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Brief Title: Testing the Safety of the Anti-Cancer Drugs Durvalumab and Olaparib During Radiation Therapy for Locally Advanced Unresectable Pancreatic Cancer
Official Title: A Phase 1 Study of Olaparib in Combination With Durvalumab (MEDI4736) and Concurrent Radiation Therapy Following First-Line Chemotherapy in Locally Advanced Unresectable Pancreatic Cancer
Study ID: NCT05411094
Brief Summary: This phase I trial tests the safety and tolerability of olaparib in combination with durvalumab and radiation therapy in patients with pancreatic cancer that has spread to nearby tissue or lymph nodes (locally advanced) and cannot be removed by surgery (unresectable). Olaparib is an inhibitor of PARP, an enzyme that helps repair deoxyribonucleic acid (DNA) when it becomes damaged. Blocking PARP may help keep cancer cells from repairing their damaged DNA, causing them to die. PARP inhibitors are a type of targeted therapy. Immunotherapy with monoclonal antibodies, such as durvalumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Radiation therapy uses high energy x-rays, particles, or radioactive seeds to kill cancer cells and shrink tumors. The combination of targeted therapy with olaparib, immunotherapy with durvalumab and radiation therapy may stimulate an anti-tumor immune response and promote tumor control in locally advanced unresectable pancreatic cancer.
Detailed Description: PRIMARY OBJECTIVE: I. Determine the maximum tolerated dose (MTD)/recommended phase 2 dose (RP2D) of olaparib in combination with durvalumab and radiation therapy (RT). SECONDARY OBJECTIVES: I. To observe and record anti-tumor activity. II. Correlate response with the circulating frequency and diversity of T cells within the peripheral blood. III. Evaluate the safety and toxicity of olaparib in combination with durvalumab and RT. EXPLORATORY OBJECTIVES: I. Evaluate the genetic and clinicopathologic markers of response and resistance including prior receipt of platinum therapy. II. To correlate response with baseline tumoral immune infiltrate. OUTLINE: This is a dose-escalation study of olaparib in combination with fixed dose durvalumab and radiation therapy. Patients receive olaparib orally (PO) twice daily (BID) on days 1-28 and durvalumab intravenously (IV) over 55-65 minutes on day 1 of each cycle. Beginning cycle 2, patients also undergo radiation therapy daily on weekdays for 3 weeks. Chemotherapy and immunotherapy cycles repeat every 28 days for up to 2 years in the absence of disease progression or unacceptable toxicity. Patients undergo tumor biopsy, diagnostic imaging and blood sample collection throughout the study. After completion of study treatment, patients are followed up at 90 days and every 12 weeks thereafter for two years on until death, whichever occurs first.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
Los Angeles General Medical Center, Los Angeles, California, United States
USC / Norris Comprehensive Cancer Center, Los Angeles, California, United States
UC Irvine Health/Chao Family Comprehensive Cancer Center, Orange, California, United States
University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan, United States
University of Michigan - Brighton Center for Specialty Care, Brighton, Michigan, United States
UNC Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, United States
Ohio State University Comprehensive Cancer Center, Columbus, Ohio, United States
University of Wisconsin Carbone Cancer Center - University Hospital, Madison, Wisconsin, United States
University Health Network-Princess Margaret Hospital, Toronto, Ontario, Canada
Name: Michael D Green
Affiliation: University of Michigan Comprehensive Cancer Center EDDOP
Role: PRINCIPAL_INVESTIGATOR