Phase II Study of Concurrent Radiotherapy With Envafolimab and Capecitabine in LAPC

Phase 2

Recruiting

• Conditions: Envafolimab; Capecitabine; Pancreatic Cancer; Radiotherapy
• Interventions: Radiation: concurrent radiotherapy with envafolimab and capecitabine

• Registration Number: NCT06202014
• Lead Sponsor: Cancer Institute and Hospital, Chinese Academy of Medical Sciences

Brief Summary

This is a single-arm prospective phase II clinical trial to investigate the efficacy and safety of concurrent radiotherapy with envafolimab and capecitabine in locally advanced pancreatic cancer.Eligibility patients will receive intensity-modulated radiotherapy(IMRT)or volumetric modulated arc therapy(VMAT) to pancreatic lesions,metastatic lymph nodes and high-risk lymphatic drainage areas,concurrent with and followed by envafolimab and capecitabine.

Detailed Description

This is a single-arm prospective phase II clinical trial to investigate the efficacy and safety of concurrent radiotherapy with envafolimab and capecitabine in locally advanced pancreatic cancer.Primary enrollment criteria is locally advanced non-resectable pancreatic cancer without systemic metastases other than retroperitoneal lymph nodes.Eligibility patients will receive intensity-modulated radiotherapy(IMRT)or volumetric modulated arc therapy(VMAT) to pancreatic lesions,metastatic lymph nodes and high-risk lymphatic drainage areas,concurrent with and followed by envafolimab and capecitabine.Concurrent and sequential dose of envafolimab is 200mg subcutaneous injection weekly.Capecitabine is with a concurrent and sequential dose of 500-800 mg/m2 bid po , taken orally for 2 weeks and stopped for 1 week (standard concurrent dose is 800 mg/m2 bid po , but for patients ≥70 years of age, 500 mg/m2 bid po depending on physical status ) until progression or intolerance.

Study Timeline

• Status Verified: 2024-01
• Study First Submitted: 2024-01-02
• Study First Submitted QC: 2024-01-02
• Study First Posted: 2024-01-11
• Last Update Submitted: 2024-01-18
• Last Update Posted: 2024-01-19
• Study Start: 2024-01-31
• Primary Completion: 2024-12-31
• Study Completion: 2025-12-31

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 43

Inclusion Criteria

1. Age: 18-90 years old.

2. Pancreatic cancer diagnosed by histology or cytology.

3. Locally or regionally advanced non-resectable pancreatic cancer without systemic metastases other than retroperitoneal lymph nodes.

4. Patients who have not received prior systemic chemotherapy or who have progressed on first-line therapy.

5. At least one measurable lesion (≥10 mm long diameter on CT scan for tumor lesions and ≥15 mm short diameter on CT scan for lymph node lesions according to RECIST 1.1 criteria).

6. ECOG score: 0-1.

7. Expected survival ≥ 3 months.

8. Normal function of major organs, meeting the following criteria:

9. Criteria for routine blood tests need to be met (no blood and blood products transfusion within 14 days):

   1. ANC ≥ 1.5×10^9/L
   2. PLT ≥80×10^9/L

10. Biochemical tests need to meet the following criteria:

    1. TBIL<1.5 ULN
    2. ALT and AST < 2.5ULN and in patients with liver metastases < 5ULN
    3. Serum Cr ≤ 1.25ULN or endogenous creatinine clearance > 45 ml/min (Cockcroft-Gault formula) 11).Subjects voluntarily enrolled in this study and signed an informed consent form, were compliant and cooperated with the follow-up.

Exclusion Criteria

1. Presence of any active autoimmune disease or history of autoimmune disease in the subject.
2. Allergy to study-used medications.
3. Subjects who are on immunosuppressive, or systemic, or absorbable topical hormone therapy for immunosuppression (dose >10mg/day prednisone or other equipotent hormone) and who continue to be on it within 2 weeks prior to enrollment.
4. Class III-IV cardiac insufficiency according to NYHA criteria, or cardiac ultrasound suggesting left ventricular ejection fraction (LVEF) <50%.
5. Those with abnormal coagulation function (INR>1.5,APTT>1.5 ULN) and bleeding tendency.
6. prolonged unhealed wounds or fractures; major surgical procedures or severe traumatic injuries, fractures or ulcers within 4 weeks.
7. Subjects with congenital or acquired immune deficiency (e.g., HIV-infected individuals), or active hepatitis (Hepatitis B reference: HBV DNA test value exceeding the upper limit of normal, Hepatitis C reference: HCV viral titer or RNA test value exceeding the upper limit of normal).
8. Subject has received other prior PD-1 antibody immunotherapy or other immunotherapy targeting PD-1 or PD-L1.
9. Known existing hereditary or acquired bleeding and thrombotic tendencies (e.g., hemophiliacs, coagulation disorders, thrombocytopenia, hypersplenism, etc.) or events of arterial or venous thrombosis in the last 6 months (up to the first medication use of envafolimab ).
10. Subjects with active infection or unexplained fever >38.5 degrees Celsius during screening and prior to the first dose.
11. Patients with central nervous system metastases;
12. Subjects who have had a live bacterial vaccine or live attenuated vaccine vaccine within 30 days prior to the first dose of study treatment.
13. Subjects with previous or concurrent other malignant tumors.
14. Women who are pregnant or breastfeeding.
15. Those with a history of psychotropic substance abuse that cannot be abstained from or patients with psychiatric disorders.
16. Patients with concomitant illnesses that, in the judgment of the investigator, seriously jeopardize patient safety or interfere with the patient's ability to complete the study.
17. Those who are not suitable for inclusion in the judgment of the investigator.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Concurrent Radiotherapy With Envafolimab and Capecitabine	concurrent radiotherapy with envafolimab and capecitabine	Concurrent radiotherapy with envafolimab and capecitabine, post-adjuvant envafolimab and capecitabine for locally advanced pancreatic cancer

Primary Outcome Measures

Name	Time	Method
ORR	1-3 months after radiotherapy	Overall Response Rate (ORR) was defined as the total of CR (Complete Response) and PR (Partial Response). CR and PR were assessed by independent reviewers according to the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. ORR evaluated in 1 to 3 months after the completion of radiotherapy.

Secondary Outcome Measures

Name	Time	Method
Incidence of grade 3 and above adverse events	up to 24 months	Adverse events was evaluated during received protocol therapy according to the NCI Common Terminology Criteria for Adverse Events 4.03(CTCAE 4.03).
DCR	up to 24 months	Complete response(CR)and partial response(PR)
PFS	up to 24 months	Progress free survival
DoR	up to 24 months	During of response
OS	up to 24 months	Overall Survival (OS) was defined as the duration from the date of patient recruited to the date of death with any reason

Trial Locations

Locations (1)

Bo Chen; 🇨🇳 Beijing, Beijing, China