E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Locally Advanced, Unresectable Pancreatic Cancer |
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E.1.1.1 | Medical condition in easily understood language |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10033606 |
E.1.2 | Term | Pancreatic cancer non-resectable |
E.1.2 | System Organ Class | 100000004864 |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To evaluate the efficacy and safety of neoadjuvant treatment with pamrevlumab in combination with either gemcitabine plus nab-paclitaxel or FOLFIRINOX when compared to treatment with gemcitabine plus nab-paclitaxel alone in locally advanced, unresectable pancreatic cancer. |
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E.2.2 | Secondary objectives of the trial |
To evaluate the effect of neoadjuvant treatment with pamrevlumab in combination with gemcitabine plus nab-paclitaxel or gemcitabine plus nab-paclitaxel alone on resection rates. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal 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 subjects with partners of childbearing potential and female subjects of childbearing potential are required to use highly effective double barrier contraception methods during 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 NCCN Guidelines® Version 2.2018 as determined by central imaging 8. Measurable disease as defined by Response Evaluation Criteria in Solid Tumors RECIST 1.1 criteria as determined by central imaging 9. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 10. Adequate liver function 11. Adequate bone marrow function 12. Adequate renal function 13. Less than grade 2 pre-existing peripheral neuropathy (per CTCAE)
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E.4 | Principal exclusion criteria |
1. Prior chemotherapy or radiation for pancreatic cancer 2. Previous (within the past 3 years) or concurrent malignancy diagnosis except non 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 stents are permitted. 4. History of allergy or hypersensitivity to human, humanized or chimeric monoclonal antibodies 5. History of allergy or hypersensitivity to any of the chemotherapy agents being prescribed or their excipients 6. Any medical or surgical condition that may place the subject at increased risk while 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 5 half lives of the investigational drug (whichever is longer) 9. Uncontrolled intercurrent illness including, but not limited to, ongoing or active systemic infections, symptomatic congestive heart failure, unstable angina pectoris, clinically significant cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements 10. Documented history of drug or alcohol abuse within 6 months of signing informed consent 11. Any medical condition that, in the opinion of the investigator, may pose a safety risk to a subject in this trial, may confound the assessment of safety and efficacy, or may interfere with study participation of safety and efficacy, or may interfere with study participation 12. Subjects with a history of; interstitial pulmonary disease, HCV, HBV or HIV infection 13. Subjects who have been administered a live vaccine within four weeks prior to the first administration of therapy 14. Subjects who cannot stop chronic medications that inhibit or induce CYP2C8 or CYP3A4 15. Subjects with poorly controlled comorbid conditions, including; congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), uncontrolled diabetes mellitus (DM) or neurologic disorders (not acutely related to pancreatic cancer) or limited function |
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E.5 End points |
E.5.1 | Primary end point(s) |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Time from randomization to death due to any cause. |
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E.5.2 | Secondary end point(s) |
Event-free survival (EFS), defined as the time from randomization to one of the following events, whichever occurs first: - Progression that precludes surgery - Local or distant recurrence - Death
Change in Patient Reported Outcomes (PROs) as measured by: - Mean change from baseline during the treatment period in physical function by EORTC-QLQ-C30 - Mean change from baseline during the treatment period in abdominal pain by NCI-PRO-CTCAE - Mean change from baseline during the treatment period in fatigue by NCI-PRO-CTCAE
Progression-free survival (PFS), defined as the time from randomization until objective tumor progression or death (whichever occurs first) |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
PFS is defined as the time from randomization until disease progression or death, whichever occurs first. For subjects who did not have progression at data cut or at study losure, the latest date of the following events will be defined as the censoring date: last post-baseline CT, last post-baseline PET scans, the last known record of 'Not Progressed', and last dose. PFS will be summarized descriptively using the Kaplan-Meier method. The Cox proportional hazard model including treatment and stratification factors: chemotherapy treatment regimen, SMA encasement, unreconstructible disease and geographic region will be conducted to compare treatment effect and to estimate the hazard ratio and corresponding 95% CI. |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 4 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 35 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Australia |
Austria |
Belgium |
Canada |
China |
France |
Germany |
Israel |
Italy |
Korea, Republic of |
Spain |
United Kingdom |
United States |
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E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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LSLV All subjects will be followed for survival (until death) or until the last subject to complete treatment reaches 18 months post-treatment. |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 2 |
E.8.9.1 | In the Member State concerned months | 2 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 4 |
E.8.9.2 | In all countries concerned by the trial months | 0 |
E.8.9.2 | In all countries concerned by the trial days | 0 |