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Brief Title: MK0752 and Gemcitabine Hydrochloride in Treating Patients With Stage III and IV Pancreatic Cancer That Cannot Be Removed by Surgery
Official Title: A Cancer Research UK Phase I Trial of an Oral Notch Inhibitor (MK-0752) in Combination With Gemcitabine in Patients With Stage III and IV Pancreatic Cancer
Study ID: NCT01098344
Brief Summary: RATIONALE: MK0752 may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as gemcitabine hydrochloride, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving MK0752 together with gemcitabine hydrochloride may kill more tumor cells. PURPOSE: This phase I trial is studying the side effects and best dose of giving MK0752 together with gemcitabine hydrochloride and to see how well it works in treating patients with stage III or IV pancreatic cancer that cannot be removed by surgery.
Detailed Description: OBJECTIVES: Primary * To determine the recommended phase II dose of MK0752 in combination with gemcitabine hydrochloride in patients with unresectable stage III and IV pancreatic cancer. (Phase I) Secondary * To evaluate tumor response in patients treated with this regimen. * To determine the time to disease progression and 6 months and 1-year survival. * To determine the percentage of change in CA19-9 levels. Tertiary * To assess target inhibition of MK0752 in plasma. * To explore the feasibility of measuring MK0752 levels in tumor tissue. * To establish relationships between measures of tumor expression of molecular target and objective tumor response. * To determine the pharmacokinetic profile of MK0752 in plasma when administered with and without gemcitabine hydrochloride. OUTLINE: This is a multicenter, phase I, dose-escalation study of MK0752 and gemcitabine hydrochloride. Patients receive gemcitabine hydrochloride IV on days 1, 8, and 15. Patients receive oral MK0752 on days -14, -7, 1, 8, 15, and 22 in course 1 only and on days 1, 8, 15, and 22 beginning in course 2 and for all subsequent courses. Treatment with MK0752 and gemcitabine hydrochloride repeats every 28 days\* for 6 courses in the absence of disease progression or unacceptable toxicity. NOTE: \*The first course is 42 days. Patients undergo biopsy of tumor at baseline and on day -7. Tumor samples are analyzed to determine Notch pathway inhibition via IHC and qualitative RT-PCR analysis and for MK0752 concentrations. Hair follicle (from the head) samples are collected at baseline and on day -7 to determine Notch pathway inhibition via RT-PCR. Blood samples are collected periodically to determine changes in CA 19-9 levels and MK0752 concentrations. After completion of study treatment, patients are followed for 28 days and then every 2 months for 1 year. Patients will then be followed up as part of their normal clinic visits for up to one year after the last patient was treated on the study. Peer Reviewed and Funded or Endorsed by Cancer Research UK
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
Addenbrooke's Hospital, Cambridge, England, United Kingdom
Leicester Royal Infirmary, Leicester, England, United Kingdom
Barts and the London School of Medicine, London, England, United Kingdom
Beatson West of Scotland Cancer Centre, Glasgow, Scotland, United Kingdom
St James' Hospital, Leeds, , United Kingdom
Name: Duncan Jodrell, MD
Affiliation: Cambridge University Hospitals NHS Foundation Trust
Role: PRINCIPAL_INVESTIGATOR