Title

Antigen-specific Cancer Immunotherapy (TG01) and Gemcitabine as Adjuvant Therapy in Resected Pancreatic Cancer
A Phase I/II Trial of TG01 and Gemcitabine as Adjuvant Therapy for Treating Patients With Resected Adenocarcinoma of the Pancreas
  • Phase

    Phase 1/Phase 2
  • Study Type

    Interventional
  • Intervention/Treatment

    apricoxib ...
  • Study Participants

    32
The purpose of this study is to investigate the effect of TG01 and Granulocyte macrophage colony stimulating factor (GM-CSF) when given in addition to gemcitabine (chemotherapy) and

Understand any possible side effects of the additional use of TG01/GM-CSF with gemcitabine
Investigate whether TG01/GM-CSF when given with gemcitabine can produce an immune response
Investigate if the treatment can delay or reduce recurrence of the disease
Study Started
Dec 31
2012
Primary Completion
May 31
2019
Study Completion
May 31
2019
Results Posted
May 14
2020
Last Update
May 14
2020

Biological TG01

TG01 and GM-CSF will be administered on days 1, 8, 15, 22 and 36. TG01 alone will also be given on days 36 and 50 for DTH assessment. Gemcitabine will start at least 3 weeks after TG01/GM-CSF and will be given on days 1, 8 and 15 of a four-weeks cycle up to 6 cycles in total. Once chemotherapy is completed, GM-CSF and TG01 injections will resume and will be given every 4 weeks from the end of the chemotherapy period up to week 52 (plus once at week 5 post-chemotherapy) and then every 12 weeks from week 52 to week 104. TG01 alone will be given 8 weeks after the end of chemotherapy for DTH assessment. TG01 will be given at a dose of 0.70 mg/injection and GM-CSF will be given at a dose of 30 micrograms both as intradermal injections. Gemcitabine will be given at a dose of 1000 mg/m2 iv over 30 minutes

Biological TG01

For patients not able to start TG01 quickly after surgery, the vaccination can start at the same time as the chemotherapy as long as they start within 12 weeks from surgery. Gemcitabine will start at the same time as TG01/GM-CSF and will be given on days 1, 8 and 15 of a four-weeks cycle up to 6 cycles in total. TG01 will be given at a dose of 0.70 mg/injection and GM-CSF will be given at a dose of 30 micrograms both as intradermal injections. Gemcitabine will be given at a dose of 1000 mg/m2 iv over 30 minutes

TG01/GM-CSF and Gemcitabine Experimental

Criteria

Inclusion Criteria:

Histologically or cytologically confirmed diagnosis of adenocarcinoma of the pancreas
Stage I or II disease (clinical stage T1-3, N0-1, M0 by AJCC staging criteria).

Successful surgical resection

Complete resection (R0) or with microscopic residual disease (R1)
Expected to receive gemcitabine monotherapy as adjuvant chemotherapy

Laboratory Values:

Absolute neutrophil count ≥ 1.5 x 10^9/l
Platelets ≥100 x 10^9/l
Haemoglobin ≥ 9 g/dl
Total bilirubin ≤ 1.5 x UNL
Serum creatinine ≤ 1.5 x UNL
Albumin ≥ 2.5 g/dl
AST or ALT ≥ 5 x UNL
18 years of age or older.
ECOG performance status (PS) of 0-1.
Life expectancy of at least 6 months
Men and women of childbearing potential must be willing to use effective methods of contraception to prevent pregnancy
Provide written (signed) informed consent to participate in the trial prior to any trial specific screening procedures

Exclusion Criteria:

Has received an investigational drug within 4 weeks prior to Trial drug administration
Has received previous therapy for pancreatic cancer including radiation or chemotherapy (except for the primary resection or primary neoadjuvant chemotherapy).
Is currently receiving any agent with a known effect on the immune system, unless at dose levels that are not immunosuppressive (e.g. Prednisone at 10 mg/day or less or as inhaled steroid at doses used for the treatment of asthma).

Has any other serious illnesses or medical conditions such as, but not limited to:

Any uncontrolled infection
Uncontrolled cardiac failure classification III or IV (NY Heart Association)
Uncontrolled systemic and gastro-intestinal inflammatory conditions
Bone marrow dysplasia
History of auto-immune disease
History of adverse reactions to vaccines
Known history of positive tests for HIV/AIDS, hepatitis B or C
Pregnant or lactating females or have no pregnancy test at baseline (postmenopausal women must have been amenorrhoeic for at least 12 months to be considered of non-childbearing potential).
Contraindication to gemcitabine treatment
Have had any other malignancies within last 3 years (except for adequately treated carcinoma of the cervix or basal or squamous cell skin cancer)
Known malignant brain lesion(s)
Are unlikely to start chemotherapy within 12 weeks of surgery (e.g. delayed wound healing, or infection, etc.)
Are not expected to complete 6 cycles of chemotherapy
Are planned to receive yellow fever or other live (attenuated) vaccines during the course of study

Summary

TG01/GM-CSF and Gemcitabine

All Events

Event Type Organ System Event Term TG01/GM-CSF and Gemcitabine

Patients' Safety During Study

Assess the safety (number and nature of Adverse events and laboratory data occurring during study (before, during and after chemotherapy is given) in subjects treated with the Pancreatic Cancer ASCI

TG01/GM-CSF and Gemcitabine

AEs related to TG01 and/or GM-CSF

90.0
Events related to TG01 and /or GM-CSF

SAEs related to TG01 and/or GM-CSF

2.0
Events related to TG01 and /or GM-CSF

Patients' Immune Response

Assess the Immune response (DTH responses and Proliferative T-cell responses) up to 2 years of treatment

TG01/GM-CSF and Gemcitabine

94.0
percentage of patients

Clinical Efficacy

Efficacy exploring disease free survival and overall survival.

TG01/GM-CSF and Gemcitabine

Disease free survival

16.1
Months (Median)
Full Range: 11.1 to 19.6

Overall survival

33.3
Months (Median)
Full Range: 24.0 to 40.0

Relationship Between (KRAS) Status and Clinical Efficacy

Relationship between KRAS status and recurrence

TG01/GM-CSF and Gemcitabine

Age, Continuous

64.1
Years (Mean)
Full Range: 46.0 to 79.0

Age, Categorical

Race (NIH/OMB)

Region of Enrollment

Sex: Female, Male

Overall Study

TG01/GM-CSF and Gemcitabine