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M402 in Combination With Nab-Paclitaxel and Gemcitabine in Pancreatic Cancer

Phase 1
Terminated
Conditions
Metastatic Pancreatic Cancer
Interventions
Registration Number
NCT01621243
Lead Sponsor
Momenta Pharmaceuticals, Inc.
Brief Summary

People with primary metastatic pancreatic cancer will be treated with nab-paclitaxel and gemcitabine in combination with an investigational agent called necuparanib (M402). It is made from heparin, which is a well known blood thinner. Blood thinners have been shown in prior animal and human studies to have anti-cancer effects. Necuparanib has been re-engineered from heparin to have much lower blood thinning activity while keeping the anti-tumor activity. The investigators are testing whether necuparanib administered in combination with nab-paclitaxel and gemcitabine may be more effective than nab-paclitaxel and gemcitabine.

Detailed Description

Part A was an open-label, multiple ascending dose patient study of necuparanib given first as a single dose and then daily in combination with the nab-paclitaxel and gemcitabine regimen. It was conducted to evaluate the safety and tolerability of necuparanib alone and in combination with nab-paclitaxel and gemcitabine and to recommend a necuparanib dose regimen for subsequent evaluation in Part B. Part B is a randomized, double-blind study investigating the antitumor activity of necuparanib in combination with nab-paclitaxel and gemcitabine compared with nab-paclitaxel, gemcitabine, and placebo. In both Parts A and B, a treatment period consists of one 28-day cycle. The Study Patient and Investigator can decide to continue with additional 28-day cycles according to the patient's status at the end of each 28-day cycle. Part A has completed enrollment and Part B is currently open.

Part A - Primary Objectives:

* To evaluate the safety and tolerability of necuparanib in combination with nab-paclitaxel and gemcitabine.

* To determine the dose of necuparanib to be carried forward into Part B.

Part B - Primary Objective:

To evaluate overall survival in patients treated with necuparanib + nab-paclitaxel + gemcitabine compared with placebo + nab-paclitaxel + gemcitabine.

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
128
Inclusion Criteria
  • Age of 18 years or older
  • Confirmed pancreatic ductal adenocarcinoma
  • Metastatic disease as documented by CT scan or MRI (locally advanced disease only NOT eligible)
  • At least 1 site of disease measurable by RECIST ver1.1
  • ECOG performance status of 0 to 1
  • Adequate bone marrow, renal capacity and hepatic function
  • Willing to administer daily subcutaneous injections at home
Exclusion Criteria
  • Any prior radiotherapy, chemotherapy, surgery, or investigational therapy for adjuvant or metastatic pancreatic cancer
  • History of suspected history, or presence of heparin induced toxicity (w/ or w/o thrombosis)
  • History of unexplained bleeding episodes within 3 months of M402 dosing
  • Received thrombolytic agents w/in the previous month
  • Had full-dose anticoagulation with heparin, enoxaparin, dalteparin, other LMWH, a/or other anticoagulants w/in 90 days before first dose of M402
  • High cardiovascular risk, including but not limited to, recent coronary stenting or myocardial infarction in the past year
  • Major trauma or surgery w/in prior 4 weeks

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
nab-paclitaxel, gemcitabine, placebonab-paclitaxelPart A: Not applicable. Part B: nab-paclitaxel, gemcitabine, and placebo. Placebo administered daily along with nab-paclitaxel and gemcitabine administration on Day 1, Day 8, and Day 15 of each 28-day cycle.
nab-paclitaxel, gemcitabine, placeboplaceboPart A: Not applicable. Part B: nab-paclitaxel, gemcitabine, and placebo. Placebo administered daily along with nab-paclitaxel and gemcitabine administration on Day 1, Day 8, and Day 15 of each 28-day cycle.
nab-paclitaxel, gemcitabine, necuparanibnab-paclitaxelPart A: Following a single-dose of necuparanib and a 7-day follow-up period, necuparanib was administered daily along with nab-paclitaxel and gemcitabine administration on Day 1, Day 8, and Day 15 of each 28-day cycle. Dose escalation of necuparanib proceeded by cohort in a 3+3 design. Part B: A fixed dose of necuparanib will be administered daily along with nab-paclitaxel and gemcitabine administration on Day 1, Day 8, and Day 15 of each 28-day cycle.
nab-paclitaxel, gemcitabine, placebogemcitabinePart A: Not applicable. Part B: nab-paclitaxel, gemcitabine, and placebo. Placebo administered daily along with nab-paclitaxel and gemcitabine administration on Day 1, Day 8, and Day 15 of each 28-day cycle.
nab-paclitaxel, gemcitabine, necuparanibgemcitabinePart A: Following a single-dose of necuparanib and a 7-day follow-up period, necuparanib was administered daily along with nab-paclitaxel and gemcitabine administration on Day 1, Day 8, and Day 15 of each 28-day cycle. Dose escalation of necuparanib proceeded by cohort in a 3+3 design. Part B: A fixed dose of necuparanib will be administered daily along with nab-paclitaxel and gemcitabine administration on Day 1, Day 8, and Day 15 of each 28-day cycle.
nab-paclitaxel, gemcitabine, necuparanibNecuparanibPart A: Following a single-dose of necuparanib and a 7-day follow-up period, necuparanib was administered daily along with nab-paclitaxel and gemcitabine administration on Day 1, Day 8, and Day 15 of each 28-day cycle. Dose escalation of necuparanib proceeded by cohort in a 3+3 design. Part B: A fixed dose of necuparanib will be administered daily along with nab-paclitaxel and gemcitabine administration on Day 1, Day 8, and Day 15 of each 28-day cycle.
Primary Outcome Measures
NameTimeMethod
Part A: SafetyPart A: Baseline to 28 days after first-dose and end of study

At baseline and then each of 6 visits after the start of dosing in a 28-day treatment cycle, adverse event surveillance, liver function enzyme levels, WBC with differential, ANC, aPTT, and PT are measured. This is repeated for each 28 day treatment cycle until disease progression or end of treatment. A final assessment is performed 30 days post-final necuparanib dose.

Part B: Overall SurvivalTime in months from first dose of study medication until death

Time in months from first dose of study medication until death

Secondary Outcome Measures
NameTimeMethod
Part A: Maximum concentration of necuparanibBaseline to 28 days after first dose.

One before and seven blood samples after the first dose followed by 5 additional lab draws, once at each of the 5 remaining visits in the first 28-day cycle.

Part B: Duration of progression-free survivalTime from first dose of study drug until disease progression

Time in months from first dose of study drug until disease progression

Trial Locations

Locations (37)

Metro-Minnesota Community Clinical Oncology Program

🇺🇸

Saint Louis Park, Minnesota, United States

Illinois Cancer Specialists

🇺🇸

Arlington Heights, Illinois, United States

University of New Mexico Cancer Center

🇺🇸

Albuquerque, New Mexico, United States

Loyola University Medical Center

🇺🇸

Maywood, Illinois, United States

Crescent City Research Consortium

🇺🇸

Marrero, Louisiana, United States

Texas Oncology, P.A.

🇺🇸

Tyler, Texas, United States

Poudre Valley Health System

🇺🇸

Fort Collins, Colorado, United States

Clearview Cancer Institute

🇺🇸

Huntsville, Alabama, United States

Memorial Sloan Kettering Cancer Center

🇺🇸

New York, New York, United States

Arizona Clinical Research Center

🇺🇸

Tucson, Arizona, United States

Penn State Hershey Cancer Center

🇺🇸

Hershey, Pennsylvania, United States

Southeastern Regional Medical Center

🇺🇸

Newnan, Georgia, United States

University of Kansas Cancer Center

🇺🇸

Kansas City, Missouri, United States

Cancer Center of the Carolinas/ITOR

🇺🇸

Greenville, South Carolina, United States

The Ottawa Hospital Cancer Center

🇨🇦

Ottawa, Ontario, Canada

Hartford Healthcare Cancer Institute at Midstate Medical Center

🇺🇸

Meriden, Connecticut, United States

Montefiore-Einstein Center for Cancer Care

🇺🇸

Bronx, New York, United States

Texas Oncology

🇺🇸

Tyler, Texas, United States

Ohio State University

🇺🇸

Columbus, Ohio, United States

University of Wisconsin Hospital and Clinics

🇺🇸

Madison, Wisconsin, United States

CHUM Hospital St-Luc

🇨🇦

Montreal, Quebec, Canada

University of Maryland- St Joseph's Medical Center

🇺🇸

Towson, Maryland, United States

University of Arizona

🇺🇸

Tucson, Arizona, United States

University of Texas Health Sciences Center

🇺🇸

San Antonio, Texas, United States

Dana-Farber Cancer Institute

🇺🇸

Boston, Massachusetts, United States

University of Alabama at Birmingham Comprehensive Cancer Center

🇺🇸

Birmingham, Alabama, United States

Northwest Cancer Specialists

🇺🇸

Portland, Oregon, United States

Massachusetts General Hospital

🇺🇸

Boston, Massachusetts, United States

Karmanos Cancer Center

🇺🇸

Detroit, Michigan, United States

Mayo Clinic

🇺🇸

Rochester, Minnesota, United States

Umass Memorial Medical Center

🇺🇸

Worcester, Massachusetts, United States

Sunnybrook Health Sciences Centre

🇨🇦

Toronto, Ontario, Canada

University of Colorado School of Medicine - Division of Medical Oncology

🇺🇸

Aurora, Colorado, United States

St. Joseph Mercy Hospital

🇺🇸

Ann Arbor, Michigan, United States

Florida Hospital Tampa

🇺🇸

Tampa, Florida, United States

Ochsner Medical Center

🇺🇸

New Orleans, Louisiana, United States

Montefiore Medical Center

🇺🇸

Bronx, New York, United States

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