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Safety and Immunological Effect of Pembrolizumab in Resectable or Borderline Resectable Pancreatic Cancer

Phase 1
Conditions
Pancreatic Cancer
Interventions
Radiation: Neoadjuvant Chemoradiation
Registration Number
NCT02305186
Lead Sponsor
Craig L Slingluff, Jr
Brief Summary

The purpose of this clinical trial is to study an experimental drug called pembrolizumab or MK-3475 for use in combination with chemotherapy and radiation therapy for patients with resectable (surgical removal) or borderline resectable pancreatic cancer. In general, pancreatic cancer that cannot be removed by surgery is sometimes treated with chemotherapy and radiation therapy, called neoadjuvant treatment, to shrink the tumor so that surgery might be possible. However, this is not always effective at shrinking the tumor enough to allow it to be removed with surgery. Recent discoveries suggest that the investigators own immune system might have a role in controlling the growth of tumors. Drugs such as pembrolizumab can stimulate the immune system against cancer. The purpose of this study is to investigate whether pembrolizumab can be used safely during neoadjuvant treatment and can improve the body's immune response against pancreatic cancer.

Pembrolizumab has been approved for treatment of patients with melanoma but has not been proven to be safe or helpful in patients with pancreatic cancer and is not approved by the U.S. Food and Drug Administration (FDA) for this purpose.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
68
Inclusion Criteria
  1. Measurable disease based on Response Evaluation Criteria in Solid Tumors (RECIST) 1.
  2. Performance status of 0 or 1 on the Eastern Cooperative Oncology Group (ECOG) Performance Scale
  3. Adequate organ function
  4. In subjects requiring biliary decompression, metal stent or drainage using percutaneous transhepatic cholangiogram (PTC) are allowed
Exclusion Criteria
  1. Immunodeficiency or taking steroid or any other form of immunosuppressive therapy
  2. Has a plastic biliary stent for decompression
  3. Metastatic disease
  4. Prior treatment for pancreatic cancer (other than 4-8 cycles of Folfirinox) or prior treatment with radiation for other diagnoses to the expected pancreatic cancer treatment area
  5. Active autoimmune disease
  6. Pregnancy or Nursing
  7. Known history of Human Immunodeficiency Virus (HIV) or Hepatitis B or C
  8. Prior monoclonal antibody within 4 weeks prior to study Day 1
  9. Known additional malignancy that is progressing or requires active treatment
  10. Evidence of interstitial lung disease or active, non-infectious pneumonitis
  11. Active infection requiring systemic therapy
  12. Prior therapy with an anti-Program Death (PD-1) antibody, anti-PD-L1, anti-PD-L2, or anti-Cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4) antibody

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Neodjuvant CRT + PembrolizumabPembrolizumabStandard neoadjuvant chemoradiation treatment (CRT) with pembrolizumab
Neodjuvant CRT + PembrolizumabNeoadjuvant ChemoradiationStandard neoadjuvant chemoradiation treatment (CRT) with pembrolizumab
Neoadjuvant CRTNeoadjuvant ChemoradiationStandard neoadjuvant chemoradiation treatment (CRT) alone
Primary Outcome Measures
NameTimeMethod
Number of Tumor Infiltrating Lymphocytes (TILs) per high powered field (hpf) in pancreatic tissue (resected tissue).2-3 years
Safety: Incidence of Dose-Limiting Toxicities (DLTs)2-3 years
Secondary Outcome Measures
NameTimeMethod
Disease-free survival (DFS)2-4 years
Overall survival (OS)2-4 years
Response Rate (RR)2-3 years

Trial Locations

Locations (6)

Hartford HealthCare

🇺🇸

Hartford, Connecticut, United States

Dana-Farber Cancer Institute

🇺🇸

Boston, Massachusetts, United States

Mayo Clinic Cancer Center

🇺🇸

Phoenix, Arizona, United States

University of Miami

🇺🇸

Miami, Florida, United States

MD Anderson

🇺🇸

Houston, Texas, United States

University of Virginia Cancer Center

🇺🇸

Charlottesville, Virginia, United States

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