Description:
This phase-2 monocenter non-randomized prospective clinical trial evaluates the effectiveness of minimally invasive microwave ablation plus immunotherapy for unresectable non-metastatic locally advanced pancreatic cancer.
This phase-2 monocenter non-randomized prospective clinical trial evaluates the effectiveness of minimally invasive microwave ablation plus immunotherapy for unresectable non-metastatic locally advanced pancreatic cancer.
Recruiting
Phase 2
Drug | Synonyms | Arms |
---|---|---|
Durvalumab 50 MG/ML | MEDI4736, IMFINZI | MIMIPAC |
Tremelimumab | MIMIPAC | |
Gemcitabine | Gemzar | MIMIPAC |
Research Hypothesis Does MIS-MWA combined with durvalumab (MEDI4736) plus tremelimumab and gemcitabine prolong progression-free survival in patients with unresectable non-metastatic adenocarcinoma of the pancreas? Investigational Product(s) and Reference Therapy: Combination of Durvalumab (fixed dose of 1500 mg) and Tremelimumab (fixed dose of 75 mg) will be given 2 weeks before surgery. Minimally invasive surgical microwave ablation (MIS-MWA) of the pancreatic tumor will be performed two weeks after the first dose of Durvalumab and Tremelimumab After 4 doses of Durvalumab and Tremelimumab, only Durvalumab 1500mg is provided q4w until disease progression. Systemic gemcitabine will be started 6 weeks after MIS-MWA. Gemcitabine will be given at a dose of 1000 mg /m² body surface, once a week for 3 weeks, followed with a week of rest. Objectives: Primary Objectives: Progression-free survival (PFS) Secondary Objectives: - Safety: clinical and hematological toxicity (NCI CTCAE v. 5.0) of chemotherapy and immunotherapy - Safety: number and type of postoperative complications of the MIS-MWA procedure - Length of hospital stay Tertiary Objectives Overall survival (OS)
Name | Type | Description | Interventions |
---|---|---|---|
MIMIPAC | Experimental | Intervention: MIS-MWA plus immunotherapy using the combination of durvalumab with tremelimumab |
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Inclusion Criteria: - Patients with unresectable non-metastatic Locally Advanced Pancreatic Cancer (LAPC) defined according to NCCN guidelines Version 2.2017 - Histologically proven adenocarcinoma of the pancreas located in the head, body or tail - LAPC tumor greatest diameter maximum 5 cm - Male or female, age 18 years and older, ECOG PS 0-1 - Life expectancy of at least 12 weeks - Only patients who did not receive chemotherapy for their PC are allowed - Patients without distant organ metastases on conventional diagnostic imaging - Pre-operative biliary drainage for obstructive jaundice is allowed, but the type of biliary stent is standardized in all jaundiced patients - Patients fit for MIS-MWA - Able to receive Durvalumab and Tremelimumab. - Patients with good liver and renal function and with good hematology - Effective contraception for both male and female patients if applicable. Women of childbearing potential must have negative blood pregnancy test at screening visit. - Written informed consent (+ optional for TR) must be given according to ICH/GCP and national/European regulations Exclusion Criteria: - Pregnancy - Metastatic PC on conventional diagnostic imaging or staging laparoscopy - LAPC tumor greatest diameter is larger than 5 cm - Borderline or resectable PC defined according to the NCCN guidelines version 2.2017 - Systemic chemo(radio)therapy is not allowed before MIS-MWA - Major surgical procedure within 28 days prior to the first dose of investigational products - Classic contraindications for PDL and CTLA antibodies
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Measure: | Progression-free survival (PFS) |
Time Frame: | 12 months |
Safety Issue: | |
Description: | The study is exploratory and cannot be statistically powered for comparisons. Median progression-free survival (PFS) time is chosen as the clinically meaningful outcome. Survival estimates will be calculated using the Kaplan-Meier method. For information, the reference PFS time in patients with non-metastatic LAPC treated with gemcitabine monotherapy is about 6 months. Results will be presented descriptively. |
Phase: | Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | Baki Topal |
November 4, 2020