A Phase 1b, open-label, multicenter, dose escalation and dose expansion study of S-1 in combination with nab-paclitaxel and gemcitabine (GAS) in subjects with metastatic pancreatic adenocarcinoma. This study is a dose escalation and dose expansion study with the objective to establish the MTD and/or RP2D and/or DLT of nab-paclitaxel and gemcitabine in combination with a body surface area(BSA)-based dose of S-1 in subject with metastatic pancreatic adenocarcinoma.
Pancreatic ductal adenocarcinoma (PDAC) is the seventh leading cause of cancer- related death worldwide as the second leading cause of cancer mortality in the United States by 2030 . The overall 5-year survival rate is around 5% for advanced PDAC and 15-30% for resected PDAC. While recent advances have emerged in precision medicine and immunotherapy in a variety of cancer types, unfortunately these drugs are not applicable to most patients with PDAC. To date, polychemotherapy combinations remain the mainstay of systemic treatments for advanced PDAC. Of note, FOLFIRINOX is a triplet combination regimen while nab-Paclitaxel and gemcitabine is a doublet combination. Both NALIRIFOX and FOLFIRINOX showed the same median OS with about 11.1 months from NAPOLI 3 and PRODIGE4 trials, respectively, demonstrating the biologically comparable anti-tumor effects. On the other hand, the median OS of 8.5 months of gemcitabine plus nab-paclitaxel raised the question-would it be possible to add the third active drug in this doublet combination to achieve more potential efficacy, being comparable with triplet combination such as FOLFIRINOX or NALIRIFOX. Therefore, in this study the investigator aimed to investigate whether adding S-1 to nab-paclitaxel and gemcitabine as GAS regimen can be a potential triplet combination.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
70
Dose escalation study-dose level 1
Dose escalation study-dose level 2
Dose escalation study-dose level 3
Chiayi Chung Gung Memmorial Hospital
Chiayi City, Taiwan
RECRUITINGChang-Gung Memorial Hospital, Kaohsiung Branch
Kaohsiung City, Taiwan
NOT_YET_RECRUITINGChang-Gung Memorial Hospital, Linkou Branch
Taoyuan, Taiwan
RECRUITINGMaximum tolerated dose (MTD)
To determine a recommended Phase 2 dose (RP2D) of nab-paclitaxel and gemcitabine in combination with body surface area (BSA) - based dose of S-1 in subject with metastatic pancreatic adenocarcinoma
Time frame: From cycle 1 day 1 (each cycle is 14 days) untill the date of radiographic tumor assessment confirm tumor recurrence or specified AE occur, assessed up to 3 years
Dose-limiting toxicity (DLT)
Time frame: From cycle 1 day 1 (each cycle is 14 days) untill the date of radiographic tumor assessment confirm tumor recurrence or specified AE occur, assessed up to 3 years
Objective response rate (ORR)
Tumor response will be evaluated according to the Response Evaluation Criteria Solid Tumors (RECIST) criteria version 1.1.
Time frame: From cycle 1 day 1 (each cycle is 14 days) untill the date of radiographic tumor assessment confirm tumor recurrence or specified AE occur, assessed up to 3 years
Safety profile of GAS regimen
Safety profile will be recorded and graded according to NCI-CTCAE v 5.0.
Time frame: From cycle 1 day 1 (each cycle is 14 days) untill the date of radiographic tumor assessment confirm tumor recurrence or specified AE occur, assessed up to 3 years
Disease Control Rate (DCR)
Defined as having complete response, partial response or stable disease at 12 weeks. (based on RECIST Version 1.1)
Time frame: Through study completion, an average of 3 year
Duration of Response (DoR)
Time from documentation of tumor response to disease progression. (based on RECIST Version 1.1)
Time frame: Through study completion, an average of 3 year
Progression-free Survival (PFS)
From the start date of study treatment to the date of progression disease or death. (based on RECIST Version 1.1)
Time frame: Through study completion, an average of 3 year
Overall Survival (OS)
From the start date of study treatment to the date of death.
Time frame: Through study completion, an average of 3 year
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.