- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05286827
Olaparib in Subjects With Advanced Pancreatic Acinar Cell Carcinoma
Phase II Study of Olaparib in Subjects With Advanced Pancreatic Acinar Cell Carcinoma
Background:
Pancreatic Acinar Cell Carcinoma (PACC) is a rare pancreatic tumor. People with PACC usually present with advanced disease, and their prognosis is poor. Researchers want to learn if a cancer drug called olaparib can help.
Objective:
To see if olaparib is an effective treatment for PACC.
Eligibility:
People aged 18 and older with PACC whose cancer did not respond to previous treatments or is not eligible for surgery.
Design:
Participants will be screened with the following:
Medical history
Physical exam
Blood and urine tests
Electrocardiogram (to test heart function)
Computed tomography (CT) scans
Pregnancy test (if needed)
Tumor biopsy (if a sample is not available)
Treatment will be given in 21-day cycles. Participants will take olaparib by mouth twice daily for each cycle. They will keep a medicine diary. They will receive treatment for up to 2 years. They may stop treatment early if their cancer gets worse or they have serious side effects.
Participants will have study visits at the beginning of each cycle. At visits, they will repeat some screening tests. They will be asked about any changes in medicines they are taking and how they are feeling. They will have CT scans every 8 weeks starting in cycle 2.
Participants will give blood samples for research. They may have optional tumor biopsies.
Participants will have 2 follow-up visits in the 30 days after treatment ends or before they begin a new anti-cancer treatment. Then they will be contacted every 3 months by phone for 1 year.
Participation will last for up to 3 years.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Background:
- Pancreatic Acinar Cell Carcinoma (PACC) is a rare pancreatic tumor, representing 0.5-1% of all pancreatic malignancies.
- PACC is commonly advanced at presentation and median overall survival in this population is poor.
- PACC is pathologically and biochemically distinct from pancreatic adenocarcinoma.
- No clinical trials for PACC have ever been reported.
- Patients are most commonly treated with combination regimens used for either pancreatic or colon adenocarcinoma with poor (approximately 30%) response rates in the first-line setting.
- PACC pathological specimens demonstrate evidence of high chromosomal instability, a hallmark of DNA repair deficiency.
- Data derived from ovarian and prostate cancer patients has demonstrated that mutations in DNA repair genes can define subgroups of cancer patients with distinct vulnerabilities to DNA damage response inhibitors.
- Olaparib is a Poly-ADP ribose polymerase (PARP)-1 inhibitor that has been FDA approved for the treatment of BRCA-mutant homologous recombination repair (HRR) deficient cancers.
- As PACC has multiple hallmarks of HRR deficiency, we hypothesize that PACC will be sensitive to PARP inhibition with olaparib.
- Pre-clinical modeling of PACC has been very limited with no currently available animal models or cell lines, which precludes testing this hypothesis in the laboratory setting.
Objective:
- To assess the anti-tumor activity of single agent olaparib, a PARP inhibitor, in participants with advanced pancreatic acinar cell carcinoma (PACC)
Eligibility:
- Participants must have advanced previously treated PACC
- Age >=18 years
- Adequate organ and bone marrow function
Design:
- This is a phase II, single arm, single center study of olaparib in subjects with advanced previously treated PACC.
- All subjects will take olaparib by mouth twice daily for up to two years or until disease progression or intolerable side effects.
- Subjects will be assessed for safety (continuously) and efficacy (every 8 weeks).
- Up to 13 evaluable participants will be enrolled.
Study Type
Enrollment (Estimated)
Phase
- Phase 2
Contacts and Locations
Study Contact
- Name: Christine C Alewine, M.D.
- Phone Number: (240) 760-6146
- Email: alewinecc@mail.nih.gov
Study Contact Backup
- Name: NCI Medical Oncology Referral Office
- Phone Number: (888) 624-1937
- Email: ncimo_referrals@nih.gov
Study Locations
-
-
Maryland
-
Bethesda, Maryland, United States, 20892
- Recruiting
- National Institutes of Health Clinical Center
-
Contact:
- For more information at the NIH Clinical Center contact Office of Patient Recruitment (OPR)
- Phone Number: TTY dial 711 800-411-1222
- Email: ccopr@nih.gov
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
-INCLUSION CRITERIA:
- Histological or cytological diagnosis of Pancreatic Acinar Cell Carcinoma (PACC) as confirmed by NIH Laboratory of Pathology.
- Participants must have received one prior line of combination chemotherapy (or be ineligible to receive combination chemotherapy) with tumor still not amenable for potentially curative resection or be ineligible to receive combination chemotherapy. There is no limit on the number of prior therapies.
- Access to medical records from past treatment
- Measurable disease, per RECIST 1.1.
- Age >=18 years.
- ECOG performance status <=1.
- At least 3 weeks from previous chemotherapy or radiation therapy prior to planned start of treatment.
- At least 30 days or 5 half-lives (whichever is greater) since receipt of any investigational therapy prior to planned start of treatment.
- Fully recovered from all reversible sequalae and >=2 weeks from major surgery or from minor surgical procedure such as biliary or duodenal stenting prior to planned start of treatment.
- At least 2 weeks since last use of known strong CYP3A inhibitors (e.g., itraconazole, telithromycin, clarithromycin, protease inhibitors boosted with ritonavir or cobicistat, indinavir, saquinavir, nelfinavir, boceprevir, telaprevir) or moderate CYP3A inhibitors (e.g., ciprofloxacin, erythromycin, diltiazem, fluconazole, verapamil).
- At least 5 weeks since last use of phenobarbital, enzalutamide, and at least 3 weeks since last use of other strong (e.g., phenytoin, rifampicin, rifabutin, rifapentine, carbamazepine, nevirapine and St John s Wort) or moderate (e.g., bosentan, efavirenz, modafinil) CYP3A inducers.
Adequate organ and marrow function as measured within 28 days prior to study treatment as defined below:
- leukocytes >=3,000/mcL
- absolute neutrophil count >=1,500/mcL
- hemoglobin >= 10 g/dL with no blood transfusion within the last 28 days
- platelets >=100,000/mcL
- total bilirubin within 1.5x normal institutional upper limit of normal (ULN)
- AST(SGOT)/ALT(SGPT) <= institutional ULN unless liver metastases are present in which case they may be <=5x ULN
Creatinine clearance must be >51 mL/min as estimated using the Cockroft-Gault equation* or measured by 24- hour urine test
- Estimated creatinine clearance = (140-age [years]) x weight (kg) (x F) serum/ creatinine (mg/dL) x 72^a, where F=0.85 for females and F=1 for males
This list includes eligibility-defining laboratory value requirements for treatment; laboratory value requirements should be adapted according to local regulations and guidelines for the administration of specific chemotherapies.
- The effects of olaparib on the developing human fetus are unknown. For this reason and because PARP inhibitor agents are known to be teratogenic, women of child-bearing potential and men must agree to use adequate contraception prior to study entry and for the duration of study participation.
- Participants must agree to abstain from consuming grapefruit juice throughout the duration of study treatment with olaparib.
- Ability of subject to understand and the willingness to sign a written informed consent document.
EXCLUSION CRITERIA:
- History of allergic reactions attributed to compounds of similar chemical or biologic composition to olaparib.
- Participants unable to swallow orally administered medication or suffering from GI disorders likely to interfere with absorption of study medication.
- Participants with HIV are excluded even if viral load is undetectable
- Active hepatitis B or C
- Resting ECG indicating uncontrolled, potentially reversible cardiac conditions, as judged by the investigator (e.g., unstable ischemia, uncontrolled symptomatic arrhythmia, congestive heart failure, QTcF prolongation >500 ms, electrolyte disturbances, etc.), or participants with congenital long QT syndrome.
- Recent (within 3 months) myocardial infarction
- Unstable angina pectoris.
- Symptomatic congestive heart failure
- Uncontrolled major seizure disorder
- Superior vena cava syndrome
- Extensive interstitial bilateral lung disease on High Resolution Computed Tomography (HRCT) scan
- Psychiatric illness/social situations (within the last 3 months) that would limit compliance with study requirements or prohibits obtaining informed consent
- Uncontrolled intercurrent illness or participants considered a poor medical risk due to a serious, uncontrolled medical disorder, non-malignant systemic disease or active uncontrolled infection as documented in prior records or suggested by medical history, physical examination or standard clinical assessments such as imaging and laboratory studies
- Participants with myelodysplastic syndrome/acute myeloid leukemia or with features suggestive of MDS/AML.
- Solid or liquid malignancy other than PACC unless curatively treated with no evidence of disease for >=5 years, except: adequately treated non-melanoma skin cancer, curatively treated in situ cancer of the cervix, ductal carcinoma in situ (DCIS), Stage 1, grade 1 endometrial carcinoma.
- Previous allogenic bone marrow transplant or double umbilical cord blood transplantation (dUCBT).
- Women who are breastfeeding and unwilling to stop.
- Participants with symptomatic uncontrolled brain metastases. A scan to confirm the absence of brain metastases is not required. Brain metastases are considered uncontrolled if the dose of corticosteroid being provided for control of brain metastases has been titrated in the 4 weeks prior to start of treatment.
- Participants with spinal cord compression unless considered to have received definitive treatment for this and evidence of clinically stable disease for >=28 days. Participants with unstable spinal cord compression are ineligible even if previously treated.
- Participants with large volume ascites, serum albumin < 2.5 mg/dL, or having received paracentesis within the last 4 weeks
- Participants with persistent toxicities > grade 2 or with new grade 2 events within the last 2 weeks per Common Terminology Criteria for Adverse Event (CTCAE) version 5 caused by previous cancer therapy.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Arm 1
Olaparib, taken orally, twice daily
|
Administered orally (300 mg) twice daily continuously for 21-day cycles for up to 2 years.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
antitumor activity
Time Frame: 1 year post-last dose of olaparib
|
Objective response rate (ORR, CR+PR)
|
1 year post-last dose of olaparib
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
anti-tumor efficacy
Time Frame: 1 year after last olaparib treatment
|
Disease control rate, median duration of treatment response, median progression-free survival (PFS) and median overall survival (OS)
|
1 year after last olaparib treatment
|
safety
Time Frame: from start of treatment to 30 days after last treatment
|
AEs and SAEs of olaparib
|
from start of treatment to 30 days after last treatment
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Christine C Alewine, M.D., National Cancer Institute (NCI)
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
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
Additional Relevant MeSH Terms
Other Study ID Numbers
- 10000596
- 000596-C
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ICF
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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.
Clinical Trials on Pancreatic Acinar Cell Carcinoma
-
National Cancer Institute (NCI)RecruitingPancreatic Acinar Cell Carcinoma | Pancreatic Adenosquamous Carcinoma | Pancreatic Squamous Cell Carcinoma | Resectable Pancreatic Acinar Cell Carcinoma | Resectable Pancreatic Adenocarcinoma | Resectable Pancreatic Adenosquamous Carcinoma | Resectable Pancreatic CarcinomaUnited States
-
Alliance for Clinical Trials in OncologyNational Cancer Institute (NCI)RecruitingPancreatic Adenocarcinoma | Pancreatic Ductal Adenocarcinoma | Stage IV Pancreatic Cancer AJCC v8 | Pancreatic Carcinoma | Pancreatic Acinar Cell Carcinoma | Pancreatic Adenosquamous Carcinoma | Pancreatic Squamous Cell CarcinomaUnited States
-
National Cancer Institute (NCI)CompletedPancreatic Ductal Adenocarcinoma | Recurrent Pancreatic Carcinoma | Stage IV Pancreatic Cancer | Pancreatic Acinar Cell CarcinomaUnited States
-
National Cancer Institute (NCI)CompletedPancreatic Ductal Adenocarcinoma | Recurrent Pancreatic Carcinoma | Stage IV Pancreatic Cancer | Pancreatic Acinar Cell CarcinomaUnited States
-
Mohammed Najeeb Al HallakNational Cancer Institute (NCI)CompletedAcinar Cell Adenocarcinoma of the Pancreas | Duct Cell Adenocarcinoma of the Pancreas | Stage IV Pancreatic CancerUnited States
-
National Cancer Institute (NCI)TerminatedAcinar Cell Adenocarcinoma of the Pancreas | Duct Cell Adenocarcinoma of the Pancreas | Stage IV Pancreatic CancerUnited States
-
The Clatterbridge Cancer Centre NHS Foundation...Cancer Research UK; University of LiverpoolSuspendedPancreatic Neoplasms | Pancreatic Acinar CarcinomaUnited Kingdom
-
Fox Chase Cancer CenterNational Cancer Institute (NCI)TerminatedAcinar Cell Adenocarcinoma of the Pancreas | Duct Cell Adenocarcinoma of the Pancreas | Stage III Pancreatic Cancer | Stage IIB Pancreatic CancerUnited States
-
National Cancer Institute (NCI)Active, not recruitingPancreatic Ductal Adenocarcinoma | Recurrent Pancreatic Carcinoma | Stage IV Pancreatic Cancer AJCC v6 and v7 | Pancreatic Acinar Cell Carcinoma | Adult Solid NeoplasmUnited States
-
National Cancer Institute (NCI)Active, not recruitingPancreatic Ductal Adenocarcinoma | Stage III Pancreatic Cancer AJCC v6 and v7 | Stage IV Pancreatic Cancer AJCC v6 and v7 | Pancreatic Acinar Cell Carcinoma | Locally Advanced Pancreatic AdenocarcinomaUnited States
Clinical Trials on Olaparib
-
Memorial Sloan Kettering Cancer CenterActive, not recruitingSmall Cell Lung Carcinoma | Small-cell Lung CancerUnited States
-
AstraZenecaMerck Sharp & Dohme LLC; Iqvia Pty LtdCompletedMalignant Solid TumorBelgium
-
CSPC Ouyi Pharmaceutical Co., Ltd.CompletedHealthy ParticipantsChina
-
Dana-Farber Cancer InstituteNovartis; AstraZenecaCompleted
-
AstraZenecaEuropean Network of Gynaecological Oncological Trial Groups (ENGOT)CompletedEpithelial Ovarian CancerDenmark, France, Germany, Italy, Spain, Poland, Belgium, Canada, United Kingdom, Israel, Norway
-
AstraZenecaMerck Sharp & Dohme LLC; European Network of Gynaecological Oncological Trial... and other collaboratorsActive, not recruitingRelapsed Ovarian Cancer | Following Complete or Partial Response to Platinum Based Chemotherapy | Platinum Sensitive | BRCA MutatedKorea, Republic of, France, China, Italy, United States, Israel, United Kingdom, Canada, Japan, Germany, Brazil, Netherlands, Belgium, Poland, Australia, Russian Federation, Spain
-
Nordic Society of Gynaecological Oncology - Clinical...Hellenic Cooperative Oncology Group; European Network of Gynaecological Oncological... and other collaboratorsRecruiting
-
Qilu Pharmaceutical Co., Ltd.Completed
-
Leiden University Medical CenterUniversity Medical Center Groningen; Erasmus Medical CenterRecruitingBRCA1 Mutation | BRCA2 Mutation | Homologous Recombination Deficiency | Ovarian Neoplasm EpithelialNetherlands
-
SandozCompleted