NCT03816163

Brief Summary

Zolbetuximab is being studied as a treatment for people with pancreatic cancer. Most people with pancreatic cancer have a protein called Claudin 18.2 (CLDN18.2) in their tumor. Zolbetuximab is thought to work by attaching to CLDN 18.2 in their tumor. This switches on the body's immune system to attack the tumor. Zolbetuximab is a potential treatment for people with pancreatic cancer. There is an unmet medical need to treat people with pancreatic cancer. This study will help find the dose of zolbetuximab to be used with chemotherapy and provide more information on this treatment in adults with metastatic pancreatic cancer. The study is currently ongoing globally. People in this study will be treated with either zolbetuximab and chemotherapy or chemotherapy by itself. The study's main aims are to find a suitable dose of zolbetuximab to be used with chemotherapy in the second part of this study, to check if zolbetuximab and chemotherapy compared to chemotherapy by itself can improve the survival of people with pancreatic cancer, and to check the safety of zolbetuximab when given with chemotherapy and how well people cope with medical problems during the study. Adults with metastatic pancreatic cancer can take part. Their cancer is metastatic, has the CLDN18.2 marker in a tumor sample and has not previously been treated with chemotherapy. Metastatic means the cancer has spread to other parts of the body. People cannot take part are if they have recently had radiotherapy and have not recovered, need to take medicines to suppress their immune system, have history of nervous system metastases from their pancreatic cancer, or they have other active cancers that need treatment. People who have a specific heart condition or infections also cannot take part. This study will be in 2 parts. Part 1 is called the Safety Lead-in Phase. Groups of people will receive 1 of 2 different doses of zolbetuximab: a lower dose or a higher dose, both together with chemotherapy. A medical expert panel will check the results and decide the dose to use in Part 2. Part 2 is called the Randomization Phase. People will be put in 1 of 2 groups by chance and will be given different treatments either zolbetuximab and chemotherapy or chemotherapy by itself. The chance of receiving zolbetuximab and chemotherapy is twice as high as receiving chemotherapy by itself. In both parts of the study, zolbetuximab and chemotherapy or chemotherapy by itself will be given through a vein. This is called an infusion. Each treatment cycle is 4 weeks (28 days) long and people will have either 2 infusions of zolbetuximab and 3 infusions of chemotherapy or 3 infusions of chemotherapy by itself during each treatment cycle. People will visit the clinic on certain days during their treatment. The study doctors will check for any medical problems from zolbetuximab. Also, people in the study will have a health check including blood tests. On some visits they will also have scans to check for any changes in their cancer. Tumor samples will be taken before treatment if a previous sample is not available. People will have the option of giving a tumor sample after treatment has finished. People will visit the clinic after they stop treatment. They will be asked about any medical problems and will have a health check including blood tests. The number of visits and checks done at each visit will depend on the health of each person and whether they completed their treatment or not.

Trial Health

87
On Track

Trial Health Score

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

Strong global presence with extensive site network
Enrollment
393

participants targeted

Target at P75+ for phase_2 pancreatic-cancer

Timeline
4mo left

Started Mar 2019

Longer than P75 for phase_2 pancreatic-cancer

Geographic Reach
13 countries

136 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 Progress96%
Mar 2019Aug 2026

First Submitted

Initial submission to the registry

January 23, 2019

Completed
2 days until next milestone

First Posted

Study publicly available on registry

January 25, 2019

Completed
2 months until next milestone

Study Start

First participant enrolled

March 15, 2019

Completed
7.5 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

August 31, 2026

Expected
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

August 31, 2026

Last Updated

March 12, 2026

Status Verified

March 1, 2026

Enrollment Period

7.5 years

First QC Date

January 23, 2019

Last Update Submit

March 10, 2026

Conditions

Keywords

metastatic pancreatic cancerIMAB362nab-paclitaxelgemcitabinezolbetuximabmetastatic pancreatic adenocarcinomapancreatic cancerCLDN 18.2

Outcome Measures

Primary Outcomes (9)

  • Dose Limiting Toxicities (DLT) - (safety lead in)

    Incidence of dose limiting toxicities.

    Up to 28 days

  • Overall Survival (OS)

    OS is defined as the time from the date of randomization until the date of death from any cause.

    Up to 65 months

  • Safety assessed by Adverse Events (AEs)

    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.

    Up to 65 months

  • Safety assessed by incidence of serious adverse events (SAE)

    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.

    Up to 65 months

  • Safety assessed by incidence of treatment emergent adverse events (TEAE)

    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.

    Up to 65 months

  • Number of participants with laboratory value abnormalities and/or adverse events (AEs)

    Number of participants with potentially clinically significant laboratory values.

    Up to 65 months

  • Number of participants with vital sign abnormalities and /or adverse events (AEs)

    Number of participants with potentially clinically significant vital sign values.

    Up to 65 months

  • Number of participants with electrocardiograms (ECG) abnormalities and or adverse events

    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.

    Up to 65 months

  • Number of participants with Eastern Cooperative Oncology Group (ECOG) performance status abnormalities and or adverse events

    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.

    Up to 65 months

Secondary Outcomes (32)

  • Progression Free Survival (PFS)

    Up to 65 months

  • Objective Response Rate (ORR)

    Up to 65 months

  • Number of anti-drug antibody (ADA) Positive Participants

    Up to 65 months

  • Disease Control Rate (DCR)

    Up to 65 months

  • Duration Of Response (DOR)

    Up to 65 months

  • +27 more secondary outcomes

Study Arms (2)

zolbetuximab +nab-paclitaxel + gemcitabine

EXPERIMENTAL

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.

Drug: zolbetuximabDrug: nab-paclitaxelDrug: gemcitabine

nab-paclitaxel + gemcitabine

ACTIVE COMPARATOR

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.

Drug: nab-paclitaxelDrug: gemcitabine

Interventions

Administered as an intravenous infusion.

Also known as: IMAB362
zolbetuximab +nab-paclitaxel + gemcitabine

Administered as an intravenous infusion

nab-paclitaxel + gemcitabinezolbetuximab +nab-paclitaxel + gemcitabine

Administered as an intravenous infusion

nab-paclitaxel + gemcitabinezolbetuximab +nab-paclitaxel + gemcitabine

Eligibility Criteria

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

You may qualify if:

  • 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.
  • +12 more criteria

You may not qualify if:

  • 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.
  • 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.
  • Subjects with positive hepatitis C serology but negative hepatitis C virus RNA test results are eligible.
  • 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;
  • +10 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (136)

St. Joseph Heritage Medical Group

Fullerton, California, 92835, United States

Location

TOI Clinical research

Whittier, California, 90603, United States

Location

Midstate Medical Center

Meriden, Connecticut, 06451, United States

Location

Lynn Cancer Institute

Boca Raton, Florida, 33486, United States

Location

Baptist Health

Miami, Florida, 33176, United States

Location

Cancer Treatment Centers of Atlanta

Newnan, Georgia, 30265, United States

Location

University of Illinois at Chicago

Chicago, Illinois, 60612, United States

Location

Norton Cancer Institute (NCI)

Louisville, Kentucky, 40202, United States

Location

Ochsner Health System

New Orleans, Louisiana, 70121, United States

Location

David C Pratt Cancer Center

Creve Coeur, Missouri, 63141, United States

Location

Memorial Sloan Kettering Basking Ridge

Basking Ridge, New Jersey, 07920, United States

Location

Memorial Sloan Kettering Bergen

Montvale, New Jersey, 07645, United States

Location

Roswell Park Cancer Institute

Buffalo, New York, 14203, United States

Location

Memorial Sloan Kettering Commack

Commack, New York, 11725, United States

Location

Memorial Sloan Kettering Westchester

Harrison, New York, 10604, United States

Location

Northwell Health Cancer Institute

Lake Success, New York, 11042, United States

Location

Memorial Sloan-Kettering Cancer Center

New York, New York, 10022, United States

Location

Memorial Sloan Kettering Nassau

Uniondale, New York, 11553, United States

Location

Novant Health Presbyterian Medical Center

Charlotte, North Carolina, 28204, United States

Location

Novant Health

Winston-Salem, North Carolina, 27103, United States

Location

Houston Methodist Hospital

Houston, Texas, 77030, United States

Location

Utah Cancer Specialists

Salt Lake City, Utah, 84106, United States

Location

MultiCare Regional Cancer Center - Gig Harbor

Gig Harbor, Washington, 98335, United States

Location

Vista Oncology

Olympia, Washington, 98502, United States

Location

Virginia Mason

Seattle, Washington, 98101, United States

Location

Site AU61008

Gosford, New South Wales, NSW 2250, Australia

Location

Site AU61007

Wollongong, New South Wales, HVGM+3C, Australia

Location

Site AU61005

Fitzroy, Victoria, 5XRF+WX, Australia

Location

Site AU61006

Warrnambool, Victoria, VIC 3280, Australia

Location

Site BR55012

Porto Alegre, Rio Grande do Sul, Brazil

Location

Site BR55009

Centro Passo Fundo, Brazil

Location

Site BR55008

Rio Grande, Brazil

Location

Site BR55004

Santa Catarina, Brazil

Location

Site BR55010

São Paulo, Brazil

Location

Site BR55011

São Paulo, Brazil

Location

Site CN86001

Beijing, China

Location

Site CN86008

Beijing, China

Location

Site CN86014

Beijing, China

Location

Site CN86026

Changchun, China

Location

Site CN86009

Chongqing, China

Location

Site CN86004

Guangdong, China

Location

Site CN86020

Guangdong, China

Location

Site CN86016

Guangzhou, China

Location

Site CN86012

Harbin, China

Location

Site CN86002

Hubei, China

Location

Site CN86005

Jiangsu, China

Location

Site CN86011

Jiangsu, China

Location

Site CN86025

Jiangsu, China

Location

Site CN86023

Shandong, China

Location

Site CN86006

Shanghai, China

Location

Site CN86013

Shanghai, China

Location

Site CN86019

Shanghai, China

Location

Site CN86007

Tianjin, China

Location

Site CN86022

Xinjiang, China

Location

Site CN86024

Yanxi, China

Location

Site CN86003

Zhejiang, China

Location

Site CN86018

Zhejiang, China

Location

Site CN86010

Zhengzhou, China

Location

Site FR33008

Besançon, Besancon Cedex, 6XG7+42, France

Location

Site FR33010

Brest, Brest Cedex, 9GV7+4G, France

Location

Site FR33015

Caen, Cedex 5, 14076, France

Location

Site FR33006

Chambray, Cedex 9, 37170, France

Location

Site FR33012

Herblain, Herblain Cedex, 44805, France

Location

Site FR33016

La Chaussée-Saint-Victor, Loir-et-Cher, 41260, France

Location

Site FR33009

Nancy, Nancy Cedex, 54000, France

Location

Site FR33017

Rouen, Normandy, 76000, France

Location

Site FR33003

Aquitaine, Pessac, 33604, France

Location

Site FR33013

Villejuif, Villejuif Cedex, 94805, France

Location

Site FR33001

Bayonne, 64109, France

Location

Site FR33018

Bordeaux, France

Location

Site FR33002

Grenoble, France

Location

Site FR33019

La Roche-sur-Yon, France

Location

Site FR33021

Nice, France

Location

Site FR33023

Pierre-Bénite, France

Location

Site FR33014

Plérin, 22190, France

Location

Site FR33005

Pringy, 74374, France

Location

Site FR33007

Strasbourg, 67000, France

Location

Site IR35301

Elm Park, Dublin, D04 T6F4, Ireland

Location

Site IT39006

Rozzano, Milan, 20089, Italy

Location

Site IT39004

Candiolo, Torino, 10060, Italy

Location

Site IT39002

Cremona, 26100, Italy

Location

Site IT39010

Lombardia, Italy

Location

Site IT39003

Milan, 20141, Italy

Location

Site IT39014

Toscana, Italy

Location

Site IT39008

Veneto, Italy

Location

Site JP81007

Nagoya, Aichi-ken, Japan

Location

Site JP81001

Kashiwa, Chiba, Japan

Location

Site JP81005

Sapporo, Hokkaido, Japan

Location

Site JP81006

Yokohama, Kanagawa, Japan

Location

Site JP81003

Kashihara, Nara, Japan

Location

Site JP81011

Bunkyo-ku, Tokyo, Japan

Location

Site JP81012

Chuo-ku, Tokyo, Japan

Location

Site JP81014

Koto-ku, Tokyo, Japan

Location

Site JP81013

Mitaka, Tokyo, Japan

Location

Site JP81002

Shinjuku-ku, Tokyo, Japan

Location

Site JP81015

Ube, Yamaguchi, Japan

Location

Site JP81004

Fukuoka, Japan

Location

Site JP81010

Osaka, Japan

Location

Site JP81009

Wakayama, Japan

Location

Site MX52004

Distrito Federal, Mexico

Location

Site MX52003

San Luis Potosí City, Mexico

Location

Site MX52005

Veracruz, Mexico

Location

Site KR82005

Seongnam-si, Gyeonggi-do, 013620, South Korea

Location

Site KR82008

Suwon, Gyeonggi-do, South Korea

Location

Site KR82010

Daegu, South Korea

Location

Site KR82009

Gyeonggi-do, South Korea

Location

Site KR82001

Seoul, 03080, South Korea

Location

Site KR82003

Seoul, 120-752, South Korea

Location

Site KR82004

Seoul, 138-736, South Korea

Location

Site KR82007

Seoul, 152-703, South Korea

Location

Site KR82002

Seoul, F3QP+76, South Korea

Location

Site KR82006

Seoul, G234+36, South Korea

Location

Site ES34004

Llobregat, Barcelona, 08908, Spain

Location

Site ES34003

Pamplona, Navarre, 31008, Spain

Location

Site ES34010

Barcelona, 08028, Spain

Location

Site ES34013

Barcelona, 08036, Spain

Location

Site ES34007

Barcelona, 08916, Spain

Location

Site ES34018

Barcelona, Spain

Location

Site ES34021

Barcelona, Spain

Location

Site ES34014

Cáceres, 10003, Spain

Location

Site ES34022

Córdoba, Spain

Location

Site ES34005

Lleida, 25198, Spain

Location

Site ES34015

Madrid, 28027, Spain

Location

Site ES34006

Madrid, 28033, Spain

Location

Site ES34009

Madrid, 28034, Spain

Location

Site ES34026

Málaga, Spain

Location

Site ES34017

Santiago de Compostela, Spain

Location

Site TW88608

New Taipei City, Taiwan

Location

Site TW88602

Taichung, 5M5J+36, Taiwan

Location

Site TW88601

Taipei, 4G9C+W3, Taiwan

Location

Site TW88609

Taipei, Taiwan

Location

Site TR90004

Ankara, Turkey (Türkiye)

Location

Site TR90006

Ankara, Turkey (Türkiye)

Location

Site TR90003

Diyarbakır, Turkey (Türkiye)

Location

Site TR90002

Istanbul, Turkey (Türkiye)

Location

Site TR90001

Konya, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Pancreatic Neoplasms

Interventions

zolbetuximab130-nm albumin-bound paclitaxelGemcitabine

Condition Hierarchy (Ancestors)

Digestive System NeoplasmsNeoplasms by SiteNeoplasmsEndocrine Gland NeoplasmsDigestive System DiseasesPancreatic DiseasesEndocrine System Diseases

Intervention Hierarchy (Ancestors)

Heterocyclic CompoundsDeoxycytidineCytidinePyrimidine NucleosidesPyrimidinesHeterocyclic Compounds, 1-Ring

Study Officials

  • Medical Director

    Astellas Pharma Global Development

    STUDY DIRECTOR

Study Design

Study Type
interventional
Phase
phase 2
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
INDUSTRY
Responsible Party
SPONSOR
Expanded Access
Yes

Study Record Dates

First Submitted

January 23, 2019

First Posted

January 25, 2019

Study Start

March 15, 2019

Primary Completion (Estimated)

August 31, 2026

Study Completion (Estimated)

August 31, 2026

Last Updated

March 12, 2026

Record last verified: 2026-03

Data Sharing

IPD Sharing
Will share

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 products 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. Further details on Astellas' data sharing policy can be found at https://www.clinicaltrials.astellas.com/transparency/.

Shared Documents
STUDY PROTOCOL, SAP, 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.
More information

Locations