Clinical trial

An Open-label, Randomised, Multicentre, Phase III Study of Irinotecan Liposome Injection, Oxaliplatin, 5-fluorouracil/Leucovorin Versus Nab-paclitaxel Plus Gemcitabine in Subjects Who Have Not Previously Received Chemotherapy for Metastatic Adenocarcinoma of the Pancreas

Name
D-US-60010-001
Description
The purpose of this study is to look at the efficacy and safety of Irinotecan liposome injection in combination with other approved drugs used for cancer therapy, namely 5 fluorouracil/leucovorin (5FU/LV) plus oxaliplatin compared to nab-paclitaxel + gemcitabine treatment in improving the overall survival of patients not previously treated for metastatic pancreatic cancer.
Trial arms
Trial start
2020-02-11
Estimated PCD
2022-07-23
Trial end
2024-12-31
Status
Active (not recruiting)
Phase
Early phase I
Treatment
Irinotecan Liposomal Injection
Irinotecan liposome injection is irinotecan in the form of the sucrosofate salt, encapsulated in liposomes for i.v. infusion. It is supplied in sterile, single-use vials containing 10 mL of irinotecan liposome injection at a concentration of 4.3 mg/mL free base equivalent (FBE).
Arms:
Irinotecan liposome injection + Oxaliplatin + 5-FU/LV
Other names:
Onivyde®, Nal-IRI
Oxaliplatin
Oxaliplatin injection, USP is supplied in single-dose vials containing 50 mg, 100 mg or 200 mg of oxaliplatin as a sterile, preservative-free, aqueous solution at a concentration of 5 mg/mL.
Arms:
Irinotecan liposome injection + Oxaliplatin + 5-FU/LV
Other names:
Eloxatin®
5Fluorouracil
Fluorouracil injection, USP is a colorless to faint yellow, aqueous, sterile, nonpyrogenic injectable solution available in 50 mL and 100 mL pharmacy bulk package. Each mL contains 50 mg fluorouracil in water for injection, USP.
Arms:
Irinotecan liposome injection + Oxaliplatin + 5-FU/LV
Other names:
Adrucil®, flurouracil, 5-FU
Leucovorin
Leucovorin Calcium for Injection is supplied in vials ranging from 50-500 mg and available as an injectable solution or lyophilized powder for reconstitution.
Arms:
Irinotecan liposome injection + Oxaliplatin + 5-FU/LV
Other names:
Folinic Acid
Nab-paclitaxel
Nab-paclitaxel is a lyophilised powder containing 100 or 250 mg of paclitaxel formulated as albumin-bound particles in single-use vials for re-constitution. Each mL of the reconstituted formulation will contain 5 mg/mL paclitaxel.
Arms:
Nab-paclitaxel + Gemcitabine
Other names:
Abraxane®
Gemcitabine
Gemcitabine for injection is a lyophilised powder for solution for infusion, with each single use vial containing 200 mg, 1 g or 2 g of gemcitabine.
Arms:
Nab-paclitaxel + Gemcitabine
Other names:
Gemzar®
Size
770
Primary endpoint
Overall Survival (OS)
Assessments performed at baseline (within 28 days before start of study treatment), every 8 weeks after first dose, end of treatment (EoT) visit, then every 2 months thereafter up to DCO date of 23 July 2022 (maximum of 893 days)
Eligibility criteria
Inclusion Criteria: * Histological or cytologically confirmed adenocarcinoma of the pancreas that has not been previously treated in the metastatic setting. * Initial diagnosis of metastatic disease must have occurred ≤6 weeks prior to screening. * Subject has one or more metastatic lesions measurable by computed tomography (CT) scan (or magnetic resonance imaging (MRI), if the subject is allergic to CT contrast media) according to RECIST Version 1.1 criteria. * Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1. * Subject has adequate biological parameters as demonstrated by the following blood counts:(a) Absolute neutrophil count (ANC) ≥2000/mm3 without the use of hemopoietic growth factors within the last 7 days prior to randomisation (b) Platelet count ≥100,000/mm3 (c) Haemoglobin (Hgb) ≥9 g/dL obtained ≤14 days prior to randomisation. * Adequate hepatic function as evidenced by: (a) Serum total bilirubin ≤1.5x ULN (biliary drainage is allowed for biliary obstruction), and (b) Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤2.5x upper limit of normal (ULN) (≤5x ULN is acceptable if liver metastases are present). * Adequate renal function as evidenced by creatinine clearance ≥30 mL/min. * Adequate coagulation studies (obtained ≤14 days prior to randomisation) as demonstrated by prothrombin time and partial thromboplastin time within normal limits (≤1.5xULN ). Exclusion Criteria: * Prior treatment of pancreatic cancer in the metastatic setting with surgery, radiotherapy, chemotherapy or investigational therapy * Prior treatment of pancreatic adenocarcinoma with chemotherapy in the adjuvant setting, except those where at least 12 months have elapsed since completion of the last dose and no persistent treatment-related toxicities are present. * Subject has only localised advanced disease. * Documented serum albumin \<3 g/dL * Known history of central nervous system (CNS) metastases. * Clinically significant gastrointestinal disorder * History of any second malignancy in the last 2 years * Concurrent illnesses that would be a relative contraindication to trial participation * Use of strong inhibitors or inducers of CYP3A, CYP2C8 and UGT1A1 * Neuroendocrine (carcinoid, islet cell) or acinar pancreatic carcinoma * Known low or absent dihydropyrimidine dehydrogenase (DPD) activity
Protocol
{'studyType': 'INTERVENTIONAL', 'phases': ['PHASE3'], 'designInfo': {'allocation': 'RANDOMIZED', 'interventionModel': 'PARALLEL', 'primaryPurpose': 'TREATMENT', 'maskingInfo': {'masking': 'NONE'}}, 'enrollmentInfo': {'count': 770, 'type': 'ACTUAL'}}
Updated at
2024-04-30

1 organization

6 products

2 abstracts

1 indication

Organization
Ipsen
Product
Leucovorin
Abstract
NALIRIFOX versus nab-paclitaxel and gemcitabine in treatment-naïve patients with metastatic pancreatic ductal adenocarcinoma (mPDAC): Updated overall survival analysis with 29-month follow-up of NAPOLI 3.
Org: Florida Cancer Specialists North Division, Gastrointestinal and Endocrine Tumor Unit Vall d'Hebron University Hospital and Vall d'Hebrón Institute of Oncology (VHIO), IPSEN Bioinnovation Limited, Università degli studi di Verona and Azienda Ospedaliera Universitaria Integrata,
Abstract
Liposomal irinotecan + 5-fluorouracil/leucovorin + oxaliplatin (NALIRIFOX) versus nab-paclitaxel + gemcitabine in treatment-naive patients with metastatic pancreatic ductal adenocarcinoma (mPDAC): 12- and 18-month survival rates from the phase 3 NAPOLI 3 trial.
Org: Memorial Sloan Kettering Cancer Center, Azienda Ospedaliera Universitaria Integrata di Verona, Hospital Universitario Miguel Servet, Centre Léon Bérard, Masaryk Memorial Cancer Institute,