Chemotherapy plus paricalcitol in patients with untreated, metastatic pancreatic cancer.

Phase 1

• Conditions: Stage IV pancreatic adenocarcinoma; MedDRA version: 21.1Level: LLTClassification code 10033605Term: Pancreatic cancer metastaticSystem Organ Class: 100000004864; Therapeutic area: Diseases [C] - Cancer [C04]

• Registration Number: EUCTR2017-004467-13-GB
• Lead Sponsor: Barts Health NHS Trust

Brief Summary

Not available

Detailed Description

Not available

Study Timeline

• Results First Posted: 1900-01-01
• Study Start: 2018-07-04
• Last Update Posted: 6 April 2020

Recruitment & Eligibility

• Status: Authorised-recruitment may be ongoing or finished
• Sex: All
• Target Recruitment: 14

Inclusion Criteria

1. Willing and able to provide written informed consent.
2. Ability to comply with the protocol.
3. Aged = 18 years; male or female.
4. Histologically or cytologically confirmed metastatic (stage IV) pancreatic ductal adenocarcinoma.
5. Karnofsky performance status =70.
6. At least one lesion that can be measured accurately at baseline as =10mm in the longest diameter (except lymph nodes which must have a short axis =15mm) with CT/MRI and which is suitable for repeated measurements per RECIST v1.1
7. Adequate haematological and end-organ function, as per the local institutions reference ranges, within 72 hrs prior to day 1 of cycle 1 of treatment defined by the following:
a. Haematology: ANC >1.5 x 109/L (>1500 cells / mm3); Platelet count > 100 x 109/L (>100,000 cells/mm3); haematocrit level >27% for females or >30% for males
b. Coagulation: INR and aPTT =1.5 x ULN.
c. Biochemistry: serum creatinine < 1.5mg/dl, bilirubin < 1.5 x ULN; AST / ALT = 2.5 x ULN (or = 5 x ULN in the presence of liver metastasis) calculated creatinine clearance = 50ml/min (as measured by Cockcroft & Gault), calcium (corrected for calcium) = 1 x ULN
8. Life expectancy = 12 weeks.
9. Women of childbearing potential must agree not to become pregnant (e.g. post-menopausal for at least 1 year, surgically sterile, or practising adequate birth control methods) for the duration of the study and for 1 month after last dose of study treatment. Women of child bearing potential must have a negative serum or urine pregnancy test within 14 days of Cycle 1 Day 1 (preferably as close to the study treatment day as possible). Both male and female patients of reproductive potential must agree to use a reliable method of birth control from 2 weeks before the start of study treatment and until 1 month (female participants) or 6 months (male participants) after completion of treatment.
10. Tumour sites amenable to repeated biopsies.
11. Willingness to undergo paired tumour biopsies during the trial.

Optional: For patients who are entering the trial at the stage of starting Paricalcitol only:
12. A patient must have received paclitaxel protein bound and gemcitabine as first line chemotherapy for metastatic disease in exactly the same way as mandated in the current trial, to be enrolled directly to the add on paricalcitol component of the trial. The patient must have previously received the following minimum doses: abraxane 75 mg/m2 and gemcitabine 600 mg/m2. If lower than these doses then the patient will be ineligible for enrolment into the PINBALL trial.

Are the trial subjects under 18? no
Number of subjects for this age range: 0
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range 10
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range 4

Exclusion Criteria

1. Patients must have received no previous radiotherapy, surgery, chemotherapy or investigational therapy for the treatment of metastatic disease. Prior treatments in the adjuvant setting with gemcitabine and/or 5-FU or gemcitabine administered as a radiation sensitizer are allowed, provided at least 6 months have elapsed since completion of the last dose and no lingering toxicities are present. If a patient has received paclitaxel protein bound and gemcitabine as first line chemotherapy for metastatic disease in the same way as mandated in the current trial, they can be considered eligible to be enrolled directly to the add on paricalcitol component of the trial. Unless the patient meets inclusion criteria 12.
2. Palliative surgery and/or radiation treatment less than 4 weeks prior to initiation of study treatment.
3. Exposure to any investigational agent within 4 weeks prior to initiation of study treatment.
4. Evidence of central nervous system (CNS) metastasis (negative imaging study, if clinically indicated, within 28 days of Cycle 1 Day 1).
5. History of other malignancies (except cured basal or squamous cell carcinoma, superficial bladder cancer, prostate cancer in active surveillance, or carcinoma in situ of the cervix) unless documented free of cancer for =2 years.
6. Pre-existing hypercalcaemia, defined as baseline serum calcium (corrected for albumin) above the institutional ULN.
7. Current, serious, clinically significant cardiac arrhythmias as determined by the investigator.
8. History of HIV infection.
9. Active, clinically significant serious infection requiring treatment with antibiotics, antivirals or anti-fungals (see Section 6.10).
10. History of symptomatic genitourinary stones (e.g. kidney stones) within 12months of Cycle 1 Day 1.
11. Pre-existing, clinically significant peripheral neuropathy = G2
12. Hypersensitivity to the active study drug substance or to any of its excipients as listed in section 6 of the SmPC of each study drug.
13. Patient is on prohibited concurrent medication (see Section 6.10). In particular, vitamin D and calcium supplements must be stopped at the time of enrolment and for the duration of study treatment.
14. Any other disease, metabolic dysfunction, physical examination finding or clinical laboratory finding that, in the investigator’s opinion, gives reasonable suspicion of a disease or condition that contraindicates the use of study treatment, may affect the interpretation of the results, render the patient at high risk from treatment complications or interferes with obtaining informed consent.
15.Female patients who are pregnant or nursing.

Study & Design

• Study Type: Interventional clinical trial of medicinal product
• Study Design: Not specified