A Phase II Randomized, Open-Label, Multicenter Study Comparing CO-1.01 With Gemcitabine as First-Line Therapy in Patients With Metastatic Pancreatic Adenocarcinoma
试验速览
- 阶段
- 2 期
- 状态
- 已完成
- 入组人数
- 367
- 试验地点
- 95
- 主要终点
- Overall Survival in Patients With Low High Human Equilibrative Nucleoside Transporter 1 (hENT1) Expression
研究概览
简要总结
The purpose of this study is to determine whether CO-1.01 is safe and effective in the treatment of patients with metastatic pancreatic cancer and low hENT1 expression compared with gemcitabine.
详细描述
Pancreatic cancer is a very serious form of cancer. The majority of patients present with unresectable disease, and the condition is often not diagnosed until the cancer is relatively advanced. The standard first-line treatment for patients with unresectable pancreatic cancer is gemcitabine monotherapy. Unfortunately many of these patients fail to derive benefit from this treatment. No clinical or molecular marker has been established to predict benefit from gemcitabine therapy, so patients are treated empirically until evidence of disease progression or worsening performance status.
The potential for human equilibrative nucleoside transporter-1 (hENT1) expression to predict survival in gemcitabine-treated patients has been studied, and data suggest that patients with low levels of tumor cell hENT1 expression derive less benefit from gemcitabine treatment than patients with high levels of tumor cell hENT1 expression. These data support the hypothesis to be tested in this study that patients with pancreatic tumors expressing low levels of hENT1 will derive minimal benefit from gemcitabine, but will receive benefit from CO-1.01 (gemcitabine elaidate) which enters tumor cells in a hENT1-independent fashion.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Metastatic pancreatic ductal adenocarcinoma (i.e., Stage 4).
- •Histological/cytological confirmation of metastatic tissue (not primary tumor) by a central pathology laboratory (H&E stain) to ensure sufficient material is available for later hENT1 analysis.
- •Adjuvant chemotherapy/radiotherapy ≥ 6 months prior to randomization.
- •Palliative radiotherapy (if administered) ≥ 1 month prior to randomization.
- •CT scan ≤30 days prior to randomization
- •Performance Status (ECOG) 0 or
- •Estimated life expectancy ≥ 12 weeks.
- •Age ≥ 18 years.
- •Adequate hematological and biological function.
- •Written consent on an Institutional Review Board/Institutional Ethics Committee-approved Informed Consent Form prior to any study-specific evaluation.
排除标准
- •Prior palliative chemotherapy for pancreatic cancer.
- •Radical pancreatic resections (e.g., Whipple procedure) are not allowed < 6 months prior to randomization. Exploratory laparotomy, palliative (e.g., bypass) surgery, or other procedures (e.g., stents) are not allowed < 14 days prior to randomization. In both cases the patient must be sufficiently recovered and stable.
- •Symptomatic brain metastases.
- •Participation in other investigational drug clinical studies ≤ 30 days prior to randomization.
- •Concomitant treatment with prohibited medications.
- •History of allergy to gemcitabine or eggs.
- •Presence of any serious or unstable concomitant systemic disorder incompatible with the clinical study (e.g., substance abuse, uncontrolled intercurrent illness including active infection, arterial thrombosis, symptomatic pulmonary embolism).
- •Any disorder that would hamper protocol compliance.
- •Prior nonpancreatic malignancy treated with chemotherapy. Prior malignancies treated with surgery or radiotherapy alone must be in remission ≥ 3 years. The following prior malignancies are allowable irrespective of when they occurred: in situ carcinoma of the cervix, in situ ductal breast cancer, low-grade local bladder cancer, and nonmelanotic skin cancer.
- •Females who are pregnant or breastfeeding.
- •Refusal to use adequate contraception for fertile patients (females and males during the study and for 6 months after the last study treatment). Adequate forms of contraception are double-barrier methods (condoms or diaphragm with spermicidal jelly or foam); oral, depot, or injectable contraceptives; intrauterine devices; tubal ligation.
- •Any other reason the investigator considers the patient should not participate in the study.
研究组 & 干预措施
CO-1.01
干预措施: CO-1.01 (Drug)
gemcitabine
干预措施: Gemcitabine (Drug)
结局指标
主要结局
Overall Survival in Patients With Low High Human Equilibrative Nucleoside Transporter 1 (hENT1) Expression
时间窗: Monthly follow up after treatment discontinuation until death, up to 1.5 years.
次要结局
- Overall Survival in All Patients and Patients With hENT1 Expression(Monthly follow up after treatment discontinuation until death, up to 1.5 years)
- ORR, Duration of Response, and Progression Free Survival (PFS) in Patients With Measurable/Evaluable Disease, Using RECIST 1.1, up to 1.5 Years(Every 8 weeks)
- Cancer Antigen (CA)19-9 Response Rates(Every 4 weeks, up to 1.5 years)
- Drug Tolerability and Toxicity(Every week, up to 1.5 years)
- Change From Baseline in Pain Severity(Every 4 weeks, up to 1.5 years)
- Change From Baseline in Health Status(Every 4 weeks, up to 1.5 years)
- Pharmacokinetic (PK) Profile of CO-1.01 Based on Sparse Sampling(30 days after first dose)