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Trial record 9 of 2070 for:    Pancreatic Cancer AND Digestive System Neoplasms

Perioperative MVT-5873, a Fully Human Monoclonal Antibody Against a CA 19-9 Epitope, for Operable CA 19-9 Producing Pancreatic Cancers, Cholangiocarcinomas, and Metastatic Colorectal Cancers

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ClinicalTrials.gov Identifier: NCT03801915
Recruitment Status : Not yet recruiting
First Posted : January 14, 2019
Last Update Posted : October 23, 2019
Sponsor:
Information provided by (Responsible Party):
National Institutes of Health Clinical Center (CC) ( National Cancer Institute (NCI) )

Brief Summary:

Background:

Gastrointestinal tumors have a molecule called CA19-9 in the tumors and blood. The agent MVT-5873 was designed to block this molecule. Researchers want to test how safe it is to give this agent to people before and after surgery to remove a tumor. They want to learn the highest dose tolerated. They want to see if getting the agent at surgery helps slow down the disease.

Objective:

To test the safety of giving MVT-5873 at surgery to remove cancer and see if it slows the progression of the disease.

Eligibility:

Adults at least 18 years old with certain cancers and certain blood CA19-9 levels

Design:

Participants will be screened with:

  • Medical history
  • Physical exam
  • Blood and heart tests
  • Scans
  • Review of normal activities
  • Review of tumor sample
  • Pregnancy test

A few days before surgery, participants will get a dose of the study agent. They will get it through a small plastic tube in a vein over about 2 hours.

Participants will sign a separate consent and have the surgery. A sample of the tumor and normal liver will be removed for research.

For 1-2 weeks after surgery, participants will recover in intensive care then regular care at the hospital. They will be monitored and treated throughout the stay.

After leaving the hospital, participants will get the study agent every week for 1 month. Then they will get it every other week for 2 months. They will repeat screening tests at study visits and at a follow-up visit. That will be about 5 weeks after the last dose.


Condition or disease Intervention/treatment Phase
Colon Cancer Pancreatic Cancer Cholangiocarcinoma Mestatic Colon Carcinoma Liver Metastasis Drug: MVT-5873 Procedure: pancreatectomy or hepatectomy Phase 2

Detailed Description:

Background:

  • Resections to remove tumors in the liver, bile ducts and pancreas are rarely curative, and patients frequently succumb to disease recurrence in the ensuing months to year(s) after the operation.
  • Standard adjuvant therapies, which typically begin 6-12 weeks after surgery, offer little demonstrable decreases in the rates of tumor recurrence.
  • The concept and implementation of immediate perioperative therapy has not been evaluated given the serious concerns related to healing and recovery with standard cytotoxic chemotherapy and newer targeted agents.
  • A significant percentage of metastatic colorectal cancers, and primary tumors of the pancreas and bile ducts express Sialyl Lewis, an epitope on the well-established tumor marker, CA 19-9.
  • MVT-5873, a fully human antibody against Sialyl Lewis, has displayed ADCC and CDC in vitro, potentiated chemotherapeutic efficacy in mouse models and demonstrated efficacy in Phase 1 trials of patients with advanced inoperable HPB cancers.
  • MVT-5873 is well tolerated as a single agent; moderate elevations in AST/ALT appear to be dose-limiting.
  • Patients with resectable Sialyl Lewis-expressing cancers represent an ideal population to explore the use of perioperative MVT-5873 given moderate level of CA 19-9 elevations, and the potential for extension of recurrence-free survival.

Objectives:

  • Document the safety of perioperative MVT-5873 in patients undergoing pancreas and liver resections.
  • Determine if perioperative MVT-5873 can decrease 1-year recurrence rates for patients with operable CA 19-9-producing cancers.

Eligibility:

  • Histologically or cytologically confirmed adenocarcinoma of the

    • Colon (metastatic to liver)
    • Pancreas
    • Bile Ducts (Cholangiocarcinoma)
  • Serum CA19-9 levels greater than the upper limit of normal, but less than 2500.
  • Disease amenable to complete surgical extirpation.

Design:

-Pre-operative one-time treatment with MVT-5873, resection to remove all demonstrable disease in the liver, bile ducts and pancreas, and continuing MVT-5873 mono-therapy until off treatment criteria are met.


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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 105 participants
Allocation: Non-Randomized
Intervention Model: Sequential Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Perioperative MVT-5873, a Fully Human Monoclonal Antibody Against a CA 19-9 Epitope, for Operable CA 19-9 Producing Pancreatic Cancers, Cholangiocarcinomas, and Metastatic Colorectal Cancers
Estimated Study Start Date : October 28, 2019
Estimated Primary Completion Date : December 31, 2022
Estimated Study Completion Date : December 31, 2022

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: 1/Arm 1
Pre-operative escalation doses of MVT-5873,pancreatectomy or hepatectomy and post-operative MVT-5873 treatment
Drug: MVT-5873
1 mg/kg or 3 mg/kg for pre-operative dose, 1 mg/kg during post-operative period

Procedure: pancreatectomy or hepatectomy
Pancreatectomy or hepatectomy

Experimental: 2/Arm 2
Pre-operative RD of MVT-5873, pancreatectomy orhepatectomy and post-operative MVT-5873 treatment
Drug: MVT-5873
1 mg/kg or 3 mg/kg for pre-operative dose, 1 mg/kg during post-operative period

Procedure: pancreatectomy or hepatectomy
Pancreatectomy or hepatectomy




Primary Outcome Measures :
  1. Determine if perioperative MVT-5873 can decrease 1-year recurrence rates for subjects with operable CA 19-9 producing cancers. [ Time Frame: 1 year ]
    Proportion of patients that have progressive disease after 1 year

  2. Document the safety of perioperative MVT-5873 in patients undergoing pancreas and liver resections [ Time Frame: 10 days ]
    List of adverse event frequency and grade



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria
  • INCLUSION CRITERIA:
  • Subjects must have histologically or cytologically confirmed diagnoses of adenocarcinoma in one of the following scenarios:

    • Primary tumors of the pancreas
    • Primary tumors of the bile duct and ampulla
    • Metastatic colorectal cancers to the liver
  • Subjects must have disease resectable with a standard pancreatectomy (pancreaticoduodenectomy or distal pancreatectomy) or liver resection.
  • Subjects may have received prior therapy, including neoadjuvant regimens.
  • Subjects must have serum CA 19-9 elevations greater than the upper limit of normal but less than 2500 U/mL.
  • Age greater than or equal to 18 years.
  • ECOG performance status less than or equal to 1
  • Subjects must have adequate organ and marrow function as defined below:

    • leukocytes >3,000/mcL
    • absolute neutrophil count >1,500/mcL
    • platelets >90,000/mcL
  • For subjects with Periampullary cancers that require a pancreaticoduodenectomy for complete tumor extirpation:

    • total bilirubin <10 ULN*
    • AST(SGOT)/ALT(SGPT) <5 X institutional upper limit of normal
    • creatinine <1.5X institutional upper limit of normal

      • Subjects with periampullary cancers typically present with biliary obstruction resulting in significant abnormalities in liver function tests that do not reflect liver dysfunction. These values normalize after tumor removal. They can be normalized pre-operatively with biliary stenting but several large studies have demonstrated an increase in infectious complications with drainage. As such, a practice standard has been to avoid stenting until bilirubin level rises above 10 X ULN.
  • For subjects with liver tumors (cholangiocarcinoma or metastatic colorectal cancer) requiring a hepatectomy for complete tumor extirpation:

    • total bilirubin <2.5 X institutional upper limit of normal*
    • AST(SGOT)/ALT(SGPT) <5 X institutional upper limit of normal*
    • creatinine <1.5X institutional upper limit of normal

      • Liver abnormalities in this range are consistent with parenchymal destruction from the tumor.
  • For subjects with pancreas tumors that require a distal pancreatectomy for extirpation:

    • total bilirubin <1.5 X institutional upper limit of normal*
    • AST(SGOT)/ALT(SGPT) <2 X institutional upper limit of normal*
    • creatinine <1.5X institutional upper limit of normal

      • Liver abnormalities in this range are consistent with pancreas cancer destruction from the tumor.
  • The effects of MVT-5873 on the developing human fetus are unknown. For this reason, women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation and for 3 months after completion of study treatment. Should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately.
  • Ability of subject to understand and the willingness to sign a written informed consent document.

EXCLUSION CRITERIA:

  • Presence of disease outside the confines of a standard operation for subjects with periampullary cancers (pancreatic and cholangiocarcinoma).
  • Presence of disease outside the liver for subjects with intrahepatic/hilar cholangiocarcinoma or metastatic colorectal cancer, other than a primary tumor for subjects with metastatic colorectal cancer.
  • Subjects who are receiving any other investigational agents.
  • Fewer than 28 days (or 5 half-lives for systemic agents, whichever is shorter) from prior anticancer therapy, including chemotherapy, hormonal, investigational, and or biological therapies and irradiation.
  • Uncontrolled inter-current illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study

requirements.

-Active concurrent malignancies within the last five years other than the primary tumor

in subjects with metastatic colorectal cancer, basal or squamous cell skin carcinoma or non- medullary thyroid carcinoma.

  • Pregnant women are excluded from this study because of the potential for teratogenic or abortifacient effects of the MVT-5873. Because there is an unknown but potential
  • Subjects with active, Hepatitis B or C infection because of the potential for increased liver toxicity given the damaging effects of the virus.
  • Allergic to chimeric, humanized or human antibodies.
  • Received live vaccine within 4 weeks prior to entering the study.
  • Infection requiring hospitalization or herpes zoster treatment within 2 weeks prior to entering the study.
  • Long-term infectious diseases (tuberculosis, fungal infections) active within 2 years prior to entering the study.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03801915


Contacts
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Contact: Cathleen E Hannah (240) 409-8860 cathleen.hannah@nih.gov

Locations
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United States, Maryland
National Institutes of Health Clinical Center Not yet recruiting
Bethesda, Maryland, United States, 20892
Contact: For more information at the NIH Clinical Center contact National Cancer Institute Referral Office    888-624-1937      
Sponsors and Collaborators
National Cancer Institute (NCI)
Investigators
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Principal Investigator: Jonathan M Hernandez, M.D. National Cancer Institute (NCI)

Additional Information:
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Responsible Party: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT03801915     History of Changes
Other Study ID Numbers: 190039
19-C-0039
First Posted: January 14, 2019    Key Record Dates
Last Update Posted: October 23, 2019
Last Verified: October 7, 2019

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by National Institutes of Health Clinical Center (CC) ( National Cancer Institute (NCI) ):
Well Tolerated Agent
Pancreas and Liver Resections
Recurrence Free Survival
Additional relevant MeSH terms:
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Pancreatic Neoplasms
Digestive System Neoplasms
Neoplasms by Site
Neoplasms
Digestive System Diseases
Endocrine Gland Neoplasms
Pancreatic Diseases
Endocrine System Diseases
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Cholangiocarcinoma
Adenocarcinoma
Carcinoma
Antibodies
Antibodies, Monoclonal
Immunologic Factors
Physiological Effects of Drugs