined as the time from the date of registration to the date of death (any cause).
Time to disease progression (TTP)
Time to disease progression is defined as the time from registration until confirmed tumor progression, but not including deaths.
Disease control rate (DCR)
Disease control rate (SD for ≥16 weeks plus CR and PR) will be analyzed using Kaplan-Meier methods.
Duration of disease control
Disease control duration is measured from the time of registration until documented confirmed tumor progression.
Adverse events
Safety will be evaluated by the incidence of treatment-emergent adverse events (AEs) and serious adverse events (SAEs), physical examination, laboratory abnormalities during study drug dosing and percentage of patients experiencing dose modifications, interruptions, and/or discontinuation.

Full Information

First Posted
December 18, 2014
Last Updated
February 7, 2022
Sponsor
SynerGene Therapeutics, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT02340117
Brief Title
Study of Combined SGT-53 Plus Gemcitabine/Nab-Paclitaxel for Metastatic Pancreatic Cancer
Official Title
Phase II Study of Combined Targeted p53 Gene Therapy (SGT-53) Plus Gemcitabine/Nab-Paclitaxel for Treatment of Metastatic Pancreatic Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
February 2022
Overall Recruitment Status
Recruiting
Study Start Date
January 2015 (undefined)
Primary Completion Date
December 2022 (Anticipated)
Study Completion Date
December 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
SynerGene Therapeutics, Inc.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This clinical trial is an open label Phase II study of the combination of intravenously administered SGT-53 and gemcitabine/nab-paclitaxel in patients with metastatic pancreatic cancer. The objective of the study is to evaluate the safety, tolerability, toxicity and efficacy (specifically Progression Free Survival at 5.5 month (PFS5.5mos)) of this combination therapy.
Detailed Description
The p53 is a vital human tumor suppressor gene. Loss of p53 suppressor function is present in the majority of human cancers. The p53 protein has a diverse range of functions including regulation of cell cycle checkpoints, cell death (apoptosis), senescence, DNA repair, maintenance of genomic integrity, and control of angiogenesis. Abnormalities of the p53 gene may impact the efficacy of standard anticancer treatments such as radiation and chemotherapy. P53 mutation and pathway dysfunction are associated with poor clinical outcomes and the presence of the p53 mutation correlates with resistance to chemotherapy and radiation. The development of somatic gene therapy has created the potential to restore wild type function of p53. SGT-53 is a complex of cationic liposome encapsulating a normal human wild type p53 DNA sequence in a plasmid backbone. This complex has been shown to efficiently and specifically deliver the p53 cDNA to the tumor cells. Introduction of the p53 cDNA sequence is expected to restore wtp53 function in the apoptotic pathway. P53 restoration has been shown most effective in enhancing cytotoxicity in combination with an agent which results in DNA damage or initiates apoptosis. This is a Phase II clinical trial of SGT-53 plus the recently approved chemotherapeutic combination of gemcitabine/Abraxane® (nab-paclitaxel) in patients with confirmed metastatic pancreatic cancer. In addition to determining Progression Free Survival at 5.5 months (PFS5.5mos), this trial will evaluate the response rate, overall survival and time to progression as well as the tolerability and safety of SGT-53 in combination with gemcitabine/nab-paclitaxel.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
28 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
SGT-53 with gemcitabine/nab-paclitaxel
Arm Type
Experimental
Arm Description
A course of therapy will include 7 weeks of treatment. SGT-53, at 3.6 mg DNA/infusion, will be administered bi-weekly on days 1 and 5 in weeks 1-3, weekly on day 3 in week 4, and weekly on day 1 in weeks 5-7. Patients who are responding to treatment may receive two additional courses (7 weeks) of SGT-53/gemcitabine/nab-paclitaxel therapy at investigator discretion. If still responding to treatment, they may continue on SGT-53/gemcitabine/nab-paclitaxel at investigator discretion with the approval of the sponsor.
Intervention Type
Genetic
Intervention Name(s)
SGT-53
Intervention Description
The dose of SGT-53 will be 3.6 mg DNA/infusion. If necessary, the dose of SGT-53 can be de-escalated to 2.4 mg, 1.2 mg or 0.6 mg DNA per infusion in the event that increased toxicity probably or definitely related to SGT-53 is observed with the combination.
Intervention Type
Drug
Intervention Name(s)
nab-paclitaxel
Other Intervention Name(s)
Abraxane ABI-007, Albumin-bound paclitaxel
Intervention Description
The dose of nab-paclitaxel will be 125 mg/m² and will be administered once weekly (day 3) in weeks 1, 2, 3, 5, 6 and 7. If increased toxicities related to administration of nab-paclitaxel is observed, the dose of nab-paclitaxel can be reduced to 100 or 75 mg/m² when appropriate.
Intervention Type
Drug
Intervention Name(s)
Gemcitabine
Other Intervention Name(s)
Gemzar
Intervention Description
The dose of gemcitabine will be 1000 mg/m² and will be administered once weekly (day 3) in weeks 1, 2, 3, 5, 6 and 7, after the administration of nab-paclitaxel. If increased toxicities related to administration of gemcitabine is observed, the dose of gemcitabine can be reduced to 800 or 600 mg/m² when appropriate.
Primary Outcome Measure Information:
Title
Progression free survival (PFS) at 5.5 months
Description
PFS5.5mos will be assessed by objective radiographic assessment
Time Frame
5.5 months
Title
Objective response rate (ORR)
Description
ORR will be assessed by objective radiographic assessment using RECIST 1.1 criteria
Time Frame
Up to 5 years
Secondary Outcome Measure Information:
Title
Progression free survival (PFS)
Description
Progression free survival (PFS) will be defined as the time from registration until confirmed tumor progression or death, whichever occurs first.
Time Frame
Up to 5 years
Title
Overall survival (OS)
Description
Survival will be defined as the time from the date of registration to the date of death (any cause).
Time Frame
Up to 5 years
Title
Time to disease progression (TTP)
Description
Time to disease progression is defined as the time from registration until confirmed tumor progression, but not including deaths.
Time Frame
Up to 5 years
Title
Disease control rate (DCR)
Description
Disease control rate (SD for ≥16 weeks plus CR and PR) will be analyzed using Kaplan-Meier methods.
Time Frame
16 weeks
Title
Duration of disease control
Description
Disease control duration is measured from the time of registration until documented confirmed tumor progression.
Time Frame
Up to 5 years
Title
Adverse events
Description
Safety will be evaluated by the incidence of treatment-emergent adverse events (AEs) and serious adverse events (SAEs), physical examination, laboratory abnormalities during study drug dosing and percentage of patients experiencing dose modifications, interruptions, and/or discontinuation.
Time Frame
Study drug initiation through 30 days after the last dose of study drug or end of treatment, whichever is later.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients with histologic or cytologic diagnosis of stage IV metastatic pancreatic adenocarcinoma. One or more tumors measurable on CT scan. Eastern Cooperative Oncology Group (ECOG) performance status ≤ 1. Life expectancy of at least 3 months. Age ≥ 18 years. Signed, written IRB-approved informed consent. A negative pregnancy test (if female and of child-bearing potential). Acceptable liver function: Bilirubin ≤ 1.5 times upper limit of normal AST (SGOT), ALT (SGPT) ≤ 3.0 x ULN Serum creatinine ≤ 1.5 X ULN Acceptable hematologic status: Absolute neutrophil count ≥ 1500 cells/mm³ Platelet count ≥ 100,000 (plt/mm³) Hemoglobin ≥ 10 g/dL Acceptable blood sugar control *Fasting glucose value ≤ 160 mg/dL Urinalysis: No clinically significant abnormalities. PT and PTT ≤ 1.5 X ULN For men and women of child-producing potential, willingness to use of effective contraceptive methods during the study. NOT have received any prior cytotoxic chemotherapy or investigational therapy. However, this study may be used as 2nd line treatment of patients who progressed on or were intolerant of 1st line FOLFIRINOX for the primary or metastatic disease. Prior treatment with gemcitabine administered as radiation sensitizer in the adjuvant setting is allowed, provided at least 6 months have elapsed since completion of the last dose and no lingering toxicities are present. They also must NOT have received chemotherapy, radiotherapy, surgery or investigational therapy for the treatment of metastatic disease. Organ function characterized by ≤ Grade 1. Exclusion Criteria: Patient has received any prior cytotoxic chemotherapy for pancreatic cancer with the exception of patients who progressed on or were intolerant of 1st line FOLFIRINOX in primary or metastatic disease. Prior treatment with gemcitabine administered as a radiation sensitizer in the adjuvant setting is allowed, provided at least 6 months have elapsed since completion of the last dose and no lingering toxicities are present. Patients who previously had and were treated with standard therapy for non-pancreatic cancer will be evaluated for entry into the trial on a case-by-case basis. New York Heart Association Class III or IV, cardiac disease, myocardial infarction within the past 6 months, unstable arrhythmia, unstable angina (chest pain greater than three times weekly while on therapy), evidence of ischemia on ECG, or abnormal stress echocardiogram with evidence of ischemia, or LVEF < 50%. Active, uncontrolled bacterial, viral, or fungal infections, requiring systemic therapy. Treated with antibiotics for infection within one week prior to study entry. Fever (> 38.1°C) Have hematological malignancy Have diastolic blood pressure of > 90 mm Hg resting at baseline despite medication. Pregnant or nursing women. Treatment with surgery, or investigational therapy within 28 days prior to study entry or radiation therapy within 6 months prior to study entry. Have received chemotherapy, radiotherapy, surgery or investigational therapy for the treatment of metastatic disease. Unwillingness or inability to comply with procedures required in this protocol. Known infection with HIV, Hepatitis B, or Hepatitis C. Serious nonmalignant disease that could compromise protocol objectives in the opinion of the Investigator and/or the Sponsor. Patients who are currently receiving any other investigational agent. Patients who are currently taking Coumadin or Coumadin derivatives other than to maintain patency of venous access lines. Receiving systemic steroids or other chronic immunosuppressive medications within 30 days prior to study entry Receiving hematopoietic growth factors on a regular basis Had within six months prior to enrollment any of the following: Cerebrovascular accident Uncontrolled congestive heart failure Have significant baseline neuropathies Requires renal dialysis Had prior exposure to gene vector delivery products Had previously experienced a severe hypersensitivity reaction to gemcitabine or nab-paclitaxel
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Referral Office
Phone
972-566-3000
Email
referral@marycrowley.org
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Minal Barve, MD
Organizational Affiliation
Mary Crowley Cancer Research Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Mary Crowley Cancer Research Center
City
Dallas
State/Province
Texas
ZIP/Postal Code
75201
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Alyssa Roth
Phone
972-566-3061
Email
aroth@marycrowley.org

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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Study of Combined SGT-53 Plus Gemcitabine/Nab-Paclitaxel for Metastatic Pancreatic Cancer

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