Patient case: 54-year-old male with Pancreatic cancer. Genetic variant: CDKN2A. Other conditions: Diabetes, Hypertension.

Clinical trial: A Study of Abemaciclib (LY2835219) Alone or in Combination With Other Agents in Participants With Previously Treated Pancreatic Ductal Adenocarcinoma

Summary: The purpose of this study is to evaluate the safety and efficacy of abemaciclib alone and in combination with other drugs versus standard of care in participants with previously treated metastatic pancreatic ductal adenocarcinoma (PDAC).


Eligibility: Inclusion Criteria:
  -  Histological or cytological diagnosis of ductal adenocarcinoma of the pancreas.
  -  Metastatic disease with documented disease progression following previous treatment with at least one, but no more than 2 prior therapies, with one of the prior therapies having been either gemcitabine-based or fluoropyrimidine-based therapy. Neoadjuvant and/or adjuvant therapies for localized resectable or unresectable PDAC each count as a line of therapy if multiagent chemotherapy regimens were administered (and neoadjuvant regimen was different than adjuvant regimen) and if the participant progressed with metastatic disease while taking or within 6 months of completion of (neo)adjuvant therapy.
  -  Measurable disease per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1.
  -  Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
  -  Participant for whom treatment with monotherapy chemotherapy such as gemcitabine or capecitabine is a reasonable choice.
  -  Discontinued all prior treatment for cancer at least 14 days prior to initial dose of study treatment.
  -  Adequate organ function.
  -  allow alanine aminotransferase (ALT) or aspartate aminotransferase (AST) up to 5x upper limit of normal (ULN) if liver metastases.
  -  allow bilirubin up to 2.5 times ULN if elevation is not associated with other signs of liver toxicity or can be explained by mechanical obstruction - requires clinical research physician approval.
  Exclusion Criteria:
  -  Severe cardiac disease:
  -  myocardial infarction within 6 months prior to study screening, unstable angina pectoris, New York Heart Association Class III/IV congestive heart failure, or uncontrolled hypertension.
  -  documented major electrocardiogram (ECG) abnormalities, at the investigator's discretion (for example, symptomatic or sustained atrial or ventricular arrhythmias, second- or third-degree atrioventricular block, bundle branch blocks, ventricular hypertrophy, or recent myocardial infarction), not responding to medical treatments or not clinically stable for at least 6 months prior to study screening.
  -  major cardiac abnormalities documented by echocardiography (ECHO) with Doppler that are not clinically stable for at least 6 months prior to study screening (for example, severe heart valve function defect and/or left ventricular ejection fraction [LVEF] <50%, evaluation based on the institutional lower limit of normal).
  -  Predisposing conditions that are consistent with development of aneurysms of the ascending aorta or aortic stress (for example, family history of aneurysms, Marfan-Syndrome, bicuspid aortic valve, or evidence of damage to the large vessels of the heart documented by Computed Tomography [CT] scan or magnetic resonance imaging [MRI] with contrast).
  -  Have insulin-dependent diabetes mellitus. Participants with type 2 diabetes mellitus are eligible if adequate control of blood glucose level is obtained by oral anti-diabetics as documented by hemoglobin A1c (HbA1c) <7%.
  -  Have symptomatic central nervous system metastasis. Screening of asymptomatic participants is not required for enrollment.
  -  Have had major surgery within 7 days prior to initiation of study drug to allow for postoperative healing of the surgical wound and site(s).
  -  Have previously received treatment with any cyclin-dependent kinase (CDK) 4 and 6 inhibitor, transforming growth factor beta (TGF-β) inhibitor, or phosphatidylinositol 3-kinase (PI3K) and/or mammalian target of rapamycin (mTOR) inhibitor or have a known hypersensitivity to any component of the investigational products in this study.
  -  Have a known hypersensitivity to gemcitabine or capecitabine.

Relevance to patient case: not relevant