A clinical trial to evaluate a new medicine (Zolbetuximab) for the treatment of pancreatic cancer

Phase 1

• Conditions: First Line Treatment in Subjects with Claudin 18.2 (CLDN18.2) Positive, Metastatic Pancreatic Adenocarcinoma; MedDRA version: 21.0Level: LLTClassification code 10033599Term: Pancreatic adenocarcinoma metastaticSystem Organ Class: 100000004864; Therapeutic area: Diseases [C] - Cancer [C04]

• Registration Number: EUCTR2018-002551-15-IE
• Lead Sponsor: Astellas Pharma Global Development, Inc. (APGD)

Brief Summary

Not available

Detailed Description

Not available

Study Timeline

• Study Start: 2018-12-21
• Last Update Posted: 18 June 2024

Recruitment & Eligibility

• Status: ot Recruiting
• Sex: All
• Target Recruitment: 369

Inclusion Criteria

1. Institutional Review Board (IRB)/Independent Ethics Committee (IEC) approved written informed consent and privacy language as per national regulations (e.g., Health Insurance Portability and Accountability Act Authorization for United States sites) must be obtained from the subject or legally authorized representative prior to any study related procedures (including withdrawal of prohibited medication, if applicable).
2. Subject is considered an adult according to local regulation at the time of signing informed consent.
3. Subject agrees not to participate in another interventional study while
receiving study drug in present study.
4. A female subject is eligible to participate if she is not pregnant or lactating and at least 1 of the following conditions applies:
? Not a woman of childbearing potential (WOCBP) as defined in the Protocol.
OR
? WOCBP who agrees to follow the contraceptive guidance as defined in the Protocol throughout the treatment period and for at least 6 months after the final study drug administration.
5. Female subject must agree not to breastfeed starting at screening and
throughout the study period, and for 6 months after the final study drug administration.
6. Female subject must not donate ova starting at screening and throughout the study period, and for 6 months after the final study drug administration.
7. A male subject with female partner(s) of child-bearing potential must agree to use contraception as detailed in the Protocol during the treatment period and for at least 6 months after the final study drug administration.
8. A male subject must not donate sperm during the treatment period and for 6 months after the final study drug administration.
9. Male subject with a pregnant or breastfeeding partner(s) must agree to remain abstinent or use a condom for the duration of the pregnancy or time partner is breastfeeding throughout the study period and for 6 months after the final study drug administration.
Disease Specific Criteria
10. Subject has histologically or cytologically confirmed adenocarcinoma of pancreas.
11. Subjects must have metastatic pancreatic adenocarcinoma that has not been previously treated with chemotherapy.
• Prior treatment with 5-FU or GEM administered as a radiation sensitizer during and up to 4 weeks after radiation therapy is allowed (if there is lingering toxicity, then the sponsor should be consulted).
• If a subject received adjuvant therapy, tumor recurrence or disease progression must have occurred at least 6 months after completing the last dose of the adjuvant therapy.
• Subjects whose disease progressed on prior treatment with Nab-P and GEM are not eligible.
12. Subject has a measurable lesion(s) on at least 1 metastatic site based on RECIST 1.1 within 28 days prior to randomization. For subjects with only 1 measureable lesion and prior radiotherapy, the lesion must be outside the field of prior radiotherapy or must have documented progression following radiation therapy.
13. Subject's tumor sample has CLDN18.2 expression in = 75% of tumor cells demonstrating moderate to strong membranous staining as determined by central IHC testing.

Physical or Laboratory Findings
14. Subject has ECOG performance status of 0 or 1.
15. Subject has predicted life expectancy = 12 weeks in the opinion of the investigator.
16. Subject must meet all of the following criteria based on the laboratory tests collected within 14 days prior to randomization. In case

Exclusion Criteria

Subject will be excluded from participation if any of the following apply:
Prohibited Treatment or Therapies
1. Subject has received other investigational treatment within 28 days prior to randomization.
2. Subject has received radiotherapy for metastatic pancreatic adenocarcinoma = 14 days prior to randomization and has not recovered from any related toxicity.
3. Subject has received systemic immunosuppressive therapy, including systemic corticosteroids within 14 days prior to randomization. Subject using a physiologic replacement dose of hydrocortisone or its equivalent (defined as up to 30 mg per day of hydrocortisone or up to 10 mg per day of prednisone), receiving a single dose of systemic corticosteroids or receiving systemic corticosteroids as premedication for radiologic imaging contrast use are allowed.
4. Subject has prior severe allergic reaction or intolerance to known ingredients of zolbetuximab or other monoclonal antibody, including humanized or chimeric
antibodies.
5. Subject has known immediate or delayed hypersensitivity, intolerance or
contraindication to any component of study treatment.
6. Subject has a known history of a positive test for human immunodeficiency virus infection or known active Hepatitis B (positive HBs antigen [Ag]) or
Hepatitis C infection. NOTE: Screening for these infections should be conducted per local requirements.
For subjects who are negative for HBs Ag, but Hepatitis B core antibody positive, a Hepatitis B virus DNA test will be performed and if positive, the subject will be excluded. Subjects with positive serology but negative Hepatitis C virus RNA test results are eligible. Subjects treated for hepatitis C with undetectable viral load results are eligible.
7. Subject has a history of interstitial pneumonia or pulmonary fibrosis.
8. Subject has pleural effusion or ascites = Grade 3 per CTCAE v 4.03.
9. Subject has an active autoimmune disease that has required systemic treatment in the past 3 months prior to randomization.
10. Subject has active infection requiring systemic therapy that has not completely resolved per investigator judgment within 7 days prior to randomization.
11. Subject has significant cardiovascular disease, including:
? Congestive heart failure (defined as New York Heart Association Class III or IV), myocardial infarction, unstable angina, coronary angioplasty, coronary stenting, coronary artery bypass graft, cerebrovascular accident or hypertensive crisis within 6 months prior to randomization;
? History of clinically significant ventricular arrhythmias (i.e., sustained ventricular tachycardia, ventricular fibrillation or Torsades de Pointes);
? QTc interval > 450 msec for male subjects; QTc interval > 470 msec for female subjects;
? Cardiac arrhythmias requiring anti-arrhythmic medications (Subjects with rate controlled atrial fibrillation for > 1 month prior to randomization are eligible.)
12. Subject has a history of central nervous system metastases and/or carcinomatous meningitis from pancreatic adenocarcinoma.
13. Subject has known peripheral sensory neuropathy = Grade 2 per CTCAE v.4.03 unless the absence of deep tendon reflexes is the sole neurological abnormality.
14. Subject has had a major surgical procedure = 28 days prior to randomization.
15. Subject without complete recovery from a major surgical procedure = 14 days prior to randomization.
16. Psychiatric illness or social situations that would preclude study compliance per

Study & Design

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