Pancreatic Cancer Clinical Trial
Official title:
A Randomized Multi-center Phase I/II Trial of ICM (Irinotecan, Cisplatin, Mitomycin C) With or Without AZD2281 (Olaparib) in Patients With Advanced Pancreatic Cancer
Patients whose pancreatic cancers have defects in the BRCA/Fanconi DNA repair pathway or other defects in homologous repair will have cancers that respond to olaparib when given in combination with the DNA damaging agents, irinotecan, cisplatin, mitomycin C (ICM).
The trial is designed to evaluate the role of Parp inhibitor based therapy, combining the
most well studied and potent Parp inhibitor currently available with a low-dose combination
of DNA damaging agents to optimize the effects of Parp inhibition. To ensure optimal
response rates in the trial, to enrich our population for patients likely to achieve the
best clinical response to Parp inhibitor based therapy, we will recruit and enroll patients
with known BRCA mutations, patients of Jewish ancestry, patients with familial pancreatic
cancer, as well as with sporadic pancreatic cancer. We will test patients and their cancers
for other inherited or acquired defects in homologous DNA repair. For the phase 1 study, we
will enroll up to 30 patients. For the phase 2 component of the study, 100 patients with
locally, advanced, unresectable or metastatic pancreatic cancer will be enrolled. An initial
phase I analysis will be performed to test the safety of the ICM with Olaparib regimen at
the doses we predict will be effective for the phase 2 and ensure that these doses are below
the maximum tolerated dose. For this phase 1 we will use a standard 3+3 design and will test
the following dose regimens in a 28 day cycle:
Dose level 1: Cisplatin/Irinotecan i.v.(day 1, 8) and Olaparib (100 mg bid p.o., Day 1 & Day
8) Dose level 2: Cisplatin/Irinotecan i.v.(day 1, 8) and Olaparib 100 bid p.o. day 1-3, day
8-10 (if this dose is not tolerated, go to Dose 5: Mitomycin + Olaparib Dose level 1) Dose
level 3: Cisplatin/Irinotecan i.v.(day 1, 8) and Olaparib 200 bid p.o.day 1-3, day 8-10 (if
this dose is not tolerated, go to Dose 5: Mitomycin + Olaparib Dose level 2) Dose level 4:
Cisplatin/Irinotecan i.v.(day 1, 8) and Olaparib 200 bid p.o. day 1-12 (if this dose is not
tolerated, go to Dose 5: Mitomycin + Olaparib Dose level 3)) Dose level 5:
Cisplatin/Irinotecan i.v.(day 1, 8), Mitomycin Day 1 (5 mg/m2 IV), along with the
established tolerated dose level of Olaparib.
Other intermediate dose schedules of Olaparib may be considered to achieve the most optimal
tolerable regimen" If there are DLTs at Dose 1, we will reduce the duration of Olaparib
Note: The Principal Investigator and Astrazeneca decided not to move forward with the Phase
II part of the study. Therefore the arms of Irinotecan, Cisplatin, Mitomycin C with Olaparib
versus Irinotecan, Cisplatin, Mitomycin C without Olaparib will not be compared.
;
Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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