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“NALPAC” A NON-COMPARATIVE RANDOMIZED PHASE 2 STUDY, EVALUATING THE EFFICACY OF 5-FU + NALIRI AND 5-FU + NALIRINOX FOR METASTATIC PANCREATIC DUCTAL ADENOCARCINOMA (PDAC), PROGRESSIVE AFTER GEMCITABINE-ABRAXANE OR GEMCITABINE MONOTHERAPY.

Phase 2
Recruiting
Conditions
METASTATIC PANCREATIC DUCTAL ADENOCARCINOMA
Registration Number
2024-516336-97-00
Lead Sponsor
Groupe Belge D'Oncologie Digestive
Brief Summary

Progression-free-survival rate (PFSR) at day 85

Detailed Description

Not available

Recruitment & Eligibility

Status
Ongoing, recruiting
Sex
Not specified
Target Recruitment
134
Inclusion Criteria

Histologically proven metastatic adenocarcinoma of the pancreas

Effective contraception for both male and female patients if the risk of conception exists

Peripheral Neuropathy < grade 2

Progression documented after first line treatment with Gemcitabine-Abraxane or gemcitabine alone

Signed written informed consent

Age ≥ 18

ECOG PS 0/1 at study entry

Measurable disease

Adequate renal (serum creatinine ≤ 1.5x upper reference range), liver (total bilirubin ≤ 1.5x upper reference range) and hematopoietic functions (PMN ≥ 1,5x109/L, platelets ≥ 100x109/L, hemoglobin ≥ 9g/dl)

INR/PTT ≤ 1.5x ULN

Life expectancy of at least 12 weeks

Exclusion Criteria

Uncontrolled concurrent CNS, cardiac, infectious diseases, hypertension

Complete DPD deficiency

Liver failure, cirrhosis Child Pugh B or C

Active chronic hepatitis B or C with a need for antiviral treatment

Brain metastasis

Major surgery, open biopsy or significant traumatic injury within 4 weeks prior to the first dose of treatment

History of organ allograft

Ongoing uncontrolled, serious infection

Renal failure requiring dialysis

Patients receiving or having received any investigational treatment within 4 weeks prior to the first dose of treatment, or participating to another clinical study

The following drugs are noted as interacting with Pegylated liposomal irinotecan (in combination with 5-FU and LV, in patients who have progressed following gemcitabine-based therapy), and are therefore excluded from the study: Live or live-attenuated vaccines in patients immunocompromised by chemotherapy, strong CYP3A4 inducers such as anticonvulsants (phenytoin, phenobarbital or carbamazepine), rifampin, rifabutin and St. John’s wort. Strong CYP3A4 inhibitors (e.g. grapefruit juice, clarithromycin, indinavir, itraconazole, lopinavir, nefazodone, nelfinavir, ritonavir, saquinavir, telaprevir, voriconazole and ketoconazole). Strong CYP3A4 inhibitors should be discontinued at least 1 week prior to starting ONIVYDE pegylated liposomal therapy. Strong UGT1A1 inhibitors (e.g. atazanavir, gemfibrozil, indinavir, regorafenib)

History of myocardial infarction, deep venous or arterial thrombosis, CVA during the last 6 months

Known hypersensitivity to any of the components of study treatments

Previous malignancy in the last past 3 years except basal cell cancer of the skin, pre-invasive cancer of the cervix or carcinoma in situ of any type

Pregnancy or breast feeding

Medical or psychological conditions that would not permit the patient to complete the study or sign inform consent

Unstable angina, congestive heart failure ≥NYHA class II

Uncontrolled hypertension despite optimal management (systolic blood pressure >150 mmHg or diastolic pressure > 90mmHg

HIV infection

Study & Design

Study Type
Interventional clinical trial of medicinal product
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
PFSR is defined as the proportion of patients alive and free of progression at day 85. Patients who do not progress are considered achieving either a stable disease (SD), a partial response (PR) or a complete response (CR) at day 85, according to RECIST 1.1 criteria. Patients who are unable to be evaluated at day 85, due to rapid clinical deterioration or death from any cause or start of an additional anti-tumor therapy, will be considered as progressive disease (PD).

PFSR is defined as the proportion of patients alive and free of progression at day 85. Patients who do not progress are considered achieving either a stable disease (SD), a partial response (PR) or a complete response (CR) at day 85, according to RECIST 1.1 criteria. Patients who are unable to be evaluated at day 85, due to rapid clinical deterioration or death from any cause or start of an additional anti-tumor therapy, will be considered as progressive disease (PD).

Secondary Outcome Measures
NameTimeMethod
Safety/toxicity and tolerability profile: Adverse events, laboratory safety assessment, physical examination

Safety/toxicity and tolerability profile: Adverse events, laboratory safety assessment, physical examination

PFS and sensitivity analysis

PFS and sensitivity analysis

Objective tumor response according to RECIST v 1.1

Objective tumor response according to RECIST v 1.1

Overall survival

Overall survival

Disease control

Disease control

Duration of response

Duration of response

Exploratory endpoint: Translational analysis on tumor tissue and blood samples

Exploratory endpoint: Translational analysis on tumor tissue and blood samples

Trial Locations

Locations (12)

AZ Turnhout

🇧🇪

Turnhout, Belgium

Antwerp University Hospital

🇧🇪

Edegem, Belgium

Az Sint-Lucas

🇧🇪

Brugge, Belgium

CHU Helora

🇧🇪

La Louviere, Belgium

Grand Hopital De Charleroi

🇧🇪

Charleroi, Belgium

Az Maria Middelares Gent

🇧🇪

Gent, Belgium

Centre Hospitalier Regional Sambre et Meuse

🇧🇪

Namur, Belgium

CHC MontLegia

🇧🇪

Liege, Belgium

Universitair Ziekenhuis Gent

🇧🇪

Gent, Belgium

Cliniques Universitaires Saint-Luc

🇧🇪

Sint-Lambrechts-Woluwe, Belgium

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AZ Turnhout
🇧🇪Turnhout, Belgium
Leen Mortier
Site contact
014406912
leen.mortier@azturnhout.be

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