Clinical Trials /

Epacadostat, Pembrolizumab, and CRS-207, With or Without CY/GVAX Pancreas in Patients With Metastatic Pancreas Cancer

NCT03006302

Description:

This study will enroll patients who have metastatic pancreatic cancer and have progressed on prior chemotherapy. Part 1 (dose escalation) participants will receive epacadostat/pembrolizumab/cyclophosphamide(CY)/GVAX pancreas vaccine followed by epacadostat/pembrolizumab/CRS-207, Part 1X (dose escalation) participants will receive epacadostat/pembrolizumab/CRS-207. Part 2X (dose expansion) participants will receive epacadostat/pembrolizumab/CRS-207. The primary objectives of this study are to determine the recommended dose of epacadostat in this combination and assess survival of subjects in both treatment groups.

Related Conditions:
  • Pancreatic Adenocarcinoma
Recruiting Status:

Recruiting

Phase:

Phase 2

Trial Eligibility

Document

Title

  • Brief Title: Epacadostat, Pembrolizumab, and CRS-207, With or Without CY/GVAX Pancreas in Patients With Metastatic Pancreas Cancer
  • Official Title: Phase 2 Study of Epacadostat, Pembrolizumab, and CRS-207, With or Without Cyclophosphamide and GVAX Pancreas Vaccine in Patients With Metastatic Pancreas Cancer

Clinical Trial IDs

  • ORG STUDY ID: J16173
  • SECONDARY ID: IRB00118520
  • NCT ID: NCT03006302

Conditions

  • Metastatic Pancreatic Adenocarcinoma

Interventions

DrugSynonymsArms
EpacadostatINCB024360Epacadostat/Pembrolizumab/CRS-207
PembrolizumabMK-3475, anti-PD-1 mAbEpacadostat/Pembrolizumab/CRS-207
CRS-207Epacadostat/Pembrolizumab/CRS-207
CYcyclophosphamide, cytoxanEpacadostat/Pembrolizumab/CY/GVAX/CRS-207
GVAXGVAX Pancreas Vaccine, Panc 10.05 pcDNA-1/GM-Neo, Panc 6.03 pcDNA-1/GM-NeoEpacadostat/Pembrolizumab/CY/GVAX/CRS-207

Purpose

This study will enroll patients who have metastatic pancreatic cancer and have progressed on prior chemotherapy. Part 1 (dose escalation) participants will receive epacadostat/pembrolizumab/cyclophosphamide(CY)/GVAX pancreas vaccine followed by epacadostat/pembrolizumab/CRS-207, Part 1X (dose escalation) participants will receive epacadostat/pembrolizumab/CRS-207. Part 2X (dose expansion) participants will receive epacadostat/pembrolizumab/CRS-207. The primary objectives of this study are to determine the recommended dose of epacadostat in this combination and assess survival of subjects in both treatment groups.

Trial Arms

NameTypeDescriptionInterventions
Epacadostat/Pembrolizumab/CY/GVAX/CRS-207Experimental
  • Epacadostat
  • Pembrolizumab
  • CRS-207
  • CY
  • GVAX
Epacadostat/Pembrolizumab/CRS-207Experimental
  • Epacadostat
  • Pembrolizumab
  • CRS-207

Eligibility Criteria

        Inclusion Criteria (abbreviated):

          -  Documented adenocarcinoma of the pancreas

          -  Have disease progression after prior chemotherapy for metastatic pancreas cancer (or
             adjuvant or neoadjuvant if progression occurred within 6 months of completing this
             regimen)

          -  Presence of at least one measurable lesion

          -  Patient acceptance to have a tumor biopsy of an accessible lesion at 2 time points
             (baseline and on study)

          -  ECOG performance status of 0 or 1

          -  Life expectancy of greater than 3 months

          -  Adequate organ and marrow function defined by study-specified laboratory tests

        Exclusion Criteria (abbreviated):

          -  Brain metastases

          -  Clinical or radiographic ascites (some trace amount may be allowed)

          -  Rapidly progressing disease

          -  Live vaccine within 30 days of study treatment (flu vaccine allowed)

          -  Surgery within 28 days of study treatment (some exceptions for minor procedures)

          -  Use of an investigational agent or device within 28 days of study treatment.

          -  Chemotherapy, radiation, or biological cancer therapy within 14 days of study
             treatment.

          -  Prior treatment with anti-CTLA-4, anti-PD-1, anti-PD-L1, or anti PD-L2, or with IDO
             inhibitor.

          -  Use of growth factors within 14 days of study treatment

          -  Use of any systemic steroids within 14 days of study treatment or other
             immunosuppressive agents within 7 days of study treatment.

          -  Use of more than 2 g/day of acetaminophen

          -  Use of any UGT1A9 inhibitor

          -  Use of warfarin

          -  Use of MAOIs or drugs with significant MAOI activity within the 21 days of screening

          -  History of Seratonin Syndome

          -  Known allergy to both penicillin and sulfa

          -  Known or suspected hypersensitivity to any monoclonal antibody or any study drug
             component

          -  Have artificial joints or implants that cannot be easily removed or a history of
             infection associated with an implant

          -  Significant or malignant pleural effusion

          -  New pulmonary embolism, extremity deep venous thromboembolism, or portal vein
             thrombosis within 2 months of study enrollment

          -  History of autoimmune disease (exceptions for Graves or Hashimoto's disease, vitiligo,
             and type I diabetes mellitus)

          -  Gastrointestinal condition that may affect drug absorption

          -  Significant heart disease or heart disease requiring antibiotic for prevention of
             endocarditis

          -  History of abnormal electrocardiogram (ECG) that is deemed meaningful by the
             investigator

          -  History of (non-infectious) pneumonitis that required steroids, evidence of
             interstitial lung disease or active, non-infectious pneumonitis

          -  Pulse oximetry of < 92% on room air or the need for supplemental home oxygen

          -  Infection with HIV, hepatitis B or hepatitis C

          -  Other conditions, including alcohol or drug dependence, intercurrent illness, or lack
             of sufficient peripheral venous access that would affect the patient's ability to
             comply with study visits and procedures

          -  Pregnant or breastfeeding women

          -  Unwillingness or inability to follow the study schedule for any reason
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Recommended Dose of Epacadostat
Time Frame:1 year
Safety Issue:
Description:Evaluate 4 dose levels of epacadostat, in order to determine recommended dose for use in combination with pembrolizumab, CY, GVAX, and CRS-207

Secondary Outcome Measures

Measure:Number of patients experiencing treatment related toxicities
Time Frame:4 years
Safety Issue:
Description:
Measure:Overall Survival (OS)
Time Frame:4 years
Safety Issue:
Description:Average time from randomization to death due to any cause
Measure:Progression Free Survival (PFS)
Time Frame:4 years
Safety Issue:
Description:Average time from randomization to disease progression (by RECIST 1.1) or death, whichever comes first
Measure:immune-related Progression Free Survival (irPFS)
Time Frame:4 years
Safety Issue:
Description:Average time from randomization to disease progression (by irRC) or death, whichever comes first.
Measure:Objective Response Rate (ORR)
Time Frame:4 years
Safety Issue:
Description:Proportion of subjects who achieve a Complete Response (CR) or Partial Response (PR) by RECIST 1.1
Measure:immune-related Objective Response Rate (irORR)
Time Frame:4 years
Safety Issue:
Description:Proportion of subjects who achieve a Complete Response (CR) or Partial Response (PR) by irRC
Measure:Best Overall Response (BOR)
Time Frame:4 years
Safety Issue:
Description:Summary of the best response (by RECIST 1.1) achieved by each patient
Measure:immune-related Best Overall Response (irBOR)
Time Frame:4 years
Safety Issue:
Description:Summary of the best response (by irRC) achieved by each patient
Measure:Time to Objective Response (TTOR)
Time Frame:4 years
Safety Issue:
Description:Average time from randomization to partial or complete response by RECIST 1.1
Measure:immune-related Time to Objective Response (irTTOR)
Time Frame:4 years
Safety Issue:
Description:Average time from randomization to partial or complete response by irRC
Measure:Duration of Response (DOR)
Time Frame:4 years
Safety Issue:
Description:Average time from partial or complete response to disease progression, by RECIST 1.1
Measure:immune-related Duration of Response (irDOR)
Time Frame:4 years
Safety Issue:
Description:Average time from partial or complete response to disease progression, by irRC
Measure:Duration of Clinical Benefit (DCB)
Time Frame:4 years
Safety Issue:
Description:Average time from randomization to date of disease progression in subjects achieving a partial or complete response by RECIST 1.1
Measure:immune-related Duration of Clinical Benefit (irDCB)
Time Frame:4 years
Safety Issue:
Description:Average time from randomization to date of disease progression in subjects achieving a partial or complete response by RECIST 1.1
Measure:Disease Control Rate (DCR)
Time Frame:4 years
Safety Issue:
Description:Percentage of subjects achieving stable disease or better by RECIST 1.1
Measure:immune-related Disease Control Rate (irDCR)
Time Frame:4 years
Safety Issue:
Description:Percentage of subjects achieving stable disease or better by irRC
Measure:Tumor Marker (CA19-9) Kinetics
Time Frame:4 years
Safety Issue:
Description:

Details

Phase:Phase 2
Primary Purpose:Interventional
Overall Status:Recruiting
Lead Sponsor:Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

Trial Keywords

  • pancreatic cancer
  • vaccine
  • immunotherapy
  • MK-3475
  • PD-1
  • IDO

Last Updated

August 20, 2021