NCT03257761

Brief Summary

This phase Ib trial studies the side effects and best dose of guadecitabine and how well it works when given together with durvalumab in treating patients with liver, pancreatic, bile duct, or gallbladder cancer that has spread to other places in the body. Guadecitabine may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Monoclonal antibodies, such as durvalumab, may block tumor growth in different ways by targeting certain cells. Giving guadecitabine and durvalumab may work better in treating patients with liver, pancreatic, bile duct, or gallbladder cancer.

Trial Health

75
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
55

participants targeted

Target at P50-P75 for phase_1

Timeline
6mo left

Started Feb 2018

Longer than P75 for phase_1

Geographic Reach
1 country

3 active sites

Status
active not recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress94%
Feb 2018Dec 2026

First Submitted

Initial submission to the registry

August 19, 2017

Completed
3 days until next milestone

First Posted

Study publicly available on registry

August 22, 2017

Completed
6 months until next milestone

Study Start

First participant enrolled

February 7, 2018

Completed
3.6 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

September 27, 2021

Completed
5.3 years until next milestone

Study Completion

Last participant's last visit for all outcomes

December 31, 2026

Expected
Last Updated

June 1, 2026

Status Verified

May 1, 2026

Enrollment Period

3.6 years

First QC Date

August 19, 2017

Last Update Submit

May 27, 2026

Conditions

Outcome Measures

Primary Outcomes (2)

  • Incidence of adverse events

    Graded according to Common Terminology Criteria for Adverse Events version 4.03.

    Up to 56 days

  • Tumor response (dose expansion)

    Will be calculated by the percentage of patients having complete or partial response among all patients who have been treated at maximum tolerated dose/recommended phase II dose in each cohort. Will be assessed according to Response Evaluation Criteria in Solid Tumors (RECIST).

    Up to 2 years

Secondary Outcomes (2)

  • Overall survival

    From start of treatment until death due to any cause, assessed up to 2 years

  • Progression-free survival

    From start of treatment to time of progression per RECIST 1.1 or death whichever comes first, assessed up to 2 years

Study Arms (1)

Treatment (guadecitabine, durvalumab)

EXPERIMENTAL

Patients receive guadecitabine SC QD on days 1-5 and durvalumab IV over 60 minutes on day 8. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

Biological: DurvalumabDrug: Guadecitabine

Interventions

DurvalumabBIOLOGICAL

Given IV

Treatment (guadecitabine, durvalumab)

Given SC

Treatment (guadecitabine, durvalumab)

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Patients must have an Eastern Cooperative Oncology Group (ECOG) performance status of 0-1
  • Absolute neutrophil count (ANC) \>= 1.5 x 10\^9/L (\> 1500 per mm\^3) except for patients with HCC for whom ANC \>= 1000 per mm\^3 is allowed
  • Platelet count \>= 100 x 10\^9/L (\> 100,000 per mm\^3), except for patients with HCC for whom a platelet count \> 60,000 per mm\^3 is allowed
  • Hemoglobin \>= 8.0 g/dL; if patients have a hemoglobin level below 8, blood transfusion is allowed to meet the eligibility criteria as long as post transfusion hemoglobin is maintained at \>= 8.0 g/dL for 7 days or longer
  • Aspartate aminotransferase (AST)/serum glutamic-oxaloacetic transaminase (SGOT) and alanine aminotransaminase (ALT)/serum glutamate pyruvate transaminase (SGPT) =\< 2.5 x institutional upper limit of normal unless liver metastases are present or unless patient is known to have chronic liver disease (hepatitis) in which case AST and ALT must be =\< 5 x institutional upper limit of normal (IULN)
  • Serum bilirubin =\< 2.5 x institutional upper limit of normal (ULN)
  • Serum albumin \>= 2.5 g/dL
  • Serum creatinine clearance (CL) \> 40 mL/min by the Cockcroft-Gault formula or by 24-hour urine collection for determination of creatinine clearance
  • Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry, for the duration of study participation, and for 90 days following completion of therapy; should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately
  • A female of child-bearing potential is any woman (regardless of sexual orientation, having undergone a tubal ligation, or remaining celibate by choice) who meets the following criteria:
  • Has not undergone a hysterectomy or bilateral oophorectomy; or
  • Has not been naturally postmenopausal for at least 12 consecutive months (i.e., has had menses at any time in the preceding 12 consecutive months)
  • Female subjects must either be of non-reproductive potential (ie, post-menopausal by history: \>= 60 years old and no menses for \>= 1 year without an alternative medical cause; OR history of hysterectomy, OR history of bilateral tubal ligation, OR history of bilateral oophorectomy) or must have a negative serum pregnancy test upon study entry
  • Ability to understand a written informed consent
  • Signed written informed consent and Health Insurance Portability and Accountability Act (HIPAA) obtained from the subject prior to performing any protocol-related procedures, including screening evaluations
  • +19 more criteria

You may not qualify if:

  • Patients may not be receiving any other investigational agents
  • Patients must not be nursing due to the potential for congenital abnormalities and the potential of this regimen to harm nursing infants
  • Any previous treatment with a hypomethylating agent, or with a PD1 or PD-L1 or anti-PD-L2 or anti-CTLA4 inhibitor, including durvalumab (or any other antibody or drug specifically targeting T-cell costimulation or checkpoint pathways); any immunomodulatory agent that is not described above should be cleared by the principal investigator (PI)
  • History of another primary malignancy except for:
  • Malignancy treated with curative intent and with no known active disease \>= 3 years before the first dose of study drug
  • Adequately treated non-melanoma skin cancer or lentigo maligna without evidence of disease
  • Adequately treated carcinoma in situ without evidence of disease eg, cervical cancer in situ
  • Controlled, superficial bladder carcinoma
  • T1a or T1b or T1c prostate carcinoma treated with radiation \>= 1 year prior to study enrollment and prostate specific antigen (PSA) within normal limits (WNL) since treatment
  • T2a or b prostate carcinoma treated curatively \>= 1 year prior to study enrollment and PSA undetectable since curative treatment
  • Other early stage cancers that have a minimal chance of recurrence (i.e stage I endometrial cancer, cervical cancer, etc.) may be cleared by the PI
  • Receipt of the last dose of anti-cancer therapy (chemotherapy, immunotherapy, endocrine therapy, targeted therapy, biologic therapy, tumor embolization, monoclonal antibodies, other investigational agent) within 28 days prior to the first dose of study drug and within 6 weeks for nitrosourea or mitomycin C
  • Mean QT interval corrected for heart rate (QTc) \>= 470 ms calculated from 3 electrocardiograms (ECGs) using Fridericia?s correction
  • Current or prior use of immunosuppressive medication within 28 days before the first dose of durvalumab, with the exceptions of intranasal and inhaled corticosteroids or systemic corticosteroids at physiological doses, which are not to exceed 10 mg/day of prednisone, or an equivalent corticosteroid; live attenuated vaccines within 30 days of durvalumab dosing (ie, 30 days prior to the first dose, during treatment with durvalumab and for 30 days post discontinuation of durvalumab); inactivated vaccines, such as the injectable influenza vaccine, are permitted
  • Any unresolved toxicity Common Terminology Criteria for Adverse Events (CTCAE) grade 2 or more from previous anti-cancer therapy, except alopecia, hearing loss, peripheral neuropathy or non-clinically significant laboratory abnormalities
  • +16 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (3)

USC / Norris Comprehensive Cancer Center

Los Angeles, California, 90033, United States

Location

Hoag Memorial Hospital Presbyterian

Newport Beach, California, 92663, United States

Location

Johns Hopkins University/Sidney Kimmel Cancer Center

Baltimore, Maryland, 21287, United States

Location

MeSH Terms

Conditions

CholangiocarcinomaGallbladder NeoplasmsCarcinoma, HepatocellularPancreatic Neoplasms

Interventions

durvalumabguadecitabine

Condition Hierarchy (Ancestors)

AdenocarcinomaCarcinomaNeoplasms, Glandular and EpithelialNeoplasms by Histologic TypeNeoplasmsBiliary Tract NeoplasmsDigestive System NeoplasmsNeoplasms by SiteBiliary Tract DiseasesDigestive System DiseasesGallbladder DiseasesLiver NeoplasmsLiver DiseasesEndocrine Gland NeoplasmsPancreatic DiseasesEndocrine System Diseases

Study Officials

  • Anthony El-Khoueiry, MD

    University of Southern California

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
phase 1
Allocation
NA
Masking
NONE
Purpose
TREATMENT
Intervention Model
SINGLE GROUP
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

August 19, 2017

First Posted

August 22, 2017

Study Start

February 7, 2018

Primary Completion

September 27, 2021

Study Completion (Estimated)

December 31, 2026

Last Updated

June 1, 2026

Record last verified: 2026-05

Locations