Pancreas Cancer Clinical Trial
Official title:
A Phase 1b Trial of Neoadjuvant Stereotactic Body Radiotherapy With or Without CCR2 Inhibitor (CCX872-B) Immunotherapy for Preoperative Treatment of Resectable Pancreatic Cancer
Standard treatment for newly diagnosed operable pancreatic cancer usually involves undergoing
surgery first and then receiving chemotherapy with or without radiation therapy. However, the
pancreatic cancer often comes back after this treatment. Therefore, the investigators are
studying whether giving treatment prior to surgery can help decrease the risk the cancer
returns.
Stereotactic Body Radiation Therapy (SBRT) is a highly focused type of radiation therapy
commonly used in the treatment of pancreatic cancer. This treatment has been shown to be safe
and effective for the preoperative treatment of pancreatic cancer. The purpose of this study
is to determine if combining an experimental drug, CCX872-B, with SBRT continues to be safe
and whether the combination treatment may be more effective at boosting the participant's
immune system's ability to kill the pancreatic cancer.
The investigators have shown that preoperative SBRT followed by surgical resection is
feasible and safe in patients in the previous trial UGIP14107. The investigators have also
presented preclinical evidence that inhibiting entry of CCR2+ IM using a small molecule
antagonist against CCR2 results in enhanced efficacy of RT 26. The investigators hypothesize
that inhibition of the CCR2 axis can potentially up regulate the immune response following
radiation, therefore leading to a more robust tumor killing response. In preclinical studies,
CCR2 inhibitor has little effect in the absence of RT, therefore, the investigators are not
including a drug therapy alone group. To test this hypothesis, a phase Ib clinical trial has
been proposed to evaluate the effect of combining stereotactic body radiotherapy with CCR2
inhibition in the neoadjuvant treatment of surgically resectable adenocarcinoma of the head
of the pancreas.
The study will consist of two parts in sequential fashion. The first fifteen patients will be
assigned to Group 1 and undergo SBRT with CCR2 inhibitor CCX872-B. The primary objective is
to establish safety and feasibility of the treatment and analyze biomarkers to determine if
combined treatment can stimulate an immune response in human patients. A second group of 5
patients will undergo SBRT alone as a comparison group for biomarker immune response.
The investigators would like to proceed with SBRT and CCX872-B as Group 1 given the
investigators already have sufficient data from UGIP14107 to show that SBRT is safe and
feasible and studying the combination of SBRT with CCX872-B is the primary scientific
objective of this study. If unexpected safety issues occur with Group 1, the investigators
would consider closing trial at that time without enrolling any patients in Group 2 which
would reduce the number of patients exposed to the study.
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