Study of NABPLAGEM vs. Nab-Paclitaxel/Gemcitabine in BRCA1/2 or PALB2 Pancreatic Cancer

Launched by UNIVERSITY HEALTH NETWORK, TORONTO · Jan 16, 2025

Keywords

ClinConnect Summary

This clinical trial is investigating two different treatments for patients with advanced pancreatic cancer who have specific genetic mutations (BRCA1/2 or PALB2) and have not responded well to their initial chemotherapy. The study aims to compare a new treatment called NABPLAGEM with a standard treatment that combines nab-paclitaxel and gemcitabine. By doing this, researchers hope to find out if the new treatment is more effective in helping patients manage their cancer.

To be eligible for this trial, participants must be at least 18 years old and have a confirmed diagnosis of metastatic pancreatic cancer with the specific genetic mutations mentioned. They should have measurable cancer and must have experienced disease progression after their first treatment, which was likely a chemotherapy regimen called FOLFIRINOX. Participants will need to recover from any significant side effects of previous treatments before joining the trial. The study is currently not recruiting, but once it begins, those who qualify may have a chance to access potentially beneficial treatments while contributing to important research.

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Eligibility criteria

• Inclusion Criteria:
• • Metastatic pancreatic adenocarcinoma. Adenosquamous carcinoma, squamous carcinoma, acinar cell carcinoma, and carcinoma not otherwise specified are also acceptable.
• • BRCA1/2 or PALB2 mutation (somatic or germline).
• • Measurable disease.
• • Potential trial participants should have recovered from clinically significant adverse events of their most recent therapy/intervention prior to enrollment.
• • Clinical or radiographic progression on first-line FOLFIRINOX (or NALIRIFOX) for metastatic disease.
• • Patients whose front-line chemotherapy was required to be simplified due to toxicity associated with any of the constituent components of FOLFIRINOX/NALIRIFOX (e.g. simplified to FOLFOX, FOLFIRI, 5-FU (including capecitabine)) will be eligible.
• • Patients with progressive disease while on maintenance PARP inhibitor treatment after FOLFIRINOX (or NALIRIFOX), irrespective of how long ago they received FOLFIRINOX/NALIRIFOX, will also be eligible.
• • Patients who develop metastatic disease during or within 6 months after completing FOLFIRINOX/NALIRIFOX in either the locally advanced or adjuvant/neoadjuvant settings will be eligible.
• • Age 18 years or older.
• • Ability to understand and willing to sign a written informed consent document.
• • Eastern Cooperative Oncology Group (ECOG) Performance Status 0-2 (Karnofsky Performance Status ≥60).
• • Required Initial Laboratory Values
• • Not pregnant and not nursing.
• Exclusion Criteria:
• • Patients may not have received prior cisplatin for their pancreatic cancer in any setting.
• • Patients with \> grade 2 peripheral sensory neuropathy are not eligible.
• • Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial.
• • Patients with treated brain metastases are eligible if follow-up brain imaging after central nervous system (CNS)-directed therapy shows no evidence of progression for at least 8-weeks. Patients with known, new or progressive brain metastases (active brain metastases) or leptomeningeal disease are ineligible.
• • HIV-infected patients on effective anti-retroviral therapy with undetectable viral load anytime within 6 months prior to registration are eligible for this trial.
• • For patients with evidence of chronic hepatitis B virus (HBV) infection, the HBV viral load must be undetectable on suppressive therapy, if indicated. Patients with a history of hepatitis C virus (HCV) infection must have been treated and cured. For patients with HCV infection who are currently on treatment, they are eligible if they have an undetectable HCV viral load.
• • Concomitant Chronic concomitant treatment with strong inhibitors of CYP3A4 is not allowed on this study. Patients on strong CYP3A4 inhibitors must discontinue the drug for 14 days prior to registration on the study. Chronic concomitant treatment with strong CYP3A4 inducers is not allowed. Patients must discontinue the drug 14 days prior to the start of study treatment.