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| Name | Class |
|---|---|
| Bristol-Myers Squibb | INDUSTRY |
| GlaxoSmithKline | INDUSTRY |
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The main purpose of this study is to look at the effectiveness, safety, and anti-tumor activity (preventing growth of the tumor) of the drugs Niraparib with either Ipilimumab or Nivolumab on patients and their pancreatic cancer.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Arm A | Experimental | Niraparib + Nivolumab |
|
| Arm B | Experimental | Niraparib + Ipilimumab |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Niraparib + Nivolumab | Drug | Niraparib 200mg PO daily on days 1-28 of each 28-day cycle. Nivolumab 480mg IV day 1 of each cycle. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Rate of Progression-free Survival at 6 Months (PFS6) | The PFS6 rate will be estimated using the Kaplan-Meier method, and the 95% confidence interval will be estimated from the Kaplan-Meier curve. The null hypothesis is that the PFS6 rate in this population of subjects is 44%. Progressive disease is defined as at least a 20% increase in the sum of all the longest diameter (LD) 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 5mm. The appearance of one or more new lesions is also considered progression. Target lesions assessed according to RECIST v1.1. | 6 months after initiation of study therapy |
| Measure | Description | Time Frame |
|---|---|---|
| Objective Response Rate (ORR) Per RECIST v.1.1 as Assessed by Radiology Review | The proportion of patients who achieve a complete or partial response, as determined by RECIST | From first restaging assessment through completion of study treatment (maximum 42 months) |
| Overall Survival (OS) |
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Inclusion Criteria:
Histologically or cytologically confirmed diagnosis of pancreatic adenocarcinoma with locally advanced or metastatic disease
≥18 years of age
Patients must be able to understand the study procedures and agree to participate in the study by providing written informed consent
Patients must have received treatment with platinum-based (cisplatin, oxaliplatin or carboplatin) treatment for locally advanced or metastatic pancreatic cancer and have received a minimum of 16 weeks of therapy without evidence of disease progression based on the investigator's opinion. This does not have to be the patient's current treatment.
Patients may have previously failed non-platinum containing therapy or may never have previously progressed on treatment
Measurable disease is not a requirement for study entry
Female participant has a negative serum pregnancy test within 24 hours prior to taking study treatment if of childbearing potential and agrees to abstain from activities that could result in pregnancy from screening through 6 months after the last dose of study treatment, or is of nonchildbearing potential
Male patient agrees to use an adequate method of contraception starting with the first dose through 90 days after the last dose of study treatment
Adequate organ function confirmed by the following laboratory values obtained ≤7 days prior to the first day of study therapy:
Eastern Cooperative Oncology (ECOG) performance status of 0 to 1.
Exclusion Criteria:
Prior treatment with a PARP inhibitor, ipilimumab, nivolumab or other cytotoxic T-lymphocyte-associated protein (CTLA-4), PD-1 or PD-L1 inhibitor.
Patients who have demonstrated resistance to platinum agents (e.g. oxaliplatin, cisplatin) are not eligible to participate in this study
Clinical evidence of uncontrolled malabsorption and/or any other gastrointestinal disorder or defect that would, in the opinion of the investigator, interfere with the absorption of niraparib
Acute infection requiring intravenous antibiotics, antiviral or antifungal agents during the 14 days prior to first dose of study therapy
Patients will be excluded if they have an active, known or suspected autoimmune disease, defined as: patients with a history of inflammatory bowel disease are excluded from this study, as are patients with a history of symptomatic autoimmune disease (e.g. rheumatoid arthritis, systemic progressive sclerosis (scleroderma), systemic lupus erythematosus, autoimmune vasculitis e.g. Wegener's Granulomatosis); motor neuropathy considered of autoimmune origin (e.g. Guillain-Barre Syndrome).
NOTE: Patients are permitted to enroll if they have vitiligo, type I diabetes mellitus, residual hypothyroidism due to autoimmune condition only requiring hormone replacement, psoriasis not requiring systemic treatment, or conditions not expected to recur in the absence of an external trigger.
Has a history of interstitial lung disease or active, non-infectious pneumonitis
Has received a live vaccine within 4 weeks prior to the first dose of trial therapy (Note: seasonal influenza vaccines for injection are generally inactivated and are allowed; however intranasal influenza vaccines (e.g. Flu-Mist) are live attenuated vaccines and are not allowed
For fertile patient (female able to become pregnant or male able to father a child), refusal to use effective contraception during the period of the trial and:
Received any systemic treatment for pancreatic cancer ≤14 days prior to first dose of therapy. Patients must not have had investigational therapy administered ≤4 weeks, or within a time interval less than at least 5 half-lives of the investigational agent, whichever is longer, prior to the first scheduled day of dosing in this study
Patients will be excluded if they have a condition requiring systemic treatment with either corticosteroids (>10mg daily prednisone equivalents) or other immunosuppressive medications within 14 days of study drug administration. Inhaled or topical steroids and adrenal replacement doses >10mg daily prednisone equivalents are permitted in the absence of active autoimmune disease.
Patient has had any known Grade 3 or 4 anemia, neutropenia or thrombocytopenia due to prior chemotherapy that persisted > 4 weeks and was related to the most recent treatment.
Non-study related minor surgical procedure ≤5 days, or major surgical procedure ≤21 days, prior to the first dose of therapy; in all cases, patients must be sufficiently recovered and stable before treatment administration.
Active drug or alcohol use or dependence that would interfere with study compliance.
Presence of any other condition that may increase the risk associated with study participation or may interfere with the interpretation of study results, and, in the opinion of the investigator, would make the patient inappropriate for entry into the study.
Patient must not have any known history of myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML)
Patients must not be simultaneously enrolled in any therapeutic clinical trial
Patients must not have had radiotherapy within 4 weeks of the first dose of study treatment
Patients must not have a known hypersensitivity to the components of niraparib or the excipients
Patients must not have received a transfusion (platelets or red blood cells) ≤ 4 weeks of the first dose of study treatment
Patients must not be undergoing treatment for an active cancer at the time of randomization. Exceptions include: local therapies for skin cancers and hormonal therapies for breast or prostate cancer.
Patients must not have a history of positive test for human immunodeficiency virus (HIV) or known acquired immunodeficiency syndrome (AIDS), and must not test positive for HIV during study screening.
Patients must not have known, symptomatic brain or leptomeningeal metastases
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Pennsylvania, Abramson Cancer Center | Philadelphia | Pennsylvania | 19104 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 35810751 | Derived | Reiss KA, Mick R, Teitelbaum U, O'Hara M, Schneider C, Massa R, Karasic T, Tondon R, Onyiah C, Gosselin MK, Donze A, Domchek SM, Vonderheide RH. Niraparib plus nivolumab or niraparib plus ipilimumab in patients with platinum-sensitive advanced pancreatic cancer: a randomised, phase 1b/2 trial. Lancet Oncol. 2022 Aug;23(8):1009-1020. doi: 10.1016/S1470-2045(22)00369-2. Epub 2022 Jul 7. |
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104 subjects enrolled. 11 failed eligibility criteria. 2 withdrew consent. 91 randomly assigned and included in the safety analysis.
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| ID | Title | Description |
|---|---|---|
| FG000 | Niraparib + Nivolumab (Arm A) | Niraparib + Nivolumab: Niraparib 200mg PO daily on days 1-28 of each 28-day cycle. Nivolumab 480mg IV day 1 of each cycle. |
| FG001 | Niraparib + Ipilimumab (Arm B) | Niraparib + Ipilimumab: Niraparib 200mg PO daily on days 1-21 of each 21-day cycle. Ipilimumab 3mg/kg IV day 1 of each cycle, for the first 4 cycles only. |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Arm A | Niraparib + Nivolumab Niraparib + Nivolumab: Niraparib 200mg PO daily on days 1-28 of each 28-day cycle. Nivolumab 480mg IV day 1 of each cycle. |
| BG001 | Arm B | Niraparib + Ipilimumab Niraparib + Ipilimumab: Niraparib 200mg PO daily on days 1-21 of each 21-day cycle. Ipilimumab 3mg/kg IV day 1 of each cycle, for the first 4 cycles only. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Rate of Progression-free Survival at 6 Months (PFS6) | The PFS6 rate will be estimated using the Kaplan-Meier method, and the 95% confidence interval will be estimated from the Kaplan-Meier curve. The null hypothesis is that the PFS6 rate in this population of subjects is 44%. Progressive disease is defined as at least a 20% increase in the sum of all the longest diameter (LD) 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 5mm. The appearance of one or more new lesions is also considered progression. Target lesions assessed according to RECIST v1.1. | The efficacy population will consist of all patients who received at least one dose of study treatment and had a least one post-treatment assessment of response by RECIST v.1.1. | Posted | Number | 95% Confidence Interval | percentage of participants with PFS | 6 months after initiation of study therapy |
|
Adverse events were assessed from 6 months after initiation of study therapy. All-Cause Mortality was from Cycle 1 Day 1 until death, loss to follow-up, withdrawal of consent or until 5 years have passed, whichever occurs first.
The safety population consisted of all patients who received at least one dose of study treatment.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Niraparib + Nivolumab (Arm A) | Niraparib + Nivolumab: Niraparib 200mg PO daily on days 1-28 of each 28-day cycle. Nivolumab 480mg IV day 1 of each cycle. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Myocardial infarction | Cardiac disorders | CTCAE 5.0 | Systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Anemia | Blood and lymphatic system disorders | CTCAE 5.0 | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Regulatory Lead | University of Pennsylvania | 215-662-4484 | psom-ind-ide@pobox.upenn.edu |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Jun 6, 2024 | Feb 7, 2025 | Prot_SAP_004.pdf |
| ICF | No | No | Yes | Informed Consent Form | Jul 12, 2024 | Feb 7, 2025 | ICF_005.pdf |
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| ID | Term |
|---|---|
| C545685 | niraparib |
| D000077594 | Nivolumab |
| D000074324 | Ipilimumab |
| ID | Term |
|---|---|
| D061067 | Antibodies, Monoclonal, Humanized |
| D000911 | Antibodies, Monoclonal |
| D000906 | Antibodies |
| D007136 | Immunoglobulins |
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| Niraparib + Ipilimumab | Drug | Niraparib 200mg PO daily on days 1-21 of each 21-day cycle. Ipilimumab 3mg/kg IV day 1 of each cycle, for the first 4 cycles only. |
|
|
Start of treatment to death due to any cause or last patient contact alive. |
| Cycle 1 Day 1 until death, loss to follow-up, withdrawal of consent or until 5 years have passed, whichever occurs first |
| Bowel obstruction |
|
| Incorrect pathological diagnosis on internal review |
|
| BG002 | Total | Total of all reporting groups |
| Participants |
|
| Age, Continuous | Median | Full Range | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| OG000 |
| Niraparib + Nivolumab (Arm A) |
Niraparib + Nivolumab: Niraparib 200mg PO daily on days 1-28 of each 28-day cycle. Nivolumab 480mg IV day 1 of each cycle. |
| OG001 | Niraparib + Ipilimumab (Arm B) | Niraparib + Ipilimumab: Niraparib 200mg PO daily on days 1-21 of each 21-day cycle. Ipilimumab 3mg/kg IV day 1 of each cycle, for the first 4 cycles only. |
|
|
| Secondary | Objective Response Rate (ORR) Per RECIST v.1.1 as Assessed by Radiology Review | The proportion of patients who achieve a complete or partial response, as determined by RECIST | The efficacy population consisted of all patients who received at least one dose of study treatment and had at least one post-treatment assessment of response by RECIST. | Posted | Number | 95% Confidence Interval | Percentage of participants | From first restaging assessment through completion of study treatment (maximum 42 months) |
|
|
|
| Secondary | Overall Survival (OS) | Start of treatment to death due to any cause or last patient contact alive. | The efficacy population consisted of all patients who received at least one dose of study treatment and had at least one post-treatment assessment of response by RECIST. | Posted | Median | 95% Confidence Interval | Months | Cycle 1 Day 1 until death, loss to follow-up, withdrawal of consent or until 5 years have passed, whichever occurs first |
|
|
|
| 7 |
| 46 |
| 20 |
| 46 |
| 46 |
| 46 |
| EG001 | Niraparib + Ipilimumab (Arm B) | Niraparib + Ipilimumab: Niraparib 200mg PO daily on days 1-21 of each 21-day cycle. Ipilimumab 3mg/kg IV day 1 of each cycle, for the first 4 cycles only. | 5 | 45 | 15 | 45 | 44 | 45 |
| Abdominal pain | Gastrointestinal disorders | CTCAE 5.0 | Systematic Assessment |
|
| Ascites | Gastrointestinal disorders | CTCAE 5.0 | Systematic Assessment |
|
| Colitis | Gastrointestinal disorders | CTCAE 5.0 | Systematic Assessment |
|
| Duodenal ulcer | Gastrointestinal disorders | CTCAE 5.0 | Systematic Assessment |
|
| Gastric hemorrhage | Gastrointestinal disorders | CTCAE 5.0 | Systematic Assessment |
|
| Obstruction gastric | Gastrointestinal disorders | CTCAE 5.0 | Systematic Assessment |
|
| Pancreatitis | Gastrointestinal disorders | CTCAE 5.0 | Systematic Assessment |
|
| Small intestinal obstruction | Gastrointestinal disorders | CTCAE 5.0 | Systematic Assessment |
|
| Fever | General disorders | CTCAE 5.0 | Systematic Assessment |
|
| Other: Acute cholangitis | Hepatobiliary disorders | CTCAE 5.0 | Systematic Assessment |
|
| Biliary tract infection | Infections and infestations | CTCAE 5.0 | Systematic Assessment |
|
| Sepsis | Infections and infestations | CTCAE 5.0 | Systematic Assessment |
|
| Blood bilirubin increased | Investigations | CTCAE 5.0 | Systematic Assessment |
|
| Platelet count decreased | Investigations | CTCAE 5.0 | Systematic Assessment |
|
| Hyperkalemia | Metabolism and nutrition disorders | CTCAE 5.0 | Systematic Assessment |
|
| Hyponatremia | Metabolism and nutrition disorders | CTCAE 5.0 | Systematic Assessment |
|
| Dysarthria | Nervous system disorders | CTCAE 5.0 | Systematic Assessment |
|
| Stroke | Nervous system disorders | CTCAE 5.0 | Systematic Assessment |
|
| Confusion | Psychiatric disorders | CTCAE 5.0 | Systematic Assessment |
|
| Suicide attempt | Psychiatric disorders | CTCAE 5.0 | Systematic Assessment |
|
| Acute kidney injury | Renal and urinary disorders | CTCAE 5.0 | Systematic Assessment |
|
| Other: Passing gallbladder obstruction | Renal and urinary disorders | CTCAE 5.0 | Systematic Assessment |
|
| Pneumonitis | Respiratory, thoracic and mediastinal disorders | CTCAE 5.0 | Systematic Assessment |
|
| Pulmonary edema | Respiratory, thoracic and mediastinal disorders | CTCAE 5.0 | Systematic Assessment |
|
| Rash maculo-papular | Skin and subcutaneous tissue disorders | CTCAE 5.0 | Systematic Assessment |
|
| Hypertension | Vascular disorders | CTCAE 5.0 | Systematic Assessment |
|
| Palpitations | Cardiac disorders | CTCAE 5.0 | Systematic Assessment |
|
| Abdominal distension | Gastrointestinal disorders | CTCAE 5.0 | Systematic Assessment |
|
| Abdominal pain | Gastrointestinal disorders | CTCAE 5.0 | Systematic Assessment |
|
| Constipation | Gastrointestinal disorders | CTCAE 5.0 | Systematic Assessment |
|
| Diarrhea | Gastrointestinal disorders | CTCAE 5.0 | Systematic Assessment |
|
| Dry mouth | Gastrointestinal disorders | CTCAE 5.0 | Systematic Assessment |
|
| Gastroesophageal reflux disease | Gastrointestinal disorders | CTCAE 5.0 | Systematic Assessment |
|
| Mucositis oral | Gastrointestinal disorders | CTCAE 5.0 | Systematic Assessment |
|
| Nausea | Gastrointestinal disorders | CTCAE 5.0 | Systematic Assessment |
|
| Vomiting | Gastrointestinal disorders | CTCAE 5.0 | Systematic Assessment |
|
| Chills | General disorders | CTCAE 5.0 | Systematic Assessment |
|
| Fatigue | General disorders | CTCAE 5.0 | Systematic Assessment |
|
| Fever | General disorders | CTCAE 5.0 | Systematic Assessment |
|
| Pain | General disorders | CTCAE 5.0 | Systematic Assessment |
|
| Urinary tract infection | Infections and infestations | CTCAE 5.0 | Systematic Assessment |
|
| Alanine aminotransferase increased | Investigations | CTCAE 5.0 | Systematic Assessment |
|
| Alkaline phosphatase increased | Investigations | CTCAE 5.0 | Systematic Assessment |
|
| Aspartate aminotransferase increased | Investigations | CTCAE 5.0 | Systematic Assessment |
|
| Blood bilirubin increased | Investigations | CTCAE 5.0 | Systematic Assessment |
|
| Creatinine increased | Investigations | CTCAE 5.0 | Systematic Assessment |
|
| Neutrophil count decreased | Investigations | CTCAE 5.0 | Systematic Assessment |
|
| Platelet count decreased | Investigations | CTCAE 5.0 | Systematic Assessment |
|
| Thyroid stimulating hormone increased | Investigations | CTCAE 5.0 | Systematic Assessment |
|
| Weight loss | Investigations | CTCAE 5.0 | Systematic Assessment |
|
| White blood cell decreased | Investigations | CTCAE 5.0 | Systematic Assessment |
|
| Anorexia | Metabolism and nutrition disorders | CTCAE 5.0 | Systematic Assessment |
|
| Hyperkalemia | Metabolism and nutrition disorders | CTCAE 5.0 | Systematic Assessment |
|
| Hypocalcemia | Metabolism and nutrition disorders | CTCAE 5.0 | Systematic Assessment |
|
| Hypokalemia | Metabolism and nutrition disorders | CTCAE 5.0 | Systematic Assessment |
|
| Hypomagnesemia | Metabolism and nutrition disorders | CTCAE 5.0 | Systematic Assessment |
|
| Hyponatremia | Metabolism and nutrition disorders | CTCAE 5.0 | Systematic Assessment |
|
| Hypophosphatemia | Metabolism and nutrition disorders | CTCAE 5.0 | Systematic Assessment |
|
| Arthralgia | Musculoskeletal and connective tissue disorders | CTCAE 5.0 | Systematic Assessment |
|
| Back pain | Musculoskeletal and connective tissue disorders | CTCAE 5.0 | Systematic Assessment |
|
| Dizziness | Nervous system disorders | CTCAE 5.0 | Systematic Assessment |
|
| Dysgeusia | Nervous system disorders | CTCAE 5.0 | Systematic Assessment |
|
| Headache | Nervous system disorders | CTCAE 5.0 | Systematic Assessment |
|
| Insomnia | Psychiatric disorders | CTCAE 5.0 | Systematic Assessment |
|
| Cough | Respiratory, thoracic and mediastinal disorders | CTCAE 5.0 | Systematic Assessment |
|
| Dyspnea | Respiratory, thoracic and mediastinal disorders | CTCAE 5.0 | Systematic Assessment |
|
| Pneumonitis | Respiratory, thoracic and mediastinal disorders | CTCAE 5.0 | Systematic Assessment |
|
| Pruritus | Skin and subcutaneous tissue disorders | CTCAE 5.0 | Systematic Assessment |
|
| Rash acneiform | Skin and subcutaneous tissue disorders | CTCAE 5.0 | Systematic Assessment |
|
| Rash maculo-papular | Skin and subcutaneous tissue disorders | CTCAE 5.0 | Systematic Assessment |
|
| Other: Rash | Skin and subcutaneous tissue disorders | CTCAE 5.0 | Systematic Assessment |
|
| Hot flashes | Vascular disorders | CTCAE 5.0 | Systematic Assessment |
|
| Hypertension | Vascular disorders | CTCAE 5.0 | Systematic Assessment |
|
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| D007162 |
| Immunoproteins |
| D001798 | Blood Proteins |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
| D012712 | Serum Globulins |
| D005916 | Globulins |