This phase I trial tests the safety, side effects, and best dose of calaspargase pegol-mknl in combination with cobimetinib in treating patients with pancreatic cancer that has spread to nearby tissue or lymph nodes (locally advanced) or has spread to other places in the body (metastatic). Cobimetinib attacks a protein called MEK that has been known to stimulate cells that promote the growth of cancer cells in the body. Calaspargase pegol-mknl is an enzyme that converts the amino acid L-asparagine into aspartic acid and ammonia. Many types of cancer cell rely on the amino acid L-asparagine, and depleting this amino acid with calaspargase pegol-mknl starves cancer cells of this nutrient. Attacking the MEK protein with cobimetinib is thought to further prevent cancer cells from using this amino acid, causing them to die. Giving calaspargase pegol-mknl in combination with cobimetinib may help control the disease in patients with pancreatic cancer.
PRIMARY OBJECTIVE: I. To determine the maximum tolerated dose (MTD) of calaspargase pegol-mknl in combination with cobimetinib. SECONDARY OBJECTIVES: I. To assess the safety of calaspargase pegol-mknl in combination with cobimetinib. II. To assess preliminary response to treatment with calaspargase pegol-mknl and cobimetinib. III. To monitor levels of plasma asparaginase. EXPLORATORY OBJECTIVE: I. To evaluate therapy induced changes in the tumor and tumor ecosystem. OUTLINE: This is a dose-escalation study. Patients receive calaspargase pegol-mknl intravenously (IV) over 1 hour on day 1 and cobimetinib orally (PO) once daily (QD) on days 1-14. Treatment repeats every 21 days for up to 6 cycles in the absence of disease progression or unacceptable toxicity. Patients may also undergo a biopsy before cycle 1, day1 and again on cycle 2 day 15 per the investiagator's discretion, with an additional biopsy at the time of disease progression. After completion of study intervention, patients are followed up at 3 and 6 months.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
15
OHSU Knight Cancer Institute
Portland, Oregon, United States
Incidence of dose-limiting toxicities (DLTs)
Defined as any treatment-related grade \>= 3 non-hematological or hematological adverse events. The incidence of DLT at each dose level will be summarized using the proportion and exact binomial confidence interval. Dose-limiting toxicities will specifically be reported for the DLT evaluation period using the maximum tolerated dose (MTD)-evaluable population. The MTD will be identified using isotonic regression.
Time frame: Up to cycle 2 day 21 (1 cycle = 21 days)
Incidence of treatment-emergent adverse events (AEs) and serious AEs
Evaluated by Common Terminology Criteria for Adverse Events version 5.0.
Time frame: Up to 30 days after last dose of study intervention
Objective response rate (ORR)
Evaluated using Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. Overall response will be summarized descriptively. ORR will be estimated with 95% confidence interval. The confidence interval will be calculated based on the exact method for binomial distributions.
Time frame: Up to 6 months after initiating study intervention
Disease control rate (DCR)
Evaluated using RECIST version 1.1. An estimate of DCR will be measured and reported with 95% exact confidence interval. Participants who achieve a complete response, partial response, or stable disease for at least 6 months on the current protocol will be qualified as deriving benefit from therapy and will count towards the DCR measurement.
Time frame: Up to 6 months after initiating study intervention
Mean plasma asparaginase activity
Will be reported with 95% confidence interval.
Time frame: Up to 6 cycles from initiating study intervention (1 cycle = 21 days)
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.