Experimental Combination Treatment For Chemotherapy-Refractory (treatment resistant) Metastatic Pancreatic Cancer

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Age: 18 years or older
Gender:
Any
Healthy Volunteers: No
Keywords: cancer, pancreatic cancer, metastatic cancer, metastatic pancreatic adenocarcinoma
Type: Biological study, Phase 1
Target:
6 Participants
Investigator:
Description
This is a research study for cancer treatment resistant metastatic pancreatic cancer.

It will test the safety and effectiveness of an experimental combination treatment. The combination treatment used in this study includes nivolumab, SD-101 and radiation therapy. The study team hopes to learn how patients with metastatic pancreatic cancer respond to this combination.

The study drug Nivolumab has not been approved by the FDA for this particular type of cancer. It is approved for other types of cancer.

This study will also use SD-101. SD-101 is an experimental drug injected by needle into your tumor. Experimental means that the drug has not been approved by the FDA.

This combination treatment is experimental for chemotherapy refractory metastatic pancreatic adenocarcinoma.
This study requires

The study team will make sure you qualify to take part in the study. Qualified participants will receive detailed information about the study. This may include a list of study-related tests and procedures.

Who can participate

Inclusion criteria:

  • Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0 - 2
  • Able and willing to provide written informed consent
  • Pathology confirmed pancreatic adenocarcinoma by histology or cytology
  • Life expectancy >= 3 months
  • Progression during or after greater than or equal to 1 line of systemic treatment for metastatic pancreatic adenocarcinoma. Patients who do not tolerate 1st line systemic treatment for metastatic pancreatic adenocarcinoma are also eligible
  • = 1 metastatic liver lesion amenable for radiation, intratumoral injection, and core biopsy

  • Lesion for radiation, intratumoral injection, and biopsy may not be a previously irradiated lesion but may have been previously treated with liver directed therapy (e.g., radiofrequency ablation [RFA], transarterial chemoembolization [TACE], selective internal radiation therapy [SIRT], etc.) provided there is radiographic evidence of disease progression in the interim since last local/regional treatment
  • = 1 target lesion outside the field of radiation, measurable by RECIST v1.1

  • Absolute neutrophil count (ANC) >= 1000 cells/mm^3
  • Platelet count >= 50,000/mm^3
  • Hemoglobin >= 8 g/dL
  • Aspartate aminotransferase (AST), alanine aminotransferase (ALT) =< 5 times upper limit of normal (ULN)
  • Alkaline phosphatase =< 5 times ULN
  • Total bilirubin =< 2 times ULN
  • Creatinine =< 2 times ULN
  • Patients with hepatitis B virus are allowed if antiviral therapy has been given for > 8 weeks with viral loads < 100 IU/mL prior to the first dose of trial therapy. Subjects with hepatitis C virus are allowed. Viral loads for hepatitis B and C will be monitored every 4 weeks for patients with active hepatitis B and/or C
  • Women with childbearing potential and males must be willing to use adequate birth control on trial and until 5 months for women or 7 months for men after the last of study therapy
  • Ability to adhere to study schedule and protocol requirements
  • Willing to undergo pre-treatment biopsy and on-treatment biopsy

Exclusion criteria:

  • Actively receiving cancer directed, systemic therapy
  • Prior systemic treatment for pancreatic adenocarcinoma within 2 weeks of first study treatment
  • Known active auto-immune disease or immunodeficiency requiring systemic steroid equivalent to prednisone >= 10 mg/day or immunosuppressive therapy within 14 days or 5 half-lives prior to first dose of trial therapy
  • History of non-infectious pneumonitis or interstitial lung disease
  • Active infection requiring systemic therapy defined as ongoing signs/symptoms related to the infection without improvement despite appropriate antibiotics, antiviral therapy, and/or other treatment
  • Pregnant or lactating women
  • Live attenuated vaccine received =< 30 days before first dose of trial therapy
  • Known history of positive test for human immunodeficiency virus (HIV) or known acquired immunodeficiency syndrome (AIDS)
  • Contraindications to radiotherapy including but not limited to radiation sensitivity syndromes e.g., xeroderma pigmentosum, ataxia telangiectasia
  • Any significant medical condition including additional active malignancies, laboratory abnormalities, or psychiatric illness that would prevent the subject from participating and adhering to study related procedures in the view of the principal investigator
Benefits and risks of participating
BENEFITS:

We cannot promise any benefits to you as a result of taking part in this research study.


RISKS:

The study doctor will discuss the risks associated with taking part in this research study.
Compensation
You will not be paid to take part in this research study.
Resources
Schedule
Study duration and period
You will be in the study as long as your cancer is not growing and you are not having any unmanageable side effects. After you finish the study treatment, your doctor will ask you to visit the office at least one more time for a follow-up exam. After that, we will collect follow-up information about your cancer and any further treatment you receive for the rest of your life.
Recruitment period
From July 12, 2019
Location
UC Davis Comprehensive Cancer Center
4501 X Street
Sacramento, CA 95817
Contact
Morris, Leigh Anne
Research Topic
Conditions:
  • Metastatic Pancreatic Adenocarcinoma
  • Refractory Pancreatic Adenocarcinoma
  • Stage IV Pancreatic Cancer AJCC v8

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