Clinical trial NCT01233375: Study to Evaluate Efficacy of CO-1.01 as Second Line Therapy for Gemcitabine-Refractory Stage IV Pancreatic Adenocarcinoma
Official title: A Phase II, Open-Label, Multicenter Study to Evaluate the Antitumor Efficacy of CO-1.01 for Infusion as Second-Line Therapy for Gemcitabine- Refractory Patients With Stage IV Pancreatic Adenocarcinoma and No Tumor hENT1 Expression
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE2
Conditions: Metastatic Pancreatic Adenocarcinoma
Keywords: cancer
metastatic
pancreatic
pancreas
adenocarcinoma
gemcitabine
human equilibrative nucleoside transporter-1 (hENT1)
CO-1.01
CO-101
CO101
Stage 4
Stage IV
Gemcitabine-Refractory
Second-Line Therapy
Lead sponsor: Clovis Oncology, Inc.
Sponsor class: INDUSTRY
First posted: 2010-11-03
Enrollment: 19
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: The purpose of this study is to determine whether CO-1.01 is safe and effective for treating metastatic pancreatic cancer that did not respond to gemcitabine.

Detailed description: Pancreatic tumors with low hENT1 expression may show less benefit from gemcitabine compared with those with higher expression of this nucleoside transporter. Nonclinical studies indicate that CO-1.01, a gemcitabine derivative, is effective independent of such transporters. Thus patients with low or no meaningful expression of hENT1 who failed to respond to gemcitabine might derive benefit from CO1.01 before needing alternative (combination) chemotherapy. Furthermore, the PK profiles of CO-1.01 and gemcitabine are dissimilar and this may confer additional clinical benefit on CO1.01.

Eligibility criteria: Inclusion Criteria:

1. Gemcitabine-refractory metastatic ductal adenocarcinoma of the pancreas

   * At least 1 measurable lesion according to RECIST 1.1 criteria
   * Computerized tomography (CT) scan ≤ 28 days prior to CO-1.01
   * First-line treatment included at least 3 doses of gemcitabine (as monotherapy or combination therapy) with the last dose administered at least 2 weeks prior to CO 1.01
   * Radiological best response of disease progression after 1st-line treatment (no radiological stable disease or better allowed at any time)
   * Patients who experienced progressive disease during (neo)-adjuvant gemcitabine-based therapy are also eligible
   * Patients who have completed previous adjuvant therapy without progression, then subsequently have a radiological best response of disease progression on 1st line gemcitabine for metastatic disease are eligible
2. No hENT1 expression in primary or metastatic tumor sample, confirmed with IHC by a core pathology laboratory prior to study entry also eligible
3. Performance Status (ECOG) 0 or 1
4. Age ≥18 years
5. Palliative radiotherapy (if administered) ≥2 weeks prior to CO-1.01
6. Adequate hematological and biological function, with no residual gemcitabine-related toxicity
7. Written consent on an Institutional Review Board (IRB)-approved IC Form prior to any study-specific evaluation

Exclusion Criteria:

1. Patients who have had stable disease, partial response or complete response to first line gemcitabine-based therapy
2. First-line chemotherapy regimen that does not contain gemcitabine
3. First-line treatment discontinued due to intolerable gemcitabine-induced toxicity
4. Second or subsequent line therapy for advanced disease. Prior exposure to CO-1.01 or prior randomization in a protocol studying CO-1.01 (e.g.,Protocol CO-101-001)
5. Tumor that cannot be evaluated for hENT1 expression or that has hENT1 staining in \>50% of cells
6. Symptomatic brain metastases
7. Concomitant treatment with prohibited medications (e.g., concurrent anticancer therapy including other chemotherapy, radiation, hormonal treatment \[except corticosteroids and megestrol acetate\], or immunotherapy) ≤14 days prior to CO-1.01
8. Exploratory laparotomy, palliative (e.g., bypass) surgery, or other procedures are not allowed \<14 days prior to CO-1.01 administration; stenting procedures are permissible at any time prior to dosing; in all cases, the patient must be sufficiently recovered and stable
9. History of allergy to gemcitabine or eggs
10. Females who are pregnant or breastfeeding
11. Refusal to use adequate contraception for fertile patients (females and males during the study and for 6 months after the last dose of CO-1.01)
12. Presence of any serious or unstable concomitant systemic disorder incompatible with the clinical study (e.g., substance abuse, psychiatric disturbance, uncontrolled intercurrent illness including active infection, arterial thrombosis, or symptomatic pulmonary embolism)
13. Any other reason for which the investigator considers the patient should not participate in the study

Primary outcomes:
measure: Disease Control Rate (CR, PR, or SD) using RECIST 1.1
timeFrame: Every 8 weeks until disease progression
Secondary outcomes:
measure: Overall Response Rate (ORR)
timeFrame: Every 8 weeks
measure: CA 19-9 response rate
timeFrame: Every 4 weeks
measure: Progression-free survival (PFS)
timeFrame: Every 8 weeks
measure: Number of Participants with Adverse Events as a Measure of Safety and Tolerability
timeFrame: Every week
measure: Overall survival (OS)
timeFrame: 3, 6, 9, and 12 months
measure: Median progression-free survival
timeFrame: 3, 6, 9, and 12 months
measure: Median overall survival
timeFrame: 3, 6, 9, and 12 months
measure: Duration of response
timeFrame: Every 8 weeks
Other outcomes:
Locations:
city: Tucson
country: United States
facility: Arizona Cancer Center at University of Arizona
state: Arizona
city: Denver
country: United States
facility: Rocky Mountain Cancer Center
state: Colorado
city: Boynton Beach
country: United States
facility: Palm Beach Institute / Collaborative Research Group
state: Florida
city: Miami
country: United States
facility: University of Miami
state: Florida
city: Atlanta
country: United States
facility: Piedmont Healthcare Research Institute (PHRI)
state: Georgia
city: Louisville
country: United States
facility: Norton Cancer Institute Research Program
state: Kentucky
city: Baltimore
country: United States
facility: Johns Hopkins Oncology Center
state: Maryland
city: Boston
country: United States
facility: Massachusetts General Hospital (MGH)
state: Massachusetts
city: New York
country: United States
facility: Memorial Sloan-Kettering Cancer Center
state: New York
city: New York
country: United States
facility: Columbia University Medical Center, Milstein Hospital
state: New York
city: Oklahoma City
country: United States
facility: University of Oklahoma Health Sciences Center
state: Oklahoma
city: Pittsburgh
country: United States
facility: University of Pittsburgh Cancer Institute
state: Pennsylvania
city: Milwaukee
country: United States
facility: Medical College of Wisconsin
state: Wisconsin
Study officials:
affiliation: Memorial Sloan Kettering Cancer Center
name: Eileen O'Reilly, M.D.
role: PRINCIPAL_INVESTIGATOR
References: