People with primary metastatic pancreatic cancer will be treated with nab-paclitaxel and gemcitabine in combination with an investigational agent called necuparanib (M402). It is made from heparin, which is a well known blood thinner. Blood thinners have been shown in prior animal and human studies to have anti-cancer effects. Necuparanib has been re-engineered from heparin to have much lower blood thinning activity while keeping the anti-tumor activity. The investigators are testing whether necuparanib administered in combination with nab-paclitaxel and gemcitabine may be more effective than nab-paclitaxel and gemcitabine.
Part A was an open-label, multiple ascending dose patient study of necuparanib given first as a single dose and then daily in combination with the nab-paclitaxel and gemcitabine regimen. It was conducted to evaluate the safety and tolerability of necuparanib alone and in combination with nab-paclitaxel and gemcitabine and to recommend a necuparanib dose regimen for subsequent evaluation in Part B. Part B is a randomized, double-blind study investigating the antitumor activity of necuparanib in combination with nab-paclitaxel and gemcitabine compared with nab-paclitaxel, gemcitabine, and placebo. In both Parts A and B, a treatment period consists of one 28-day cycle. The Study Patient and Investigator can decide to continue with additional 28-day cycles according to the patient's status at the end of each 28-day cycle. Part A has completed enrollment and Part B is currently open. Part A - Primary Objectives: * To evaluate the safety and tolerability of necuparanib in combination with nab-paclitaxel and gemcitabine. * To determine the dose of necuparanib to be carried forward into Part B. Part B - Primary Objective: To evaluate overall survival in patients treated with necuparanib + nab-paclitaxel + gemcitabine compared with placebo + nab-paclitaxel + gemcitabine.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
128
nab-paclitaxel dosed on Day 1, Day 8, Day 15 of each 28-day cycle
gemcitabine will be dosed on Day 1, Day 8, Day 15 of each 28-day cycle
Placebo will be dosed daily
Necuparanib will be dosed daily
University of Alabama at Birmingham Comprehensive Cancer Center
Birmingham, Alabama, United States
Clearview Cancer Institute
Huntsville, Alabama, United States
Arizona Clinical Research Center
Tucson, Arizona, United States
University of Arizona
Tucson, Arizona, United States
University of Colorado School of Medicine - Division of Medical Oncology
Aurora, Colorado, United States
Part A: Safety
At baseline and then each of 6 visits after the start of dosing in a 28-day treatment cycle, adverse event surveillance, liver function enzyme levels, WBC with differential, ANC, aPTT, and PT are measured. This is repeated for each 28 day treatment cycle until disease progression or end of treatment. A final assessment is performed 30 days post-final necuparanib dose.
Time frame: Part A: Baseline to 28 days after first-dose and end of study
Part B: Overall Survival
Time in months from first dose of study medication until death
Time frame: Time in months from first dose of study medication until death
Part A: Maximum concentration of necuparanib
One before and seven blood samples after the first dose followed by 5 additional lab draws, once at each of the 5 remaining visits in the first 28-day cycle.
Time frame: Baseline to 28 days after first dose.
Part B: Duration of progression-free survival
Time in months from first dose of study drug until disease progression
Time frame: Time from first dose of study drug until disease progression
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Poudre Valley Health System
Fort Collins, Colorado, United States
Hartford Healthcare Cancer Institute at Midstate Medical Center
Meriden, Connecticut, United States
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Tampa, Florida, United States
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Newnan, Georgia, United States
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Arlington Heights, Illinois, United States
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