Non resectable locally advanced or metastatic pancreatic cancer MedDRA version: 18.0 Level: PT Classification code 10033610 Term: Pancreatic carcinoma metastatic System Organ Class: 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Conditions
Sponsors
AB Science
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: First randomisation inclusion criteria: 1. Histologically or cytologically confirmed adenocarcinoma of the pancreas, non resectable 2. Patient with pain related to the disease, as assessed by the investigator and the patient: - Pain related to the disease as assessed by the investigator is defined as clinical and documented evaluation by the investigator during physical examinations at screening and/or baseline. - Pain, as assessed by the patient is defined as at least one value out of two values > 20mm on Visual Analogic Scale at screening or baseline. Visual Analogic scale consists in the visual representation of pain amplitude as perceived by the patient. The amplitude is represented by a 100 mm long line having no reference marks. One extremity indicates an absence of pain (0 value) and the other the worst imaginable pain (100 value). OR Patient treated with opioid analgesics at a dose = 1 mg/kg/day (morphinic equivalent). OR Patients with ‘genetic fingerprint of aggressiveness’: ACOX1 (DCt = 3.05)’ 3. Chemotherapy naïve patient for the advanced/metastatic disease 4. Documented decision justifying non eligibility for surgical resection. 5. Patient with measurable tumor lesions with longest diameter = 20 mm using conventional techniques or = 10 mm with spiral CT scan according to RECIST 1.1 6. Patient with ECOG = 1 7. Patient with adequate organ functions: • Absolute neutrophils count (ANC) = 1.5 x 109/L • Haemoglobin = 10 g/dL • Platelets (PTL) = 75 x 109/L • AST/ALT = 5 x ULN • Gamma GT = 5 x ULN • Bilirubin = 3 x ULN • Normal Creatinine or if abnormal creatinine, creatinine clearance = 50 mL/min (Cockcroft and Gault formula) • Albumin > 1x LLN • Proteinuria 3 months 8. Male or female patient, age ?18 years 9. Patient with a BMI > 18 kg/m² and >40 kg 10. Male patient and female patient of childbearing potential must agree to use two methods (one for the patient and one for the partner) of medically acceptable forms of contraception (with failure rate < 1%) during the study and for 3 months after the last treatment intake for women 11. Female patient of childbearing potential must agree to have a negative pregnancy test at screening and baseline. 12. Patient able and willing to comply with study procedures as per protocol 13. Patient able to understand the patient card and to follow the patient card procedures, in case of signs or symptoms of severe neutropenia or severe cutaneous toxicity during the first 2 months of treatment. 14. Patient able to understand, sign, and date the written informed consent form at the screening visit prior to any protocol-specific procedures are performed. If the patient is deemed by the treating physician to be cognitively impaired or questionably impaired in such a way that the ability of the patient to give informed consent is questionable, the designated legal guardian must sign the informed consent. Second randomisation inclusion criteria: 1. Patient under disease progression (according to RECIST 1.1 or investigator claim) after first line treatment with masitinib in combination with gemcitabine OR Patient not under disease progression but who discontinued First line treatment for any adverse event not defined as a severe adverse event (grade = 3) due to the mechanism of action of masitinib (i.e. ras
Exclusion criteria
Exclusion criteria: First randomisation exclusion criteria: 1. Patient treated for a cancer other than pancreatic cancer within 5 years before enrolment, with the exception of basal cell carcinoma or cervical cancer in situ 2. Patient with no pain related to the disease (as defined in the inclusion criterion number 2) and no genetic fingerprint of aggressiveness 3. Patient with ECOG = 2 4. Patient with active central nervous system (CNS) metastasis or with history of CNS metastasis 5. Patient presenting with cardiac disorders defined by at least one of the following conditions: • Patient with recent cardiac history (within 6 months) of: - Acute coronary syndrome - Acute heart failure (class III or IV of the NYHA classification) - Significant ventricular arrhythmia (persistent ventricular tachycardia, ventricular fibrillation, resuscitated sudden death) • Patient with cardiac failure class III or IV of the NYHA classification • Patient with severe conduction disorders which are not prevented by permanent pacing (atrio-ventricular block 2 and 3, sino-atrial block) • Syncope without known aetiology within 3 months • Uncontrolled severe hypertension according to the judgement of the investigator, or symptomatic hypertension 6. Patient with history of poor compliance or history of drug/alcohol abuse, or excessive alcohol beverage consumption that would interfere with the ability to comply with the study protocol, or current or past psychiatric disease that might interfere with the ability to comply with the study protocol or give informed consent 7. Pregnant, intent to be pregnant, or nursing female patient Second randomisation exclusion criteria: 1. Patient intolerant to masitinib The patient is considered as intolerant to masitinib if he/she presented with a severe adverse event (grade = 3) due to the mechanism of action of masitinib (i.e. rash, nausea, vomiting or diarrhea) which led to interruption and/or dose reduction of first line treatment followed by a re-challenge of first line treatment leading to the same severe adverse event. 2. Patient having presented with disabling or life-threatening adverse event due to first line treatment
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Main Objective: Overall survival (OS);Primary end point(s): • Overall Survival (OS) is defined as the time from the randomization to the date of documented death;Timepoint(s) of evaluation of this end point: Date of documented death;Secondary Objective: •Survival rate every 24W (weeks) •Tumour assessment: every 8W -Overall Progression Free Survival (PFS) central and local -PFS rate -Time To Progression (TTP) central and local -TTP rate central and local -Overall TTP (RECIST 1.1) -TTP rate (RECIST 1.1) -Overall Time to Treatment switch (TTS) -TTS rate -Best response along study: Complete response (CR) rate, Partial Response (PR) rate, Progressive disease (PD) -Level of serum CA 19-9 •Quality of life assessment: every 4W until W48 then every 8W -EORTC QLQ-C30 questionnaire -ECOG Performance Status -Patient’s visual analogue scale (VAS) and Brief Pain Inventory (BPI) -Analgesic consumption •Pharmacogenomic assessment Relationship between genomic data and all efficacy variables •Safety profile (NCI CTC v4.02 classification) -Discontinuation for related AE -Related Grade 3 non haematological or any related grade 4 related AE -AE leading to death -Cardiac AE -AE related to cancer pain | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary end point(s): Progression Free Survival ;Timepoint(s) of evaluation of this end point: Every 8 weeks | — |
Countries
Argentina, Austria, Belgium, Brazil, Canada, China, Czech Republic, Germany, Greece, Hong Kong, Hungary, India, Italy, Korea, Republic of, Malaysia, Mexico, Morocco, Peru, Philippines, Poland, Romania, Russian Federation, Singapore, Slovakia, South Africa, Spain, Tunisia, Ukraine, United Kingdom, United States
Contacts
Public ContactDenys Zaitsev
AB Science
Outcome results
None listed