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Phase Ib Multicenter, Cohort Dose Escalation Trial to Determine the Safety, Tolerance and Preliminary Antineoplastic Activity of Gemcitabine Administered in Combination With Continuous Intravenous Doses of PRI-724, a CBP/ β- Catenin Inhibitor, to Patients With Advanced or Metastatic Pancreatic Adenocarcinoma Eligible for Second-Line Therapy After Failing First-Line Therapy With FOLFIRINOX (or FOLFOX)


Phase 1
18 Years
N/A
Open (Enrolling)
Both
Advanced Pancreatic Cancer, Metastatic Pancreatic Cancer, Pancreatic Adenocarcinoma

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Trial Information

Phase Ib Multicenter, Cohort Dose Escalation Trial to Determine the Safety, Tolerance and Preliminary Antineoplastic Activity of Gemcitabine Administered in Combination With Continuous Intravenous Doses of PRI-724, a CBP/ β- Catenin Inhibitor, to Patients With Advanced or Metastatic Pancreatic Adenocarcinoma Eligible for Second-Line Therapy After Failing First-Line Therapy With FOLFIRINOX (or FOLFOX)


PRI-724 is a small molecule antagonist that binds to the co-activator CBP thereby
specifically inhibiting the subset of Wnt/β-catenin-driven genes that are up-regulated in
cancer cells. PRI-724 is being developed as a potential antineoplastic agent.

Purpose:

To determine the safety, tolerability, dose-limiting toxicities (DLTs), and maximum
tolerated dose (MTD) of sequential escalating doses per cohort of PRI-724 administered in
combination with gemcitabine to patients with adenocarcinoma of the pancreas that is locally
advanced, metastatic, or otherwise inoperable, who are candidates for second-line therapy
after failing first-line therapy with FOLFIRINOX (i.e., folinic acid [leucovorin],
fluorouracil, irinotecan, oxaliplatin)

- PRI-724: 320, 640, 905 mg/m2/day, continuous intravenous (CIV) infusion over 24 h,
daily × 7 days, 1 week on with 1 week recovery × 2 (4 weeks equals 1 cycle)

- Gemcitabine: 1000 mg/m2 IV over 30 minutes; 3 weeks on with 1 week recovery (4 weeks
equals 1 cycle)

Patients with documented, measurable or evaluable adenocarcinoma of the pancreas that is
locally advanced, metastatic, or otherwise inoperable, who are candidates for second-line
therapy after failing first-line therapy with FOLFIRINOX, will be entered into this phase
1b, multicenter, open-label, non-randomized, dose-escalation per cohort study. The trial is
designed to evaluate the safety, tolerability, DLT(s), and MTD of escalating doses of
PRI-724, a CBP/ β- catenin inhibitor, when administered in combination with a standard dose
of gemcitabine. Correlative studies include characterization of the PK profiles of PRI-724
and gemcitabine, evaluation of the utility of potential PD markers of PRI-724 activity, as
well as preliminary assessment of the antineoplastic activity of PRI-724 plus gemcitabine in
this patient population.


Inclusion Criteria:



1. Male or female patients, > 18 years of age.

2. Patients with a documented (histologically- or cytologically-proven) epithelial
cell/adenocarcinoma of the pancreas that is relapsed, locally advanced, or
metastatic.

3. Patients with measurable or evaluable disease according to the response evaluation
criteria in solid tumors

4. Patients eligible for second-line therapy after failing first-line therapy with the
regimen FOLFIRINOX.

5. Patients with a malignancy that is currently not amenable to surgical intervention,
due to either medical contraindications or non-resectability of the tumor.

6. Patients with a Karnofsky Performance Status of 70% to 100% (or equivalent, Eastern
Cooperative Oncology Group [ECOG] performance status of 0 or 1); Performance Status
Evaluation), and an anticipated life expectancy of ≥ 3 months.

7. Patients, both male and female, who are either not of childbearing potential or who
agree to use a medically effective method of contraception during the study and for 3
months after the last dose of study drug.

8. Patients with the ability to understand and give written informed consent for
participation in this trial, including all evaluations and procedures as specified by
this protocol.

Exclusion Criteria:

1. Women who are pregnant or lactating. Women of child-bearing potential (WOCBP) and
fertile men with a WOCBP partner, not using adequate birth control.

2. Patients with islet cell tumors or other non-epithelial cell malignancies of the
pancreas.

3. Patients with known CNS (or leptomeningeal) metastases not controlled by prior
surgery or radiotherapy, or patients with symptoms suggesting CNS involvement for
which treatment is required.

4. Patients with an active second malignancy within the last 2 years with the exception
of:

- Treated, non-melanoma skin cancers

- Treated CIS of the breast or cervix

- Controlled, superficial bladder carcinoma

- T1a or b prostate carcinoma involving < 5% of resected tissue and PSA within
normal limits (WNL) since resection

5. Patients with any of the following hematologic abnormalities at baseline:

- Hemoglobin < 9.0 g/dL

- Absolute neutrophil count (ANC) < 1,500 per mm3

- Platelet count < 100,000 per mm3

6. Patients with any of the following serum chemistry abnormalities at baseline:

- Total bilirubin > 1.5× the ULN for the institution, unless considered due to
Gilbert's Syndrome

- AST or ALT > 3× the ULN for the institution (> 5× ULN if due to hepatic
involvement by tumor)

- Serum albumin < 2.5 g/dL

- Serum creatinine > 1.5× ULN (or a calculated creatinine clearance < 60
mL/min/1.73 m2)

7. Patients with a significant cardiovascular disease or condition, including:

- Congestive heart failure (CHF) currently requiring therapy

- Need for anti-arrhythmic therapy for a ventricular arrhythmias

- Severe conduction disturbances

- Angina pectoris requiring therapy

- Left ventricular ejection fraction (LVEF) < 50% by MUGA or echocardiogram

- QTcF interval > 450 msec (males) or > 470 msec (females)

- Uncontrolled hypertension (per Investigator's discretion)

- Class III or IV cardiovascular disease according to the New York Heart
Association's (NYHA) Functional Criteria.

- Myocardial infarction (MI) within 6 months prior to first study drug
administration

8. Patients with known osteopenia or osteoporosis.

9. Patients with a known or suspected hypersensitivity to either gemcitabine or any of
the components of PRI-724.

10. Patients with a history of human immunodeficiency virus (HIV) or active infection
with hepatitis B virus (HBV) or hepatitis C virus (HCV).

11. Patients with any other serious/active/uncontrolled infection, any infection
requiring parenteral antibiotics, or unexplained fever > 38ºC within 2 weeks prior to
first study drug administration.

12. Patients with inadequate recovery from acute toxicity associated with any prior
antineoplastic therapy

13. Patients with inadequate recovery from any prior surgical procedure, or patients
having undergone any major surgical procedure within 1 month prior to first study
drug administration.

14. Patients with any other life-threatening illness, significant organ system
dysfunction, or clinically significant laboratory abnormality, which, in the opinion
of the Investigator, would either compromise the patient's safety or interfere with
evaluation of the safety of the study drug

15. Patients with a psychiatric disorder or altered mental status that would preclude
understanding of the informed consent process and/or completion of the necessary
studies

16. Patients with the inability, in the opinion of the Investigator, to comply with the
protocol requirements

Type of Study:

Interventional

Study Design:

Endpoint Classification: Safety Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

The Maximum Tolerated Dose (MTD) of PRI-724 + Gemcitabine measured by the number of dose limiting toxicities (DLTs) that occur.

Outcome Description:

If no DLT occurs in the first 3 patients of a cohort, the dose will be escalated to the next dose cohort. If 1 DLT occurs in the first 3 patients of a cohort, that cohort is expanded to 6 patients. If more than 1 DLT occurs in a 6 patient cohort, escalation is stopped & next lower dose is expanded to 12 patients to confirm the MTD.

Outcome Time Frame:

18 months. DLTs will be measured as they occur throughout the patients' time on study.

Safety Issue:

Yes

Principal Investigator

Robert R. McWilliams, M.D.

Investigator Role:

Principal Investigator

Investigator Affiliation:

Mayo Clinic

Authority:

United States: Institutional Review Board

Study ID:

PRI-724-102

NCT ID:

NCT01764477

Start Date:

March 2013

Completion Date:

February 2015

Related Keywords:

  • Advanced Pancreatic Cancer
  • Metastatic Pancreatic Cancer
  • Pancreatic Adenocarcinoma
  • Adenocarcinoma
  • Adenocarcinoma, Mucinous
  • Pancreatic Neoplasms

Name

Location

Mayo Clinic Rochester, Minnesota  55905
USC Norris Comprehensive Cancer Center Los Angeles, California  90089
Mayo Clinic Arizona Scottsdale, Arizona  85259
Mayo Clinic Jacksonville, FL Jacksonville, Florida  32224