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Metastatic Pancreatic Ductal AdenocarcinomaPhase 2NALPACNCT05472259

A Study Evaluating the Efficacy of 5-FU + NALIRI and 5-FU + NALIRINOX for PDAC (NALPAC)

A Phase 2 study testing Nanoliposomal irinotecan, 5 FU and Leucovorin in people with Metastatic Pancreatic Ductal Adenocarcinoma, run by Belgian Group of Digestive Oncology at 13 sites in Belgium.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

A non-comparative randomized phase 2 study, evaluating the efficacy of 5-FU + NALIRI and 5-FU + NALIRINOX for metastatic pancreatic ductal adenocarcinoma (PDAC), progressive after Gemcitabine-Abraxane or Gemcitabine monotherapy Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Nanoliposomal irinotecan, 5 FU and Leucovorin
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
134 participants
Where
13 sitesBelgium
Study dates
25 May 2022to 31 Dec 2027
Phase
Phase 2
Are there results?
Not yet: the study is under way

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 proven metastatic adenocarcinoma of the pancreas
  • Progression documented after gemcitabine-Abraxane, or gemcitabine monotherapy
  • Signed written informed consent
  • Age ≥ 18
  • ECOG PS 0/1 at study entry
  • Measurable disease
Show all 11Show fewer
  • Adequate renal (serum creatinine ≤ 1.5x upper reference range), liver (total bilirubin ≤ 1.5x upper reference range) and hematopoietic functions (PMN ≥ 1,5x109/L, platelets ≥ 100x109/L, hemoglobin ≥ 9g/dl)
  • INR/PTT ≤ 1.5x ULN
  • Life expectancy of at least 12 weeks
  • Effective contraception for both male and female patients if the risk of conception exists during treatment and for one month after the last administration
  • Peripheral Neuropathy < grade 2

Who cannot join

  • Uncontrolled concurrent CNS, cardiac, infectious diseases, hypertension
  • History of myocardial infarction, deep venous or arterial thrombosis, CVA during the last 6 months
  • Known hypersensitivity to any of the components, including excipients, of study treatments
  • Previous malignancy in the last past 3 years except basal cell cancer of the skin or preinvasive cancer of the cervix or carcinoma in situ of any type
  • Pregnancy or breast feeding
  • Medical or psychological conditions that would not permit the patient to complete the study or sign inform consent
Show all 18Show fewer
  • Unstable angina, congestive heart failure ≥NYHA class II
  • Uncontrolled hypertension despite optimal management (systolic blood pressure >150 mmHg or diastolic pressure > 90mmHg)
  • HIV infection
  • Complete DPD deficiency
  • Liver failure, cirrhosis Child Pugh B or C
  • Active chronic hepatitis B or C with a need for antiviral treatment
  • Brain metastasis
  • Major surgery, open biopsy or significant traumatic injury within 4 weeks prior to the first dose of treatment
  • History of organ allograft
  • Ongoing uncontrolled, serious infection
  • Renal failure requiring dialysis
  • Patients receiving or having received any investigational treatment within 4 weeks prior to study entry, or participating to another clinical study

Trial locations and contacts

13 sites in 1 country. Contact the study team or a site near you to ask about taking part.

13 sites in 1 country

Belgium13 sites, 13 recruiting
  • UZ Antwerpen

    Antwerp, Antwerp, 2650

    Sanne Wouters

    Timon Vandamme, Prof

    Recruiting
  • AZ Imelda

    Bonheiden

    Doreen Iwens

    Pieter-Jan Cuyle, Dr.

    Recruiting
  • AZ St-Lucas

    Bruges, West-Vlaanderen

    Tania Maerten

    Liesbeth Holvoet, Dr

    Not yet recruiting
  • ULB Erasme

    Brussels, Brussels Capital, 1070

    Axelle Ghilain

    Jean-Luc Van Laethem, Dr

    Recruiting
  • Cliniques Universitaires Saint-Luc UCL

    Brussels, Brussels Capital, 1200

    Tuan Le

    Ivan Borbath, Prof

    Recruiting
  • Grand Hopital de Charleroi

    Charleroi

    Matthias Papier

    Javier Carrasco, Dr.

    Recruiting
  • AZ Maria Middelares

    Ghent

    Margaux Vansteelant

    Els Monsaert, Dr.

    Recruiting
  • University Hospital Ghent

    Ghent

    Tine Derre

    Karen Geboes, Prof.

    Recruiting
  • Pôle Hospitalier Jolimont (HELORA)

    Haine-Saint-Paul, 7100

    Isabelle Buelens, 064/234662, Isabelle.Buelens@helora.be

    Recruiting
  • CHC MontLégia

    Liège, Liège, 4000

    Jocelyne Gilson

    Ghislain Houbiers, Dr

    Recruiting
  • CHU Ambroise Paré

    Mons

    Mariane Blockmans

    Marie Diaz, Dr.

    Recruiting
  • CHR Namur

    Namur

    Christine Leon

    Yeter Gokburun, Dr.

    Recruiting
  • AZ Turnhout

    Turnhout, 2300

    Nel Bovin, 0032 14406912, nel.bovin@azturnhout.be

    Recruiting

Other trials in Belgium

About this study

Official title: A Non-comparative Randomized Phase 2 Study, Evaluating the Efficacy of 5-FU + NALIRI and 5-FU + NALIRINOX for Metastatic Pancreatic Ductal Adenocarcinoma (PDAC), Progressive After Gemcitabine-Abraxane or Gemcitabine Monotherapy

A non-comparative randomized phase 2 study, evaluating the efficacy of 5-FU + NALIRI and 5-FU + NALIRINOX for metastatic pancreatic ductal adenocarcinoma (PDAC), progressive after Gemcitabine-Abraxane or Gemcitabine monotherapy

Read the detailed description

Based on the results of previous studies, the sponsor aims to assess efficacy and safety of this triplet (irinotecan, 5FU/LV and oxaliplatin) in second-line treatment in fit patients (ECOG 0-1) metastatic PDAC.

The primary objective is to assess the efficacy of NALIRINOX (= investigational arm) and NALIRI (= standard care arm) in terms of Progression-Free Survival Rate (PFSR).

As secondary objectives, the following will be evaluated in both arms:

  • Safety/toxicity and tolerability profile according to the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE), version 5.
  • Progression free survival (PFS)
  • Overall response rate and duration of response as assessed by imaging (RECIST 1.1) and tumor markers
  • Overall survival (OS)
Being tested
Nanoliposomal irinotecan, 5 FU, Leucovorin, Oxaliplatin

What participants receive

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

  • Nanoliposomal irinotecanDrug

    Also called Onyvide

    In the control arm (Naliri) a dose of 70mg/m² is administered in combination with 5FU and leucovorin In the investigational arm (Nalirinox) a dose of 50mg/m² is administered in combination with 5FU, leucovorin and oxaliplatin

  • 5 FUDrug

    Also called Fluorouracil

    In the control arm (Naliri) a dose of 2400 mg/m² is administered in combination with nanoliposomal irinotecan and leucovorin In the investigational arm (Nalirinox) a dose of 2400 mg/m² is administered in combination with nanoliposomal irinotecan, leucovorin and oxaliplatin

  • LeucovorinDrug

    Also called Folinate, Elvorine

    In the control arm (Naliri) a dose of 400 mg/m² is administered in combination with nanoliposomal irinotecan and 5FU In the investigational arm (Nalirinox) a dose of 400 mg/m² is administered in combination with nanoliposomal irinotecan, 5FU and oxaliplatin

  • OxaliplatinDrug

    Only administered in the investigational arm (Nalirinox): a dose of 60 mg/m² is administered in combination with nanoliposomal irinotecan, 5FU and Leucovorin

Study groups in NCT05472259
Study groupRoleWhat they receive
Arm A NALIRIActive comparatorCycle length: 14 days Day 1: * Leucovorin: 400 mg/m² IV - Dilute in 250 mL DSW and administer over two hours * Liposomal irinotecan (FBE): 70 mg/m² IV* - Dilute in 500 mL DSW and administer over 90 min * 5 FU: 2400 mg/m² IV - Dilute in 500 to 1000 mL 0,9% NS of DSW and administer as a continuous IV infusion over 46 hours. To accommodate an ambulatory pump for outpatient treatment can be administered undiluted (50 mg/mL) or the total dose diluted in 100 to 150 mL NS. * Patients who are known to be homozygous for UGT1A1*28 should start treatment with 50 mg/m2 ONIVYDE. If they do not encounter drug related toxicities during the first cycle of therapy (started at a reduced dose of 50 mg/m2), they may have the dose of ONIVYDE increased to a dose of 70 mg/m2 in subsequent cycles based on individual patient tolerance.
Receives: Drug: Nanoliposomal irinotecan; Drug: 5 FU; Drug: Leucovorin
Arm B NALIRINOXExperimentalCycle length: 14 days Day 1: * Oxaliplatin 60 mg IV - Dilute in 500 mL D5W and administer over two hours (prior to leucovorin). Shorter oxaliplatin administration schedules (eg. 1mg/m2 per minute) appear to be safe. * Leucovorin: 400 mg/m² IV - Dilute in 250 mL DSW and administer over two hours (after oxaliplatin) * Nanoliposomal irinotecan (FBE): 50 mg/m² IV - Dilute in 500 mL D5W and administer over 90 min * 5 FU: 2400 mg/m² IV - Dilute in 500 to 1000 mL 0,9% NS of DSW and administer as a continuous IV infusion over 46 hours. To accommodate an ambulatory pump for outpatient treatment can be administered undiluted (50 mg/mL) or the total dose diluted in 100 to 150 mL NS.
Receives: Drug: Nanoliposomal irinotecan; Drug: 5 FU; Drug: Leucovorin; Drug: Oxaliplatin

What is being measured

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

  1. Efficacy of NALIRINOX and NALIRI through Progression-Free Survival at D85

    NALIRINOX is the investigational arm and NALIRI is the standard care arm. The efficacy will be assessed in terms of the Progression-Free Survival Rate (PFSR). This is defined as the proportion of patients alive and free of progression at day 85.

    Measured: at day 85 from randomization

Secondary outcomes (12)
  1. Safety/toxicity and tolerability profil: Severety of adverse events

    Adverse events and Serious Adverse events will be assessed during the study treatment and until 14 days later. Severety will be graded according to the NCI-CTCAE version 5.0 and relationship to the study medication will be defined.

    Measured: until 14 days after End of Treatment

  2. Safety/toxicity and tolerability profil: Laboratory assessments

    Standard laboratory safety assessments: They are mandatory prior to each administration of study medication and at the 15 days follow-up visit.

    Clinically significant vs not clinically significant.

    Measured: until 14 days after End of Treatment

  3. Safety/toxicity and tolerability profil: ECOG

    WHO ECOG performance status (PS) will be defined prior to each administration of study medication and at the 15 days follow-up visit following the ECOG Performance Status Scale.

    Measured: until 14 days after End of Treatment

  4. Safety/toxicity and tolerability profil: review of body systems

    A full review of body systems will be performed: heart rate, blood pressure, respiratory rate, body temperature, height, weight and ECG (screening visit only, unless clinically indicated).

    Clinically significant versus not clinically significant

    Measured: until 14 days after End of Treatment

  5. Progression Free Survival and sensitivity analysis: Effect of Center on prognostic factors

    The effect of potential prognostic factors will be assessed through sensitivity analyses, including:

    • Investigational Center

    Measured: From date of first study treatment administration until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 5 years after End of Treatment.

  6. Progression Free Survival and sensitivity analysis: Effect of tumor location on prognostic factors

    The effect of potential prognostic factors will be assessed through sensitivity analyses, including:

    • Location of tumor (head of the pancreas versus other location)

    Measured: From date of first study treatment administration until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 5 years after End of Treatment

  7. Progression Free Survival and sensitivity analysis: Effect of previous chemotherapy on prognostic factors

    The effect of potential prognostic factors will be assessed through sensitivity analyses, including:

    • Previous chemotherapy: gemcitabine alone vs gem-abx

    Measured: From date of first study treatment administration until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 5 years after End of Treatment

  8. Progression Free Survival and sensitivity analysis: effect of ECOG on prognostic factors

    The effect of potential prognostic factors will be assessed through sensitivity analyses, including:

    • WHO ECOG performance status (0 versus 1)

    Measured: From date of first study treatment administration until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 5 years after End of Treatment

  9. Objective tumor response: Rate of complete response and partial response

    Tumor (response) evaluation will be performed according to RECIST criteria v. 1.1 (CT scan thorax, abdomen and pelvis or MRI abdomen and pelvis + CT chest) based upon the investigator's assessment. Overall response is defined as a best response of either CR or PR (CR+PR).

    Measured: performed within 28 days before start therapy, 3 times every 6 weeks and afterwards every 8 weeks

  10. Duration of overall survival

    For patients who are still alive at the time of study analysis or who are lost to follow up, survival will be censored at the last recorded date that the patient is known to be alive or at the date of data cut-off, whatever occurs earlier.

    Measured: Time from Day 1 of therapy to death until maximum 5 years after End of Treatment

  11. Duration of disease control

    Disease control is defined as a best response of either CR, PR, or SD (CR+PR+SD).

    Measured: From date of first study treatment administration until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 5 years after End of Treatment

  12. Duration of response

    The duration of response will be censored on the date of last known tumor assessment for not progressed patients lost to follow up or deceased prior to the next planned tumor assessment (within 60 days). Not evaluable patients at one time point assessment will be censored at the date of last known assessment.

    Measured: Time from measurement criteria are first met for CR/PR to either the first time disease progression is documented or death (for not progressed patients who deceased within 60 days from last tumor assessment) until maximum 5 years after EOT

Timeline

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

  1. First posted25 Jul 2022
  2. Study start25 May 2022
  3. Primary completion31 Dec 2026 (estimated)
  4. Study completion31 Dec 2027 (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
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
134 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05472259
Sponsor's protocol ID
NALPAC
Acronym
NALPAC
Status last verified
Feb 2024
First submitted
9 Dec 2021
Last updated
6 Feb 2025
Results posted
No
Data monitoring committee
Yes
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 Nanoliposomal irinotecan, 5 FU and Leucovorin in people with Metastatic Pancreatic Ductal Adenocarcinoma, run by Belgian Group of Digestive Oncology at 13 sites in Belgium.

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 11 inclusion and 18 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: looking for participants now, as of the sponsor's last update on 6 Feb 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 13 sites in Belgium. 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?

This study is still under way. Results are not available in the source record yet.

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

Contact Lina Dewever (+32 (0) 479 36 63 82, lina.dewever@bgdo.org), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Efficacy of NALIRINOX and NALIRI through Progression-Free Survival at D85 (time frame: at day 85 from randomization). 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 6 Feb 2025.

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