- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03767582
Trial of Neoadjuvant and Adjuvant Nivolumab and BMS-813160 With or Without GVAX for Locally Advanced Pancreatic Ductal Adenocarcinomas.
A Phase I/II Trial of Combination Immunotherapy With Nivolumab and a CCR2/CCR5 Dual Antagonist (BMS-813160) With or Without GVAX Following Chemotherapy and Radiotherapy for Locally Advanced Pancreatic Ductal Adenocarcinomas (PDACs).
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Actual)
Phase
- Phase 2
- Phase 1
Contacts and Locations
Study Locations
-
-
Maryland
-
Baltimore, Maryland, United States, 21231
- Sidney Kimmel Comprehensive Cancer Center
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age ≥18 years.
- Patients with histologically- or cytologically-proven, surgically unresectable, locally advanced pancreatic adenocarcinoma.
- If the patient does not have a diagnostic biopsy that is adequate for review at our institution, the patient must agree to a research core biopsy to be performed at Johns Hopkins.
- If the patient's available imaging is not adequate for review by our institution, the patient must agree to a repeat imaging to be performed at Johns Hopkins.
- ECOG performance status 0 or 1
- Life expectancy greater than 3 months.
- Able to swallow pills or capsules.
- Patient must have adequate organ function defined by the study-specified laboratory tests.
- Patients must be eligible to receive FOLFIRINOX-based chemotherapy.
- Patients must be willing to be treated with stereotactic body radiation therapy (SBRT) only at Johns Hopkins Hospital.
- Patients must be willing to undergo a core biopsy of the pancreatic cancer.
- Patients must be willing to undergo a biopsy of the pancreatic cancer if the patient is not deemed a surgical candidate during the pre-surgical evaluation.
- Must use acceptable form of birth control while on study.
- Ability to understand and willingness to sign a written informed consent document.
Exclusion Criteria:
- Patients cannot have had any prior therapy for the locally advanced pancreatic adenocarcinoma.
- Have received any anti-neoplastic biologics, vaccines or hormonal treatment, including investigational drugs, within 28 days of the first dose of study.
- History of past treatment with immunotherapy agents prior to initial enrollment into this study (including, but not limited to: IL-2, interferon, anti-PD-1, anti-PD-L1, anti-PD-L2, anti-CD137, anti-OX-40, anti-CD40, anti-CTLA-4 or anti-CCR2/5 drugs).
- Have had prior organ or tissue allograft or allogeneic bone marrow transplantation, including corneal transplants.
- Is currently participating or has participated in a study of an investigational agent or using an investigational device for the treatment of cancer.
- Current use of immunosuppressive medications within 14 days prior to study medications.
- Have received any vaccine within 14 days prior to study medications.
- Receiving growth factors including, but not limited to, granulocyte-colony stimulating factor (G-CSF), GM-CSF, erythropoietin, within 14 days of the first dose of study medication.
- History of any autoimmune disease. Patients with thyroid disease will be allowed.
- Has a history of (non-infectious) pneumonitis or current pneumonitis.
- Has a pulse oximetry < 92% on room air.
- Requires the use of home oxygen.
- Patients with uncontrolled intercurrent illness including, but not limited to, myocardial infarction or stroke/transient ischemic attack within the past 6 months, uncontrolled infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
- 12-lead electrocardiogram with QRS ≥ 120 msec, except right bundle branch block ; QTcF (QT corrected for heart rate using Fridericia's method) ≥ 480 msec, except right bundle branch block
- Has an active infection requiring systemic therapy.
- Infection with HIV or hepatitis B or C.
- Any concurrent malignancy other than non-melanoma skin cancer, non-invasive bladder cancer, early stage prostate cancer, or carcinoma in situ of the cervix.
- Current or recent (within 3 months of study treatment administration) gastrointestinal disease that could impact the absorption of study treatment.
- Any gastrointestinal surgery that is likely impact upon the absorption of study treatment.
- Inability to tolerate oral medication.
- Unable to have blood drawn.
- Have had surgery within 28 days of the first dose of study medication.
- Prior use of strong/moderate CYP3A4 inhibitors or inducers within 28 days of the first dose of BMS-813160.
- Prior use of Class I antiarrhythmics within 28 days of first dose of study medication.
- Has ascites requiring medical management.
- Presence of duodenal or gastric invasion by the tumor.
- Hypersensitivity reaction to any monoclonal antibody.
- Known allergy or hypersensitivity to study drugs or any of their components of the study arm that participant is enrolling.
- Woman who are pregnant or breastfeeding.
- Patient is unwilling or unable to follow the study schedule for any reason.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Sequential Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
|
Experimental: Phase I - GVAX/Nivolumab/CCR2/CCR5 dual antagonist
|
SBRT (6.6 Gy over 5 days) will be administered between 2 to 4 weeks after chemotherapy.
(Prior to surgery)
Nivolumab (480 mg) will be administered IV over 30 minutes, on day 1 of cycle 1 (within 1 to 2 weeks after SBRT prior to surgery).
Post - surgery Nivolumab will be given on Day 1 of cycles 2-5.
Cycles are 4 weeks long.
Other Names:
CCR2/CCR5 dual antagonist (150 mg capsules) will be administered orally twice a day, on days 1-28 of cycle 1 (within 1 to 2 weeks after SBRT prior to surgery).
Post - surgery CCR2/CCR5 dual antagonist will be given daily on cycles 2-5.
Cycles are 4 weeks long.
Other Names:
Vaccine (5x10^8 cells) will be administered on day 2 of cycle 1 (within 1 to 2 weeks after SBRT prior to surgery).
Post - surgery GVAX will be given on Day 2 of cycles 2-5.
Cycles are 4 weeks long.
Six intradermal injections every 4 weeks.
Other Names:
|
|
Experimental: Phase II - Arm A: Nivolumab/CCR2/CCR5 dual antagonist
|
SBRT (6.6 Gy over 5 days) will be administered between 2 to 4 weeks after chemotherapy.
(Prior to surgery)
Nivolumab (480 mg) will be administered IV over 30 minutes, on day 1 of cycle 1 (within 1 to 2 weeks after SBRT prior to surgery).
Post - surgery Nivolumab will be given on Day 1 of cycles 2-5.
Cycles are 4 weeks long.
Other Names:
CCR2/CCR5 dual antagonist (150 mg capsules) will be administered orally twice a day, on days 1-28 of cycle 1 (within 1 to 2 weeks after SBRT prior to surgery).
Post - surgery CCR2/CCR5 dual antagonist will be given daily on cycles 2-5.
Cycles are 4 weeks long.
Other Names:
|
|
Experimental: Phase II - Arm B: Nivolumab/GVAX/CCR2/CCR5 dual antagonist
|
SBRT (6.6 Gy over 5 days) will be administered between 2 to 4 weeks after chemotherapy.
(Prior to surgery)
Nivolumab (480 mg) will be administered IV over 30 minutes, on day 1 of cycle 1 (within 1 to 2 weeks after SBRT prior to surgery).
Post - surgery Nivolumab will be given on Day 1 of cycles 2-5.
Cycles are 4 weeks long.
Other Names:
CCR2/CCR5 dual antagonist (150 mg capsules) will be administered orally twice a day, on days 1-28 of cycle 1 (within 1 to 2 weeks after SBRT prior to surgery).
Post - surgery CCR2/CCR5 dual antagonist will be given daily on cycles 2-5.
Cycles are 4 weeks long.
Other Names:
Vaccine (5x10^8 cells) will be administered on day 2 of cycle 1 (within 1 to 2 weeks after SBRT prior to surgery).
Post - surgery GVAX will be given on Day 2 of cycles 2-5.
Cycles are 4 weeks long.
Six intradermal injections every 4 weeks.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Study Drug-related Adverse Events
Time Frame: Up to 18 months
|
Number of participants who experienced study drug-related toxicities as defined by CTCAE v5.0
|
Up to 18 months
|
|
Tumor Immune Response (CD8+ CD137+ Tumor Infiltration)
Time Frame: 7 months
|
Number of participants who had >80% increase of infiltration of CD8+CD137+ T cells into their tumors after treatment with SBRT and immunotherapy.
Baseline biopsies were collected at time of fiducial placement for SBRT (after completion of chemotherapy) and post-treatment tumor was collected at time of surgical resection
|
7 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Overall Survival (OS)
Time Frame: 3 years
|
Number of months from start of immunotherapy until death from any cause
|
3 years
|
|
Metastasis Free Survival (MFS)
Time Frame: 3 years
|
Number of months from the start of immunotherapy until first documented distant metastases on radiographic imaging or death from any cause, whichever occurs first.
|
3 years
|
|
Local Progression Free Survival (LPFS)
Time Frame: 3 years
|
Number of months from the start of immunotherapy until first documented local progression on radiographic imaging or death from any cause, whichever occurs first.
Local progression is defined as appearance of new lesions in the pancreas or surgical resection bed (for surgically resected patients) or clinically meaningful tumor growth in the primary pancreas tumor (for patients that were not surgically resectable).
|
3 years
|
|
Surgical Resectability Rate
Time Frame: 7 months
|
Number of participants who are able to undergo successful tumor resection (as defined by R0 and R1 resection).
|
7 months
|
|
Pathological Response Rate
Time Frame: 7 months
|
Number of participants who with a moderate, marked, or complete pathologic response after chemotherapy, SBRT, and one cycle of immunotherapy as determined by surgical margins and residual disease. Tumor response grading Complete response (grade 0): no viable residual cancer cells Marked response (grade 1): single cells or rare small groups of cancer cells Moderate response (grade 2): residual cancer outgrown by fibrosis Poor or no response (grade 3): extensive residual cancer |
7 months
|
Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: Amol Narang, MD, Johns Hopkins Medical Institution
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
- Monoclonal antibody
- Nivolumab
- Checkpoint inhibitor
- Immunotherapy
- Anti-PD-1
- Pancreatic Ductal Adenocarcinoma
- SBRT
- Pancreatic cancer
- Neoadjuvant chemotherapy
- Stereotactic body radiation therapy
- Cancer vaccine
- GVAX
- PDAC
- LAPC
- CCR2/CCR5 dual antagonist
- Myeloid modulating agent
- Locally advanced pancreatic ductal adenocarcinoma
Additional Relevant MeSH Terms
- Endocrine System Diseases
- Neoplasms by Site
- Neoplasms
- Digestive System Neoplasms
- Digestive System Diseases
- Endocrine Gland Neoplasms
- Pancreatic Diseases
- Pancreatic Neoplasms
- Amino Acids, Peptides, and Proteins
- Proteins
- Investigative Techniques
- Therapeutics
- Surgical Procedures, Operative
- Antibodies, Monoclonal, Humanized
- Antibodies, Monoclonal
- Antibodies
- Immunoglobulins
- Immunoproteins
- Blood Proteins
- Serum Globulins
- Globulins
- Radiotherapy
- Stereotaxic Techniques
- Neurosurgical Procedures
- Nivolumab
- Radiosurgery
- BMS-813160
Other Study ID Numbers
- J18163
- IRB00190660 (Other Identifier: JHMI IRB)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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