The purpose of the study is to evaluate a new treatment strategy for advanced pancreatic cancer disease by combining the new investigational medicinal product Atu027 with the standard chemotherapeutic gemcitabine. This combination aims at enhancing gemcitabine´s anti-tumor activity with Atu027. The objectives of this clinical trial are to evaluate safety and activity of two Atu027 schedules in combination with standard gemcitabine treatment in patients with advanced or metastatic pancreatic adenocarcinoma.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
29
Subjects will be treated in a 28-day cycle with Atu027 twice weekly for 4 weeks and gemcitabine once weekly for the first three weeks.
Subjects will be treated in a 28-day cycle with Atu027 and gemcitabine once weekly for three consecutive weeks (on days 1, 8, and 15). During week four no treatment is administered. Treatment will be continued in consecutive 28-day cycles until unacceptable toxicity or disease progression occurs.
Subjects will be treated in a 28-day cycle with gemcitabine once weekly (on days 4, 11, and 18) and Atu027 twice weekly (on days 1, 4, 8, 11, 15, 18, 22, and 25). The 28-day combination cycle is followed by a 28-day gemcitabine monotherapy cycle. Treatment will be continued in consecutive 28-day cycles until unacceptable toxicity or disease progression occurs.
Charité - Universitätsmedizin Berlin Charité Centrum für Tumormedizin
Berlin, Germany
Klinikum Dortmund gGmbH Medizinische Klinik Mitte
Dortmund, Germany
Universitätsklinikum Freiburg, Innere Medizin II
Freiburg im Breisgau, Germany
Number of subjects with adverse events
Time frame will be 18 weeks if patient will be withdrawn after 3 cycles because of disease progression or toxicity.
Time frame: Baseline till follow up visit 1 (18 weeks)
Subject physical examination
Additional time frames in arm 1: 8 days after baseline. Additional time frames in arm 2 and safety cohort (cycle 1 only): 4 and 15 days after baseline.
Time frame: At baseline; later on in 4 week intervals till last follow up visit (1 year);
Measuring of subject vital signs and body weight
End of treatment visit will be after 13 weeks only when patient is withdrawn after 3 cycles. Additional time frames in arm 1: 8 days after baseline. Additional time frames in arm 2 and safety cohort (cycle 1 only): 4 and 15 days after baseline.
Time frame: At baseline; end of treatment (13 weeks); later on in 4 week intervals till last follow up visit (1 year)
Performance of 12-lead ECG
End of treatment visit will be after 13 weeks only when patient is withdrawn after 3 cycles. Additional time frames in arm 1: 8 days after baseline. Additional time frames in arm 2 and safety cohort (cycle 1 only): 4 and 15 days after baseline.
Time frame: At baseline; later on in 4 week intervals till end of treatment (13 weeks)
Assessment of clinically significant laboratory parameters outside normal range
Additional time frames in arm 1: During treatment on days 1, 8, 15 of each cycle. Additional time frames in arm 2 and safety cohort (cycle 1 only): During treatment on days 1, 4, 8, 11, 15, 18, 22, 25 of each cycle.
Time frame: At baseline; at end of treatment (week 13 if patient withdrawn after 3 cycles); at follow up visit 1 (week 18 if patient withdrawn after 3 cycles); at each follow up visit till end of trial (1 year)
Maximum concentration (Cmax), area under the curve (AUC), time to maximum concentration (tmax), and half life (t½) of the Atu027 siRNA single strand (A-strand), and of AtuFect01 and the helper lipid DPyPE
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Medizinische Klinik III - Hämatologie/Onkologie Marienhospital Herne
Herne, Germany
Klinikum Kassel GmbH Medizinischen Klinik IV;Onkologie,
Kassel, Germany
Klinikum Nürnberg Nord Medizinische Klinik 5
Nuremberg, Germany
Klinik und Poliklinik für Innere Medizin I Universitätsklinikum Regensburg
Regensburg, Germany
Klinikum Stuttgart Klinik Hämatologie, Onkologie und Palliativmedizin
Stuttgart, Germany
Universitätsklinikum Ulm Zentrum für Innere Medizin
Ulm, Germany
Additional time frames in arm 1: During cycles 1 and 2 of treatment on days 1, 8, 15 of each cycle; in cycle 3 and following only on day 1; Additional time frames in arm 2 and safety cohort (cycle 1 only): During the first treatment cycle on days 1, 4, 8, 11, 15, 18; in cycle 3 and following odd numbered cycles only on day 1; in all even numbered cycles no samples are taken. Pharmacokinetics will be assessed in subjects of the safety cohort and in the first 4 subjects per treatment arm.
Time frame: At end of treatment (week 13 if patient withdrawn after 3 cycles); at follow up visit 1 (week 18 if patient withdrawn after 3 cycles)
Objective response rate
Response will be assessed by RECIST Version 1.1 using abdominal magnetic resonance imaging (MRI) or computed tomography (CT) scans. An objective response is defined when the overall response is complete response (CR), partial response (PR), or stable disease (SD).
Time frame: At baseline and in 8 week intervals till end of trial (1 year)
Progression-free survival and overall survival
Progression-free survival and overall survival, based on the objective response definition will be analyzed using Kaplan-Meier methods.
Time frame: From baseline in 8 week intervals till end of trial (1 year).
ECOG performance score
Additional time frames: During treatment on day 1 of each cycle. The ECOG performance status, and its change from baseline, will be summarized descriptively by visit and treatment arm. The ECOG performance status will also be assessed during the 1 year follow-up period of the study and results including changes to baseline will be summarized.
Time frame: At baseline; at end of treatment (13 weeks if patient withdrawn after 3 cycles); at follow up visit 1 (18 weeks if patient withdrawn after 3 cycles); at each following follow up visit till end of trial (1 year)
Biomarker response
Serum protein markers and circulating microRNA will be analyzed and changes to baseline will be summarized descriptively by treatment arm.
Time frame: At baseline; at day 1 of cycle 3; end of treatment (13 weeks if patient withdrawn after 3 cycles); follow up visit 1 (18 weeks if patient withdrawn after 3 cycles)
Tumor marker response
Additional time frame: At day 1 of cycle 3 and day 1 of each following second cycle; Tumor markers will be summarized descriptively for each analyzed marker.
Time frame: At baseline; at end of treatment (13 weeks if patient withdrawn after 3 cycles); at follow up visit 1 (18 weeks if patient withdrawn after 3 cycles); at each following follow up visit till end of trial (1 year)
Quality of life
Different scales of quality of life assessed with the EORTC questionnaire and their changes from baseline will be summarized descriptively by visit and treatment arm.
Time frame: At baseline; at day 1 of all cycles except cycle 1; at end of treatment (week 13 if patient withdrawn after 3 cycles)