Laboratory studies suggest that the study drug may stop cancer cells from growing by affecting an interaction between proteins in the cells referred to as cAMP-response element-binding protein and ß-catenin. The purpose of this research study is to determine the highest safe dose of study drug that may be used when it is given together with a chemotherapy drug to patients with cancer of the pancreas.
PRI-724 is a small molecule antagonist that binds to the co-activator CBP thereby specifically inhibiting the subset of Wnt/β-catenin-driven genes that are up-regulated in cancer cells. PRI-724 is being developed as a potential antineoplastic agent. Purpose: To determine the safety, tolerability, dose-limiting toxicities (DLTs), and maximum tolerated dose (MTD) of sequential escalating doses per cohort of PRI-724 administered in combination with gemcitabine to patients with adenocarcinoma of the pancreas that is locally advanced, metastatic, or otherwise inoperable, who are candidates for second-line therapy after failing first-line therapy with FOLFIRINOX (i.e., folinic acid \[leucovorin\], fluorouracil, irinotecan, oxaliplatin) * PRI-724: 320, 640, 905 mg/m2/day, continuous intravenous (CIV) infusion over 24 h, daily × 7 days, 1 week on with 1 week recovery × 2 (4 weeks equals 1 cycle) * Gemcitabine: 1000 mg/m2 IV over 30 minutes; 3 weeks on with 1 week recovery (4 weeks equals 1 cycle) Patients with documented, measurable or evaluable adenocarcinoma of the pancreas that is locally advanced, metastatic, or otherwise inoperable, who are candidates for second-line therapy after failing first-line therapy with FOLFIRINOX, will be entered into this phase 1b, multicenter, open-label, non-randomized, dose-escalation per cohort study. The trial is designed to evaluate the safety, tolerability, DLT(s), and MTD of escalating doses of PRI-724, a CBP/ β- catenin inhibitor, when administered in combination with a standard dose of gemcitabine. Correlative studies include characterization of the PK profiles of PRI-724 and gemcitabine, evaluation of the utility of potential PD markers of PRI-724 activity, as well as preliminary assessment of the antineoplastic activity of PRI-724 plus gemcitabine in this patient population.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
20
Gemcitabine: 1000 mg/m2 IV over 30 minutes; once weekly dosing; 3 weeks on with 1 week recovery (4 weeks per cycle) PRI-724: Cohort 1: 320 mg/m2/day; Cohort 2: 640 mg/m2/day; Cohort 3: 905 mg/m2/day; Continuous IV over 24 hours; daily x 7 days; 1 week on with 1 week recovery × 2 (4 weeks per cycle)
USC Norris Comprehensive Cancer Center
Los Angeles, California, United States
University of California, San Francisco
San Francisco, California, United States
Massachusetts General Hospital Cancer Center
Boston, Massachusetts, United States
Mayo Clinic
Rochester, Minnesota, United States
University of Washington Seattle Cancer Care Alliance
Seattle, Washington, United States
The Maximum Tolerated Dose (MTD) of PRI-724 + Gemcitabine measured by the number of dose limiting toxicities (DLTs) that occur.
If no DLT occurs in the first 3 patients of a cohort, the dose will be escalated to the next dose cohort. If 1 DLT occurs in the first 3 patients of a cohort, that cohort is expanded to 6 patients. If more than 1 DLT occurs in a 6 patient cohort, escalation is stopped \& next lower dose is expanded to 12 patients to confirm the MTD.
Time frame: 18 months. DLTs will be measured as they occur throughout the patients' time on study.
Pharmacokinetic parameters of C max , T max , AUC (tau), and t ½.
The secondary outcome measures of PKs, PDs, MMP7, hair follicle sampling, and Response Criteria by RECIST comprise the correlative studies of this trial and are designed to evaluate PK profiles, assess and evaluate the utility of potential biomarkers, and evaluate antineoplastic activity of PRI-724 + Gemcitabine.
Time frame: C 1 D 1 hrs 0, 1, 2, D 8 hrs 0, :15, :30, 1, 2, 4, 6, D 9 hrs 24, D 15 at hrs 0
Pharmacodynamic mRNA expression of survivin
The secondary outcome measures of PKs, PDs, MMP7, hair follicle sampling, and Response Criteria by RECIST comprise the correlative studies of this trial and are designed to evaluate PK profiles, assess and evaluate the utility of potential biomarkers, and evaluate antineoplastic activity of PRI-724 + Gemcitabine
Time frame: C 1 D 1, D 8, D 15, D 22, All Cycles D 22, end of treatment
Evaluation of antineoplastic activity of PRI-724 + gemcitabine per RECIST 1.1 criteria
The secondary outcome measures of PKs, PDs, MMP7, hair follicle sampling, and Response Criteria by RECIST comprise the correlative studies of this trial and are designed to evaluate PK profiles, assess and evaluate the utility of potential biomarkers, and evaluate antineoplastic activity of PRI-724 + Gemcitabine
Time frame: Screening, end of C 2, every 2 cycles, end of treatment
MMP7 levels in blood as ng/ml
The secondary outcome measures of PKs, PDs, MMP7, hair follicle sampling, and Response Criteria by RECIST comprise the correlative studies of this trial and are designed to evaluate PK profiles, assess and evaluate the utility of potential biomarkers, and evaluate antineoplastic activity of PRI-724 + Gemcitabine.
Time frame: C 1 Wk 1, Wk 4, Wk 4 all cycles, end of treatment
Gene expressions in hair follicle epithelial cells
The secondary outcome measures of PKs, PDs, MMP7, hair follicle sampling, and Response Criteria by RECIST comprise the correlative studies of this trial and are designed to evaluate PK profiles, assess and evaluate the utility of potential biomarkers, and evaluate antineoplastic activity of PRI-724 + Gemcitabine
Time frame: Screening, C 1 D 14, C 2 Wk 4, end of treatment
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