A Trial of Y101D in Combination With Gemcitabine and Albumin Paclitaxel in Patients With Advanced Pancreatic Cancer

Advanced Pancreatic Adenocarcinoma Clinical Trial

Official title:

Phase Ib/II Trial of Y101D Combined With Gemcitabine and Albumin Paclitaxel in First-line Treatment of Patients With Advanced Pancreatic Cancer

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT06266143
• Other study ID #: Y101D03
• Status: Active, not recruiting
• Phase: Phase 1/Phase 2
• Start date: February 8, 2023
• Est. completion date: December 31, 2024

Study information

• Verified date: January 2024
• Source: Wuhan YZY Biopharma Co., Ltd.
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The Phase Ib/II study is an open-label, single-arm, multicenter trial designed to assess the efficacy and safety of Y101D in combination with Gemcitabine and Albumin Paclitaxel as first-line systemic treatment for advanced pancreatic cancer patients. The Phase Ib portion of the study aims to evaluate the safety of escalating doses of Y101D in combination with the standard regimen of Gemcitabine and Albumin Paclitaxel and determine the recommended phase 2 dose (RP2D). The Phase II portion of the study aims to evaluate the effectiveness of this combination treatment in a small population of patients.

Description:

A total of 57-81 systemic treatment-naïve patients with advanced pancreatic cancer will be enrolled in the study. Phase Ib will enroll 12-36 patients to assess the safety of Y101D combined with Gemcitabine and Albumin Paclitaxel at doses of 20mg/kg or 30mg/kg. The recommended phase 2 dose (RP2D) for Y101D in combination with the other drugs will be determined based on the safety profile and preliminary efficacy data.

Following determination of the RP2D, Phase II will enroll a total of 40-45 patients to evaluate the effectiveness of the combination treatment using the RP2D of Y101D. The primary endpoint of the Phase II study will be the objective response rate. Secondary endpoints will include progression-free survival (PFS), overall survival (OS), duration of response (DOR) and safety profiles. Pharmacodynamic parameters such as serum tumor biomarkers and TGF-β concentration will also be evaluated.

Overall, the study aims to assess the safety, efficacy, and pharmacodynamics of Y101D in combination with Gemcitabine and Albumin Paclitaxel as a first-line systemic treatment for advanced pancreatic cancer patients.

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 71
• Est. completion date: December 31, 2024
• Est. primary completion date: July 30, 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 75 Years

Eligibility

Inclusion Criteria:

• Patients diagnosed with pancreatic cancer (including ductal adenocarcinoma and acinar cell carcinoma) confirmed by histology or cytology; and evidence of unresectable or distant metastasis.

• No prior systemic treatment for advanced/metastatic pancreatic cancer.

• Previous use of anti-tumor Chinese herbal medicine or traditional Chinese medicine preparations, but discontinued use at least 28 days before the first administration of the investigational drug.

• According to RECIST 1.1 criteria, the subject must have at least one measurable target lesion confirmed by CT or MRI examination that has not been locally treated (unless the target lesion has clearly progressed).

• Expected survival time = 12 weeks.

• Eastern Cooperative Oncology Group (ECOG) performance status score of 0-1.

• According to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) version 5.0, any toxicity from previous anti-tumor treatment or surgery must have recovered to grade 0-1 or to the level specified by the inclusion/exclusion criteria. Note: Exclusions include alopecia, pigmentation changes, = grade 2 neuropathy, hypothyroidism due to hormone replacement, or other adverse events confirmed to have become chronic.

• Organ function levels must meet the following requirements:

Hematology: Absolute neutrophil count (ANC) = 1.5 × 109/L, lymphocyte count = 0.5 × 109/L, platelets (PLT) = 100 × 109/L, hemoglobin (HGB) = 90g/L (within 14 days before screening without blood transfusion, use of blood products, or correction with granulocyte colony-stimulating factor [G-CSF] or other hematopoietic growth factors).

Liver function: Total bilirubin (TBIL) = 1.5 times the upper limit of normal, aspartate transaminase (AST) and alanine transaminase (ALT) = 3 times the upper limit of normal (if there is liver metastasis, AST and ALT up to 5 times the upper limit of normal are allowed).

Renal function: Serum creatinine (Cr) = 1.5 times the upper limit of normal or creatinine clearance rate = 50 mL/min (Cockcroft-Gault formula).

Coagulation function: International normalized ratio (INR) = 1.5, prothrombin time (PT), and activated partial thromboplastin time (APTT) = 1.5 times the upper limit of normal.

Exclusion Criteria:

• Patients diagnosed with central nervous system (CNS) metastasis confirmed by imaging.

• Patients with diseases associated with a high risk of clinically significant gastrointestinal bleeding (such as tumor invasion of the gastrointestinal tract or bile ducts) or any other condition or history related to severe bleeding.

• Presence of clinically uncontrollable third-space fluid accumulation before the first administration of the investigational drug, such as pleural effusion, ascites, or pericardial effusion that cannot be controlled by drainage or other methods, as determined by the investigator.

• Underwent major surgery within 4 weeks prior to the first administration of the investigational drug (excluding needle biopsies and tooth extractions).

• Use of immunosuppressive drugs within 7 days prior to the first administration of the investigational drug, excluding nasal and inhaled corticosteroids or physiological doses of systemic corticosteroid hormones

• Significant clinical pancreatitis.

• History of allogeneic organ transplantation or allogeneic hematopoietic stem cell transplantation.

• Presence of active clinical infection of grade 2 or higher (according to CTCAE v5.0 criteria) at screening, requiring systemic (oral or intravenous) antimicrobial treatment.

• Patients requiring long-term use of steroids or immunosuppressive agents for conditions such as active autoimmune diseases or post-organ transplant maintenance therapy. Exceptions include type 1 diabetes, hypothyroidism that can be controlled by replacement therapy alone, and skin diseases (such as vitiligo, psoriasis, or alopecia) that do not require systemic treatment.

• Severe respiratory system diseases or patients judged by the investigator to be unsuitable for inclusion, or patients with concomitant interstitial pneumonia.

• Average corrected QT interval (QTcF) >450 msec (males) or >470 msec (females) based on three electrocardiogram (ECG) examinations during screening (repeat testing and averaging of three measurements are required only if the first ECG indicates QTcF >450 msec [males] or >470 msec [females]). History of long or short QT syndrome in the family or individual, or significant cardiovascular diseases within 6 months before screening.

• History of non-study malignancy (excluding non-invasive lesions with extremely low risk of recurrence, such as squamous cell carcinoma and basal cell carcinoma of the skin, cervical carcinoma in situ, or breast carcinoma in situ) within 5 years prior to the first administration of the investigational drug.

• Active hepatitis B (positive hepatitis B surface antigen [HBsAg] or hepatitis B core antibody [HBcAb], peripheral blood HBV DNA titers <500 IU/mL allow inclusion), active hepatitis C, active syphilis, HIV-positive patients.

• Pregnant or lactating women, or individuals with reproductive potential within 6 months after the end of this clinical study, regardless of gender.

• Known history of substance abuse or drug addiction.

• History of clear neurological or psychiatric disorders, as determined by the investigator, that would hinder compliance with treatment or adherence to instructions.

Related Conditions & MeSH terms

• Advanced Pancreatic Adenocarcinoma

Intervention

Drug:
• Y101D
Intravenous infusion of Y101D at day1, combined with Gemcitabine and Nab-Paclitaxel IV infusion at day1, 8, a 21-day cycle. After 6 cycles, Y101D and Gemcitabine infusion is applied as the maintenance treatment.

Locations

Country	Name	City	State
China	Union Hospital, Tongji Medical College, Huazhong University of Science and Technology	Wuhan	Hubei

Sponsors (1)

Lead Sponsor	Collaborator
Wuhan YZY Biopharma Co., Ltd.

Country where clinical trial is conducted

China, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Dose Limiting Toxicities (DLTs)	Dose limiting toxicities during the first 21 days after the first administrations of Y101D in each cohort.	From the time of the first dose (Day 1) until Day 21
Primary	RP2D	Recommended Phase 2 Dose of Y101D	From the enrollment of first patient through phae 1b study completion, an average of 1 year
Primary	Objective Response Rate (ORR)	Objective Response Rate assessed according to RECIST 1.1 per investigator	From the time of first dosing (Day 1) until disease progression (up to 6 months)
Secondary	Peak Serum Concentration (Cmax)	The highest Y101D concentration in serum during one treatment cycle (21 days)	From the time of first dosing (Day 1) until disease progression or toxicity intolerance (up to 6 months).
Secondary	Trough Serum Concentration (Ctrough)	The lowest Y101D concentration in serum during one treatment cycle (21 days)	From the time of first dosing (Day 1) until disease progression or toxicity intolerance (up to 6 months).
Secondary	Area under the serum concentration versus time curve (AUC) during one treatment cycle (21 days)	The area under the serum concentration versus tiem curve of Y101D during one treatment cycle (21 days)	From the time of first dosing (Day 1) until disease progression or toxicity intolerance (up to 6 months).
Secondary	The TGF-ß concentration in serum	The TGF-ß concentreation in serum at 30 minutes before the first treatment dosing of Y101D and the subsequent dosing of Y101D every two cycles (Cycle 3 Day 1, Cycle 5 Day 1, etc.) until the disease progression or death or toxicity intolerance of Y101D.	From the time of first dosing (Day 1) until disease progression or death or toxicity intolerance (up to 6 months).
Secondary	The CA19-9 concentration in serum	The CA19-9 concentreation in serum at 30 minutes before the first treatment dosing of Y101D and the subsequent dosing of Y101D every two cycles (Cycle 3 Day 1, Cycle 5 Day 1, etc.) until the disease progression or death or toxicity intolerance of Y101D.	From the time of first dosing (Day 1) until disease progression or death or toxicity intolerance (up to 6 months).
Secondary	The positive rate of Anti-Drug Antibody (ADA) and Neutralizing antibody (Nab)	The potivie rate of Anti-Drug Antibody and neutralizing antibody in serum 30 minutes before the Y101D infusion at Day 1 of Cycle 1, Cycle 2, Cycle 4 and Cycle 7 (a 21-day cycle).	From the time of first dosing (Day 1) until disease progression or toxicity intolerance (up to 6 months)
Secondary	Disease control rate (DCR)	Disease control rate assessed according to RECIST 1.1 per investigator	From the time of first dosing (Day 1) until disease progression or toxicity intolerance (up to 6 months).
Secondary	Duration of response (DOR)	The time from the first objective response to disease progression or death	From the time of first dosing (Day 1) until one month after the EOT
Secondary	Progression-free survival (PFS)	The time from the first objective response to disease progression or death (Up to 12 months)	From the time of first dosing (Day 1) until disease progression or death (up to 12 months).
Secondary	Overall survival (OS)	The time from the first objective response to death (Up to 2 yrs)	From the time of first dosing (Day 1) until death (up to 2 years).