A Phase 1b Study of Single Agent Idelalisib Followed by Idelalisib in Combination With Chemotherapy in Subjects With Metastatic Pancreatic Ductal Adenocarcinoma
Overview
- Phase
- Phase 1
- Intervention
- Idelalisib
- Conditions
- Previously Untreated Pancreatic Ductal Adenocarcinoma
- Sponsor
- Gilead Sciences
- Enrollment
- 16
- Locations
- 9
- Primary Endpoint
- Single-agent IDL: Percentage of Participants Who Experienced Treatment-Emergent Adverse Events (TEAEs)
- Status
- Terminated
- Last Updated
- 5 years ago
Overview
Brief Summary
The primary objective of this study is to evaluate the safety of single agent idelalisib and to evaluate safety and define the maximum tolerated dose (MTD) of idelalisib in combination with chemotherapy in adults with metastatic pancreatic ductal adenocarcinoma.
Investigators
Eligibility Criteria
Inclusion Criteria
- •The presence of metastatic pancreatic adenocarcinoma plus 1 of the following:
- •Histological diagnosis of pancreatic adenocarcinoma confirmed pathologically, OR
- •Pathologist confirmed histological/cytological diagnosis of adenocarcinoma consistent with pancreas origin
- •Measurable disease per response evaluation criteria in solid tumors (RECIST) v1.1
- •Prior systemic chemotherapy treatment for metastatic pancreatic ductal adenocarcinoma (Arm: idelalisib single agent only)
- •Received one prior line of chemotherapy for metastatic pancreatic ductal adenocarcinoma (Arm: idelalisib + mFOLFOX6 only)
- •Adequate organ function defined as follows:
- •Hepatic: Total bilirubin ≤ 1.25 x upper limit of normal (ULN) (Arm: idelalisib + nab-paclitaxel ); total bilirubin ≤1.5 x ULN (Arm: single agent idelalisib and Arm: idelalisib + mFOLFOX6); aspartate transaminase (AST) serum glutamic oxaloacetic transaminase (SGOT), alanine transaminase (ALT) serum glutamic pyruvic transaminase (SGPT) \< 2.5 x ULN, and albumin \> 3.0 g/dL
- •Hematological: absolute neutrophil count (ANC) \> 1,500 cells/cubic millimetre (m\^3), platelet \> 100,000 cells/mm\^3, hemoglobin \> 9.0 grams/decilitre (g/dL)
- •Renal: Serum creatinine ≤ 1.5 x ULN OR calculated creatinine clearance (CrCl) \> 30 millilitre (ml)/min as calculated by the Cockcroft-Gault method
Exclusion Criteria
- •Currently or previously treated with biologic, or immunotherapy
- •Currently or previously treated with conventional chemotherapy, or other agents for metastatic pancreatic ductal adenocarcinoma (Arm: idelalisib + nab-paclitaxel only)
- •Evidence of ongoing systemic bacterial, fungal, or viral infection at the time of enrollment
- •Known human immunodeficiency viruses (HIV) infection
- •History of a concurrent or second malignancy except for adequately treated local basal cell or squamous cell carcinoma of the skin, cervical carcinoma in situ, superficial bladder cancer, asymptomatic prostate cancer without known metastatic disease and with no requirement for therapy or requiring only hormonal therapy and with normal prostate-specific antigen for ≥ 1 year prior to enrollment, adequately treated Stage 1 or 2 non-pancreatic cancer currently in complete remission, or any other non-pancreatic cancer that has been in complete remission for ≥ 5 years
- •Diagnosis of pancreatic islet neoplasm, acinar cell carcinoma, non-adenocarcinoma (eg, lymphoma, sarcoma), adenocarcinoma originating from the biliary tree or cystadenocarcinoma
- •History of serious allergic reaction, including anaphylaxis and toxic epidermal necrolysis
- •Presence of peripheral neuropathy ≥ Grade 2 (Arm: idelalisib + nab-paclitaxel and Arm: idelalisib + mFOLFOX6)
- •Documented myocardial infarction or unstable/uncontrolled cardiac disease (eg, unstable angina, congestive heart failure \[New York Heart Association \> Class III\]) within 6 months or enrollment
- •Known hypersensitivity to idelalisib, its metabolites, or formulation excipients
Arms & Interventions
Idelalisib 150 mg
Participants were administered with idelalisib (IDL) 150 mg tablets orally, twice daily (morning and evening) for 8 weeks.
Intervention: Idelalisib
Idelalisib + nab-paclitaxel
Participants will receive escalating doses of idelalisib at a dose level of up to 150mg + nab-paclitaxel.
Intervention: Idelalisib
Idelalisib + nab-paclitaxel
Participants will receive escalating doses of idelalisib at a dose level of up to 150mg + nab-paclitaxel.
Intervention: Nab-paclitaxel
Idelalisib + mFOLFOX6
Participants will receive escalating doses of idelalisib at a dose level of up to 150mg + mFOLFOX6.
Intervention: Idelalisib
Idelalisib + mFOLFOX6
Participants will receive escalating doses of idelalisib at a dose level of up to 150mg + mFOLFOX6.
Intervention: mFOLFOX6
Outcomes
Primary Outcomes
Single-agent IDL: Percentage of Participants Who Experienced Treatment-Emergent Adverse Events (TEAEs)
Time Frame: First dose date up to last dose date (Maximum: 8 weeks) plus 30 days
TEAEs were defined as adverse events (AEs) with onset dates on or after the study drug start date and no later than 30 days after the permanent discontinuation of the study drug. It also included the AEs that led to premature discontinuation of study drug.
Single-agent IDL: Percentage of Participants Who Experienced Treatment-Emergent Laboratory Abnormalities
Time Frame: First dose date up to last dose date (Maximum: 8 weeks) plus 30 days
Treatment-emergent laboratory abnormalities were defined as values that increased at least 1 toxicity grade from baseline at any post baseline time point, up to and including the date of last dose of study drug plus 30 days. If the relevant baseline laboratory value was missing, any abnormality of at least Grade 1 observed within the time frame specified above was considered treatment emergent. Severity grade is defined by Common Terminology Criteria for Adverse Events (CTCAE) version 4.03 (1=Mild, 2=Moderate, 3=Severe, 4=Life-threatening). The percentage of participants for any post-baseline abnormal laboratory value in the Grade 1-4 category is reported. The term 'hypo' indicates less than the normal count of a parameter and 'hyper' indicates more than the normal count of a parameter.
Idelalisib in Combination With Chemotherapy: Percentage of Participants With Dose Limiting Toxicities (DLTs)
Time Frame: Up to 28 days
Dose limiting toxicities were defined as toxicities experienced during the first 28 days of treatment (Cycle 1) that were judged to be clinically significant and at least possibly related to study treatment.
Secondary Outcomes
- Change From Baseline in FoxP3+ and Cluster Determinant 8+ (CD8+) Cells From Tumor Tissue Samples as a Measure of Pharmacodynamics Activity(Up to 2 years)
- Idelalisib Plasma Concentrations Following Idelalisib 150 mg Twice Daily(Cycle 1, Day 1: Predose and 0.5, 1, 1.5, 2, 3, 4, and 8 hours (h) postdose; Day 8: Predose and 1.5 h postdose; Day 15: Predose and 1.5 h postdose Cycle 2, Day 1: Predose and 1.5 h postdose)
- Idelalisib Metabolite (GS-563117) Plasma Concentrations Following Idelalisib 150 mg Twice Daily(Cycle 1, Day 1: Predose and 0.5, 1, 1.5, 2, 3, 4, and 8 h postdose; Day 8: Predose and 1.5 h postdose; Day 15: Predose and 1.5 h postdose Cycle 2, Day 1: Predose and 1.5 h postdose)
- Overall Response Rate (ORR)(Up to 2 years)
- Overall Survival (OS)(Up to 2 years)
- Progression Free Survival (PFS)(Up to 2 years)