Background:
Pancreas cancer ranks 4th in all cancer-related deaths in the United States (U.S.)
Gemcitabine is a standard treatment for it. M7824 (MSB0011359C) blocks a pathway that
prevents the immune system from effectively fighting cancer. The two drugs together might
help people with pancreas cancer.
Objective:
To test if giving M7824 together with gemcitabine is safe and causes tumors to shrink.
Eligibility:
People ages 18 and older with pancreatic cancer already treated with standard therapies
Design:
Participants will be screened with:
Medical history
Physical exam
Scans in a machine that takes pictures of the body
Blood, urine, and heart tests
Some participants may have a tumor sample removed.
Participants will get M7824 by intravenous (IV) once every 2 weeks. They will continue until
their disease gets worse or they have unacceptable side effects.
After the first dose, participants will also get gemcitabine by IV once weekly for 7 weeks.
Then they will get it as follows for up to 6 months: Skip 1 week, get the drug once a week
for 3 weeks, skip 1 week.
Before treatment on the first day of each cycle, participants will repeat screening tests.
They will also have:
Optional tumor biopsies before and after 3 cycles of therapy
Questions about their well-being and function
Genetic testing of tissue and blood samples
Participants will have a follow-up visit 4-5 weeks after they stop therapy. This includes a
physical exam, blood and urine tests, and maybe a scan. If their disease does not get worse,
they will be invited for scans every 12 weeks.
Additional locations may be listed on ClinicalTrials.gov for NCT03451773.
See trial information on ClinicalTrials.gov for a list of participating sites.
Background:
- M7824 (MSB0011359C) is an investigational agent in phase IB/II clinical development with
dual activity against transforming growth factor beta (TGF)-beta signaling (TGF-beta
ligand trap; extracellular domain of human TGF-beta receptor II) and immune checkpoint
ligand inhibition (PD-L1 inhibition; avelumab, fully human immunoglobulin G1 (IgG1)
monoclonal antibody (mAb) directed against human PD-L1) with an acceptable toxicity
profile and early signals of anti-cancer activity including in pancreas cancer.
- Gemcitabine (2 <=,2 <=-Difluorodeoxycytidine) is a standard-of-care nucleoside analogue
in pancreas cancer with immunomodulatory mechanisms of actions in pancreas cancer
patients.
- Preclinical studies in autochthonous and syngeneic murine models have shown that
TGF-beta inhibition and PD-L1 inhibition cooperate with gemcitabine to achieve reduction
of tumor growth and extension of survival induce anti-tumor immunity and reprogram the
immune landscape.
Objectives:
- To determine the safety and tolerability of M7824 in combination with gemcitabine in
subjects with metastatic or locally advanced pancreas cancer.
- To determine best overall response (BOR) rate according to Response Evaluation Criteria
(Response Evaluation Criteria in Solid Tumors (RECIST) 1.1) in advanced pancreas cancer
subjects.
Eligibility:
- Histologically confirmed diagnosis of adenocarcinoma of the pancreas.
- Patients must have progressed on prior chemotherapeutic regimen.
- Concurrent treatment with non-permitted drugs and other interventions, prior therapy
with gemcitabine or any antibody / drug targeting T cell co-regulatory proteins (immune
checkpoints) such as anti-PD 1, anti PD-L1, or anti-cytotoxic T lymphocyte antigen-4
(CTLA 4 antibody) is not allowed.
Design:
- The proposed study is a phase IB/II study of M7824 in combination with gemcitabine in a
safety run-in of 6-18 patients and, if safe and tolerated, will proceed to an expansion phase
II cohort with a standard Simon Minimax design.
Lead OrganizationNational Cancer Institute
Principal InvestigatorUdo Rudloff