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Study of the Safety and Efficacy of TH-302 in Combination With Gemcitabine Compared With Gemcitabine Alone in Previously Untreated Patients With Pancreatic Adenocarcinoma

Phase 2
Completed
Conditions
Pancreatic Adenocarcinoma
Interventions
Registration Number
NCT01144455
Lead Sponsor
ImmunoGenesis
Brief Summary

The purpose of this study is to determine whether Gemcitabine versus Gemcitabine and TH-302 are effective in the treatment of subjects with first-line metastatic pancreatic adenocarcinoma.

Detailed Description

A hypoxic microenvironment is a characteristic of many solid tumors including pancreatic cancer. The presence of hypoxia in solid tumors is associated with a more malignant phenotype and resistance to chemotherapy. The hypoxia-activated prodrug, TH-302, is designed to selectively physiologically target the hypoxic microenvironment. There is an absence of therapeutic options for subjects with metastatic pancreatic cancer. Gemcitabine provides clinical benefit as a single agent, but median survival is about 6 months. Combining gemcitabine with TH-302 may enable the targeting of both the normoxic and hypoxic regions of pancreatic cancer.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
214
Inclusion Criteria
  1. At least 18 years of age

  2. Ability to understand the purposes and risks of the study and has signed a written informed consent form approved by the investigator's IRB/Ethics Committee

  3. Locally advanced unresectable or metastatic pancreatic ductal adenocarcinoma proven either by histology or cytology previously untreated with chemotherapy or systemic therapy other than:

    • Radiosensitizing doses of 5-fluorouracil;
    • Radiosensitizing doses of gemcitabine if relapse occurred at least 6 months after completion of gemcitabine;
    • Neoadjuvant chemotherapy if relapse occurred at least 6 months after surgical resection;
    • Adjuvant chemotherapy if relapse occurred at least 6 months after completion of adjuvant chemotherapy.
  4. Measurable disease by RECIST 1.1 criteria (at least one target lesion outside of previous radiation fields)

  5. Documentation of disease progression since any prior therapy

  6. ECOG performance status of 0 or 1

  7. Life expectancy of at least 3 months

  8. Acceptable liver function:

    1. Bilirubin less than or equal to 1.5 times upper limit of normal
    2. AST (SGOT) and ALT (SGPT) less than or equal to 2.5 times upper limit of normal (ULN); if liver metastases are present, then less than or equal to 5 times ULN is allowed
  9. Acceptable renal function:

    a. Serum creatinine less than or equal to ULN

  10. Acceptable hematologic status (without hematologic support):

    1. ANC greater than or equal to 1500 cells/μL
    2. Platelet count greater than or equal to 100,000/μL
    3. Hemoglobin greater than or equal to 9.0 g/dL
  11. All women of childbearing potential must have a negative serum pregnancy test and male and female subjects must agree to use effective means of contraception (surgical sterilization or the use or barrier contraception with either a condom or diaphragm in conjunction with spermicidal gel or an IUD) with their partner from entry into the study through 6 months after the last dose

Exclusion Criteria
  1. New York Heart Association (NYHA) Class III or IV, cardiac disease, myocardial infarction within 6 months prior to Day 1, unstable arrhythmia or symptomatic peripheral arterial vascular disease
  2. Known brain, leptomeningeal or epidural metastases (unless treated and well controlled for at least 3 months)
  3. Previously treated malignancies, except for adequately treated non-melanoma skin cancer, in situ cancer, or other cancer from which the subject has been disease-free for at least 5 years
  4. Severe chronic obstructive or other pulmonary disease with hypoxemia (requires supplementary oxygen, symptoms due to hypoxemia or oxygen saturation <90% by pulse oximetry after a 2 minute walk) or in the opinion of the investigator any physiological state likely to cause systemic or regional hypoxemia
  5. Major surgery, other than diagnostic surgery, within 4 weeks prior to Day 1, without complete recovery
  6. Active, uncontrolled bacterial, viral, or fungal infections, requiring systemic therapy
  7. Treatment of pancreatic cancer with radiation therapy or surgery within 4 weeks prior to study entry
  8. Prior therapy with an hypoxic cytotoxin
  9. Subjects who participated in an investigational drug or device study within 28 days prior to study entry
  10. Known active infection with HIV, hepatitis B, or hepatitis
  11. Subjects who have exhibited allergic reactions to a structural compound, biological agent, or formulation (containing solutol and/or propylene glycol) similar to TH- 302
  12. Females who are pregnant or breast-feeding
  13. Concomitant disease or condition that could interfere with the conduct of the study, or that would, in the opinion of the investigator, pose an unacceptable risk to the subject in this study
  14. Unwillingness or inability to comply with the study protocol for any reason

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
240 mg/m2 TH-302 + GemcitabineGemzar (Gemcitabine)TH-302: 240 mg/m2 administered IV over 30 minutes Day 1, 8, and 15 of each 28-day cycle Gemcitabine: 1,000 mg/m2 administered IV over 30 minutes on Days 1, 8 and 15 of a 28-day cycle
340 mg/m2 TH-302 + GemcitabineGemzar (Gemcitabine)TH-302: 340 mg/m2 of TH-302 be administered IV over 30 minutes on Days 1, 8 and 15 of every 28-day cycle. Gemcitabine: 1,000 mg/m2 administered IV over 30 minutes on Days 1, 8 and 15 of a 28-day cycle
340 mg/m2 TH-302 + GemcitabineTH-302TH-302: 340 mg/m2 of TH-302 be administered IV over 30 minutes on Days 1, 8 and 15 of every 28-day cycle. Gemcitabine: 1,000 mg/m2 administered IV over 30 minutes on Days 1, 8 and 15 of a 28-day cycle
240 mg/m2 TH-302 + GemcitabineTH-302TH-302: 240 mg/m2 administered IV over 30 minutes Day 1, 8, and 15 of each 28-day cycle Gemcitabine: 1,000 mg/m2 administered IV over 30 minutes on Days 1, 8 and 15 of a 28-day cycle
GemcitabineGemzar (Gemcitabine)Gemcitabine: 1,000 mg/m2 administered IV over 30 minutes on Days 1, 8 and 15 of a 28-day cycle
Primary Outcome Measures
NameTimeMethod
Progression-free Survival (PFS)From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 1 year

Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (59)

Fairfax Northern Virginia Hematology Oncology, PC

🇺🇸

Fairfax, Virginia, United States

Massachusetts General Hospital

🇺🇸

Boston, Massachusetts, United States

Loyola University Medical Center

🇺🇸

Maywood, Illinois, United States

Atlanta Cancer Care

🇺🇸

Atlanta, Georgia, United States

New York Oncology Hematology, P.C.

🇺🇸

Hudson, New York, United States

Emerywood Hematology and Oncology

🇺🇸

High Point, North Carolina, United States

Allegheny General Hospital

🇺🇸

Pittsburgh, Pennsylvania, United States

Texas Oncology- Fort Worth - 12th Avenue

🇺🇸

Fort Worth, Texas, United States

Texas Oncology-Sherman

🇺🇸

Sherman, Texas, United States

Indiana University Melvin and Bren Simon Cancer

🇺🇸

Indianapolis, Indiana, United States

Sharp Memorial Hospital

🇺🇸

San Diego, California, United States

Disney Family Cancer Center

🇺🇸

Burbank, California, United States

UCLA Medical Center

🇺🇸

Los Angeles, California, United States

Scripps Clinical Research Services

🇺🇸

La Jolla, California, United States

Carle Cancer Center

🇺🇸

Urbana, Illinois, United States

Purchase Cancer Group

🇺🇸

Paducah, Kentucky, United States

Missouri Cancer Associates

🇺🇸

Columbia, Missouri, United States

Cancer Care of Western North Carolina, PA

🇺🇸

Asheville, North Carolina, United States

Alamance Oncology Hematolgy Associates

🇺🇸

Burlington, North Carolina, United States

Carolina Oncology Specialists, PA

🇺🇸

Hickory, North Carolina, United States

University of Pittsburgh Medical Center

🇺🇸

Pittsburgh, Pennsylvania, United States

Texas Oncology-Beaumont, Mamie McFaddin Ward Cancer Center

🇺🇸

Beaumont, Texas, United States

Texas Oncology-Seton Williamson

🇺🇸

Round Rock, Texas, United States

Providence Everett Regional Medical Center, Cancer Research Dept.

🇺🇸

Everett, Washington, United States

Columbia Basin Hematology and Oncology0

🇺🇸

Kennewick, Washington, United States

Texas Oncology-Wichita Falls Texoma Cancer Center

🇺🇸

Wichita Falls, Texas, United States

University of Arizona

🇺🇸

Tucson, Arizona, United States

Saint Edward Mercy Medical Center

🇺🇸

Fort Smith, Arkansas, United States

Los Palos Oncology and Hematology

🇺🇸

Salinas, California, United States

Roswell Park Cancer Institute

🇺🇸

Buffalo, New York, United States

Greater Philadelphia Cancer and Hematology Specialists, P.C.

🇺🇸

Philadelphia, Pennsylvania, United States

Signal Point Clinical Research Center

🇺🇸

Middletown, Ohio, United States

Texas Oncology-Dallas Presbyterian Hospital

🇺🇸

Dallas, Texas, United States

University of Texas Southwestern Medical Center at Dallas

🇺🇸

Dallas, Texas, United States

Martin Memorial Cancer Center

🇺🇸

Stuart, Florida, United States

Arizona Oncology Associates, PC - HOPE

🇺🇸

Tucson, Arizona, United States

Mayo Clinic Arizona

🇺🇸

Scottsdale, Arizona, United States

Montana Cancer Institute Foundation

🇺🇸

Missoula, Montana, United States

Ochsner Cancer Institute

🇺🇸

New Orleans, Louisiana, United States

Palo Alto Medical Foundation

🇺🇸

Mountain View, California, United States

University of Massachusetts Medical Center

🇺🇸

Worcester, Massachusetts, United States

Ocala Oncology Center

🇺🇸

Ocala, Florida, United States

Hematology Oncology Associates, PC

🇺🇸

Stamford, Connecticut, United States

LSU Health Sciences Center - Feist Weiller Cancer Center

🇺🇸

Shreveport, Louisiana, United States

Medical Oncology

🇺🇸

Baton Rouge, Louisiana, United States

Florida Cancer Institute - New Hope

🇺🇸

New Port Richey, Florida, United States

Institute for Translational Oncology Research (ITOR)

🇺🇸

Greenville, South Carolina, United States

Hematology and Oncology Associates at BridgePoint

🇺🇸

Tupelo, Mississippi, United States

Comprehensive Cancer Centers of Nevada

🇺🇸

Las Vegas, Nevada, United States

University of Wisconsin

🇺🇸

Madison, Wisconsin, United States

Birmingham Hematology and Oncology Associates, LLC

🇺🇸

Birmingham, Alabama, United States

California Pacific Medical Center

🇺🇸

San Francisco, California, United States

Rocky Mountain Cancer Centers

🇺🇸

Denver, Colorado, United States

Virgina Piper Cancer Institute

🇺🇸

Minneapolis, Minnesota, United States

Northwest Cancer Specialists, P.C.

🇺🇸

Portland, Oregon, United States

Vanderbilt University Medical Center, Div. of Medical Oncology

🇺🇸

Nashville, Tennessee, United States

Mayo Clinic Rochester

🇺🇸

Rochester, Minnesota, United States

Duke University Medical Center

🇺🇸

Durham, North Carolina, United States

Kaiser Permanente Northwest Region Oncology Hematology

🇺🇸

Portland, Oregon, United States

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