This study will assess the efficacy and safety of BL-8040 in combination with pembrolizumab (Keytruda®) and BL-8040/ Pembrolizumab in combination with liposomal irinotecan (Onivyde®)/5-fluorouracil/leucovorin (5-FU/LV) in subjects with metastatic pancreatic adenocarcinoma.
This will be an open-label, two-cohort, phase IIa study in subjects with metastatic pancreatic adenocarcinoma. The study will be comprised of 2 cohorts,. Each includes approximately 40 subjects with unresectable metastatic pancreatic adenocarcinoma. Cohorts will be conducted sequentially (one after the other). Each cohort study consists of two periods: * Monotherapy period: One week, with BL-8040 administered daily on days 1-5. * Combination therapy: Cohort 1: Three-week cycles of a combination of BL-8040 administered three times a week (TIW) and pembrolizumab administered once every three weeks. Cohort 2: Onivyde®/5-FU/LV every 2 weeks, pembrolizumab once every 3 weeks and BL-8040 twice a week. Cohort 1: Subjects with metastatic pancreatic adenocarcinoma will be enrolled and receive BL-8040 monotherapy for five days followed by a combination treatment of BL-8040 and pembrolizumab. During the monotherapy period, eligible subjects will receive daily subcutaneous (SC) injections of BL-8040 (1.25 mg/kg) on Days 1 - 5. From Day 8, subjects will begin a combination period consisting of treatment with SC BL-8040 TIW and pembrolizumab once every three weeks. The combination therapy will continue for up to 35 cycles of pembrolizumab approximately two years), or until progression, clinical deterioration or Early Termination, whichever comes first. Cohort 2: Subjects with metastatic pancreatic adenocarcinoma that have progressed following first-line treatment with gemcitabine-based chemotherapy will be enrolled and receive BL-8040 monotherapy for five days followed by a combination treatment of BL-8040, pembrolizumab and chemotherapy. During the monotherapy period, eligible subjects will receive daily SC injections of BL-8040 on Days 1 - 5. From Day 8, subjects will begin a combination period consisting of: * IV Onivyde® followed by IV leucovorin (LV), followed by IV fluorouracil (5-FU), every 2 weeks. * Pembrolizumab every three weeks. * BL-8040 twice a week The combination therapy will continue for up to 35 treatments (approximately two years), or until progression, clinical deterioration or Early Termination, whichever comes first.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
80
BL-8040 subcutaneous (SC) injections
Pembrolizumab will be given as a 30-minute IV infusion
• IV Onivyde® followed by IV leucovorin (LV), followed by IV fluorouracil (5-FU), every 2 weeks.
Objective Response Rate (ORR) Assessed by Imaging According to RECIST 1.1 Criteria
Response is determined by assessment of target lesions identified in CT or MRI imaging. The ORR is assessed according to RECIST 1.1, defined as the sum of PRs (Partial Responses) and CRs (Complete Responses) determined according to best response RECIST 1.1 criteria. PR is defined as at least a 30% decrease in the sum of the longest diameter of target lesions, taking as reference the baseline sum longest diameter. CR is defined as disappearance of all target lesions.
Time frame: Change in response between screening, end of monotherapy (Day 5), end of cycle 2 (Day 28) and approximately every 63 days until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 24 months.
Overall Survival
The length of time elapsed from monotherapy Day 1 to death
Time frame: Through study completion, an average of 2 years for cohort of the study, and follow-up until date of death up to 100 weeks.
Progression-free Survival (PFS) by Imaging (RECIST 1.1)
Progression-free Survival (PFS) by imaging (assessed according to RECIST 1.1). Progression is determined by assessment of target lesions identified in CT or MRI imaging. Progression is defined as at least a 20% increase in the sum of the longest diameter of target lesions, taking as reference the smallest sum longest diameter recorded since the treatment started or the appearance of one or more new lesions.
Time frame: Through study completion, an average of 2 years
Disease Control (DC)
Sum of Partial Response (PR), Complete Response (CR) and Stable Disease (SD). PR is defined as an at least 30% decrease in the sum of the longest diameter of target lesions, taking as reference the baseline sum longest diameter. CR is defined as disappearance of all target lesions. Progressive Disease (PD) is defined as an at least 20% increase in the sum of the longest diameter of target lesions. SD is defined as neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD.
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Mayo Clinic
Phoenix, Arizona, United States
Honor Health
Scottsdale, Arizona, United States
Ochsner Medical Center
New Orleans, Louisiana, United States
Massachusetts General Hospital (MGH)
Boston, Massachusetts, United States
Beth Israel Deaconess Medical Center (BIDMAC)
Boston, Massachusetts, United States
DF/HCC
Boston, Massachusetts, United States
Karmanos Cancer Center, Wayne State University
Detroit, Michigan, United States
Washington University of St Louis
St Louis, Missouri, United States
Atlantic Medical Group
Morristown, New Jersey, United States
NYU Langone Health
New York, New York, United States
...and 21 more locations
Time frame: Through study completion, an average of 2 years