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Study of Pembrolizumab With or Without Defactinib Following Chemotherapy as a Neoadjuvant and Adjuvant Treatment for Resectable Pancreatic Ductal Adenocarcinoma

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT03727880
Recruitment Status : Recruiting
First Posted : November 1, 2018
Last Update Posted : February 21, 2023
Sponsor:
Collaborators:
Merck Sharp & Dohme LLC
Verastem, Inc.
Information provided by (Responsible Party):
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

Brief Summary:
This study will test the effectiveness (anti-tumor activity), safety, and ability to increase the body's immune system to fight pancreatic cancer by combining standard chemotherapy before and after surgery, with study drug PD-1 antibody, pembrolizumab, with and without study drug, focal adhesion kinase inhibitor (FAK), defactinib, in people with "high risk" resectable (surgically removable) pancreatic cancer. The purpose of this study is to evaluate if reprograming the tumor microenvironment by targeting FAK following chemotherapy can potentiate anti-programmed death-1 (PD-1) antibody.

Condition or disease Intervention/treatment Phase
Resectable Pancreatic Ductal Adenocarcinoma (PDAC) Pancreatic Ductal Adenocarcinoma Drug: Pembrolizumab Drug: Defactinib Phase 2

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 36 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Randomized Phase II Study of Pembrolizumab With or Without Defactinib, a Focal Adhesion Kinase Inhibitor Following Chemotherapy as a Neoadjuvant and Adjuvant Treatment for Resectable Pancreatic Ductal Adenocarcinoma (PDAC)
Actual Study Start Date : June 4, 2019
Estimated Primary Completion Date : December 2023
Estimated Study Completion Date : July 2024

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: Arm A - Pembrolizumab and Defactinib Drug: Pembrolizumab
Following standard of care neoadjuvant chemotherapy, subjects will receive two doses of pembrolizumab (200mg) IV 3 weeks apart prior to surgery. After surgery, subjects will receive adjuvant standard of care chemotherapy. Following adjuvant chemotherapy, subjects will receive 8 doses of pembrolizumab (200mg) IV 3 weeks apart.
Other Names:
  • MK-3475
  • Keytruda

Drug: Defactinib
Following 2 cycles of standard of care neoadjuvant chemotherapy, subjects will receive 400 mg defactinib twice a day up until 2 days preceding their surgery (approximately 6 weeks) during the immunotherapy cycles with pembrolizumab. After surgery, subjects will receive adjuvant standard of care chemotherapy. Following adjuvant chemotherapy, subjects will receive 400mg defactinib twice a day for 24 weeks.

Experimental: Arm B - Pembrolizumab Drug: Pembrolizumab
Following standard of care neoadjuvant chemotherapy, subjects will receive two doses of pembrolizumab (200mg) IV 3 weeks apart prior to surgery. After surgery, subjects will receive adjuvant standard of care chemotherapy. Following adjuvant chemotherapy, subjects will receive 8 doses of pembrolizumab (200mg) IV 3 weeks apart.
Other Names:
  • MK-3475
  • Keytruda




Primary Outcome Measures :
  1. Pathologic complete response (pCR) rate [ Time Frame: 4 years ]
    Percent of subjects with a pathologic complete response (pCR) per the tumor regression grade scores established by the College of American Pathologist: Grade 0= complete response (no viable cancer cells), Grade 1= near complete response (single cells or rare small groups of cancer cells), Grade 2= partial response (residual tumor with evidence of regression), or Grade 3= no response (extensive residual tumor with no evidence of regression).


Secondary Outcome Measures :
  1. Overall survival (OS) [ Time Frame: 4 years ]
    Number of months until death

  2. Disease free survival (DFS) [ Time Frame: 4 years ]
    Number of months until disease recurrence

  3. Number of participants experiencing study drug-related toxicities [ Time Frame: 4 years ]
    Number of participants experiencing drug-related adverse events as defined by CTCAE v5.0



Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


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Ages Eligible for Study:   18 Years to 100 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Age ≥18 years.
  • Has pancreatic ductal adenocarcinoma
  • Has resectable disease at the time of diagnosis
  • Has not received any systemic therapy for pancreatic ductal adenocarcinoma
  • Has stage ≤ IIb disease at time of diagnosis and enrollment
  • Elevated tumor marker, CA (carbohydrate antigen) 19-9 >200
  • ECOG performance status 0 or 1
  • Patient must have adequate organ function defined by the study-specified laboratory tests.
  • Must use acceptable form of birth control while on study.
  • Ability to understand and willingness to sign a written informed consent document.

Exclusion Criteria:

Patients who have received any prior chemotherapy, radiotherapy or investigational agents for pancreatic cancer.

  • Patients who have received prior treatment with anti-PD-1, anti-PD-L1, anti-PD-L2, anti-CTLA-4, or with an agent directed to another stimulatory or co-inhibitory T-cell receptor (e.g., CTLA-4, OX 40, CD137).
  • Has received prior therapy with FAK inhibitor.
  • Woman who are pregnant or breastfeeding.
  • Have received a live vaccine or live-attenuated vaccine within 30 days prior to study drug.
  • Is currently or has participated in another investigational study within 4 weeks prior to receiving study drug.
  • History or current use of immunosuppressive medications within 7 days prior to study medications.
  • Has a known additional malignancy that is progressing or has required active treatment within the past 2 years or that is expected to require active treatment within two years.
  • Has active autoimmune disease that has required systemic treatment in the past 2 years.
  • Has a history of (non-infectious) pneumonitis/interstitial lung disease or current pneumonitis.
  • Has an active infection requiring systemic therapy.
  • Infection with HIV or hepatitis B or C.
  • Patient with uncontrolled intercurrent illness including, but not limited to, uncontrolled infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
  • Known allergy or hypersensitivity to the study drugs.
  • Received any growth factors including, but not limited to, granulocyte-colony stimulating factor (G-CSF), GM-CSF, erythropoietin, within 14 days of study drug administration.
  • Has history of any organ transplant, including corneal transplants.

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): NCT03727880


Contacts
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Contact: Trish Brothers, RN 410-614-3644 GIClinicaltrials@jhmi.edu
Contact: Joann Santmyer, RN 410-614-3644 GIClinicaltrials@jhmi.edu

Locations
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United States, California
Samuel Oschin Cancer Center at Cedars-Sinai Recruiting
Los Angeles, California, United States, 90048
Contact: Arsen Osipov, MD    310-423-6313    Arsen.Osipov@cshs.org   
United States, Maryland
Sidney Kimmel Comprehensive Cancer Center Recruiting
Baltimore, Maryland, United States, 21231
Contact: Trish Brothers, RN    410-614-3644    GIClinicaltrials@jhmi.edu   
Sponsors and Collaborators
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Merck Sharp & Dohme LLC
Verastem, Inc.
Investigators
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Study Chair: Lei Zheng, MD Johns Hopkins Medical Institution
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Responsible Party: Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
ClinicalTrials.gov Identifier: NCT03727880    
Other Study ID Numbers: J18140
IRB00182490 ( Other Identifier: JHMI IRB )
First Posted: November 1, 2018    Key Record Dates
Last Update Posted: February 21, 2023
Last Verified: February 2023
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Undecided

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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 Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins:
Pembrolizumab
Defactinib
Immunotherapy
Anti-PD-1
Antibody
PD-L1
Pancreatic cancer
Neoadjuvant chemotherapy
Adjuvant chemotherapy
PDAC - Pancreatic Ductal Adenocarcinoma
FAK (focal adhesion kinase) inhibitor
Resectable Pancreatic Adenocarcinoma
High Risk Resectable Pancreatic Cancer
Tumor microenvironment
CA 19-9
Surgery
Pancreatectomy
Additional relevant MeSH terms:
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Adenocarcinoma
Carcinoma
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Neoplasms
Pembrolizumab
Antineoplastic Agents, Immunological
Antineoplastic Agents
Immune Checkpoint Inhibitors
Molecular Mechanisms of Pharmacological Action