This phase II trial studies how well giving selumetinib and erlotinib hydrochloride together works in treating patients with locally advanced or metastatic pancreatic cancer that is refractory to chemotherapy. Selumetinib and erlotinib hydrochloride may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth.
PRIMARY OBJECTIVES: l. To assess overall survival (as measured by median survival and proportion of patients alive at 24 weeks) in patients with advanced pancreatic cancer who have received one prior line of systemic therapy when treated with the combination of AZD6244 (selumetinib) and erlotinib (erlotinib hydrochloride). SECONDARY OBJECTIVES: I. Progression-free survival (median progression-free survival \[PFS\] and proportion of patients with PFS at 12 and 24 weeks). II. Cancer antigen (CA)19-9 biomarker response (defined as a 50% decline in serum CA19-9 level from baseline in patients with \> 2 x upper limit of normal \[ULN\] CA19-9 measurement). III. Objective radiographic response by Response Evaluation Criteria in Solid Tumors (RECIST) criteria. IV. Safety and toxicity profile of the combination of AZ6244 and erlotinib. OUTLINE: Patients receive selumetinib orally (PO) once daily (QD) and erlotinib hydrochloride PO QD on days 1-21. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up every 2-3 months.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
46
UCSF-Mount Zion
San Francisco, California, United States
Ohio State University Medical Center
Columbus, Ohio, United States
Overall Survival (OS)
Survival will be calculated according to the method of Kaplan and Meier. Both actual and estimated probability of being alive (along with a 95% confidence interval) at 24 weeks (6 months) and for any multiple of 6 months will be calculated for which the number of uncensored subjects is not smaller than 10.
Time frame: Up to 2 years
Survival at 24 Weeks
Percent survival at 24 weeks (6 months)
Time frame: 24 weeks
Progression-free Survival (PFS)
Calculated according to the method of Kaplan and Meier. Actual and estimated probability of being alive and progression-free, along with a 95% confidence interval, will be calculated. Response and progression are evaluated in this study using the international criteria proposed by the Response Evaluation Criteria in Solid Tumors (RECIST) Committee \[JNCI 92(Macdonald et al.):205-216, 2000\]. Changes in only the largest diameter (unidimensional measurement) of the tumor lesions are used. Progressive Disease is defined as a 20% or higher increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study). In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. (Note: the appearance of one or more new lesions is also considered progressions).
Time frame: From first dose of study treatment to the date of objective progression, or death due to cancer or unknown cause, or to the date of withdrawal from the trial from unknown reasons, assessed up to 2 years
CA19-9 Biomarker Response (Defined as a 50% Decline in Serum CA19-9 Level From Baseline in Patients With > 2 x ULN CA19-9 Measurement)
The proportion of patients with CA19-9 response.
Time frame: Up to 2 years
Objective Radiographic Response by RECIST Criteria
Patient's best overall response will be tabulated by level; proportions of complete response (CR) and of CR+partial response will be calculated along with 95% confidence intervals. Per Response Evaluation Criteria In Solid Tumors (RECIST v1.0) for target lesions and assessed by MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR, \>= 30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR+PR.
Time frame: Up to 2 years
Incidence of Toxicities Graded Using the National Cancer Institute Common Terminology Criteria for Adverse Events Version 4.0
Tabulation of type of adverse events (AE) and the incidence of grade 3 and 4 for each AE
Time frame: Up to 30 days after completion of study treatment
Number of Patients With Dose Modifications and Reason for Dose Modification.
Tabulation of the reasons for dose modification with number of patients
Time frame: Up to final day of study treatment
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