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Pancreas CancerPhase 1/2NCT04605913

Nab-Paclitaxel + Cisplatin + Gemcitabine + TTF in pt. w/ Metastatic PAC

A Phase 1/2 study testing Modified GCN+TTF treatment in people with Pancreas Cancer and Metastatic Pancreatic Cancer, run by Mayo Clinic at 1 site in United States.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record

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Trial summary

This is a Phase I/Ib trial, single-center, non-randomized, open-label study of Protein-bound Paclitaxel, Cisplatin, And Gemcitabine (GCN) Combined with Tumor Treatment Fields (TTF) and G+TTF maintenance therapy in patients with metastatic pancreatic cancer. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Modified GCN+TTF treatment
Could I receive a placebo?
No, everyone receives an active treatment
How many people
40 participants
Where
1 siteUnited States
Study dates
25 Apr 2022to 17 Feb 2027
Phase
Phase 1/2

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 pancreatic adenocarcinoma or adenosquamous carcinoma with liver metastasis. Liver metastasis can be confirmed histologically / cytologically or radiologically
  • Subjects with additional sites of metastasis, except known brain metastasis, are eligible
  • Histologies excluded include squamous, small cell carcinoma, and acinar cell carcinoma. However, adeno-squamous and acinar-adenocarcinoma histologies can be enrolled
  • Patients who have recurrence or metastasis after surgery and adjuvant therapy do not need repeat biopsy for confirmation of recurrence if clinical suspicion is high per scans (magnetic resonance imaging [MRI]/computed tomography [CT] scan), with and without CA 19-9 elevation, specifically if biopsy is unsafe or technically difficult
  • Patients with no prior lines of therapy for the treatment of stage IV metastatic disease
  • Patients could have had prior neoadjuvant or adjuvant chemotherapy or chemoradiotherapy
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  • Patients who received gemcitabine-based adjuvant chemotherapy can enroll if they progress > 6 months after completion of the therapy
  • Patients who progress while on adjuvant fluorouracil, irinotecan, leucovorin and oxaliplatin (FOLFIRINOX) can enroll immediately
  • Male and female patients at least 18 years of age
  • Absolute neutrophil count (ANC) > 1500 cells/mm^3
  • Platelet count > 100,000 cells/mm^3
  • Hemoglobin >= 8 g/dL
  • Total bilirubin < 1.5 X upper limit of normal (ULN)
  • Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) < 3 X ULN
  • For patients with known liver metastases or liver neoplasms: alanine aminotransferase (ALT) or aspartate aminotransferase (AST) < 6.0 X ULN and total bilirubin < 3 x ULN
  • Serum creatinine within normal limits (WNL) or creatinine clearance > 50 mL/min
  • QT intervals: corrected QT (QTc) =< 470 msec for men and =< 490 msec for women (as measured by Hodges' Equation)
  • Estimated life expectancy of at least 3 months
  • Eastern Cooperative Oncology Group (ECOG) performance status 0-1
  • Ability to operate the Novo TTF-100L (P) / Novo TTF-200T system
  • Patients must have measurable disease on scans per RECIST 1.1
  • Negative serum pregnancy test within 14 days prior to the first dose of study therapy for women of child-bearing potential (WCBP), defined as a sexually mature woman who has not undergone a hysterectomy or who has not been naturally post-menopausal for at least 24 consecutive months (i.e., who has had menses any time in the preceding 24 consecutive months). Sexually active WCBP and male subjects must agree to use adequate methods to avoid pregnancy (oral, injectable, or implantable hormonal contraceptive; tubal ligation; intra-uterine device; barrier contraceptive with spermicide; or vasectomized partner) throughout the study and for 28 days after the completion of study treatment

Who cannot join

  • Previous front-line therapy for metastatic disease
  • Patients with known brain metastasis
  • Cardiac conduction abnormalities such as 2nd and 3rd heart-block requiring a pacemaker
  • Patient with cardiac or abdominal pacemakers or stimulators
  • Significant risk of cardiac drug toxicity due to congestive heart failure or history of myocardial infarction
  • Any other condition including but not limited to major co-morbidities, which in the opinion of the investigator would render the patient ineligible
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  • Concomitant use of drugs that have black box warning of Torsades de Pointes will also be prohibited if cannot be replaced by another drug
  • Known sensitivity to conductive hydrogels
  • Patients who are pregnant or breastfeeding
  • Patients who lack the capacity to consent for themselves

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Mayo Clinic in Florida

    Jacksonville, Florida, 32224-9980

Other trials in United States

About this study

Official title: A Phase I/Ib Pilot Trial, Single Arm, Open Label, of Protein-Bound Paclitaxel, Cisplatin, and Gemcitabine (GCN) Combined With Tumor Treatment Fields (TTF) in Patient With Metastatic Pancreatic Adenocarcinoma

This is a Phase I/Ib trial, single-center, non-randomized, open-label study of Protein-bound Paclitaxel, Cisplatin, And Gemcitabine (GCN) Combined with Tumor Treatment Fields (TTF) and G+TTF maintenance therapy in patients with metastatic pancreatic cancer.

Read the detailed description

GCN is predicted to be the front-line therapy for biliary and pancreatic cancer in the future given excellent results of current early clinical trials (ORR ≥ 67% in pancreatic cancer). This will change standard of care for front-line therapy in patients with stage IV pancreatic cancer. In this cohort of patients' tolerability after 6 cycles of therapy will be a challenge. Investigators hypothesize that developing a maintenance strategy with TTF+G will be cutting edge approach and can potentially transform front-line standard of care therapy in patients with stage IV pancreatic cancer. If this pilot study proves fruitful then a larger study to confirm findings can be conducted.

Being tested
Modified GCN+TTF treatment
Keywords
GCN, TTF, Paclitaxel, Cisplatin, Gemcitabine, Tumor Treatment Fields
Medical subject headings
Pancreatic Neoplasms, Adenocarcinoma

What participants receive

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

  • Modified GCN+TTF treatmentCombination product

    Also called NovoTTF-100L(P)

    The regimen will consist of gemcitabine (G) administered at a dose of 800 mg/m2, cisplatin (C) 30 mg/m2, and protein-bound paclitaxel (N) 150 mg/m2 administered on cycle 1 day 1 and every 2 weeks thereafter and TTF will be administered daily (150kHz 18 hours/day) starting with Cycle 1 Day 1 (dose level 1). One cycle consists of 28 days including 2 chemotherapy treatments (same regimen studied in the PAXG trial: Reni BJC 2016 without capecitabine). After completing 6 cycles, patients will then transition to a maintenance phase of G administered at a dose of 1000 mg/m2 every 2 weeks and daily TTF (150 KHZ 18 hours/day) until progression of disease (POD) per RECIST v1.1.

Study groups in NCT04605913
Study groupRoleWhat they receive
Modified GCN+TTF treatmentExperimentalThe trial will compose of 2 parts with a total of 40 subjects. The regimen will consist of gemcitabine (G) administered at a dose of 800 mg/m2, cisplatin (C) 30 mg/m2, and protein-bound paclitaxel (N) 150 mg/m2 administered on cycle 1 day 1 and every 2 weeks thereafter and TTF will be administered daily (150kHz 18 hours/day) starting with Cycle 1 Day 1 (dose level 1). After completing 6 cycles, patients will then transition to a maintenance phase of G administered at a dose of 1000 mg/m2 every 2 weeks and daily TTF (150 KHZ 18 hours/day) until progression of disease (POD) per RECIST v1.1. If 6 patients tolerate the dose level of GCN+TTF through the 1st cycle without defined dose limiting toxicities (DLTs) or grade 4 treatment related adverse events (TRAE), the 2nd part of the study (phase Ib portion) will commence. An additional 34 patients will be enrolled in the expansion cohort (phase Ib).
Receives: Combination Product: Modified GCN+TTF treatment

What is being measured

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

  1. Safety of (m)-GCN+TTF

    Assessed by incidence of adverse events, as defined by Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.

    Measured: 28 days

Secondary outcomes (5)
  1. Progression-free Survival (PFS)

    PFS is defined as the time from the date of registration to the earliest date of documented evidence of recurrent or progressive disease or the date of death due to any cause.

    Measured: Six months

  2. Overall Response Rate (ORR)

    ORR will be assessed by the percentage of patients achieving complete response (CR), partial response (PR), stable disease (SD), or progressive disease (PD), as evaluated using the Response Evaluation Criteria in Solid Tumors 1.1 (RECIST 1.1).

    Measured: Six months

  3. Overall Survival (OS)

    OS is defined as the time from the date of registration to the date of death due to any cause, or the date of last contact (censored observations).

    Measured: Twelve months

  4. Time to Progression (TTP)

    TTP is defined as the length of time from the date of registration until the disease starts to get worse or spread to other parts of the body.

    Measured: Twelve months

  5. Quality of Life - EORTC QLQ-C30

    The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ)-C30 is a 30-item questionnaire a questionnaire used to assess the quality of life of cancer patients. Twenty-eight questions are answered on a scale of 1-4 (1=not at all, 2=a little, 3=quite a bit, and 4= very much), and two questions are answered on a scale of 1-7 (1= very poor and 7=excellent). Higher summary scores indicate better health related quality of life.

    Measured: Every 2 months, up to 12 months

Timeline

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

  1. First posted28 Oct 2020
  2. Study start25 Apr 2022
  3. Primary completion17 Aug 2026
  4. Study completion17 Feb 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 1/2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Sequential
Model description
The trial will compose of 2 parts with a total of 40 subjects. The 1st part would be a safety run-in phase (phase I). In this phase, 6 patients will be treated after completing screening procedures and meeting eligibility criteria. If 6 patients tolerate this dose level of GCN+TTF through the 1st cycle without defined dose limiting toxicities (DLTs) or grade 4 treatment related adverse events (TRAE), the 2nd part of the study (phase Ib portion) will commence. An additional 34 patients will be enrolled in the expansion cohort (phase Ib).
Masking
None (open label)
Enrolment
40 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04605913
Sponsor's protocol ID
MC210405
Other IDs
NCI-2022-01522, 21-011320
Status last verified
Sep 2026
First submitted
28 Sep 2020
Last updated
29 Sep 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
Yes

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