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Brief Title: RAmucirumab Combined wIth Standard Nab-paclitaxel and Gemcitabine as First-line Chemotherapy in Patients With Advanced Pancreatic Adenocarcinoma
Official Title: Phase Ib-II Study of Ramucirumab Combined With Standard Nab-paclitaxel and Gemcitabine as First-line Treatment in Patients With Advanced Pancreatic Adenocarcinoma
Study ID: NCT03745430
Brief Summary: RACING (RAmucirumab Combined wIth standard Nab-paclitaxel and Gemcitabine as first-line chemotherapy in patients with advanced pancreatic adenocarcinoma) trial is a Greek, investigator-initiated, single-arm, open-label phase Ib-II study. Patients with advanced cytologically or histologically proven pancreatic adenocarcinoma will be treated with a combination of Ramucirumab with Nab-paclitaxel and Gemcitabine (for a maximum of 8 cycles followed by Ramucirumab maintenance) until disease progression or excessive Adverse Events (AEs) or Investigator's decision or patient's refusal of further treatment or death, whichever comes first.
Detailed Description: Phase Ib: The first 12 patients will enter the phase Ib study in 2 cohorts of 6 patients each. In the first cohort, six patients will start Ramucirumab followed by Nab-paclitaxel and Gemcitabine every 4 weeks for 2 cycles at the specific initial dose level.When the dose is determined in the first cohort, then the second cohort will be enrolled to test the safety of this dose. The Phase II Recommended dose (RD) for the phase II part of the study will be determined when all 6+6 patients will complete a maximum of 2 cycles. Phase II: In the phase II part of the trial, new patients will be recruited and start the study treatment according to the RD determined at the second cohort of the phase Ib part. Phase Ib patients will enter the phase II part by continuing the treatment beyond the second cycle at the RD level. All the patients will continue the treatment until disease progression or excessive AEs or completion of 8 cycles of Nab-paclitaxel/Gemcitabine/Ramucirumab. In patients with no progressive disease, ramucirumab monotherapy will be administered after the completion of 8 cycles of chemotherapy. The primary endpoint will be Objective Response Rate (ORR) by RECIST criteria. Secondary endpoints will be Safety, Progression-free survival (PFS) and Overall Survival (OS). All the phase II endpoints will be assessed during BOTH the phase Ib and the phase II parts of the study. Patients enrolled at the phase Ib part will start being assessed for efficacy endpoints (response rate, PFS, OS) from the first date of registration to the study and will continue being assessed for efficacy also after passing to the phase II part of the study in a seamless way. After completion of patient enrollment in the phase Ib part, new patients will be enrolled directly to the phase II part. These patients will start being assessed for efficacy endpoints again from the first day of registration to the study.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
Agios Savvas Anticancer Hospital, Athens, Attiki, Greece
Aretaieio Hospital, Athens, Attiki, Greece
"Attikon" University Hospital, Chaïdári, Attiki, Greece
Metropolitan General Hospital, Cholargós, Attiki, Greece
Metropolitan Hospital, Néo Fáliro, Attiki, Greece
Ygeia Hospital, Psychikó, Attiki, Greece
3rd Dept of Medical Oncology, Agii Anargiri Cancer Hospital, Athens, Nea Kifisia, Greece
Agii Anargiri Cancer Hospital, Athens, Nea Kifisia, Greece
University Hospital of Patra, Río, Patra, Greece
EUROMEDICA General Clinic of Thessaloniki, Thessaloníki, Thessaloniki, Greece
Haematology- Oncology Section, Dept of Clinical Therapeutics, General Hospital of Athens "Alexandra", Athens, , Greece
Department of Medical Oncology, Ioannina University Hospital, Ioánnina, , Greece
General University Hospital of Larissa, Larissa, , Greece
Name: George Papaxoinis, MD
Affiliation: 2nd Medical Department, Agios Savvas Anticancer Hospital
Role: PRINCIPAL_INVESTIGATOR