Phase II Study of Anti-Cytotoxic T-Lymphocyte-Associated Antigen-4 Monoclonal Antibody (MDX-010) in Patients With Unresectable Stage IV (Locally or Distantly Metastatic) Pancreatic Adenocarcinoma

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First Published: 5/23/2005     Last Modified: 9/20/2010  

Alternate Title

MDX-010 in Treating Patients With Stage IV Pancreatic Cancer That Cannot Be Removed By Surgery

Basic Trial Information

PhaseTypeStatusAgeSponsorProtocol IDs
Phase IITreatmentCompleted18 and overNCINCI-05-C-0141
NCI-P6557, MDX-010-24, NCT00112580

Special Category: NCI Web site featured trial



  1. Determine clinical response (partial and complete responses) in patients with unresectable stage IV (locally or distantly metastatic) pancreatic adenocarcinoma treated with anti-cytotoxic T-lymphocyte-associated antigen-4 monoclonal antibody (MDX-010).


  1. Determine whether observed responses correlate with the incidence of autoimmunity in patients treated with this drug.

Entry Criteria

Disease Characteristics:

  • Histologically confirmed pancreatic adenocarcinoma
    • Stage IV disease
      • Locally (invasion of adjacent structures, including mesenteric arteries or organs) or distantly metastatic disease
    • Unresectable disease
    • Pancreatic adenocarcinoma with intraductal papillary mucinous neoplasm allowed
  • The following diagnoses are not allowed:
    • Acinar cell carcinoma
    • Pancreaticoblastoma
    • Malignant cystic neoplasms
    • Endocrine neoplasms
    • Squamous cell carcinoma
    • Vater and periampullary duodenal or common bile duct malignancies
  • Clinically evaluable disease with ≥ 1 site of measurable disease
  • Biliary or gastric outlet obstruction allowed provided it is effectively drained by endoscopic, operative, or interventional means
  • Pancreatic, biliary, or enteric fistulae allowed provided they are controlled with an appropriate drain

Prior/Concurrent Therapy:

    Biologic therapy

  • No prior anti-cytotoxic T-lymphocyte-associated antigen-4 monoclonal antibody (MDX-010)


  • At least 3 weeks since prior chemotherapy for pancreatic adenocarcinoma and recovered
  • No concurrent chemotherapy

    Endocrine therapy

  • More than 4 weeks since prior corticosteroids
  • No concurrent systemic or topical corticosteroids


  • At least 3 weeks since prior radiotherapy for pancreatic adenocarcinoma and recovered


  • See Disease Characteristics


  • At least 3 weeks since other prior therapy for pancreatic adenocarcinoma and recovered
  • No concurrent immunosuppressants (e.g., cyclosporin or its analog)

Patient Characteristics:


  • 18 and over

    Performance status

  • ECOG 0-2

    Life expectancy

  • At least 3 months


  • WBC ≥ 2,500/mm3
  • Absolute neutrophil count ≥ 1,500/mm3
  • Platelet count ≥ 100,000/mm3
  • Hemoglobin ≥ 9 g/dL
  • Hematocrit ≥ 27%


  • Hepatitis B surface antigen negative
  • Hepatitis C virus antibody negative


  • Hepatitis C RNA negative by polymerase chain reaction


  • Creatinine < 2.0 mg/dL


  • HIV negative
  • No history of or active autoimmune disease, including uveitis or autoimmune inflammatory eye disease
  • No active uncontrolled infection


  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • No other malignancy within the past 5 years except adequately treated basal cell or squamous cell skin cancer, superficial bladder cancer, or carcinoma in situ of the cervix
  • No underlying medical condition that would preclude study participation

Expected Enrollment


A total of 42-82 patients (21-41 per stratum) will be accrued for this study within 2-4 years.


Primary Outcome(s)

Clinical response (complete and partial)

Secondary Outcome(s)

Incidence of autoimmunity


This is an open-label study. Patients are stratified according to status of disease (locally vs distantly metastatic).

Patients receive anti-cytotoxic T-lymphocyte-associated antigen-4 monoclonal antibody (MDX-010) IV over 90 minutes on days 0, 21, 42, and 63. Treatment repeats every 84 days for up to 2 courses in the absence of disease progression or unacceptable toxicity. Patients with disease progression after achieving a partial response or complete response receive 2 additional courses of therapy.

After completion of study treatment, patients are followed at 3 weeks, every 3 months for 1 year, every 6 months for 2 years, and then annually thereafter.

Published Results

Royal RE, Levy C, Turner K, et al.: Phase 2 trial of single agent Ipilimumab (anti-CTLA-4) for locally advanced or metastatic pancreatic adenocarcinoma. J Immunother 33 (8): 828-33, 2010.[PUBMED Abstract]

Trial Contact Information

Trial Lead Organizations

NCI - Center for Cancer Research

Steven Rosenberg, MD, PhD, Principal investigator
Ph: 301-496-4164

Related Information

Featured trial article

Registry Information

Official TitlePhase II Trial of Single Agent Ipilimumab (MDX-010 anti CTLA-4) for Subjects with Locally Advanced or Metastatic Pancreatic Adenocarcinoma
Trial Start Date2005-07-18
Trial Completion Date2009-08-07
Registered in ClinicalTrials.govNCT00112580
Date Submitted to PDQ2005-04-25
Information Last Verified2009-08-26

Note: The purpose of most clinical trials listed in this database is to test new cancer treatments, or new methods of diagnosing, screening, or preventing cancer. Because all potentially harmful side effects are not known before a trial is conducted, dose and schedule modifications may be required for participants if they develop side effects from the treatment or test. The therapy or test described in this clinical trial is intended for use by clinical oncologists in carefully structured settings, and may not prove to be more effective than standard treatment. A responsible investigator associated with this clinical trial should be consulted before using this protocol.