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This is a multicentre, open label, two-part study to determine whether the focal adhesion kinase (FAK) inhibitor AMP945, when given prior to dosing with gemcitabine and nab-paclitaxel, improves response to therapy in first-line patients with unresectable or metastatic pancreatic cancer.
Part A is a phase 1b dose-escalation design that will enrol at least 3 participants in each of 4 dose-level cohorts, to determine the RP2D of AMP945 to be explored in Part B.
Part B will determine the efficacy of the AMP945 regimen at the RP2D, and will be run as a Simon Two-stage design; Stage 1 will enrol 26 participants. If ≤5 of the 26 participants show an objective response, then recruitment will be paused and a detailed analysis of futility will be performed. If the study is deemed futile, recruitment will cease. If the study is determined to be not futile or >5 of the 26 participants show an objective response, recruitment will continue, and an additional 24 participants will be enrolled in Stage 2.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| AMP945 | Experimental | Part A: AMP945 administered in dose escalating cohorts Part B: AMP945 recommended phase 2 dose |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| AMP945 ascending doses | Drug | Part A is a phase 1b dose-escalation design that will enrol at least 3 participants in each of 4 dose-level cohorts, to determine the RP2D of AMP945 to be explored in Part B. Dose escalation decisions will be made using a standard 3+3 dose-escalation phase 1 oncology study design. |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants with Treatment-Emergent Adverse Events (TEAEs) from Baseline to End of Study | TEAEs during study treatment and follow up periods | From first dose of study drug to end of study, an expected average of 6 months |
| Part A: Determination of RP2D | The RP2D of AMP945 will be determined based on either the maximum tolerated dose or maximum pharmacodynamic effect, which ever is reached first | After Cycle 1 (28 days) for each Part A cohort |
| Part B: efficacy of AMP945 | Overall response rate based on RECIST 1.1 | Imaging every 56 days per participant, with an expected average duration of 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Part A: efficacy of AMP945 | Overall response rate based on RECIST 1.1 | Imaging every 56 days per participant, with an expected average duration of 6 months |
| AMP945 levels in plasma | Measurement of maximum concentration (cmax) of AMP945 |
| Measure | Description | Time Frame |
|---|---|---|
| Overall response | Overall response, based on RECIST, by imaging timepoint | Imaging every 56 days per participant, with an expected average duration of 6 months |
| Duration of response (DOR) | DOR based on RECIST defined as the time from the date of the first confirmed response to the date of progression or death |
Inclusion Criteria:
Provide written informed consent prior to any study procedures and agree to adhere to all protocol requirements.
Aged at least 18 years at the time of consent.
Confirmed histological or cytological diagnosis of advanced pancreatic adenocarcinoma that is:
Part A: metastatic or not surgically resectable.
Part B: metastatic, with initial diagnosis of metastatic disease ≤6 weeks prior to Baseline.
Has measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded) as >20 mm with conventional techniques or as >10 mm with spiral CT scan.
Eligible for treatment with nab-paclitaxel and gemcitabine as standard of care therapy.
Eastern Cooperative Oncology Group (ECOG) Performance Score of 0-1, sustained on two separate assessments: the first at least 2 weeks prior to the 1st dose of AMP945 and the 2nd within 72 hours prior to the 1st dose of AMP945. Participants not maintaining an ECOG Performance Score of 0-1 at the second assessment will be excluded from participation.
Has a life expectancy of >3 months.
Adequate organ function, as defined by the laboratory results below (samples must be obtained ≤14 days prior to study drug administration):
a) Haematology:
(i) Absolute neutrophil count (ANC) ≥1.5 × 109/L;
(ii) Platelet count ≥100,000/mm3 (100 × 109/L);
(iii) Haemoglobin (Hgb) ≥9 g/dL.
b) Serum chemistry:
(i) Aspartate transaminase (AST) (SGOT), ALT (SGPT) ≤2.5 × upper limit of normal range (ULN), unless liver metastases are clearly present, then ≤5 × ULN is allowed;
(ii) Total bilirubin ≤ULN;
(iii) Creatinine <1.5 x upper limit of normal (ULN) or estimated glomerular filtration rate (eGFR) >60 mL/min/1.73m2 (calculated using the Cockcroft-Gault equation).
c) No clinically significant abnormalities in coagulation results.
d) No clinically significant abnormalities in urinalysis results.
Agree to use contraception according to protocol
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| GenesisCare | St Leonards | New South Wales | 2065 | Australia | ||
| Calvary Mater Newcastle |
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Single arm study but 2 parts;
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|
| AMP945 RP2D | Drug | Part B will determine the efficacy of the AMP945 priming regimen at the recommended phase 2 dose (RP2D) determined in Part A. |
|
| Days -8, -7, 1, 3, 4, 8 and 10 |
| AMP945 levels in plasma | Measurement of time to cmax (tmax) | Days -8, -7, 1, 3, 4, 8 and 10 |
| AMP945 levels in plasma | Measurement of clearance (CL) | Days -8, -7, 1, 3, 4, 8 and 10 |
| Imaging every 56 days per participant, with an expected average duration of 6 months |
| Overall survival (OS) | OS of participants, defined as time from first dose until death from any cause | Imaging every 56 days per participant, with an expected average duration of 6 months |
| Progression free survival (PFS) | PFS of participants, defined as time from first dose to date of first observed progression, based on RECIST, or death from any cause (whichever comes first) | Imaging every 56 days per participant, with an expected average duration of 6 months |
| Time to progression | Time to progression, defined as time from first dosing to date of first observed progression, based on RECIST | Imaging every 56 days per participant, with an expected average duration of 6 months |
| Clinical benefit rate (CBR) | CBR defined as complete response (CR) + partial response (PR) + stable disease | Imaging every 56 days per participant, with an expected average duration of 6 months |
| Effects on tumor antigens | Changes in levels of tumour antigens (serum CA19-9) at the end of each treatment cycle compared to baseline | Every 28 days per participant, with an expected average duration of 6 months |
| Effects on biomarkers | Change in levels of other relevant blood biomarkers including p-FAK, PRO-C3, PRO-C6, PRO-C11, C3M, C6M, and C4G | Every 28 days per participant, with an expected average duration of 6 months |
| Waratah |
| New South Wales |
| 2298 |
| Australia |
| Westmead Hospital | Westmead | New South Wales | 2145 | Australia |
| Gallipolli Medical Research Foundation | Greenslopes | Queensland | 4120 | Australia |
| Epworth Healthcare | Box Hill | Victoria | 3128 | Australia |
| Monash Health | Clayton | Victoria | 3168 | Australia |
| Epworth Healthcare | Richmond | Victoria | 3121 | Australia |
| Western Health | St Albans | Victoria | 3021 | Australia |
| National Cancer Centre | Gyeonggi-do | 10408 | South Korea |
| Seoul National University Bundang Hospital | Gyeonggi-do | 13620 | South Korea |
| Severence Hospital | Seoul | 03722 | South Korea |
| Seoul National University Hospital | Seoul | 3080 | South Korea |
| Samsung Medical Centre | Seoul | 6351 | South Korea |
| ID | Term |
|---|---|
| D010190 | Pancreatic Neoplasms |
| ID | Term |
|---|---|
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D004701 | Endocrine Gland Neoplasms |
| D004066 | Digestive System Diseases |
| D010182 | Pancreatic Diseases |
| D004700 | Endocrine System Diseases |
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