- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT06001658
Perioperative Gemcitabine, Cisplatin, and Pembrolizumab in Potentially Resectable Biliary Tract Cancers
May 2, 2024 updated by: Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Tumor Microenvironment Features of Response to Perioperative Gemcitabine, Cisplatin, and Pembrolizumab in Potentially Resectable Biliary Tract Cancers
The purpose of this study is to determine the safety of peri-operative gemcitabine, cisplatin, and pembrolizumab in patients with BTC, as well as whether the combination of gemcitabine, cisplatin, and pembrolizumab (gem/cis/pembro) is feasible and lead to pathologic responses.
Study Overview
Status
Recruiting
Conditions
Intervention / Treatment
Study Type
Interventional
Enrollment (Estimated)
27
Phase
- Phase 2
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Joann Santmyer, RN
- Phone Number: 410-614-3644
- Email: GIClinicalTrials@jhmi.edu
Study Contact Backup
- Name: Colleen Apostal, RN
- Phone Number: 410-614-3644
- Email: GIClinicalTrials@jhmi.edu
Study Locations
-
-
Maryland
-
Baltimore, Maryland, United States, 21231
- Recruiting
- SKCCC Johns Hopkins
-
Contact:
- Joann Santmyer, RN
- Phone Number: 410-614-3644
- Email: GIClinicalTrials@jhmi.edu
-
Contact:
- Colleen Apostol, RN
- Phone Number: 410-614-3644
- Email: GIClinicalTrials@jhmi.edu
-
Principal Investigator:
- Marina Baretti, MD
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- Must have a newly diagnosed, biopsy-proven biliary tract cancer (BTC) including gallbladder, intrahepatic, extrahepatic, and hilar cholangiocarcinoma.
- Resectable BTC (biliary tract cancer)
- Measurable disease per RECIST 1.1 as determined by the investigator.
- Age ≥18 years.
- ECOG (Eastern Cooperative Oncology Group) performance status ≤1 or Karnofsky ≥80
- Patients must have adequate organ and marrow function defined by study-specified laboratory tests.
- Patients must have adequate liver function defined by study-specified laboratory tests.
- Patients with chronic or acute HBV or HCV infection must have disease controlled prior to enrollment.
- Women of childbearing potential (WOCBP) must have a negative urine or serum pregnancy test.
- For both Women and Men, must use acceptable form of birth control while on study.
- Ability to understand and willingness to sign a written informed consent document.
Exclusion Criteria:
- Receiving, or previously received, any systemic chemotherapy, or investigational agent for BTC.
- Has received prior radiotherapy within 2 weeks of start of study intervention.
- Patients with a history of prior treatment with anti-PD-1 and anti-PD-L1.
- Have been diagnosed with another cancer or myeloproliferative disorder whose natural history or treatment has the potential to interfere with safety or efficacy assessment of this study's investigational drugs.
- Has a known history of Human Immunodeficiency Virus (HIV)/AIDS
- Has active co-infection with HBV and HDV.
- Has a diagnosis of immunodeficiency.
- Has active autoimmune disease that has required systemic treatment in the past 2 years.
- Systemic or topical corticosteroids at immunosuppressive doses.
- Prior allogeneic stem cell transplantation or organ transplantation.
- Prior tissue or organ allograft or allogeneic bone marrow transplantation, including corneal transplants.
- Uncontrolled intercurrent active medical and/or psychiatric illness/social psychosocial problems that that would limit compliance with study requirements.
- Uncontrolled intercurrent illness including, but not limited to, uncontrolled infection, symptomatic congestive heart failure, unstable angina, cardiac arrhythmia, metastatic cancer, or psychiatric illness/social situations that would limit compliance with study requirements.
- Evidence of clinical ascites.
- Has a history of (non-infectious) pneumonitis/interstitial lung disease that required steroids or has current pneumonitis/interstitial lung disease.
- Previously identified allergy or hypersensitivity to monoclonal antibodies or any component of the study treatment formulations.
- Pregnant or breastfeeding.
- WOCBP and men with female partners (WOCBP) who are not willing to use contraception.
- Subjects unable to undergo venipuncture and/or tolerate venous access.
- Patient is at the time of signing informed consent a regular user (including "recreational use") of any illicit drugs or had a recent history (within the last year) of substance abuse (including alcohol).
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
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: Gemcitabine, Cisplatin and Pembrolizumab
|
Patients will receive treatment on Day 1 and Day 8 of each cycle.
Gemcitabine (1000 mg/m2) will be administered IV on Day 1 and Day 8 of each cycle, Q3 weeks with 2 - 4 cycles prior to surgery and then 4-6 cycles after surgery.
Patients will receive treatment on Day 1 and Day 8 of each cycle.
Cisplatin (25 mg/m2) will be administered IV on Day 1 and Day 8 of each cycle, Q3 weeks with 2 - 4 cycles prior to surgery and then 4-6 cycles after surgery.
Patients will receive treatment on Day 1 of each cycle.
Pembrolizumab (200 mg) will be administered IV on Day 1 of each cycle, Q3 weeks with 2 - 4 cycles prior to surgery and then 4-6 cycles after surgery.
Pembrolizumab (400 mg) will be administered IV Q6 weeks up to 4 cycles as maintenance.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Average minimum Euclidean distance from CD8+ T cells to immunosuppressive tumor-associated macrophages (TAMs) at the per-cell level in patients with a major pathologic response versus pathologic non-responders.
Time Frame: 4 years
|
The evaluable population of this endpoint consist of all patients who receive at least one dose of study drug and have TAMs and CD8 T cell measures at the time of surgery.
TAMs being evaluated are the following: immunosuppressive TAMs with high Arginase-1 expression (CD68+CD163+Arg-1hiPDL1-/+), immunosuppressive TAMs with low Arginase-1 expression (CD68+CD163+Arg-1lo PDL1-/+), and less immunosuppressive TAMs (CD68+CD163-HLA-DRhi/CD86hi/PDL1hi)
|
4 years
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Number of participants experiencing grade 3 or above drug-related toxicities
Time Frame: 4 years
|
When calculating the incidence of AEs, each AE (as defined by NCI CTCAE v5.0) will be counted only once for a given subject.
|
4 years
|
Number of patients proceeding to surgery without an extended treatment-related delay as a measure of feasibility
Time Frame: 144 days
|
Extended treatment delay is defined as a delay of greater than 60 days of the pre-planned surgical evaluation date, or inability to go to surgery due to an adverse event related to study treatment.
|
144 days
|
Major pathologic response rate
Time Frame: 8-12 weeks
|
The number of participants with a major pathologic response as defined by ≤ 10% residual viable tumor cells in the resection of the primary tumor and lymph nodes.
|
8-12 weeks
|
R0 resection rate
Time Frame: 60 days
|
The number of participants with a R0 resection as defined by a microscopically margin-negative resection, in which no tumor (gross or microscopic) remains in the primary tumor bed.
|
60 days
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Collaborators
Investigators
- Principal Investigator: Marina Baretti, M.D., SKCCC Johns Hopkins Medical Institution
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Estimated)
May 1, 2024
Primary Completion (Estimated)
May 1, 2028
Study Completion (Estimated)
May 1, 2028
Study Registration Dates
First Submitted
August 8, 2023
First Submitted That Met QC Criteria
August 16, 2023
First Posted (Actual)
August 21, 2023
Study Record Updates
Last Update Posted (Actual)
May 3, 2024
Last Update Submitted That Met QC Criteria
May 2, 2024
Last Verified
May 1, 2024
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Digestive System Diseases
- Neoplasms
- Neoplasms by Site
- Digestive System Neoplasms
- Biliary Tract Diseases
- Biliary Tract Neoplasms
- Molecular Mechanisms of Pharmacological Action
- Antimetabolites, Antineoplastic
- Antimetabolites
- Antineoplastic Agents
- Antineoplastic Agents, Immunological
- Immune Checkpoint Inhibitors
- Pembrolizumab
- Gemcitabine
Other Study ID Numbers
- J2390
- IRB00371087 (Other Identifier: Johns Hopkins Medicine Internal Review Board)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Yes
Studies a U.S. FDA-regulated device product
No
product manufactured in and exported from the U.S.
No
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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