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Study of Ibrutinib vs Placebo, in Combination With Nab-paclitaxel and Gemcitabine, in the First Line Treatment of Patients With Metastatic Pancreatic Adenocarcinoma (RESOLVE)

Phase 3
Completed
Conditions
Metastatic Pancreatic Adenocarcinoma
Interventions
Registration Number
NCT02436668
Lead Sponsor
Pharmacyclics LLC.
Brief Summary

This is a phase 3 study to evaluate the efficacy of ibrutinib in combination with nab-paclitaxel and gemcitabine for the first line treatment of patients with metastatic pancreatic adenocarcinoma.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
430
Inclusion Criteria
  1. Histologically or cytologically confirmed diagnosis of pancreatic adenocarcinoma.

  2. Stage IV disease diagnosed within 6 weeks of randomization

  3. Adequate hematologic function:

    • Absolute neutrophil count (ANC) ≥1.5 x 109/L
    • Platelet count ≥100 x 109/L
    • Hemoglobin ≥9 g/dL
  4. Adequate hepatic and renal function defined as:

    • AST and/or ALT ≤5.0 x upper limit of normal (ULN) if liver metastases, or ≤3 x ULN without liver metastases
    • Alkaline phosphatase <3.0 x ULN or ≤5.0 x ULN if liver or bone metastases present
    • Bilirubin ≤1.5 x ULN (unless bilirubin rise is due to Gilbert's syndrome or of non-hepatic origin, such as hemolysis)
    • Estimated Creatinine Clearance ≥30 mL/min
  5. PT/INR <1.5 x ULN and PTT (aPTT) <1.5 x ULN

  6. KPS ≥70.

  7. Eastern Cooperative Oncology Group (ECOG) 0-1

Exclusion Criteria
  1. Prior therapies: BTK inhibitor, radiotherapy, radiotherapy in the adjuvant setting, or cytotoxic chemotherapy for primary disease of pancreatic adenocarcinoma.
  2. Neuroendocrine (carcinoid, islet cell) or acinar pancreatic carcinoma
  3. Known brain or leptomeningeal disease (CT or MRI scan of the brain required only in case of clinical suspicion of central nervous system involvement).
  4. Major surgery within 4 weeks of first dose of study drug.
  5. History of stroke or intracranial hemorrhage within 6 months prior to enrollment.
  6. Treatment with a strong cytochrome P450 (CYP) 3A inhibitor.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboNab-paclitaxelPlacebo daily in combination with: Nab-paclitaxel and gemcitabine
PlaceboGemcitabinePlacebo daily in combination with: Nab-paclitaxel and gemcitabine
IbrutinibIbrutinibIbrutinib daily in combination with: Nab-paclitaxel and gemcitabine
IbrutinibNab-paclitaxelIbrutinib daily in combination with: Nab-paclitaxel and gemcitabine
IbrutinibGemcitabineIbrutinib daily in combination with: Nab-paclitaxel and gemcitabine
Primary Outcome Measures
NameTimeMethod
Progression Free Survival (PFS)Results at an overall median follow-up of 24.87 months

PFS is defined as the time from the date of randomization until disease progression per RECIST 1.1 criteria assessed by investigator, or death from any cause, whichever occurs first.

Overall Survival (OS)Results at an overall median follow-up of 24.87 months

OS, is defined as the time from date of randomization until date of death from any cause.

Secondary Outcome Measures
NameTimeMethod
Clinical Benefit ResponseResults at an overall median follow-up of 24.87 months

Subject achieved a ≥50% reduction in pain intensity (Memorial Pain Assessment Card \[MPAC\]) or analgesic consumption, or a 20-point or greater improvement in KPS for a period of at least 4 consecutive weeks, without showing any sustained worsening in other parameters.

OR Subject was stable on all of the aforementioned parameters, and showed a marked, sustained weight gain (≥7% increase maintained for ≥4 weeks) not due to fluid accumulation (Burris 1997).

Patient-reported Outcome (PRO) by European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30).Results at an overall median follow-up of 24.87 months

Unit is the month: TUDD1 - the time between random \& 1st occurrence of a decrease in QLQ-C30 score ≥10 pts w/o improvement in QoL score of ≥10 points or any further QoL data due to deterioration. The proportion of subjects who met the "responder" criteria prior to subsequent anticancer therapy initiation. Response defined as achievement of a ≥50% reduction in MPAC visual analog scale which measures pain intensity or analgesic consumption, or a ≥20-point improvement from baseline in KPS sustained for a period of ≥ 4 consecutive weeks without showing any sustained worsening from baseline in any of the other parameters OR Subject stable on all parameters (pain and KPS), \& showed a marked, sustained weight gain (≥7% increase from baseline maintained for ≥4 weeks) not due to fluid accumulation.

Overall Response RateResults at an overall median follow-up of 24.87 months

ORR is defined as the percentage of subjects who achieve a complete response or partial response, based on investigator assessment according to RECIST 1.1.

Rate of Venous Thromboembolic Events (VTE)Results at an overall median follow-up of 24.87 months

The VTE rate is defined as percentage of subjects with Venous thromboembolic events (SMQ) per investigator assessment.

Number of Participants With Adverse Events as a Measure of Safety and Tolerability of Ibrutinib and Nab-paclitaxel and Gemcitabine Versus Placebo in Combination With Nab-paclitaxel and Gemcitabine.Results at an overall median follow-up of 24.87 months

This is a measure of percentage of subjects with Treatment Emergent Adverse Events Grade 3 or above collected Up to 30 days after the last participating subject discontinues study drug.

Carbohydrate Antigen 19-9 (CA19-9) ResponseResults at an overall median follow-up of 24.87 months

The CA19-9 response rate is defined as the percentage of subjects with a decline of 20%, 90%, and other thresholds considered clinically meaningful, from baseline. This is a percentage of patients with \> or = 60% reduction from baseline.

Trial Locations

Locations (86)

Oncology Specialties, PC; Clearview Cancer Institute

🇺🇸

Huntsville, Alabama, United States

Moores UCSD Cancer Center

🇺🇸

La Jolla, California, United States

St. Mary's Medical Center

🇺🇸

Daly City, California, United States

Eastern Connecticut Hematology/Oncology Assoc.

🇺🇸

Norwich, Connecticut, United States

Cedars Sinai Medical Center

🇺🇸

Los Angeles, California, United States

Norwalk Hospital

🇺🇸

Norwalk, Connecticut, United States

Bethesda Memorial Hospital

🇺🇸

Boynton Beach, Florida, United States

University Cancer & Blood Center, LLC

🇺🇸

Athens, Georgia, United States

Northwest Georgia Oncology Centers, PC

🇺🇸

Marietta, Georgia, United States

Ingalls Memorial Hospital Cancer Research Center

🇺🇸

Harvey, Illinois, United States

Joliet Oncology-Hematology Associates, LTD

🇺🇸

Joliet, Illinois, United States

Our Lady of the Lake Physician Group

🇺🇸

Baton Rouge, Louisiana, United States

Berkshire Hematology Oncology Services at Berkshire Medical Center Cancer and Infusion Center

🇺🇸

Pittsfield, Massachusetts, United States

Sparrow Regional Cancer Center

🇺🇸

Lansing, Michigan, United States

Saint Joseph Mercy Health System

🇺🇸

Chelsea, Michigan, United States

Investigative Clinical Research of Indiana

🇺🇸

Indianapolis, Indiana, United States

The Presbyterian Hospital

🇺🇸

Charlotte, North Carolina, United States

Penn State University Milton S. Hershey Medical Center

🇺🇸

Hershey, Pennsylvania, United States

Scott & White Memorial Hospital

🇺🇸

Temple, Texas, United States

MultiCare Health System Institute for Research and Innovation

🇺🇸

Tacoma, Washington, United States

Wenatchee Valley Hospital & Clinics

🇺🇸

Wenatchee, Washington, United States

ULB Hôpital Erasme

🇧🇪

Bruxelles, Belgium

UZ Leuven

🇧🇪

Leuven, Belgium

C. H. U. Sart Tilman

🇧🇪

Liège, Belgium

Centre Antoine Lacassagne

🇫🇷

Nice cedex 02, Alpes Maritimes, France

Centre Paul Strauss

🇫🇷

Strasbourg cedex, Bas Rhin, France

Hôpital Nord Franche Comté

🇫🇷

Doubs, Montbeliard, France

Hôpital de la Timone

🇫🇷

Marseille cedex 5, Bouches-du-Rhône, France

Centre Georges François Leclerc

🇫🇷

Dijon cedex, Côte-d'Or, France

CHU de Toulouse - Hôpital Rangueil

🇫🇷

Toulouse Cedex 9, Haute Garonne, France

CHU Besançon - Hôpital Jean Minjoz

🇫🇷

Besançon, Doubs, France

Groupe Hospitalier Saint André - Hôpital Saint André

🇫🇷

Bordeaux, Gironde, France

Hôpital Saint-Antoine

🇫🇷

Paris cedex 12, Paris, France

CHU Poitiers - Hôpital la Milétrie

🇫🇷

Poitiers Cedex, Vienne, France

Groupe Hospitalier Pitie-Salpetriere

🇫🇷

Paris, France

Universitaetsklinikum Tuebingen

🇩🇪

Tuebingen, Baden Wuerttemberg, Germany

Universitaetsklinikum Ulm

🇩🇪

Ulm, Baden Wuerttemberg, Germany

Klinikum der Johann Wolfgang Goethe-Universitaet

🇩🇪

Frankfurt, Hessen, Germany

Universitaetsklinikum Koeln

🇩🇪

Koeln, Nordrhein Westfalen, Germany

Universitaetsklinikum Leipzig AoeR

🇩🇪

Leipzig, Sachsen, Germany

Gemeinschaftspraxis Haematologie und Onkologie

🇩🇪

Dresden, Sachsen Anhalt, Germany

Onkologische Schwerpunktpraxis Kurfuerstendamm

🇩🇪

Berlin, Germany

Azienda Ospedaliero Universitaria Ospedali Riuniti

🇮🇹

Ancona, Italy

Azienda Ospedaliero Universitaria San Martino

🇮🇹

Genova, Italy

IEO Istituto Europeo di Oncologia

🇮🇹

Milano, Italy

Ospedale San Raffaele

🇮🇹

Milano, Italy

Azienda Ospedaliera Ospedale Niguarda Ca' Granda

🇮🇹

Milano, Italy

IOV - Istituto Oncologico Veneto IRCCS

🇮🇹

Padova, Italy

Istituto Nazionale Tumori Fondazione G. Pascale

🇮🇹

Napoli, Italy

Azienda Ospedaliero Universitaria Pisana

🇮🇹

Pisa, Italy

Fondazione IRCCS Policlinico San Matteo

🇮🇹

Pavia, Italy

IRCCS Ospedale Casa Sollievo della Sofferenza

🇮🇹

San Giovanni Rotondo, Italy

Seoul National University Bundang Hospital

🇰🇷

Seongnam-si, Gyeonggi-do, Korea, Republic of

Chonnam National University Hwasun Hospital

🇰🇷

Hwasun, Jeollanam-do, Korea, Republic of

Seoul National University Hospital

🇰🇷

Seoul, Korea, Republic of

Yonsei University Health System

🇰🇷

Seoul, Korea, Republic of

Asan Medical Center

🇰🇷

Seoul, Korea, Republic of

Samsung Medical Center

🇰🇷

Seoul, Korea, Republic of

The Catholic University of Korea, Seoul St. Mary's Hospital

🇰🇷

Seoul, Korea, Republic of

Korea University Guro Hospital

🇰🇷

Seoul, Korea, Republic of

Hospital del Mar

🇪🇸

Barcelona, Spain

Specialist

🇪🇸

Barcelona, Spain

ICO l´Hospitalet - Hospital Duran i Reynals

🇪🇸

L'Hospitalet de Llobregat, Barcelona, Spain

Hospital Universitari Vall d'Hebron

🇪🇸

Barcelona, Spain

Hospital Clinic i Provincial de Barcelona

🇪🇸

Barcelona, Spain

Hospital Clinico Universitario Virgen de la Victoria

🇪🇸

Málaga, Spain

Hospital Universitario 12 de Octubre

🇪🇸

Madrid, Spain

Hospital Universitario La Paz

🇪🇸

Madrid, Spain

Hospital Universitario Virgen Macarena

🇪🇸

Sevilla, Spain

Hospital Universitario Virgen del Rocio

🇪🇸

Sevilla, Spain

The Clatterbridge Cancer Centre

🇬🇧

Liverpool, Merseyside, United Kingdom

Southampton General Hospital

🇬🇧

Southampton, Hampshire, United Kingdom

The Christie

🇬🇧

Manchester, Greater Manchester, United Kingdom

Royal Free Hospital

🇬🇧

London, United Kingdom

Broomfield Hospital

🇬🇧

Chelmsford, Essex, United Kingdom

Royal Marsden Hospital

🇬🇧

Sutton, Surrey, United Kingdom

Arizona Center for Cancer Care

🇺🇸

Avondale, Arizona, United States

Cliniques Universitaires Saint-Luc

🇧🇪

Bruxelles, Belgium

Gibbs Cancer Center

🇺🇸

Spartanburg, South Carolina, United States

Grand Hôpital de Charleroi

🇧🇪

Gilly, Belgium

Mary Bird Perkins Cancer Center

🇺🇸

Baton Rouge, Louisiana, United States

Derriford Hospital

🇬🇧

Plymouth, Devon, United Kingdom

Florida Hospital Tampa

🇺🇸

Tampa, Florida, United States

Center for Cancer and Blood Disorders

🇺🇸

Bethesda, Maryland, United States

Nebraska Medicine - Peggy D. Cowdery Patient Care Center

🇺🇸

Omaha, Nebraska, United States

University of Cincinnati Medical Center

🇺🇸

Cincinnati, Ohio, United States

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