Evaluation of Efficacy and Safety of Neoadjuvant Treatment With Pamrevlumab in Combination With Chemotherapy (Either Gemcitabine Plus Nab-paclitaxel or FOLFIRINOX) in Participants With Locally Advanced, Unresectable Pancreatic Cancer

Last updated: October 15, 2024
Sponsor: FibroGen
Overall Status: Completed

Phase

3

Condition

Digestive System Neoplasms

Treatment

Placebo + Gemcitabine + Nab-paclitaxel or Placebo + FOLFIRINOX

Pamrevlumab + Gemcitabine + Nab-paclitaxel or Pamrevlumab + FOLFIRINOX

Clinical Study ID

NCT03941093
FGCL-3019-087
  • Ages > 18
  • All Genders

Study Summary

This is a Phase 3, randomized, double-blind trial to evaluate the efficacy and safety of neoadjuvant treatment with pamrevlumab or placebo in combination with either gemcitabine plus nab-paclitaxel (G/NP) or FOLFIRINOX in the treatment of participants with locally advanced, unresectable pancreatic cancer.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  1. Understand and sign informed consent; be willing to comply with study procedures,including surgery

  2. Age ≥ 18 years

  3. Be a male, or non-pregnant and non-lactating female

  4. Negative serum B-hCG pregnancy test at screening for women of childbearing potential

  5. Male participants with partners of childbearing potential and female participants ofchildbearing potential are required to use highly effective contraception methodsduring the conduct of the study and for 6 months after the last dose of study drug

  6. Histologically or cytologically proven diagnosis of pancreatic ductal adenocarcinoma (PDAC)

  7. Locally advanced pancreatic cancer considered unresectable according to NCCNGuidelines® Version 2.2018 as determined by central imaging

  8. Measurable disease as defined by RECIST 1.1 criteria as determined by centralimaging

  9. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1

  10. Adequate liver function: aspartate aminotransferase (AST) and alanineaminotransferase (ALT) <2.5 x upper limit of normal (ULN), alkaline phosphatase <2.5x ULN, and bilirubin ≤1.5 x ULN or in participants with biliary stenting ≤2.0 x ULN

  11. Adequate bone marrow function: platelets >100,000 cells/mm3, hemoglobin >9.0 g/dland absolute neutrophil count (ANC) >1,500 cells/mm3

  12. Adequate renal function: creatinine < 1.5 x ULN, creatinine clearance ≥ 30 mL/min

  13. Less than grade 2 pre-existing peripheral neuropathy (per CTCAE)

Exclusion

Exclusion Criteria:

  1. Prior chemotherapy or radiation for pancreatic cancer

  2. Previous (within the past 3 years) or concurrent malignancy diagnosis exceptnon-melanoma skin cancer and in situ carcinomas (excluding in situ breast cancer)

  3. Major surgery within 4 weeks prior to signing informed consent form. Biliary stentsare permitted.

  4. History of allergy or hypersensitivity to human, humanized or chimeric monoclonalantibodies

  5. History of allergy or hypersensitivity to any of the chemotherapy agents beingprescribed or their excipients

  6. Any medical or surgical condition that may place the participant at increased riskwhile on study

  7. Any condition potentially decreasing compliance to study procedures

  8. Exposure to another investigational drug within 28 days of first dosing visit, or 5half-lives of the investigational drug (whichever is longer)

  9. Uncontrolled intercurrent illness including, but not limited to, ongoing or activesystemic infections, symptomatic congestive heart failure, unstable angina pectoris,clinically significant cardiac arrhythmia, or psychiatric illness/social situationsthat would limit compliance with study requirements

  10. Documented history of drug or alcohol abuse within 6 months of signing informedconsent

  11. Any medical condition that, in the opinion of the investigator, may pose a safetyrisk to a participant in this trial, may confound the assessment of safety andefficacy, or may interfere with study participation

  12. Participants with a history of interstitial pulmonary disease, hepatitis C virus (HCV), hepatitis B virus (HBV) or human immunodeficiency virus (HIV) infection

  13. Participants who have been administered a live vaccine within 4 weeks prior to thefirst administration of therapy

  14. Participants who cannot stop chronic medications that inhibit or induce cytochrome P (CYP) 2C8 or CYP3A4

  15. Participants with poorly controlled comorbid conditions, including; congestive heartfailure (CHF), chronic obstructive pulmonary disease (COPD), uncontrolled diabetesmellitus (DM) or neurologic disorders (not acutely related to pancreatic cancer) orlimited function

Study Design

Total Participants: 284
Treatment Group(s): 2
Primary Treatment: Placebo + Gemcitabine + Nab-paclitaxel or Placebo + FOLFIRINOX
Phase: 3
Study Start date:
May 10, 2019
Estimated Completion Date:
June 11, 2024

Study Description

Participants will be randomized in a 1:1 ratio to one of the two study treatment arms; pamrevlumab with either G/NP or FOLFIRINOX, placebo with G/NP or FOLFIRINOX.

Each participant may receive up to 6 cycles of treatment (each treatment cycle is 28 days). Tumor tissue will be collected during resection to determine surgical outcome and for biomarker analysis. Tumor response will be evaluated by changes in CT scan, FDG-PET, CA 19-9, and NCCN® guidelines.

All participants randomized will have a safety follow-up visit approximately 28 days after the last dose of study treatment and a final safety follow-up phone call at approximately 60 days after the last dose.

Participants who complete study treatment will be evaluated for surgical exploration for possible R0 or R1 resection. Surgery will occur at least 4 weeks after the last dose (allowing for a wash-out period from treatment) and only after receipt of the recommendation from the central review board with regards to surgical eligibility. Surgery will occur no longer than 8 weeks after the last dose. Participants who undergo surgery will be evaluated for surgical complications for at least an additional 90 days following discharge from surgery.

Participants who are ineligible for surgical exploration (i.e. participants who did not complete study treatment or do not meet any of the protocol defined criteria or had a contraindication to surgery) will continue in the Follow-up period and receive treatment as per standard of care (SOC) for each institution.

All participants will be followed for disease progression (if not previously detected) or recurrence following resection (local progression or metastatic disease). Participants will also be followed for any additional anti-cancer therapy received for their pancreatic cancer. All participants will be followed for survival (until death) or until the last participant to complete treatment reaches 18 months post-treatment.

Connect with a study center

  • Klinikum Wels-Grieskirchen GmbH

    Wels, 4600
    Austria

    Site Not Available

  • Medizinische Universität Wien

    Wien, 1090
    Austria

    Site Not Available

  • CUB Hôpital Erasme

    Brussels, 1070
    Belgium

    Site Not Available

  • Universitair Ziekenhuis Gent

    Gent, 9000
    Belgium

    Site Not Available

  • The Ottawa Hospital

    Ottawa, Ontario K1H 8L6
    Canada

    Site Not Available

  • Princess Margaret Cancer Centre/University Health Network

    Toronto, Ontario M5G 2M9
    Canada

    Site Not Available

  • Sunnybrook Health Sciences Centre

    Toronto, Ontario M4N 3M5
    Canada

    Site Not Available

  • McGill University Health Center

    Montreal, Quebec H4A 3J1
    Canada

    Site Not Available

  • Peking Union Medical College Hospital

    Dongcheng, Beijing 100010
    China

    Site Not Available

  • Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology

    Wuhan, Hubei
    China

    Site Not Available

  • The First Affiliated Hospital Of Xi'an Jiaotong University

    Xi'an, Shaanxi
    China

    Site Not Available

  • Huashan Hospital affiliated with Fudan University

    Jing'an, Shanghai 200040
    China

    Site Not Available

  • West China Hospital of Sichuan University

    Chengdu,
    China

    Site Not Available

  • Jiangsu Province Hospital

    Nanjing,
    China

    Site Not Available

  • Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine

    Shanghai,
    China

    Site Not Available

  • Xinhua Hospital Affiliated to Shanghai Jiaotong University School Of Medicine

    Shanghai,
    China

    Site Not Available

  • CHRU Jean Minjoz

    Besançon Cedex, 25030
    France

    Site Not Available

  • CHU Estaing

    Clermont Ferrand, 63003
    France

    Site Not Available

  • Hopital BEAUJON

    Clichy, 92118
    France

    Site Not Available

  • Centre Georges-François Leclerc

    Dijon, 21079
    France

    Site Not Available

  • CHU Grenoble Alpes

    La Tronche, 38700
    France

    Site Not Available

  • Centre Léon Bérard

    Lyon, 69373
    France

    Site Not Available

  • Hôpital Edouard Herriot

    Lyon, 69437
    France

    Site Not Available

  • Groupe Hospitalier Pitié Salpêtrière

    Paris, 750013
    France

    Site Not Available

  • Haut-Lévêque

    Pessac, 33604
    France

    Site Not Available

  • Institut de Cancérologie de l'Ouest Pays de Loire

    Saint Herblain Cedex, 44805
    France

    Site Not Available

  • Medizinische Klinik mit Schwerpunkt Hämatologie, Onkologie und Tumorimmunologie

    Berlin, 10117
    Germany

    Site Not Available

  • Technische Universität Dresden, Medizinische Klinik und Poliklinik I

    Dresden, 01307
    Germany

    Site Not Available

  • Klinikum der Universität München, Medizinische Klinik und Poliklinik III

    München, 81377
    Germany

    Site Not Available

  • Klinikum rechts der Isar der Technischen Universität München

    München, 81675
    Germany

    Site Not Available

  • Shamir Medical center Asaf Harofeh

    Be'er Ya'akov, 7030000
    Israel

    Site Not Available

  • Shamir Medical center Asaf Harofeh

    Be'er Ya'aqov, 7030000
    Israel

    Site Not Available

  • Hadassah University Hospital Ein Kerem

    Jerusalem, 9112001
    Israel

    Site Not Available

  • Meir Medical center

    Kfar Saba, 4428164
    Israel

    Site Not Available

  • Rabin Medical Center

    Petach Tikva, 4941492
    Israel

    Site Not Available

  • Instituto Scientifico Romagnolog per lo Studio e la Cura dei Tumori

    Meldola, 47014
    Italy

    Site Not Available

  • Grande Ospedale Metropolitano Niguarda, Oncologia Medica Falck

    Milano, 20162
    Italy

    Site Not Available

  • IRCCS Ospedale San Raffaele

    Milano, 20132
    Italy

    Site Not Available

  • Istituto Europeo di Oncologia

    Milano, 20141
    Italy

    Site Not Available

  • AOU Federico II

    Napoli, 80131
    Italy

    Site Not Available

  • Istituto Clinico Humanitas

    Rozzano, 20089
    Italy

    Site Not Available

  • CRC di Verona

    Verona, 37134
    Italy

    Site Not Available

  • Seoul National University Budang Hospital

    Seongnam-si, Geyonggi-do 13620
    Korea, Republic of

    Site Not Available

  • National Cancer Center

    Goyang-si, Gyeonggi-do 10408
    Korea, Republic of

    Site Not Available

  • Chonnam National University Hwasun Hospital

    Hwasun, Jeollanam-do 58128
    Korea, Republic of

    Site Not Available

  • Samsung Medical Center

    Seoul, 06351
    Korea, Republic of

    Site Not Available

  • Seoul National University Hospital

    Seoul, 03080
    Korea, Republic of

    Site Not Available

  • Severance Hospital, Yonsei University Health System

    Seoul, 03722
    Korea, Republic of

    Site Not Available

  • The Catholic University of Korea, Seoul St. Mary's Hospital

    Seoul, 06591
    Korea, Republic of

    Site Not Available

  • Alvaro Cunqueiro Hospital

    Vigo, Pontevedra 36312
    Spain

    Site Not Available

  • Hospital Universitaro Vall D'Hebron

    Barcelona, 08035
    Spain

    Site Not Available

  • Hospital de la Santa Creu i Sant Pau

    Barcelona, 8041
    Spain

    Site Not Available

  • Institut Catalá d'Oncologia (ICO Girona). Hospital Dr. Josep Trueta

    Girona, 17007
    Spain

    Site Not Available

  • Hospital Clinico San Carlos

    Madrid, 28040
    Spain

    Site Not Available

  • Hospital General Universitario Gregorio Marañon

    Madrid, 28007
    Spain

    Site Not Available

  • MD Anderson Cancer Center

    Madrid, 28033
    Spain

    Site Not Available

  • Hospital Clinico Universitario de Valencia

    Valencia, 46010
    Spain

    Site Not Available

  • Hospital Universitario Miguel Servet

    Zaragoza, 50009
    Spain

    Site Not Available

  • Imperial College Healthcare NHS Trust

    London, W2 1NY
    United Kingdom

    Site Not Available

  • University College London Hospitals NHS Foundation Trust

    London, NW1 2PG
    United Kingdom

    Site Not Available

  • St. Joseph's Hospital and Medical Cancer Center

    Phoenix, Arizona 85004
    United States

    Site Not Available

  • UC San Diego Moores Cancer Center

    La Jolla, California 92037
    United States

    Site Not Available

  • UCLA

    Los Angeles, California 90095
    United States

    Site Not Available

  • Hoag Memorial Presbyterian Hospital

    Newport Beach, California 92663
    United States

    Site Not Available

  • UC Davis Comprehensive Cancer Center

    Sacramento, California 95817
    United States

    Site Not Available

  • California Pacific Medical Center - Sutter Health

    San Francisco, California 94115
    United States

    Site Not Available

  • Yale New Haven Hospital

    New Haven, Connecticut 06510
    United States

    Site Not Available

  • University of Chicago Medical Center

    Chicago, Illinois 60637
    United States

    Site Not Available

  • Elmhurst Memorial Hospital - Nancy W. Knowles Cancer Center

    Elmhurst, Illinois 60126
    United States

    Site Not Available

  • Edward Cancer Center

    Naperville, Illinois 60540
    United States

    Site Not Available

  • Indiana University Melvin and Bren Simon Comprehensive Cancer Center

    Indianapolis, Indiana 48202
    United States

    Site Not Available

  • University of Kansas Hospital

    Westwood, Kansas 66205
    United States

    Site Not Available

  • Norton Cancer Institute, Audubon Hospital Campus

    Louisville, Kentucky 40217
    United States

    Site Not Available

  • Maine Health Cancer Care

    South Portland, Maine 04106
    United States

    Site Not Available

  • University of Massachusetts

    Worcester, Massachusetts 01655
    United States

    Site Not Available

  • University of Michigan

    Ann Arbor, Michigan 48109
    United States

    Site Not Available

  • Karmanos Cancer Institute

    Detroit, Michigan 48201
    United States

    Site Not Available

  • Saint Luke's Hospital

    Kansas City, Missouri 64111
    United States

    Site Not Available

  • University of Nebraska Medical Center

    Omaha, Nebraska 68105
    United States

    Site Not Available

  • New Mexico Cancer Care Alliance

    Albuquerque, New Mexico 87131
    United States

    Site Not Available

  • NYU Langone Health

    New York, New York 11735
    United States

    Site Not Available

  • Stony Brook University

    Stony Brook, New York 11794
    United States

    Site Not Available

  • SUNY Upstate Medical University

    Syracuse, New York 13210
    United States

    Site Not Available

  • University of Cincinnati Medical Center

    Cincinnati, Ohio 45219
    United States

    Site Not Available

  • Ohio State University

    Columbus, Ohio 43210
    United States

    Site Not Available

  • Thomas Jefferson University

    Philadelphia, Pennsylvania 19107
    United States

    Site Not Available

  • Allegheny General Hospital

    Pittsburgh, Pennsylvania 15212
    United States

    Site Not Available

  • Reading Hospital McGlinn Cancer Institute

    West Reading, Pennsylvania 19611
    United States

    Site Not Available

  • Baylor College of Medicine

    Houston, Texas 77030
    United States

    Site Not Available

  • Baylor Scott & White Medical Center

    Temple, Texas 76508
    United States

    Site Not Available

  • Renovatio Clinic

    The Woodlands, Texas 77380
    United States

    Site Not Available

  • Inova Schar Cancer Institute

    Fairfax, Virginia 22031
    United States

    Site Not Available

  • University of Washington Medical Center

    Seattle, Washington 98195
    United States

    Site Not Available

  • Virginia Mason Medical Center

    Seattle, Washington 98101
    United States

    Site Not Available

  • West Virginia University

    Morgantown, West Virginia 26506
    United States

    Site Not Available

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