The investigators hypothesize that MK2 inhibition may improve efficacy of mFOLFIRINOX chemotherapy for patients with pancreatic ductal adenocarcinoma (PDAC).
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
51
Patients should take zunsemetinib approximately 12 hours apart (if twice daily dosing) or 24 hours apart (if once daily dosing) at the same time(s) every day, with 8 oz of water.
Includes oxaliplatin, irinotecan, leucovorin, and 5-FU.
Washington University School of Medicine
St Louis, Missouri, United States
RECRUITINGRecommended phase II dose (RP2D) of zunsemetinib in combination with mFOLFIRINOX (Dose Escalation Only)
Time frame: Completion of 2 cycles (each cycle is 2 weeks - estimated to be 4 weeks)
Number of participants with dose-limiting toxicities (DLTs) (Dose Escalation only)
Time frame: Completion of 2 cycles (each cycle is 2 weeks - estimated to be 4 weeks)
Number of participants with adverse events by types
Graded by CTCAE v5.
Time frame: From start of treatment through 30 days after last zunsemetinib dose (estimated to be 13 months)
Progression-free rate (PFR) (only for those treated at RP2D)
Progressive Disease (PD): At least a 20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study). In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm and/or the appearance of one or more new lesions and/or unequivocal progression of existing non-target lesions.
Time frame: At 6 months
Disease control rate (DCR) (only for those treated at RP2D)
DCR is defined as the number of participants with complete response, partial response, or stable disease) per RECIST 1.1. Complete Response (CR): Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \<10 mm and disappearance of all non-target lesions and normalization of tumor marker level. Partial Response (PR): At least a 30% decrease in the sum of the diameters of target lesions, taking as reference the baseline sum diameters. Stable Disease (SD): Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study.
Time frame: Through completion of treatment (estimated to be 12 months)
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Overall response rate (ORR) (only for those treated at RP2D)
ORR = defined as number of participants with complete response or partial response by RECIST 1.1. Complete Response (CR): Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \<10 mm and disappearance of all non-target lesions and normalization of tumor marker level. Partial Response (PR): At least a 30% decrease in the sum of the diameters of target lesions, taking as reference the baseline sum diameters.
Time frame: Through completion of treatment (estimated to be 12 months)
Progression-free survival (PFS) (only for those treated at RP2D)
PFS is defined as the duration of time from start of treatment to time of progression or death, whichever occurs first. Progressive Disease (PD): At least a 20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study). In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm and/or the appearance of one or more new lesions and/or unequivocal progression of existing non-target lesions.
Time frame: Through completion of follow-up (estimated to be 3 years)
Overall survival (OS) (only for those treated at RP2D)
OS is defined as the duration of time from start of treatment to time of death from any cause.
Time frame: Through completion of follow-up (estimated to be 3 years)
CA19-9 response rate (only for those treated at RP2D)
Time frame: Through completion of treatment (estimated to be 12 months)
Change in plasma concentration of zunsemetinib and its metabolites
Time frame: Cycle 1 day 1 (each cycle is 2 weeks), cycle 2 day 1 (each cycle is 2 weeks), cycle 3 day 1 (each cycle is 2 weeks), cycle 4 day 1 (each cycle is 2 weeks), and end of treatment (estimated to be 12 months)