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Pancreatic Ductal AdenocarcinomaPhase 1/2NCT01431794

Gemcitabine + Nab-paclitaxel With LDE-225 (Hedgehog Inhibitor) as Neoadjuvant Therapy for Pancreatic Adenocarcinoma

A Phase 1/2 study testing LDE225-600mg, Gemcitabine and nab-paclitaxel in people with Pancreatic Ductal Adenocarcinoma, run by Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins at 1 site in United States.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

This is an open-label phase 1/2 study that will combine the chemotherapy agents gemcitabine and nab-paclitaxel with an oral hedgehog inhibitor LDE225 (Sonidegib). The objective is to assess tolerability and the resection rate of patients with borderline resectable pancreatic adenocarcinoma who use this treatment. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Pancreatic Ductal Adenocarcinoma
What is being tested?
LDE225-600mg, Gemcitabine and nab-paclitaxel
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
23 participants
Where
1 siteUnited States
Study dates
27 Dec 2011to 5 Nov 2018
Phase
Phase 1/2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Histologically or cytologically confirmed adenocarcinoma of the pancreas.
  • Must have borderline resectable pancreatic adenocarcinoma
  • Measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension
  • No previous radiotherapy, surgery, chemotherapy or investigational drug therapy.
  • Age >18 years
  • Life expectancy of greater than 1 month.
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  • ECOG (Eastern Cooperative Oncology Group) performance status 0 or 1
  • Adequate organ and marrow function
  • Asymptomatic for jaundice and ascites. Pain symptoms should be stable.
  • Negative serum pregnancy test
  • Sexually active males should agree to use a barrier form of contraception, even if they have had a vasectomy, during the study and for 6 months after stopping LDE225. Males should not donate sperm during treatment, and for up to six months after last dose. Sexually active females of child bearing potential agree to using highly effective contraception during study and for 20 months after final dose of LDE225.
  • Agree not to donate blood products for 12 months after stopping LDE225.
  • Willing to have two biopsies while on treatment for correlative studies.

Who cannot join

  • Patients who have had previous radiotherapy, surgical resection, chemotherapy or investigational drug therapy for pancreatic adenocarcinoma.
  • Patient has known metastatic disease.
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to LDE225 or other agents used in the study.
  • Patients taking medications with narrow therapeutic indices that are metabolized by cytochrome P450 (CYP450), including warfarin sodium (Coumadin®)
  • Uncontrolled illness including, but not limited to, ongoing or active infection requiring IV antibiotics, symptomatic congestive heart failure not controlled with medication, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
  • Pregnant women are excluded
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  • Patient has undergone a major surgery, other than diagnostic surgery within four weeks prior to starting treatment on this study.
  • Patients who are receiving treatment with medications known to be moderate and strong inhibitors or inducers of CYP3A4/5 or drugs metabolized by CYP2B6 or CYP2C9 that have narrow therapeutic index, and that cannot be discontinued before starting treatment with LDE225. Medications that are strong CYP3A4/5 inhibitors should be discontinued at least 7 days and strong CYP3A/5 inducers for at least 2 weeks prior to starting treatment with LDE225.
  • Patients with neuromuscular disorders.
  • Patients with impaired cardiac function.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

    Baltimore, Maryland, 21205

Other trials in United States

About this study

Official title: Phase 1/2 Safety and Feasibility of Gemcitabine and Nab-Paclitaxel in Combination With LDE-225 as Neoadjuvant Therapy in Patients With Borderline Resectable Pancreatic Adenocarcinoma.

This is an open-label phase 1/2 study that will combine the chemotherapy agents gemcitabine and nab-paclitaxel with an oral hedgehog inhibitor LDE225 (Sonidegib). The objective is to assess tolerability and the resection rate of patients with borderline resectable pancreatic adenocarcinoma who use this treatment.

Read the detailed description

The investigators propose treating 6-12 patients during the phase 1 portion and 40 patients in the phase 2 stage.

Phase 1 Stage:

Four cycles of gemcitabine 1000 mg/m2 and nab-paclitaxel 125 mg/m2 on days 1, 8 and 15 in combination with escalating doses (400mg, or 600mg, or 800mg) of LDE-225. After completion of neoadjuvant therapy, the subjects will receive combined chemotherapy and radiation. Then subjects who are eligible for resection will go ahead with surgery. Following resection, subjects will complete two additional cycles of gemcitabine 1000 mg/m2 and nab-paclitaxel 125 mg/m2 in combination with LDE-225.

Phase 2 Stage: In the Phase 2 stage the patients will be randomized to receive gemcitabine and nab-paclitaxel with or without the hedgehog inhibitor LDE225:

  1. Arm A: Four cycles of gemcitabine 1000 mg/m2 and nab-paclitaxel 125 mg/m on days 1, 8 and 15 in combination with LDE-225 at the recommended phase 2 dose.
  2. Arm B: Four cycles of gemcitabine 1000 mg/m2 and nab-paclitaxel 125 mg/m on days 1, 8 and 15.

After completion of neoadjuvant therapy, the subjects will receive combined chemotherapy and radiation. Then subjects who are eligible for resection will go ahead with surgery. Following resection, subjects will complete two additional cycles of the pre-surgical therapy.

Several correlative laboratory studies will be conducted during the course of this study. They were designed around the goals of providing us with a better understanding of how the stroma-tumor interaction and the intra-tumoral drug levels of gemcitabine are affected with the use of LDE-225. Two additional biopsies are required to participate in this study.

Being tested
LDE225-600mg, Gemcitabine, nab-paclitaxel, LDE225-400mg, LDE225-800mg
Keywords
Pancreatic ductal adenocarcinoma (PDA)Neoplasms, LDE225, nab-paclitaxel, abraxane, gemcitabine, neoadjuvant, cytotoxic, hedgehog inhibitor, stromal cells, resectable PDA, Pancreatic Diseases, Carcinoma, Sonidegib
Medical subject headings
Pancreatic Diseases, Carcinoma

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • LDE225-600mgDrug

    Also called Sonidegib

    Phase I: oral LDE225 (Sonidegib), 600mg daily.

    Phase II Arm A: LDE225 at the recommended phase 2 dose on Days 1, 8 and 15. Cycles repeated every 28 days.

  • GemcitabineDrug

    Also called gem

    Four cycles of Gemcitabine 1000 mg/m2 on days 1, 8, and 15 every 28 days.

  • nab-paclitaxelDrug

    Also called abraxane

    Four cycles of nab-Paclitaxel 125 mg/m2 on days 1, 8, and 15 every 28 days.

  • LDE225-400mgDrug

    Also called Sonidegib

    Phase I: oral LDE225 (Sonidegib), 400mg daily.

  • LDE225-800mgDrug

    Also called Sonidegib

    Phase I: oral LDE225 (Sonidegib), 800mg daily.

Study groups in NCT01431794
Study groupRoleWhat they receive
Phase I-Gem,nab-paclitaxel,LDE225-600mgExperimentalFour cycles of Gemcitabine (gem) 1000 mg/m2 and nab-Paclitaxel 125 mg/ m2 on days 1, 8, and 15 every 28 days cycle in combination with escalating doses of oral LDE225 (Sonidegib), 600 mg daily.
Receives: Drug: LDE225-600mg; Drug: Gemcitabine; Drug: nab-paclitaxel
Phase II-Arm A:Gem,nab-paclitaxel,LDE225Active comparatorFour cycles of gemcitabine 1000 mg/m2 and nab-Paclitaxel 125 mg/m2 on days 1, 8 and 15 in combination with LDE-225 at the recommended phase 2 dose. Cycles repeated every 28 days.
Receives: Drug: LDE225-600mg; Drug: Gemcitabine; Drug: nab-paclitaxel; Drug: LDE225-400mg; Drug: LDE225-800mg
Phase II-Arm B:Gem,nab-paclitaxelActive comparatorFour cycles of gemcitabine 1000 mg/m2 and nab-Paclitaxel 125 mg/m2 on days 1, 8 and 15. Cycles repeated every 28 days.
Receives: Drug: Gemcitabine; Drug: nab-paclitaxel
Phase I-Gem,nab-paclitaxel,LDE225-400mgExperimentalFour cycles of Gemcitabine (gem) 1000 mg/m2 and nab-Paclitaxel 125 mg/ m2 on days 1, 8, and 15 every 28 days cycle in combination with escalating doses of oral LDE225 (Sonidegib), 400 mg daily.
Receives: Drug: Gemcitabine; Drug: nab-paclitaxel; Drug: LDE225-400mg
Phase I-Gem,nab-paclitaxel,LDE225-800mgExperimentalFour cycles of Gemcitabine (gem) 1000 mg/m2 and nab-Paclitaxel 125 mg/ m2 on days 1, 8, and 15 every 28 days cycle in combination with escalating doses of oral LDE225 (Sonidegib), 800 mg daily.
Receives: Drug: Gemcitabine; Drug: nab-paclitaxel; Drug: LDE225-800mg

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Phase I - Safety and Feasibility of Gemcitabine and Nab-Paclitaxel in Combination With LDE-225 as Neoadjuvant Therapy as Measured by Number of Participants Who Tolerated the Maximal Dose of LDE-225

    Number of participants who tolerated the maximal dose of LDE-225 in combination with gemcitabine, nab-paclitaxel as neoadjuvant therapy in patients with borderline resectable pancreatic adenocarcinoma (PDA).

    Measured: 5 years

  2. Phase II - Resection Rate of Two Preoperative Chemotherapy Regimens in Patients With Borderline Resectable PDA

    Number of participants with borderline resectable pancreatic adenocarcinoma (PDA) who undergo resection after therapy

    Measured: 5 years

Secondary outcomes (2)
  1. Overall Survival

    Number of months alive from cycle 1, Day 1 until 5 years post-intervention or death, whichever comes first.

    Measured: 5 years

  2. Overall Tumor Response as Determined by Number of Participants With Complete or Partial Response

    Number of participants who experienced complete response (CR) or partial response (PR), as defined by RECIST v1.0; where CR is a disappearance of all target lesions and PR is ≥30% reduction of target lesions.

    Measured: 5 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted12 Sep 2011 (estimated)
  2. Study start27 Dec 2011
  3. Primary completion5 Nov 2018
  4. Study completion5 Nov 2018

Why it stopped: Study was terminated due to cease in manufacturing of study drug.

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1/2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Single group
Masking
None (open label)
Enrolment
23 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01431794
Sponsor's protocol ID
J1130
Other IDs
NA_00047491
Status last verified
Jan 2020
First submitted
19 Jul 2011
Last updated
22 Jan 2020
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing LDE225-600mg, Gemcitabine and nab-paclitaxel in people with Pancreatic Ductal Adenocarcinoma, run by Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 13 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 22 Jan 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 25 Jun 2019). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Phase I - Safety and Feasibility of Gemcitabine and Nab-Paclitaxel in Combination With LDE-225 as Neoadjuvant Therapy as Measured by Number of Participants Who Tolerated the Maximal Dose of LDE-225 (time frame: 5 years). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 Jan 2020.

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