This protocol will enroll patients with pancreatic adenocarcinoma and adenosquamous carcinoma (Cohort 1), gastrointestinal/pancreatic neuroendocrine neoplasms with Ki-67 \> 20% (Cohort 2) and neuroendocrine prostate carcinoma (Cohort 3)). Each cohort will have its own interim analysis after enrollment of 10 patients. Subjects will be given a one-month (28 day) supply of study drug (ESK981). Subjects will be instructed to take 4 capsules, with or without food, once per day for 5 consecutive calendar days, then take a drug holiday for 2 consecutive days before repeating the 5 days on-2 days off cycle in sets of 4 weeks or 28 calendar days. Subjects will be asked to keep a pill diary noting the date they take their study drug.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
66
160 mg, PO, Once daily 5 days on and 2 days off
Rogel Cancer Center
Ann Arbor, Michigan, United States
RECRUITINGBarbara Ann Karmanos Cancer Institute
Detroit, Michigan, United States
RECRUITINGUniversity of Wisconsin Carbone Cancer Center
Madison, Wisconsin, United States
RECRUITINGProgression Free Survival
Determining efficacy using proportion of patients alive and progression-free at 4 months within each cancer subtype
Time frame: 4 months after initiating study drug
Overall Response Rate (ORR) within each cancer subtype
The ORR will be assessed per RECIST v1.1 criteria (Cohort 1 and 2) or combined RECIST v1.1 + PCWG3 criteria (Cohort 3). Partial or complete response will require confirmation on repeat scan at least 4 weeks from initial radiologic response
Time frame: up to 18 months from treatment discontinuation
Duration of Response (DoR) within each cancer subtype
DoR will be measured from the start date of the best response achieved until the date of relapse (i.e., progression). Continuing responders will be right-censored as of the most recent date on which their response status had been assessed. DoR applies to only the patients who achieve either a complete response or a partial response.
Time frame: up to 18 months from treatment discontinuation
Overall Survival (OS) within each cancer subtype
The OS will be defined from the date of treatment to either date of death or censoring and estimated using the product-limit method of Kaplan and Meier. Follow-up time will be censored at the date of last disease evaluation.
Time frame: up to 18 months from treatment discontinuation
Safety and tolerability in each cancer subtype
Adverse events (AEs) will be defined per the NCI Common Toxicity Criteria for Adverse Events (CTCAE) v5.0.
Time frame: up to 30 days from treatment discontinuation
Median Progression- Free Survival (PFS) within each cancer subtype
The PFS will be defined as time from date of initial treatment to date of radiological or clinical progression (leading to withdrawal from the study treatment), or death from any cause on study treatment, whichever comes first. Follow-up time will be censored at the date of last disease evaluation.
Time frame: up to 18 months from treatment discontinuation
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