Phase II study of GM-CSF secreting allogeneic pancreatic cancer vaccine (GVAX) with PD-1 blockade antibody and stereotactic body radiation therapy (SBRT) for locally advanced pancreas cancer (LAPC).

Authors

null

Valerie Lee

The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD

Valerie Lee , Christina Rodriguez , Ella-Mae Shupe , Linda Chen , Rose Parkinson , Jennifer N. Durham , Elizabeth Sugar , Cara Wilt , Keith R. McIntyre , Amy Hacker-Prietz , Matthew J. Weiss , Jin He , Christopher Lee Wolfgang , Ana De Jesus-Acosta , Dung T. Le , Joseph M. Herman , Daniel A. Laheru , Amol Narang , Elizabeth M. Jaffee , Lei Zheng

Organizations

The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD, Johns Hopkins University School of Medicine, Department of Radiation Oncology and Molecular Radiation Sciences, Baltimore, MD, Johns Hopkins School of Public Health, Department of Biostatistics, Baltimore, MD, Johns Hopkins University School of Medicine, Department of Surgery, Baltimore, MD

Research Funding

Pharmaceutical/Biotech Company

Background: Optimal treatment strategy beyond systemic chemotherapy for LAPC remains undefined. SBRT improves local control, but distant metastasis free survival (DMFS) is only 7.7 months. Checkpoint inhibitors are poor monotherapies in pancreas cancer, but may be primed by SBRT via absocopal effect and GVAX, which induces novel lymphoid infiltrates and increased effector T-cells in tumor microenvironment. Methods: This is a single-arm, single-institution, open-label study for pts with LAPC. Eligibility: surgically unresectable LAPC, predominant adenocarcinoma at diagnosis, with ECOG 0-1, who remain metastases free after 4-8 cycles of FOLFIRINOX or gemcitabine/abraxane based-chemotherapy. Exclusion: those off chemotherapy > 49 days prior to study treatment, prior immunotherapy, active immunosuppressive use, autoimmune disease, HIV, HBV, or HCV infection, and non-oncology vaccines within 28 days of study treatment. Pts receive cyclophosphamide (200mg/m2 IV) and pembrolizumab (200mg IV) on day 1, followed by GVAX (six intradermal injections) on day 2 every three weeks for two cycles, with cycle 2 initiating concurrently with five days of SBRT. If non-metastatic, pts undergo surgical resection, nano-knife, or EUS guided biopsy (if non-surgical). Pts receive two further cycles of chemotherapy, and if remain free of metastases, receive q3 week cyclophosphamide, pembrolizumab, and GVAX for six cycles, then are monitored for two years. The primary endpoint is DMFS. Secondary endpoints include overall survival, surgical resectability, pathologic response, quality of life, and toxicity. Exploratory objectives of peripheral antigen specific t-cell responses, and changes in immune parameters of tumor microenvironment. 11 of 54 pts have been enrolled since July 2016. Clinical trial information: NCT02648282

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2017 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Gastrointestinal (Noncolorectal) Cancer

Track

Gastrointestinal Cancer—Gastroesophageal, Pancreatic, and Hepatobiliary

Sub Track

Pancreatic Cancer

Clinical Trial Registration Number

NCT02648282

Citation

J Clin Oncol 35, 2017 (suppl; abstr TPS4154)

DOI

10.1200/JCO.2017.35.15_suppl.TPS4154

Abstract #

TPS4154

Poster Bd #

134b

Abstract Disclosures