Study Stopped
Lack of Funding
Trametinib and Hydroxychloroquine in Treating Patients With Pancreatic Cancer
THREAD
THREAD: A Phase I Trial of Trametinib and Hydroxychloroquine in Patients With Advanced Pancreatic Cancer
1 other identifier
interventional
25
1 country
2
Brief Summary
This phase I trial studies the sides effects and best dose of hydroxychloroquine when given together with trametinib in treating patients with pancreatic cancer that has spread to nearby tissue, lymph nodes or other places in the body and cannot be removed by surgery. Trametinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as hydroxychloroquine, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Giving trametinib together with hydroxychloroquine may work better in treating patients with pancreatic cancer.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P25-P50 for phase_1
Started Jan 2019
Longer than P75 for phase_1
2 active sites
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
First Submitted
Initial submission to the registry
January 30, 2019
CompletedStudy Start
First participant enrolled
January 30, 2019
CompletedFirst Posted
Study publicly available on registry
January 31, 2019
CompletedPrimary Completion
Last participant's last visit for primary outcome
January 15, 2025
CompletedStudy Completion
Last participant's last visit for all outcomes
August 3, 2025
CompletedMay 14, 2026
May 1, 2026
6 years
January 30, 2019
May 12, 2026
Conditions
Outcome Measures
Primary Outcomes (1)
Rate of dose-limiting toxicities during the DLT assessment window.
To determine the recommended phase II dose (RP2D) hydroxychloroquine in combination with trametinib.
At 28 days
Secondary Outcomes (2)
Incidence of adverse events (AEs) for the duration of study treatment
30 days after last dose
Response Rate
5 years
Study Arms (1)
Treatment (trametinib, hydroxychloroquine)
EXPERIMENTALPatients receive trametinib PO QD on days 1-28 and hydroxychloroquine PO QD or BID on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity.
Interventions
Given PO
Eligibility Criteria
You may qualify if:
- Male or female subject aged ≥ 18 years.
- Subject with histologically confirmed metastatic or locally advanced, unresectable pancreatic carcinoma
- Subject is willing to provide a baseline biopsy.
- EXPANSION COHORT ONLY: Subject must have progressed during or after two standard of care lines of treatment or refused standard of care options.
- Subject must have computed tomography (CT) measurable disease by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria
- Subject must be able and willing to undergo disease assessment while on study and afterwards, if removed for reason other than progression
- Eastern Cooperative Oncology Group (ECOG) performance status =\< 2
- Adequate organ function as defined as:
- Hematologic:
- Absolute neutrophil count (ANC) \>= 1.5 x 10\^9/L
- Platelet count \>= 100 x 10\^9/L
- Hemoglobin \>= 9 g/dL
- Hepatic:
- Total bilirubin level =\< 1.5 x the upper limit of normal (ULN) range
- Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels =\< 3 x ULN. Patients with liver metastases will be allowed to enroll with AST and ALT levels =\< 5 x ULN
- +6 more criteria
You may not qualify if:
- Subject who have received systemic antineoplastic therapy (including unconjugated therapeutic antibodies and toxin immunoconjugates) or any investigational therapy within 2 weeks or within 5 half-lives of the investigational therapy prior to starting study treatment, whichever is shorter.
- Subject who have received radiotherapy within 2 weeks prior to the first dose of study treatment. Localized radiation therapy for the treatment of symptomatic bone metastasis is allowed during that timeframe
- Subjects who have undergone major surgery =\< 3 weeks prior to starting study drug or who have not recovered from side effects of such procedure
- Patients with multiple primary malignancies may be enrolled if non-pancreatic ductal adenocarcinoma (PDAC) tumor(s) does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen as determined by treating investigator and do not require active treatment
- Known brain metastases or cranial epidural disease unless adequately treated with radiotherapy and/or surgery (including radiosurgery) and stable for at least 4 weeks before first dose of study treatment. Eligible subjects must be neurologically asymptomatic and without corticosteroid treatment at the time of first dose of study treatment
- History or current evidence of retinal vein occlusion (RVO) or current risk factors for RVO (e.g. uncontrolled glaucoma or ocular hypertension, history of hyperviscosity or hypercoagulability syndromes)
- History of active major bleeding.
- Patients whom thromboembolic prophylaxis is medically contraindicated per the treating investigator's assessment.
- Current evidence of uncontrolled, significant intercurrent illness including, but not limited to, the following conditions:
- Cardiovascular disorders:
- Congestive heart failure New York Heart Association class 3 or 4, unstable angina pectoris, serious cardiac arrhythmias.
- Stroke (including transient ischemic attack \[TIA\]), myocardial infarction (MI), or other ischemic event, or thromboembolic event (eg, deep venous thrombosis, pulmonary embolism) within 3 months before first dose. The presence of an asymptomatic portal vein thrombosis will not preclude study participation.
- History of glucose-6-phosphate dehydrogenase (G6PD) deficiency
- History of seizures
- Patients who are planning on embarking on a new strenuous exercise regimen after first dose of study treatment. Muscular activities, such as strenuous exercise, that can result in significant increases in plasma creatine kinase (CK) levels should be avoided while on study treatment
- +11 more criteria
Contact the study team to confirm eligibility.
Sponsors & Collaborators
- University of Utahlead
- Novartis Pharmaceuticalscollaborator
- Huntsman Cancer Institutecollaborator
Study Sites (2)
University of California, San Francisco
San Francisco, California, 94143, United States
Huntsman Cancer Institute/University of Utah
Salt Lake City, Utah, 84112, United States
Related Publications (24)
Siegel RL, Miller KD, Jemal A. Cancer Statistics, 2017. CA Cancer J Clin. 2017 Jan;67(1):7-30. doi: 10.3322/caac.21387. Epub 2017 Jan 5.
PMID: 28055103BACKGROUNDKleeff J, Korc M, Apte M, La Vecchia C, Johnson CD, Biankin AV, Neale RE, Tempero M, Tuveson DA, Hruban RH, Neoptolemos JP. Pancreatic cancer. Nat Rev Dis Primers. 2016 Apr 21;2:16022. doi: 10.1038/nrdp.2016.22.
PMID: 27158978BACKGROUNDHidalgo M, Cascinu S, Kleeff J, Labianca R, Lohr JM, Neoptolemos J, Real FX, Van Laethem JL, Heinemann V. Addressing the challenges of pancreatic cancer: future directions for improving outcomes. Pancreatology. 2015 Jan-Feb;15(1):8-18. doi: 10.1016/j.pan.2014.10.001. Epub 2014 Oct 17.
PMID: 25547205BACKGROUNDCollisson EA, Trejo CL, Silva JM, Gu S, Korkola JE, Heiser LM, Charles RP, Rabinovich BA, Hann B, Dankort D, Spellman PT, Phillips WA, Gray JW, McMahon M. A central role for RAF-->MEK-->ERK signaling in the genesis of pancreatic ductal adenocarcinoma. Cancer Discov. 2012 Aug;2(8):685-93. doi: 10.1158/2159-8290.CD-11-0347. Epub 2012 May 24.
PMID: 22628411BACKGROUNDInfante JR, Somer BG, Park JO, Li CP, Scheulen ME, Kasubhai SM, Oh DY, Liu Y, Redhu S, Steplewski K, Le N. A randomised, double-blind, placebo-controlled trial of trametinib, an oral MEK inhibitor, in combination with gemcitabine for patients with untreated metastatic adenocarcinoma of the pancreas. Eur J Cancer. 2014 Aug;50(12):2072-81. doi: 10.1016/j.ejca.2014.04.024. Epub 2014 Jun 7.
PMID: 24915778BACKGROUNDKasuga A, Nakagawa K, Nagashima F, Shimizu T, Naruge D, Nishina S, Kitamura H, Kurata T, Takasu A, Fujisaka Y, Okamoto W, Nishimura Y, Mukaiyama A, Matsushita H, Furuse J. A phase I/Ib study of trametinib (GSK1120212) alone and in combination with gemcitabine in Japanese patients with advanced solid tumors. Invest New Drugs. 2015 Oct;33(5):1058-67. doi: 10.1007/s10637-015-0270-2. Epub 2015 Aug 12.
PMID: 26259955BACKGROUNDKinsey CG, Camolotto SA, Boespflug AM, Guillen KP, Foth M, Truong A, Schuman SS, Shea JE, Seipp MT, Yap JT, Burrell LD, Lum DH, Whisenant JR, Gilcrease GW 3rd, Cavalieri CC, Rehbein KM, Cutler SL, Affolter KE, Welm AL, Welm BE, Scaife CL, Snyder EL, McMahon M. Protective autophagy elicited by RAF-->MEK-->ERK inhibition suggests a treatment strategy for RAS-driven cancers. Nat Med. 2019 Apr;25(4):620-627. doi: 10.1038/s41591-019-0367-9. Epub 2019 Mar 4.
PMID: 30833748BACKGROUNDRodriguez-Viciana P, Tetsu O, Oda K, Okada J, Rauen K, McCormick F. Cancer targets in the Ras pathway. Cold Spring Harb Symp Quant Biol. 2005;70:461-7. doi: 10.1101/sqb.2005.70.044.
PMID: 16869784BACKGROUNDYoung A, Lyons J, Miller AL, Phan VT, Alarcon IR, McCormick F. Ras signaling and therapies. Adv Cancer Res. 2009;102:1-17. doi: 10.1016/S0065-230X(09)02001-6.
PMID: 19595305BACKGROUNDKim KB, Kefford R, Pavlick AC, Infante JR, Ribas A, Sosman JA, Fecher LA, Millward M, McArthur GA, Hwu P, Gonzalez R, Ott PA, Long GV, Gardner OS, Ouellet D, Xu Y, DeMarini DJ, Le NT, Patel K, Lewis KD. Phase II study of the MEK1/MEK2 inhibitor Trametinib in patients with metastatic BRAF-mutant cutaneous melanoma previously treated with or without a BRAF inhibitor. J Clin Oncol. 2013 Feb 1;31(4):482-9. doi: 10.1200/JCO.2012.43.5966. Epub 2012 Dec 17.
PMID: 23248257BACKGROUNDGysin S, Lee SH, Dean NM, McMahon M. Pharmacologic inhibition of RAF-->MEK-->ERK signaling elicits pancreatic cancer cell cycle arrest through induced expression of p27Kip1. Cancer Res. 2005 Jun 1;65(11):4870-80. doi: 10.1158/0008-5472.CAN-04-2848.
PMID: 15930308BACKGROUNDGysin S, Paquette J, McMahon M. Analysis of mRNA profiles after MEK1/2 inhibition in human pancreatic cancer cell lines reveals pathways involved in drug sensitivity. Mol Cancer Res. 2012 Dec;10(12):1607-19. doi: 10.1158/1541-7786.MCR-12-0188. Epub 2012 Jul 25.
PMID: 22833572BACKGROUNDAwasthi N, Zhang C, Schwarz AM, Hinz S, Wang C, Williams NS, Schwarz MA, Schwarz RE. Comparative benefits of Nab-paclitaxel over gemcitabine or polysorbate-based docetaxel in experimental pancreatic cancer. Carcinogenesis. 2013 Oct;34(10):2361-9. doi: 10.1093/carcin/bgt227. Epub 2013 Jun 26.
PMID: 23803690BACKGROUNDChew HK, Wun T, Harvey D, Zhou H, White RH. Incidence of venous thromboembolism and its effect on survival among patients with common cancers. Arch Intern Med. 2006 Feb 27;166(4):458-64. doi: 10.1001/archinte.166.4.458.
PMID: 16505267BACKGROUNDLarsen AC, Dabrowski T, Frokjaer JB, Fisker RV, Iyer VV, Moller BK, Kristensen SR, Thorlacius-Ussing O. Prevalence of venous thromboembolism at diagnosis of upper gastrointestinal cancer. Br J Surg. 2014 Feb;101(3):246-53. doi: 10.1002/bjs.9353. Epub 2014 Jan 20.
PMID: 24446107BACKGROUNDBlom JW, Osanto S, Rosendaal FR. High risk of venous thrombosis in patients with pancreatic cancer: a cohort study of 202 patients. Eur J Cancer. 2006 Feb;42(3):410-4. doi: 10.1016/j.ejca.2005.09.013.
PMID: 16321518BACKGROUNDMaraveyas A, Waters J, Roy R, Fyfe D, Propper D, Lofts F, Sgouros J, Gardiner E, Wedgwood K, Ettelaie C, Bozas G. Gemcitabine versus gemcitabine plus dalteparin thromboprophylaxis in pancreatic cancer. Eur J Cancer. 2012 Jun;48(9):1283-92. doi: 10.1016/j.ejca.2011.10.017. Epub 2011 Nov 17.
PMID: 22100906BACKGROUNDLyman GH. Venous thromboembolism in the patient with cancer: focus on burden of disease and benefits of thromboprophylaxis. Cancer. 2011 Apr 1;117(7):1334-49. doi: 10.1002/cncr.25714. Epub 2010 Nov 8.
PMID: 21425133BACKGROUNDKhorana AA, Dalal M, Lin J, Connolly GC. Incidence and predictors of venous thromboembolism (VTE) among ambulatory high-risk cancer patients undergoing chemotherapy in the United States. Cancer. 2013 Feb 1;119(3):648-55. doi: 10.1002/cncr.27772. Epub 2012 Aug 14.
PMID: 22893596BACKGROUNDLyman GH, Bohlke K, Khorana AA, Kuderer NM, Lee AY, Arcelus JI, Balaban EP, Clarke JM, Flowers CR, Francis CW, Gates LE, Kakkar AK, Key NS, Levine MN, Liebman HA, Tempero MA, Wong SL, Somerfield MR, Falanga A; American Society of Clinical Oncology. Venous thromboembolism prophylaxis and treatment in patients with cancer: american society of clinical oncology clinical practice guideline update 2014. J Clin Oncol. 2015 Feb 20;33(6):654-6. doi: 10.1200/JCO.2014.59.7351. Epub 2015 Jan 20.
PMID: 25605844BACKGROUNDKhorana AA, Otten HM, Zwicker JI, Connolly GC, Bancel DF, Pabinger I; Subcommittee on Haemostasis and Malignancy of the Scientific and Standardization Committee of the International Society on Thrombosis and Hemostasis. Prevention of venous thromboembolism in cancer outpatients: guidance from the SSC of the ISTH. J Thromb Haemost. 2014 Nov;12(11):1928-31. doi: 10.1111/jth.12725. Epub 2014 Sep 30. No abstract available.
PMID: 25208230BACKGROUNDBalaban EP, Mangu PB, Yee NS. Locally Advanced Unresectable Pancreatic Cancer: American Society of Clinical Oncology Clinical Practice Guideline Summary. J Oncol Pract. 2017 Apr;13(4):265-269. doi: 10.1200/JOP.2016.017376. Epub 2016 Oct 31. No abstract available.
PMID: 28399382BACKGROUNDSohal DP, Mangu PB, Khorana AA, Shah MA, Philip PA, O'Reilly EM, Uronis HE, Ramanathan RK, Crane CH, Engebretson A, Ruggiero JT, Copur MS, Lau M, Urba S, Laheru D. Metastatic Pancreatic Cancer: American Society of Clinical Oncology Clinical Practice Guideline. J Clin Oncol. 2016 Aug 10;34(23):2784-96. doi: 10.1200/JCO.2016.67.1412. Epub 2016 May 31.
PMID: 27247222BACKGROUNDKhorana AA, Kuderer NM, Culakova E, Lyman GH, Francis CW. Development and validation of a predictive model for chemotherapy-associated thrombosis. Blood. 2008 May 15;111(10):4902-7. doi: 10.1182/blood-2007-10-116327. Epub 2008 Jan 23.
PMID: 18216292BACKGROUND
MeSH Terms
Conditions
Interventions
Condition Hierarchy (Ancestors)
Intervention Hierarchy (Ancestors)
Study Officials
- PRINCIPAL INVESTIGATOR
Conan Kinsey, MD
Huntsman Cancer Institute/ University of Utah
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
January 30, 2019
First Posted
January 31, 2019
Study Start
January 30, 2019
Primary Completion
January 15, 2025
Study Completion
August 3, 2025
Last Updated
May 14, 2026
Record last verified: 2026-05
Data Sharing
- IPD Sharing
- Will not share