Study to Assess the Safety, Tolerability of JPI-547 in Combination With Modified FOLFIRINOX or Gemcitabine-nab-paclitaxel in Patients With Locally Advanced and Metastatic Pancreatic Cancer

The purpose of this study is to assess the safety, tolerability of JPI-547 in combination with modified FOLFIRINOX (mFOLFIRINOX) or Gemcitabine-nab-paclitaxel (GemAbraxne) in patients with locally advanced and metastatic pancreatic cancer

In combination with JPI-547 and chemotherapy in patients with locally advanced/metastatic pancreatic cancer,

Primary Objectives

* To determine the maximum tolerated dose (MTD) and recommended phase 2 dose (RP2D).
* To select the optimal combination chemotherapy based on the safety profile.

Secondary Objectives

* To assess the safety and toxicity.
* To evaluate anti-tumor activity.

Eligibility Criteria:
Inclusion Criteria:

1. Histologically or cytologically confirmed inoperable locally advanced or metastatic pancreatic ductal adenocarcinoma (PDAC)
2. Those with at least one measurable lesion in accordance with RECIST 1.1
3. Those with Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1
4. Those with an expected survival period ≥12 weeks
5. Patients with adequate hematologic function, renal and hepatic function confirmed by the following criteria (During the screening period, laboratory tests can be retested only once.)
6. Those who voluntarily decide to participate in this clinical study after hearing sufficient explanations and who consent in writing

Exclusion Criteria:

1. Those with a history of severe hypersensitivity to the investigational product or combination anticancer drugs.
2. Those with the following medical history or surgical history/procedural history confirmed

   1. Other primary malignant tumors other than pancreatic cancer
   2. Major surgery that requires general anesthesia or breathing aid
   3. Severe cardiovascular disease
   4. New York Heart Association Class 3 or 4 heart failure
   5. Severe cerebrovascular disease t
   6. Pulmonary thrombosis, deep vein thrombosis, or bronchial asthma, obstructive pulmonary disease, and other life-threatening severe lung diseases
   7. Infections requiring administration of systemic antibiotics or antivirals, etc.
   8. Hematologic malignancy
3. Those with the following diseases

   1. Massive ascites, pleural effusions requiring therapeutic paracentesis
   2. Neuropathy ≥Grade 2
   3. Diarrhea, chronic inflammatory bowel disease
   4. Intestinal paralysis, intestinal obstruction
   5. Diseases that make oral administration difficult or affect absorption
   6. Interstitial lung disease, pulmonary fibrosis
   7. Dialysis patient
   8. Patients with clinically significant symptoms or uncontrolled central nervous system or brain metastases

   j. Uncontrolled hypertension (systolic blood pressure \> 150 mmHg or diastolic blood pressure \>90 mmHg) k. Bleeding diatheses l. Active hepatitis B or C virus. m. Known human immunodeficiency virus (HIV) positive
4. Those with a medication history of the following drugs

   1. Anti-cancer drug therapy such as chemotherapy and biological therapy
   2. Radiation therapy within 2 weeks of baseline
   3. Those who are taking or expected to require administration of strong inhibitors or inducers of CYP3A4
   4. (For mFOLFIRINOX cohort) Those who are taking or expected to require administration of sorivudine
   5. Patients who require continuous administration of non-steroidal anti-inflammatory drugs (NSAIDs) with high bleeding risk
   6. Patients requiring continuous administration of systemic corticosteroid equivalent to prednisone \>10 mg/day
   7. Those who have received antithrombotic agents, including antiplatelet agents, anticoagulants, etc.
5. Pregnant women, lactating women, or women of childbearing potential and men who do not intend to practice abstinence or use appropriate contraceptive methods for until 6 months for men and 9 months for women after administration of the investigational product and during the clinical study
6. Those who have administered other investigational products or have received investigational medical device procedures within 4 weeks of the baseline
7. Other patients who are inappropriate or unable to participate in this clinical study at the discretion of the investigator