A Study to Assess the Efficacy and Safety of IMAB362 in Combination With Nab-Paclitaxel and Gemcitabine (Nab-P + GEM) as First Line Treatment in Subjects With Claudin 18.2 (CLDN18.2) Positive, Metastatic Pancreatic Adenocarcinoma

• ClinicalTrials.gov Identifier: NCT03816163
• Recruitment Status: Active, not recruiting
• First Posted: January 25, 2019
• Last Update Posted: April 19, 2024
• Sponsor: Astellas Pharma Global Development, Inc.
• Information provided by (Responsible Party): Astellas Pharma Inc ( Astellas Pharma Global Development, Inc. )

Tracking Information

• First Submitted Date: January 23, 2019
• First Posted Date: January 25, 2019
• Last Update Posted Date: April 19, 2024
• Actual Study Start Date: March 15, 2019
• Estimated Primary Completion Date: September 30, 2024 (Final data collection date for primary outcome measure)

Current Primary Outcome Measures (submitted: October 21, 2021)

• Dose Limiting Toxicities (DLT) - (safety lead in) [ Time Frame: Up to 28 days ]
  Incidence of dose limiting toxicities.
• Overall Survival (OS) [ Time Frame: Up to 65 months ]
  OS is defined as the time from the date of randomization until the date of death from any cause.
• Safety assessed by Adverse Events (AEs) [ Time Frame: Up to 65 months ]
  An AE is any untoward medical occurrence in a subject, temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a medicinal product.
• Safety assessed by incidence of serious adverse events (SAE) [ Time Frame: Up to 65 months ]
  Adverse Event (AE) is considered "serious" if the investigator or sponsor view any of the following outcomes: Death, life-threatening, persistent or significant disability/incapacity, congenital anomaly or birth defect, hospitalization, or medically important event.
• Safety assessed by incidence of treatment emergent adverse events (TEAE) [ Time Frame: Up to 65 months ]
  Treatment Emergent Adverse Event (TEAE) is defined as any AE which starts, or worsens, after the first dose of study drug through 30 days after the last dose of study drug.
• Number of participants with laboratory value abnormalities and/or adverse events (AEs) [ Time Frame: Up to 65 months ]
  Number of participants with potentially clinically significant laboratory values.
• Number of participants with vital sign abnormalities and /or adverse events (AEs) [ Time Frame: Up to 65 months ]
  Number of participants with potentially clinically significant vital sign values.
• Number of participants with electrocardiograms (ECG) abnormalities and or adverse events [ Time Frame: Up to 65 months ]
  12-lead ECGs will be recorded. Prior to the ECG, participants should rest in supine position for 10 minutes. ECGs will be read and assessed locally.
• Number of participants with Eastern Cooperative Oncology Group (ECOG) performance status abnormalities and or adverse events [ Time Frame: Up to 65 months ]
  Number of participants with potentially clinically significant ECOG performance status values. ECOG grades 0-5, where 0 = Fully active, able to carry on all pre-disease performance without restriction; 1 = Restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature, e.g., light house work, office work; 2 = Ambulatory and capable of all self-care but unable to carry out any work activities. Up and about more than 50% of waking hours; 3 = Capable of only limited self-care, confined to bed or chair more than 50% of waking hours; 4 = Completely disabled. Cannot carry on any self-care. Totally confined to bed or chair and 5 = Dead.

Original Primary Outcome Measures (submitted: January 23, 2019)

• Dose Limiting Toxicities (DLT) - (safety lead in) [ Time Frame: Up to 28 days ]
  Incidence of dose limiting toxicities.
• Overall Survival (OS) [ Time Frame: Up to 35 months ]
  OS is defined as the time from the date of randomization until the date of death from any cause.
• Safety assessed by Adverse Events (AEs) [ Time Frame: Up to 29 months ]
  An AE is any untoward medical occurrence in a subject, temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a medicinal product.
• Safety assessed by incidence of serious adverse events (SAE) [ Time Frame: Up to 29 months ]
  Adverse Event (AE) is considered "serious" if the investigator or sponsor view any of the following outcomes: Death, life-threatening, persistent or significant disability/incapacity, congenital anomaly or birth defect, hospitalization, or medically important event.
• Safety assessed by incidence of treatment emergent adverse events (TEAE) [ Time Frame: Up to 27 months ]
  Treatment Emergent Adverse Event (TEAE) is defined as any AE which starts, or worsens, after the first dose of study drug through 30 days after the last dose of study drug.
• Number of participants with laboratory value abnormalities and/or adverse events (AEs) [ Time Frame: Up to 27 months ]
  Number of participants with potentially clinically significant laboratory values.
• Number of participants with vital sign abnormalities and /or adverse events (AEs) [ Time Frame: Up to 29 months ]
  Number of participants with potentially clinically significant vital sign values.
• Number of participants with electrocardiograms (ECG) abnormalities and or adverse events [ Time Frame: Up to 27 months ]
  12-lead ECGs will be recorded. Prior to the ECG, participants should rest in supine position for 10 minutes. ECGs will be read and assessed locally.
• Number of participants with Eastern Cooperative Oncology Group (ECOG) performance status abnormalities and or adverse events [ Time Frame: Up to 29 months ]
  Number of participants with potentially clinically significant ECOG performance status values. ECOG grades 0-5, where 0 = Fully active, able to carry on all pre-disease performance without restriction; 1 = Restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature, e.g., light house work, office work; 2 = Ambulatory and capable of all self-care but unable to carry out any work activities. Up and about more than 50% of waking hours; 3 = Capable of only limited self-care, confined to bed or chair more than 50% of waking hours; 4 = Completely disabled. Cannot carry on any self-care. Totally confined to bed or chair and 5 = Dead.

Current Secondary Outcome Measures (submitted: November 15, 2021)

• Progression Free Survival (PFS) [ Time Frame: Up to 65 months ]
  PFS is defined as the time from the date of randomization until the date of radiological progressive disease (PD) per Response Evaluation Criteria In Solid Tumors (RECIST) 1.1 by investigator evaluation or death from any cause, whichever is earliest.
• Objective Response Rate (ORR) [ Time Frame: Up to 65 months ]
  ORR is defined as the proportion of participants who have a best overall response of Complete Response (CR) or Partial Response (PR) as assessed by investigator evaluation per RECIST 1.1.
• Number of anti-drug antibody (ADA) Positive Participants [ Time Frame: Up to 65 months ]
  Immunogenicity will be measured by the number of participants that are ADA positive.
• Disease Control Rate (DCR) [ Time Frame: Up to 65 months ]
  DCR is defined as the proportion of participants who have best overall response of stable disease, complete response (CR) or partial response (PR) as assessed by investigator evaluation per RECIST 1.1
• Duration Of Response (DOR) [ Time Frame: Up to 65 months ]
  DOR is defined as the time from the date of the first response (CR/PR) until the date of progressive disease as assessed by investigator evaluation per RECIST 1.1 or date of death from any cause, whichever is earliest.
• Change in CA (Cancer Antigen) 19-9 [ Time Frame: Baseline up to 65 months ]
  Change from baseline in serum CA19-9 will be assessed.
• PK of zolbetuximab: Concentration Immediately Prior to Dosing (Ctrough) [ Time Frame: Up to 65 months ]
  Ctrough will be derived from the PK serum samples collected.
• PK of Nab-P: Area Under the Concentration-time Curve from the Time of Dosing Extrapolated to Time Infinity (AUCinf) [ Time Frame: Up to 30 days ]
  AUCinf will be derived from the PK plasma samples collected.
• PK of Nab-P: Area Under the Concentration-time Curve from the Time of Dosing Until the Last Measurable Concentration (AUClast) [ Time Frame: Up to 30 days ]
  AUClast will be derived from the PK plasma samples collected.
• PK of Nab-P: Maximum Concentration (Cmax) [ Time Frame: Up to 30 days ]
  Cmax will be derived from the PK plasma samples collected.
• PK of Nab-P: Time of Maximum Concentration (Tmax) [ Time Frame: Up to 30 days ]
  Tmax will be derived from the PK plasma samples collected.
• PK of Nab-P: Terminal Elimination Half-life (T1/2) [ Time Frame: Up to 30 days ]
  T1/2 will be derived from the PK plasma samples collected.
• PK of Nab-P: Clearance (CL) [ Time Frame: Up to 30 days ]
  CL will be derived from the PK plasma samples collected.
• PK of Nab-P: Volume of Distribution During the Terminal Phase (Vz) [ Time Frame: Up to 30 days ]
  Vz will be derived from the PK plasma samples collected.
• PK of gemcitabine: Area Under the Concentration-time Curve from the Time of Dosing Extrapolated to Time Infinity (AUCinf) [ Time Frame: Up to 30 days ]
  AUCinf will be derived from the PK plasma samples collected.
• PK of gemcitabine: Area Under the Concentration-time Curve from the Time of Dosing Until the Last Measurable Concentration (AUClast) [ Time Frame: Up to 30 days ]
  AUClast will be derived from the PK plasma samples collected.
• PK of gemcitabine: Maximum Concentration (Cmax) [ Time Frame: Up to 30 days ]
  Cmax will be derived from the PK plasma samples collected.
• PK of gemcitabine: Time of Maximum Concentration (Tmax) [ Time Frame: Up to 30 days ]
  Tmax will be derived from the PK plasma samples collected.
• PK of gemcitabine: Terminal Elimination Half-life (T1/2) [ Time Frame: Up to 30 days ]
  T1/2 will be derived from the PK plasma samples collected.
• PK of gemcitabine: Clearance (CL) [ Time Frame: Up to 30 days ]
  CL will be derived from the PK plasma samples collected.
• PK of gemcitabine: Volume of Distribution During the Terminal Phase (Vz) [ Time Frame: Up to 30 days ]
  Vz will be derived from the PK plasma samples collected.
• Health Related Quality of Life (HRQoL) measured by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire - Core Questionnaire (EORTC-QLQ-C30) [ Time Frame: Up to 65 months ]
  The EORTC-QLQ-C30 is a 30-item cancer-specific instrument consisting of 5 functional scales (physical, role, emotional, social and cognitive), 9 symptom scales/items (fatigue, nausea/vomiting, general pain, dyspnea, insomnia, appetite loss, constipation, diarrhea, and financial difficulties) and a global health status scale. Participants rate items on a four-point scale, with 1 as "not at all" and 4 as "very much." For functional scales, higher scores indicate better functioning, while for symptom scales/items, higher scores indicate worse symptoms.
• Health Related Quality of Life (HRQoL) measured by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire - Pancreatic Cancer Module (EORTC-QLQ-PAN-26) [ Time Frame: Up to 65 months ]
  EORTC-QLQ-PAN26 is a 26-item questionnaire that evaluates pancreatic cancer-specific symptoms such as pain, dietary changes, jaundice, altered bowel habits, and emotional problems. Participants rate items on a four-point scale, with 1 as "not at all" and 4 as "very much." For symptom scales/items, higher scores indicate worse symptoms.
• Health Related Quality of Life (HRQoL) measured by the EuroQOL Five Dimensions Questionnaire 5L (EQ-5D-5L) [ Time Frame: Up to 65 months ]
  The EQ-5D-5L is a standardized instrument for use as a measure of health outcome consisting of 6 items that cover 5 main domains (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) and a general visual analog scale for health status. Each domain comprises 5 severity levels (no problems, slight problems, moderate problems, severe problems, extreme problems). The general visual analog scale records the respondent's self-rated health status on a vertical graduated (0 = the worst health a participant can imagine to 100 = the best health a participant can imagine) visual analogue scale. Responses to the 5 items will also be converted to a weighted health state index (utility score) based on values derived from general population samples.
• Health Related Quality of Life (HRQoL) measured by the Patient Global Impression of Change (PGIC) scale [ Time Frame: Up to 65 months ]
  The PGIC is a single-item questionnaire that asks participants to provide the overall self-assessment of change in their disease on a 7-point scale ranging from "very much worse" to "very much better" as compared to the participant starting the study treatment. Only PGIC questions assessing pain and overall status will be collected.
• Health Related Quality of Life (HRQoL) measured by the Patient Global Impression of Severity (PGIS) Scale [ Time Frame: Up to 65 months ]
  The PGIS is a single-item questionnaire that asks participants to provide the overall self-assessment of their disease severity on a 4-point scale for the past week, with 1 as "None" and 4 as "Severe". Only PGIS questions assessing pain and overall status will be collected.

Original Secondary Outcome Measures (submitted: January 23, 2019)

• Progression Free Survival (PFS) [ Time Frame: Up to 35 months ]
  PFS is defined as the time from the date of randomization until the date of radiological progressive disease (PD) per Response Evaluation Criteria In Solid Tumors (RECIST) 1.1 by investigator evaluation or death from any cause, whichever is earliest.
• Objective Response Rate (ORR) [ Time Frame: Up to 35 months ]
  ORR is defined as the proportion of participants who have a best overall response of Complete Response (CR) or Partial Response (PR) as assessed by investigator evaluation per RECIST 1.1.
• Number of anti-drug antibody (ADA) Positive Participants [ Time Frame: Up to 29 months ]
  Immunogenicity will be measured by the number of participants that are ADA positive.
• Disease Control Rate (DCR) [ Time Frame: Up to 35 months ]
  DCR is defined as the proportion of participants who have best overall response of stable disease, complete response (CR) or partial response (PR) as assessed by investigator evaluation per RECIST 1.1
• Duration Of Response (DOR) [ Time Frame: Up to 35 months ]
  DOR is defined as the time from the date of the first response (CR/PR) until the date of progressive disease as assessed by investigator evaluation per RECIST 1.1 or date of death from any cause, whichever is earliest.
• Change in CA (Cancer Antigen) 19-9 [ Time Frame: Baseline up to 27 months ]
  Change from baseline in serum CA19-9 will be assessed.
• PK of zolbetuximab: Concentration Immediately Prior to Dosing (Ctrough) [ Time Frame: Up to 29 months ]
  Ctrough will be derived from the PK serum samples collected.
• PK of paclitaxel: Area Under the Concentration-time Curve from the Time of Dosing Extrapolated to Time Infinity (AUCinf) [ Time Frame: Up to 30 days ]
  AUCinf will be derived from the PK plasma samples collected.
• PK of paclitaxel: Area Under the Concentration-time Curve from the Time of Dosing Until the Last Measurable Concentration (AUClast) [ Time Frame: Up to 30 days ]
  AUClast will be derived from the PK plasma samples collected.
• PK of paclitaxel: Maximum Concentration (Cmax) [ Time Frame: Up to 30 days ]
  Cmax will be derived from the PK plasma samples collected.
• PK of paclitaxel: Time of Maximum Concentration (Tmax) [ Time Frame: Up to 30 days ]
  Tmax will be derived from the PK plasma samples collected.
• PK of paclitaxel: Terminal Elimination Half-life (T1/2) [ Time Frame: Up to 30 days ]
  T1/2 will be derived from the PK plasma samples collected.
• PK of paclitaxel: Clearance (CL) [ Time Frame: Up to 30 days ]
  CL will be derived from the PK plasma samples collected.
• PK of paclitaxel: Volume of Distribution During the Terminal Phase (Vz) [ Time Frame: Up to 30 days ]
  Vz will be derived from the PK plasma samples collected.
• PK of gemcitabine: Area Under the Concentration-time Curve from the Time of Dosing Extrapolated to Time Infinity (AUCinf) [ Time Frame: Up to 30 days ]
  AUCinf will be derived from the PK plasma samples collected.
• PK of gemcitabine: Area Under the Concentration-time Curve from the Time of Dosing Until the Last Measurable Concentration (AUClast) [ Time Frame: Up to 30 days ]
  AUClast will be derived from the PK plasma samples collected.
• PK of gemcitabine: Maximum Concentration (Cmax) [ Time Frame: Up to 30 days ]
  Cmax will be derived from the PK plasma samples collected.
• PK of gemcitabine: Time of Maximum Concentration (Tmax) [ Time Frame: Up to 30 days ]
  Tmax will be derived from the PK plasma samples collected.
• PK of gemcitabine: Terminal Elimination Half-life (T1/2) [ Time Frame: Up to 30 days ]
  T1/2 will be derived from the PK plasma samples collected.
• PK of gemcitabine: Clearance (CL) [ Time Frame: Up to 30 days ]
  CL will be derived from the PK plasma samples collected.
• PK of gemcitabine: Volume of Distribution During the Terminal Phase (Vz) [ Time Frame: Up to 30 days ]
  Vz will be derived from the PK plasma samples collected.

• Current Other Pre-specified Outcome Measures: Not Provided
• Original Other Pre-specified Outcome Measures: Not Provided

Descriptive Information

• Brief Title: A Study to Assess the Efficacy and Safety of IMAB362 in Combination With Nab-Paclitaxel and Gemcitabine (Nab-P + GEM) as First Line Treatment in Subjects With Claudin 18.2 (CLDN18.2) Positive, Metastatic Pancreatic Adenocarcinoma
• Official Title: A Phase 2, Open-Label, Randomized Study to Assess the Efficacy and Safety of Zolbetuximab (IMAB362) in Combination With Nab-Paclitaxel and Gemcitabine (Nab-P + GEM) as First Line Treatment in Subjects With Claudin 18.2 (CLDN18.2) Positive, Metastatic Pancreatic Adenocarcinoma

Brief Summary

The purpose of this study is to confirm the recommended phase 2 dose (RP2D) of zolbetuximab in combination with Nab-P + GEM, determine overall survival and assess the safety and tolerability of the combination treatment.

This study will also evaluate tumor markers and pharmacokinetics (PK) of zolbetuximab, Nab-P and GEM, and health-related quality of life (HRQoL).

• Detailed Description: This study will have a safety lead in phase and a randomization phase.
• Study Type: Interventional
• Study Phase: Phase 2
• Study Design: Allocation: Randomized; Intervention Model: Parallel Assignment; Masking: None (Open Label); Primary Purpose: Treatment

Condition

• Pancreatic Cancer
• Metastatic Pancreatic Cancer
• Metastatic Pancreatic Adenocarcinoma

Intervention

• Drug: zolbetuximab
  Administered as an intravenous infusion.
  Other Name: IMAB362
• Drug: nab-paclitaxel
  Administered as an intravenous infusion
• Drug: gemcitabine
  Administered as an intravenous infusion

Study Arms

• Experimental: zolbetuximab +nab-paclitaxel + gemcitabine
  Participants will be treated with zolbetuximab in combination with nab-paclitaxel and gemcitabine for the phase 1 portion of the study to establish the recommended dose of zolbetuximab for the phase 2 portion. In the phase 2 portion, the participants will be treated with zolbetuximab at dose determined by the phase 1 portion of the study in combination with nab-paclitaxel and gemcitabine. Participants will be treated on continuous cycles until they no longer derive clinical benefit in the judgment of the treating physician, have unacceptable toxicity, undergo hematopoietic stem cell transplantation (HSCT), or meet one of the discontinuation criteria; whichever occurs first.
  Interventions:

  • Drug: zolbetuximab
  • Drug: nab-paclitaxel
  • Drug: gemcitabine
• Active Comparator: nab-paclitaxel + gemcitabine
  Participants will be treated with nab-paclitaxel and gemcitabine. Participants will be treated on continuous cycles until they no longer derive clinical benefit in the judgment of the treating physician, have unacceptable toxicity, undergo hematopoietic stem cell transplantation (HSCT), or meet one of the discontinuation criteria; whichever occurs first.
  Interventions:

  • Drug: nab-paclitaxel
  • Drug: gemcitabine

• Publications *: Not Provided

Recruitment Information

• Recruitment Status: Active, not recruiting
• Actual Enrollment (submitted: April 18, 2024): 393
• Original Estimated Enrollment (submitted: January 23, 2019): 141
• Estimated Study Completion Date: April 30, 2025
• Estimated Primary Completion Date: September 30, 2024 (Final data collection date for primary outcome measure)

Eligibility Criteria

Inclusion Criteria:

• A female subject is eligible to participate if she is not pregnant or lactating and at least 1 of the following conditions applies:

  • Not a woman of childbearing potential (WOCBP) OR
  • WOCBP who agrees to follow the contraceptive guidance throughout the treatment period and for at least 6 months after the final study drug administration.
• Female subject must agree not to breastfeed starting at screening and throughout the study period, and for 6 months after the final study drug administration.
• Female subject must not donate ova starting at screening and throughout the study period, and for 6 months after the final study drug administration.
• A male subject with female partner(s) of child-bearing potential must agree to use contraception during the treatment period and for at least 6 months after the final study drug administration.
• A male subject must not donate sperm during the treatment period and for at least 6 months after the final study drug administration.
• Male subject with a pregnant or breastfeeding partner(s) must agree to remain abstinent or use a condom for the duration of the pregnancy or time partner is breastfeeding throughout the study period and for 6 months after the final study drug administration.
• Subject agrees not to participate in other interventional studies while receiving study drug in present study.
• Subject has histologically or cytologically confirmed adenocarcinoma of pancreas.

• Subjects must have metastatic pancreatic adenocarcinoma that has not been previously treated with chemotherapy.

  • Prior treatment with fluorouracil (5-FU) or GEM administered as a radiation sensitizer during and up to 4 weeks after radiation therapy is allowed
  • If a subject received adjuvant therapy, tumor recurrence or disease progression must have occurred at least 6 months after completing the last dose of the adjuvant therapy.
  • Subjects whose disease progressed on prior treatment with Nab-P and GEM are not eligible.
• Subject has a measurable lesion(s) on at least 1 metastatic site based on RECIST 1.1 within 28 days prior to randomization. For subjects with only 1 measurable lesion and prior radiotherapy, the lesion must be outside the field of prior radiotherapy or must have documented progression following radiation therapy.
• Subject's tumor sample has CLDN18.2 expression in ≥ 75% of tumor cells demonstrating moderate to strong membranous staining as determined by central immunohistochemistry (IHC) testing
• Subject has Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
• Subject has predicted life expectancy ≥ 12 weeks.

• Subject must meet all of the following criteria based on the laboratory tests that will be collected within 14 days prior to randomization. In case of multiple laboratory data within this period, the most recent data should be used.

  • Hemoglobin ≥ 9 g/dl (no transfusion within 14 days of start of study treatment)
  • Absolute neutrophil count ≥ 1.5 x 10^9/L
  • Platelets ≥ 100 x 10^9/L
  • Albumin ≥ 2.5 g/dL
  • Total bilirubin ≤ 1.5 x upper limit of normal (ULN)
  • Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 2.5 x ULN without liver metastases (≤ 5 x ULN if liver metastases are present)
  • Estimated creatinine clearance ≥ 30 mL/min
  • Prothrombin time/international normalized ratio (INR) and partial thromboplastin time ≤ 1.5 x ULN (except for subjects receiving anticoagulation therapy)

Exclusion Criteria:

• Subject has received other investigational treatment within 28 days prior to randomization.
• Subject has received radiotherapy for metastatic pancreatic adenocarcinoma ≤ 14 days prior to randomization and has not recovered from any related toxicity.
• Subject has received systemic immunosuppressive therapy, including systemic corticosteroids within 14 days prior to randomization. Subject using a physiologic replacement dose of hydrocortisone or its equivalent (defined as up to 30 mg per day of hydrocortisone or up to 10 mg per day of prednisone), receiving a single dose of systemic corticosteroids or receiving systemic corticosteroids as premedication for radiologic imaging contrast use are allowed.
• Subject has prior severe allergic reaction or intolerance to known ingredients of zolbetuximab or other monoclonal antibody, including humanized or chimeric antibodies.
• Subject has known immediate or delayed hypersensitivity, intolerance or contraindication to any component of study treatment.

• Subject has a known history of a positive test for human immunodeficiency virus infection or known active hepatitis B (positive HBs antigen [Ag]) or hepatitis C infection. NOTE: Screening for these infections should be conducted per local requirements.

  1. For subjects who are negative for HBs Ag, but hepatitis B core antibody positive, a hepatitis B virus DNA test will be performed and if positive, the subject will be excluded.
  2. Subjects with positive hepatitis C serology but negative hepatitis C virus RNA test results are eligible.
  3. Subjects treated for hepatitis C with undetectable viral load results are eligible.
• Subject has a history of interstitial pneumonia or pulmonary fibrosis.
• Subject has pleural effusion or ascites ≥ Grade 3.
• Subject has an active autoimmune disease that has required systemic treatment in the past 3 months prior to randomization.
• Subject has active infection requiring systemic therapy that has not completely resolved per investigator judgment within 7 days prior to randomization.

• Subject has significant cardiovascular disease, including:

  • Congestive heart failure (defined as New York Heart Association Class III or IV), myocardial infarction, unstable angina, coronary angioplasty, coronary stenting, coronary artery bypass graft, cerebrovascular accident or hypertensive crisis within 6 months prior to randomization;
  • History of clinically significant ventricular arrhythmias (i.e., sustained ventricular tachycardia, ventricular fibrillation or Torsades de Pointes);
  • QTc interval > 450 msec for male subjects; QTc interval > 470 msec for female subjects;
  • Cardiac arrhythmias requiring anti-arrhythmic medications (Subjects with rate controlled atrial fibrillation for > 1 month prior to randomization.)
• Subject has a history of central nervous system metastases and/or carcinomatous meningitis from pancreatic adenocarcinoma.
• Subject has known peripheral sensory neuropathy ≥ Grade 2 unless the absence of deep tendon reflexes is the sole neurological abnormality.
• Subject has had a major surgical procedure ≤ 28 days prior to randomization.
• Subject without complete recovery from a major surgical procedure ≤ 14 days prior to randomization.
• Psychiatric illness or social situations that would preclude study compliance.
• Subject has another malignancy for which treatment is required.
• Subject has any concurrent disease, infection or co-morbid condition that interferes with the ability of the subject to participate in the study, which places the subject at undue risk or complicates the interpretation of data.

Sex/Gender

• Sexes Eligible for Study: All

• Ages: 18 Years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Contacts: Contact information is only displayed when the study is recruiting subjects
• Listed Location Countries: Australia, Brazil, China, France, Ireland, Italy, Japan, Korea, Republic of, Mexico, Spain, Taiwan, Turkey, United States

Administrative Information

• NCT Number: NCT03816163
• Other Study ID Numbers: 8951-CL-5201; 2018-002551-15 ( EudraCT Number ); CTR20220914 ( Registry Identifier: ChinaDrugTrials.org.cn )
• Has Data Monitoring Committee: Yes

U.S. FDA-regulated Product

• Studies a U.S. FDA-regulated Drug Product: Yes
• Studies a U.S. FDA-regulated Device Product: No

IPD Sharing Statement

• Plan to Share IPD: Yes
• Plan Description: Access to anonymized individual participant level data collected during the study, in addition to study-related supporting documentation, is planned for studies conducted with approved product indications and formulations, as well as compounds terminated during development. Studies conducted with product indications or formulations that remain active in development are assessed after study completion to determine if Individual Participant Data can be shared. Conditions and exceptions are described under the Sponsor Specific Details for Astellas on www.clinicalstudydatarequest.com.
• Supporting Materials: Study Protocol
• Supporting Materials: Statistical Analysis Plan (SAP)
• Supporting Materials: Clinical Study Report (CSR)
• Time Frame: Access to participant level data is offered to researchers after publication of the primary manuscript (if applicable) and is available as long as Astellas has legal authority to provide the data.
• Access Criteria: Researchers must submit a proposal to conduct a scientifically relevant analysis of the study data. The research proposal is reviewed by an Independent Research Panel. If the proposal is approved, access to the study data is provided in a secure data sharing environment after receipt of a signed Data Sharing Agreement.
• URL: https://www.clinicalstudydatarequest.com/

• Current Responsible Party: Astellas Pharma Inc ( Astellas Pharma Global Development, Inc. )
• Original Responsible Party: Same as current
• Current Study Sponsor: Astellas Pharma Global Development, Inc.
• Original Study Sponsor: Same as current
• Collaborators: Not Provided

Investigators

• Study Director: Medical Director; Astellas Pharma Global Development

• PRS Account: Astellas Pharma Inc
• Verification Date: April 2024