Description:
This trial is designed to evaluate multiple clinical hypotheses and mechanistically-defined
combinations to evaluate the safety and efficacy of first-line chemo-immunotherapy
combinations in participants with metastatic pancreatic ductal adenocarcinoma (mPDAC).
Title
- Brief Title: Exploratory Platform Trial to Evaluate Immunotherapy Combinations With Chemotherapy for the Treatment of Patients With Previously Untreated Metastatic Pancreatic Adenocarcinoma
- Official Title: A Multicenter, Open-label, ExploRatory Platform Trial to EValuate ImmunOtherapy Combinations With Chemotherapy for the Treatment of Patients With PreviousLy UnTreated MetastatIc Pancreatic AdenOcarciNoma (REVOLUTION)
Clinical Trial IDs
- ORG STUDY ID:
PICI0044
- NCT ID:
NCT04787991
Conditions
- Metastatic Pancreatic Adenocarcinoma
Interventions
Drug | Synonyms | Arms |
---|
Nivolumab (Cohort A) | Opdivo | Cohort A: Nivolumab + Ipilimumab + nP/gem |
Ipilimumab (Cohort A and B) | Yervoy | Cohort A: Nivolumab + Ipilimumab + nP/gem |
Hydroxychloroquine (HCQ) (Cohort B) | Plaquenil | Cohort B: Hydroxychloroquine + Ipilimumab + nP/gem |
Nab-paclitaxel (nP) (Cohort A and B) | Abraxane | Cohort A: Nivolumab + Ipilimumab + nP/gem |
Gemcitabine (gem) (Cohort A and B) | Gemzar | Cohort A: Nivolumab + Ipilimumab + nP/gem |
Purpose
This trial is designed to evaluate multiple clinical hypotheses and mechanistically-defined
combinations to evaluate the safety and efficacy of first-line chemo-immunotherapy
combinations in participants with metastatic pancreatic ductal adenocarcinoma (mPDAC).
Detailed Description
This is an open-label, non-randomized, exploratory platform trial designed to assess the
safety and antitumor activity of immunotherapy, in combination with standard of care
chemotherapy, in participants with mPDAC who have not received prior therapy. Where
supportive mechanistic data are available, immunotherapy may also be combined with other
treatment modalities (eg, radiation). Each cohort of this platform trial will test a
different immunotherapy combination and consist of up to 2 stages: an initial stage (Stage 1)
to evaluate safety, biomarkers, and/or clinical activity of the combination and an expanded
cohort (Stage 2), when warranted, based on the safety, clinical activity, and/or biomarker
results from Stage 1. The Sponsor intends to modify and/or add new combinations to the
protocol as data emerge from scientific findings, in this and other trials.
This trial will be conducted in participants with histologically or cytologically documented
diagnosis of mPDAC, with measurable disease per Response Evaluation Criteria in Solid Tumors
(RECIST) v1.1, who have not received prior systemic therapy for their disease in the
metastatic setting. Participants must have adequate organ and hematologic function and
acceptable performance status. Participants must consent to tumor biopsies, including a
pre-treatment (baseline) and on-treatment samples.
Trial Arms
Name | Type | Description | Interventions |
---|
Cohort A: Nivolumab + Ipilimumab + nP/gem | Experimental | | - Nivolumab (Cohort A)
- Ipilimumab (Cohort A and B)
- Nab-paclitaxel (nP) (Cohort A and B)
- Gemcitabine (gem) (Cohort A and B)
|
Cohort B: Hydroxychloroquine + Ipilimumab + nP/gem | Experimental | | - Ipilimumab (Cohort A and B)
- Hydroxychloroquine (HCQ) (Cohort B)
- Nab-paclitaxel (nP) (Cohort A and B)
- Gemcitabine (gem) (Cohort A and B)
|
Eligibility Criteria
Core Inclusion Criteria
1. Participant has histologically or cytologically documented diagnosis of pancreatic
adenocarcinoma with metastatic disease. Participants with locally advanced disease are
not eligible.
a. Participants with recurrent locally advanced disease are eligible, provided: i. the
last dose of chemotherapy and/or radiotherapy occurred > 4 months prior to the first
dose of study intervention, and; ii. no systemic or radiotherapy has been administered
in the metastatic setting.
2. Participant must have measurable disease by RECIST v1.1.
3. Participant must have an Eastern Cooperative Oncology Group (ECOG) performance status
of 0 or 1.
4. A baseline tumor tissue sample is mandatory for enrollment. If archival tumor tissue
is not available, then a fresh tumor biopsy must be provided.
Core Exclusion Criteria
1. Participant must not have received any prior treatment, including chemotherapy,
biological therapy, or targeted therapy for mPDAC, with the following exceptions and
notes:
1. Participants who have received prior neoadjuvant or adjuvant therapy for
pancreatic adenocarcinoma are eligible if neoadjuvant and adjuvant therapy
(including chemotherapy and/or radiotherapy) was completed more than 4 months
before the start of study intervention.
2. Prior surgical resection is permitted.
2. Prior malignancy active within the previous 2 years except for locally curable cancers
that have been apparently cured, such as basal or squamous cell skin cancer,
superficial bladder cancer, or carcinoma in situ of the prostate, cervix, or breast.
3. Participants with an active, known or suspected autoimmune disease. Participants with:
type I diabetes mellitus; hypothyroidism only requiring hormone replacement; a history
of Hashimoto syndrome, within 3 years of the first dose of study intervention, which
resolved to hypothyroidism alone; skin disorders (such as vitiligo, psoriasis, or
alopecia) not requiring systemic treatment; or conditions not expected to recur in the
absence of an external trigger are permitted to enroll.
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Incidence and severity of adverse events |
Time Frame: | Up to 2.5 years |
Safety Issue: | |
Description: | |
Secondary Outcome Measures
Measure: | Objective response rate (ORR) |
Time Frame: | Up to 2.5 years |
Safety Issue: | |
Description: | Defined as the proportion of participants who achieve a confirmed complete response (CR) or partial response (PR) per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1. |
Measure: | Disease control rate (DCR) |
Time Frame: | At 9 months |
Safety Issue: | |
Description: | Defined as the proportion of participants who achieve confirmed CR or PR or stable disease (SD) lasting at least 16 weeks |
Measure: | Duration of response (DOR) |
Time Frame: | Up to 2.5 years |
Safety Issue: | |
Description: | Defined as the time from first documentation of response (CR or PR) to first radiographic documentation of progressive disease (PD) or death due to any cause. |
Measure: | Progression-free survival (PFS) |
Time Frame: | Up to 2.5 years |
Safety Issue: | |
Description: | Defined as the time from initiation of study intervention to date of first documented radiographic progression of disease or death due to any cause. |
Measure: | Overall survival (OS) |
Time Frame: | Up to 2.5 years |
Safety Issue: | |
Description: | Defined as the time from initiation of study intervention until death due to any cause. |
Measure: | Overall survival (OS) at 12 months |
Time Frame: | At 12 months |
Safety Issue: | |
Description: | Defined as the time from initiation of study intervention until death due to any cause. |
Details
Phase: | Phase 1 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | Parker Institute for Cancer Immunotherapy |
Trial Keywords
- Metastatic Pancreatic Adenocarcinoma
- Immunotherapy
- Platform study
- Nivolumab
- Ipilimumab
- Gemcitabine
- nab-paclitaxel
- hydroxychloroquine
Last Updated
August 26, 2021