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Bile Duct CancerPhase 2NCT04298021

DDR-Umbrella Study of DDR Targeting Agents in Advanced Biliary Tract Cancer

A Phase 2 study testing AZD6738, Durvalumab and Olaparib in people with Bile Duct Cancer and Chemotherapy Effect, run by Seoul National University Hospital at 1 site in South Korea.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

To assess the effect of AZD6738 and Durvalumab combination or AZD6738 and Olaparib combination in biliary tract cancer patients who have failed to 1st-line chemotherapy. Read more about this study

Who is it for?
Ages 20 years and older
Conditions the study is for
Bile Duct Cancer, Chemotherapy Effect
What is being tested?
AZD6738, Durvalumab and Olaparib
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
74 participants
Where
1 siteSouth Korea
Study dates
25 Jun 2020to 31 Dec 2024
Phase
Phase 2
Are there results?
None posted in the registry

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

Who may be able to join

  • Written informed consent and any locally-required authorization obtained from the subject prior to performing any protocol-related procedures, including screening evaluations
  • Age > 20 years at time of study entry
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
  • Life expectancy of > 16weeks
  • Histologically proven BTC, including intrahepatic cholangiocarcinoma, extrahepatic bile duct cancer, gallbladder cancer, ampulla of vater cancer
  • Unresectable or recurrent
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  • Failed to 1st-line chemotherapy for their advanced BTC (IO is not allowed)
  • At least one measurable lesion that can be accurately assessed at baseline by computed tomography (CT) (magnetic resonance imaging [MRI] where CT is contraindicated) and is suitable for repeated assessment as per RECIST 1.1.
  • Body weight >30kg (for durvalumab cohort)
  • Adequate normal organ and marrow function measured within 28 days prior to administration of study treatment as defined below :
  • Haemoglobin ≥9.0 g/dL (>10 for olaparib cohort with no transfusion within the previous 28 days)
  • Absolute neutrophil count (ANC) ≥ 1.5 x 109/L
  • Platelet count ≥ 100 x 109/L
  • Serum bilirubin ≤1.5 x institutional upper limit of normal (ULN). (This will not apply to patients with confirmed Gilbert's syndrome (persistent or recurrent hyperbilirubinemia that is predominantly unconjugated in the absence of hemolysis or hepatic pathology), who will be allowed only in consultation with their physician.)
  • AST (SGOT)/ALT (SGPT) ≤2.5 x institutional upper limit of normal unless liver metastases are present, in which case it must be ≤5x ULN
  • Patients must have creatinine clearance estimated of ≥51 mL/min using the Cockcroft-Gault equation or based on a 24 hour urine test :
  • Estimated creatinine clearance = (140-age [years]) x weight (kg) (x F)a serum creatinine (mg/dL) x 72
  • a where F=0.85 for females and F=1 for males.
  • Postmenopausal or evidence of non-childbearing status for women of childbearing potential: negative urine or serum pregnancy test within 28 days of study treatment and confirmed prior to treatment on day 1.
  • Postmenopausal is defined as:
  • Amenorrheic for 1 year or more following cessation of exogenous hormonal treatments
  • Luteinizing hormone (LH) and Follicle stimulating hormone (FSH) levels in the post menopausal range for women under 50
  • radiation-induced oophorectomy with last menses >1 year ago
  • chemotherapy-induced menopause with >1 year interval since last menses
  • surgical sterilisation (bilateral oophorectomy or hysterectomy) 12. Male patients must use a condom during treatment and for 6 months after the last dose of study drug when having sexual intercourse with a pregnant woman or with a woman of childbearing potential. Female partners of male patients should also use a highly effective form of contraception ([see appendix H for acceptable methods]) if they are of childbearing potential 13. Patient is willing and able to comply with the protocol for the duration of the study including undergoing treatment and scheduled visits and examinations including follow up.

Who cannot join

  • Participation in another clinical study with an investigational product during the last 3 weeks
  • Patients unable to swallow orally administered medication and patients with gastrointestinal disorders likely to interfere with absorption of the study medication.
  • Any previous treatment with Immune check point inhibitor, ATR or PARP inhibitor, including Olaparib.
  • Whole blood transfusions in the last 120 days prior to entry to the study in olaparib cohort (packed red blood cells and platelet transfusions are acceptable outside of 28 days prior to treatment
  • Concurrent enrolment in another clinical study, unless it is an observational (non-interventional) clinical study or during the follow-up period of an interventional study
  • Receipt of the last dose of anti-cancer therapy (chemotherapy, immunotherapy, endocrine therapy, targeted therapy, biologic therapy, tumor embolization, monoclonal antibodies, other investigational agent) within 21 days of the first dose of study drug .2 The minimum washout period for immunotherapy is 42 days
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  • Mean QT interval:
  • Mean resting corrected QT interval (QTc) >470 msec for females and >450 for men, obtained from 3 electrocardiograms (ECGs) 2-5 minutes apart using the Fredericia formula
  • Any factors that increase the risk of QTc prolongation or risk of arrhythmic events such as congestive heart failure, unstable angina pectoris, acute myocardial infarction, hypokalaemia, congenital long QT syndrome, immediate family history of long QT syndrome or unexplained sudden death under 40 years of age, conduction abnormality not controlled with pacemaker or medication.
  • In AZD6738+Durvalumab cohort, current or prior use of immunosuppressive medication within 14days (use 28 days if combining durvalumab with a novel agent) before the first dose of durvalumab, with the exceptions of intranasal and inhaled corticosteroids or systemic corticosteroids at physiological doses, which are not to exceed 10 mg/day of prednisone, or an equivalent corticosteroid. The following are exceptions to this criterion
  • The following are exceptions to this criterion:
  • Intranasal, inhaled, topical steroids, or local steroid injections (e.g., intra articular injection)
  • Systemic corticosteroids at physiologic doses not to exceed 10 mg/day of prednisone or its equivalent
  • Steroids as premedication for hypersensitivity reactions (e.g., CT scan premedication)
  • Also, Any of the following cardiac diseases currently or within the last 6 months (by New York Heart Association (NYHA) ≥ Class 2 where applicable):
  • Unstable angina pectoris
  • Congestive heart failure or known reduced LVEF < 55%
  • Acute myocardial infarction
  • Conduction abnormality not controlled with pacemaker or medication e.g. complete left bundle branch block, third degree heart block
  • Significant ventricular or supraventricular arrhythmias e.g. (patients with chronic rate-controlled atrial fibrillation in the absence of other cardiac abnormalities are eligible)
  • Patients at risk of brain perfusion problems, e.g., medical history of carotid stenosis or pre-syncopal or syncopal episodes, history of TIAs Uncontrolled hypertension (grade 2 or above) requiring clinical intervention.
  • Any unresolved toxicity NCI CTCAE Grade ≥2 from previous anticancer therapy with the exception of alopecia, vitiligo, and the laboratory values defined in the inclusion criteria Patients with Grade ≥2 neuropathy will be evaluated on a case-by-case basis after consultation with the Study Physician.
  • Patients with irreversible toxicity not reasonably expected to be exacerbated by treatment with durvalumab may be included only after consultation with the Study Physician.
  • Any concurrent chemotherapy, IP, biologic, or hormonal therapy for cancer treatment. Concurrent use of hormonal therapy for non-cancer-related conditions (e.g., hormone replacement therapy) is acceptable.
  • Radiotherapy treatment to more than 30% of the bone marrow or with a wide field of radiation within 4 weeks of the first dose of study drug
  • Major surgical procedure (as defined by the Investigator) within 28 days prior to the first dose of IP. Note: Local surgery of isolated lesions for palliative intent is acceptable. Patients must have recovered from any effects of any major surgery
  • History of allogenic organ transplantation.
  • Active or prior documented autoimmune or inflammatory disorders (including inflammatory bowel disease [e.g., colitis or Crohn's disease], diverticulitis [with the exception of diverticulosis], systemic lupus erythematosus, Sarcoidosis syndrome, or Wegener syndrome [granulomatosis with polyangiitis, Graves' disease, rheumatoid arthritis, hypophysitis, uveitis, etc]). The following are exceptions to this criterion:
  • Patients with vitiligo or alopecia
  • Patients with hypothyroidism (e.g., following Hashimoto syndrome) stable on hormone replacement
  • Any chronic skin condition that does not require systemic therapy
  • Patients without active disease in the last 5 years may be included but only after consultation with the study physician
  • Patients with celiac disease controlled by diet alone
  • Uncontrolled intercurrent illness, including but not limited to, ongoing or active infection, symptomatic congestive heart failure, uncontrolled hypertension, unstable angina pectoris, cardiac arrhythmia, interstitial lung disease, serious chronic gastrointestinal conditions associated with diarrhea, or psychiatric illness/social situations that would limit compliance with study requirement, substantially increase risk of incurring AEs or compromise the ability of the patient to give written informed consent
  • History of another primary malignancy except for
  • Malignancy treated with curative intent and with no known active disease ≥5 years before the first dose of IP and of low potential risk for recurrence
  • Adequately treated non-melanoma skin cancer or lentigo maligna without evidence of disease
  • Adequately treated carcinoma in situ without evidence of disease
  • History of leptomeningeal carcinomatosis
  • Brain metastases or spinal cord compression. Patients with symptomatic uncontrolled brain metastases. A scan to confirm the absence of brain metastases is not required. The patient can receive a stable dose of corticosteroids before and during the study as long as these were started at least 4 weeks prior to treatment. Patients with spinal cord compression unless considered to have received definitive treatment for this and evidence of clinically stable disease for 28 days.
  • History of active primary immunodeficiency
  • Active infection or immunocompromised patients including tuberculosis (clinical evaluation that includes clinical history, physical examination and radiographic findings, and TB testing in line with local practice), hepatitis B , hepatitis C, or human immunodeficiency virus (positive HIV 1/2 antibodies). Subjects with simple HBV carrier, a past or resolved HBV infection (defined as the presence of hepatitis B core antibody [anti-HBc] and absence of HBsAg) are eligible. Subjects positive for hepatitis C (HCV) antibody are eligible only if polymerase chain reaction is negative for HCV RNA.
  • Receipt of live attenuated vaccine within 30 days prior to the first dose of IP. Note: Patients, if enrolled, should not receive live vaccine whilst receiving IP and up to 30 days after the last dose of IP.
  • Female patients who are pregnant or breastfeeding.
  • Male or female patients of reproductive potential who are not willing to employ effective birth control from screening to 6 months after the study drug. (including sperm donation for male patients)
  • Known allergy or hypersensitivity to any of the study drugs or any of the study drug excipients.
  • Past medical history of ILD, drug-induced ILD, radiation pneumonitis which required steroid treatment, or any evidence of clinically active interstitial lung disease.
  • Patients with myelodysplastic syndrome/acute myeloid leukaemia or with features suggestive of MDS/AML for olaparib cohort
  • For olaparib cohort, concomitant use of known potent (eg. phenobarbital, enzalutamide, phenytoin, rifampicin, rifabutin, rifapentine, carbamazepine, nevirapine and St John's Wort) CYP3A inducers (eg. bosentan, efavirenz, modafinil). The required washout period prior to starting study treatment is five half-lives, except for St-Johns' wort, which is 3 weeks.
  • For olaparib cohort, previous allogenic bone marrow transplant or double umbilical cord blood transplantation (dUCBT).
  • For AZD6738 cohort, diagnosis of ataxia telangiectasia.
  • Refractory nausea and vomiting, chronic gastrointestinal diseases or previous significant bowel resection, with clinically significant sequelae that would preclude adequate absorption of AZD6738.
  • For AZD6738 cohort, haematuria: +++ on microscopy or dipstick.
  • For AZD6738 cohort, Patients with relative hypotension (<100/60 mmHg) or clinically relevant orthostatic hypotension, including a fall in blood pressure of >20 mmHg.
  • Judgment by the investigator that the patient is unsuitable to participate in the study and the patient is unlikely to comply with study procedures, restrictions and requirements.
  • Involvement in the planning and/or conduct of the study
  • Previous enrolment <<or randomisation>> in the present study

Trial locations and contacts

1 site in 1 country.

South Korea1 site
  • Seoul National University Hospital

    Seoul, 110-744

Other trials in South Korea

About this study

Official title: DDR-Umbrella Study of DDR (DNA-Damage Response) Targeting Agents in Advanced Biliary Tract Cancer

To assess the effect of AZD6738 and Durvalumab combination or AZD6738 and Olaparib combination in biliary tract cancer patients who have failed to 1st-line chemotherapy.

Read the detailed description

This is a open-label, phase II, umbrella study enrolling advanced biliary tract cancer patients who have failed to 1st-line chemotherapy. Patients will be enrolled to AZD6738 and Durvalumab combination or AZD6738 and Olaparib combination cohorts. Based on the new emerging therapies, cohorts can be added into existing protocol.

  1. AZD6738 + Durvalumab cohort:
  • Durvalumab 1500 mg iv on D1
  • AZD6738 240 mg bid on D15-D28 Every 4 weeks C1D1 dose of durvalumab will be delivered, and AZD6738 of 240 mg bid will be dosed at D15-D28. Every cycle consists of 4 weeks.
  1. AZD6738 + Olaparib cohort:
  • AZD6738 160 mg qd on D1-D7
  • Olaparib 300 mg bid on D1-D28 Every 4 weeks Every cycle consists of 4 weeks. AZD6738 of 160 mg qd will be administered on D1-D7. Olaparib will be delivered as 300 mg bid dose on D1-D28.

One cycle consists of 4weeks. Response evaluation will be done every 8 weeks (every 2 cycles) of treatment

  1. tumor biopsy is mandatory : screening, after 8weeks (1st-response evaluation), at disease progression (PD)
  2. blood sampling for biomarker study is mandatory: every cycles
  3. To evaluate the metabolic changes, 18 F-FDG PET is mandatory at screening and after 8 weeks (1st-response evaluation).
Being tested
AZD6738, Durvalumab, Olaparib
Medical subject headings
Bile Duct Neoplasms

What participants receive

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

  • AZD6738Drug

    • In AZD6738+Durvalumab cohort
    • AZD6738 240 mg bid on D15-D28 Every 4 weeks
    • In AZD6738+ Olaparib cohort - AZD6738 160 mg qd on D1-7 Every 4 weeks
  • DurvalumabDrug

    Durvalumab 1500 mg iv on D1 Every 4 weeks

  • OlaparibDrug

    Olaparib 300 mg bid on D1-28 Every 4 weeks

Study groups in NCT04298021
Study groupRoleWhat they receive
AZD6738 + DurvalumabExperimental* Durvalumab 1500 mg iv on D1 * AZD6738 240 mg bid on D15-D28 Every 4 weeks C1D1 dose of durvalumab will be delivered, and AZD6738 of 240 mg bid will be dosed at D15-D28. Every cycle consists of 4 weeks.
Receives: Drug: AZD6738; Drug: Durvalumab
AZD6738 + OlaparibExperimental* AZD6738 160 mg qd on D1-D7 * Olaparib 300 mg bid on D1-D28 Every 4 weeks Every cycle consists of 4 weeks. AZD6738 of 160 mg qd will be administered on D1-D7. Olaparib will be delivered as 300 mg bid dose on D1-D28.
Receives: Drug: AZD6738; Drug: Olaparib

What is being measured

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

  1. Disease control rate of AZD6738 + Durvalumab cohort

    Disease control rate based on RECIST v1.1.

    Measured: through study completion, an average of 1 year

  2. Disease control rate of AZD6738 + Olaparib cohort

    Disease control rate based on RECIST v1.1.

    Measured: through study completion, an average of 1 year

Secondary outcomes (12)
  1. Overall response rate of AZD6738 + Durvalumab cohort

    overall response rate (ORR) based on RECIST v1.1

    Measured: through study completion, an average of 1 year

  2. progression-free survival of AZD6738 + Durvalumab cohort

    Time from enroll until disease progression or death

    Measured: through study completion, an average of 1 year

  3. duration of response of AZD6738 + Durvalumab cohort

    Time from documentation of tumor response to disease progression

    Measured: through study completion, an average of 1 year

  4. overall survival of response of AZD6738 + Durvalumab cohort

    Time from enroll until death from any cause

    Measured: every 12 weeks until death or up to 5 years

  5. Safety and tolerability of AZD6738 + Durvalumab cohort measured by number and grade of toxicity events

    CTCAE v5.0

    Measured: through study completion, an average of 1 year

  6. quality of life measurement of AZD6738 + Durvalumab cohort

    EORTC QLQ-C30

    Measured: through study completion, an average of 1 year

  7. overall response rate (ORR) of AZD6738 + Olaparib cohort

    overall response rate (ORR) based on RECIST v1.1

    Measured: through study completion, an average of 1 year

  8. progression-free survival of AZD6738 + Olaparib cohort

    Time from enroll until disease progression or death

    Measured: through study completion, an average of 1 year

  9. duration of response of AZD6738 + Olaparib cohort

    Time from documentation of tumor response to disease progression

    Measured: through study completion, an average of 1 year

  10. overall survival of AZD6738 + Olaparib cohort

    Time from enroll until death from any cause

    Measured: every 12 weeks until death or up to 5 years

  11. Safety and tolerability of AZD6738 + Olaparib cohort as measured by number and grade of toxicity events

    CTCAE v5.0

    Measured: through study completion, an average of 1 year

  12. quality of life measurement of AZD6738 + Olaparib cohort

    EORTC QLQ-C30

    Measured: through study completion, an average of 1 year

Timeline

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

  1. First posted6 Mar 2020
  2. Study start25 Jun 2020
  3. Primary completion31 Dec 2024 (estimated)
  4. Study completion31 Dec 2024 (estimated)

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 2
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
74 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04298021
Sponsor's protocol ID
BTC-DDR Umbrella
Status last verified
Apr 2024
First submitted
25 Feb 2020
Last updated
19 Apr 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing AZD6738, Durvalumab and Olaparib in people with Bile Duct Cancer and Chemotherapy Effect, run by Seoul National University Hospital at 1 site in South Korea.

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 25 inclusion and 57 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: status not confirmed, as of the sponsor's last update on 19 Apr 2024. 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 South Korea. 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 phase mean?

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?

Results are not available in the source record.

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?

Disease control rate of AZD6738 + Durvalumab cohort (time frame: through study completion, an average of 1 year). 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 19 Apr 2024.

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