Description:
The purpose of this study is to evaluate Gene Mediated Cytotoxic Immunotherapy (GMCI™) in
combination with standard of care chemoradiation and surgery for borderline resectable and
unresectable locally advanced pancreatic cancer in patients who have completed induction
chemotherapy. GMCI kills tumor cells and creates an immune stimulatory environment in the
tumor. Killing tumor cells in an immune stimulatory environment induces the body's immune
system to detect and destroy cancer cells. GMCI has shown synergy with radiation and surgery
without added toxicity. The hypothesis is that GMCI added to standard of care chemoradiation
and surgery after completion of induction chemotherapy will be safe and will improve the
clinical outcome for patients with pancreatic cancer.
Title
- Brief Title: Neoadjuvant GMCI Plus Chemoradiation for Advanced Non-Metastatic Pancreatic Adenocarcinoma
- Official Title: Neoadjuvant GMCI Plus Chemoradiation for Advanced Non-Metastatic Pancreatic Adenocarcinoma
Clinical Trial IDs
- ORG STUDY ID:
PaTK02
- NCT ID:
NCT02446093
Conditions
- Pancreatic Adenocarcinoma
Interventions
Drug | Synonyms | Arms |
---|
GMCI (aglatimagene besadenovec + valacyclovir) | CAN-2409, AdV-tk | Test Arm |
Chemotherapy | | Control Arm |
Purpose
The purpose of this study is to evaluate Gene Mediated Cytotoxic Immunotherapy (GMCI™) in
combination with standard of care chemoradiation and surgery for borderline resectable and
unresectable locally advanced pancreatic cancer in patients who have completed induction
chemotherapy. GMCI kills tumor cells and creates an immune stimulatory environment in the
tumor. Killing tumor cells in an immune stimulatory environment induces the body's immune
system to detect and destroy cancer cells. GMCI has shown synergy with radiation and surgery
without added toxicity. The hypothesis is that GMCI added to standard of care chemoradiation
and surgery after completion of induction chemotherapy will be safe and will improve the
clinical outcome for patients with pancreatic cancer.
Detailed Description
GMCI involves the injection of aglatimagene besadenovec (AdV-tk) into the tumor followed by
oral valacyclovir pills to kill tumor cells and stimulate a cancer vaccine effect. The
current protocol is designed to deliver multiple courses of GMCI in combination with standard
of care chemoradiation and surgery to capitalize on the synergies with the different
treatment modalities.
This protocol includes two phases:
- Phase 1b - completed.
- The Phase 2 is a randomized study comparing a test group receiving GMCI added to
chemoradiation and surgery to a control arm receiving chemoradiation followed by
surgery. Participants will be randomized in a 1:1 ratio to GMCI plus standard of care or
standard of care alone. Both arms receive standard of care treatment and evaluations.
Trial Arms
Name | Type | Description | Interventions |
---|
Test Arm | Experimental | GMCI + chemoradiation + surgery | - GMCI (aglatimagene besadenovec + valacyclovir)
- Chemotherapy
|
Control Arm | Active Comparator | Chemoradiation + surgery | |
Eligibility Criteria
Inclusion Criteria:
- Pathological diagnosis of pancreatic adenocarcinoma adequately treated with induction
chemotherapy for at least 2 months such that they are a candidate for localized
therapy with chemoradiation followed by surgery with or without major vascular
resection.
- Patients must be deemed to be in adequate health to undergo major surgery
(pancreaticoduodenectomy)
- Tumor accessible for injection that is classified as borderline-resectable or locally
advanced but considered potentially resectable after central review by surgical
investigators (based upon pre-induction chemotherapy imaging). Resection may include
major vascular resection with reconstruction as needed.
- Age 18-76 years
- Performance status ECOG 0-1
- SGOT (AST)<3x upper limit of normal
- Total bilirubin ≤2mg/dl
- Creatinine<2mg/dl
- Calculated creatinine clearance >30ml/m
- WBC>3000/mm3
- Absolute neutrophil count (ANC)>1500/mm3
- Platelets>100,000/mm3
- Hemoglobin > 9 g/dL.
- Patients must give study specific informed consent prior to enrollment
Exclusion Criteria:
- Primary hepatic dysfunction including known cirrhosis or active hepatitis. Patients
with biliary obstruction must be stented prior to initiating treatment.
- Evidence of clinically significant pancreatitis as determined by the investigator
- Evidence of significant ascites as determined by the investigator
- Patients on systemic corticosteroids (>10 mg prednisone per day or equivalent) or
other systemic immunosuppressive drugs
- Known to be HIV+
- Pregnant or breast-feeding. Female patients of childbearing age must have negative
serum or urine pregnancy test within 1 week of beginning therapy.
- Other current malignancy (except squamous or basal cell skin cancers)
- Other serious co-morbid illness or compromised organ function
- Known sensitivity or allergic reactions to acyclovir or valacyclovir
Maximum Eligible Age: | 76 Years |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Resection rate |
Time Frame: | 4 months |
Safety Issue: | |
Description: | The percentage of patients receiving an R0 resection will be compared between the two arms. |
Secondary Outcome Measures
Measure: | Overall survival |
Time Frame: | 2 years |
Safety Issue: | |
Description: | The percentage of patients alive at 2 years will be compared between the two arms. |
Measure: | Progression-free survival |
Time Frame: | 2 years |
Safety Issue: | |
Description: | The PFS curves will be estimated using the Kaplan-Meier method. |
Details
Phase: | Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | Candel Therapeutics, Inc. |
Trial Keywords
- pancreas cancer
- immunotherapy
- GMCI
- AdV-tk
- aglatimagene besadenovec
Last Updated
December 7, 2020