Chemotherapy + Anakinra in Patients With Pancreatic Adenocarcinoma (PDAC)

NCT ID: NCT04926467

Last Updated: 2025-11-10

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

PHASE2

Total Enrollment

24 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-07-23

Study Completion Date

2027-06-30

Brief Summary

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Based on a central role of inflammation in pancreas cancer, the role of IL 1 in acute and chronic inflammation , the inhibitory effect of IL 1 alfa and beta by anakinra and preliminary experience with anakinra in combination with chemotherapy in metastasis (with FOLFIRINOX) and localized disease (with gemcitabine/abraxane/cisplatin), a phase 2 study with anakinra in combination with perioperative chemotherapy for patients with PDAC is being proposed.

Detailed Description

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This is an open-label, single-arm, prospective phase II study conducted by Baylor Scott and White Research Institute in Dallas.

The study will enroll patients with pancreatic adenocarcinoma that are planned to receive pre-operative chemotherapy followed by surgical resection and post operative treatment. Local surgical/biopsy and pathology reports will constitute adequate documentation of histology/cytology for study inclusion.

Patients will receive pre- and post-operative chemotherapy plus Anakinra. Specifically, the pre-operative chemotherapy regimen will be a combination of Nab-paclitaxel, gemcitabine and cisplatin, while post-operative chemotherapy will use 5-Fluorouracil, oxaliplatin, and irinotecan. Patients will also receive growth factor (Neupogen followed by Neulasta) for safety and to ensure that treatment is not delayed due to neutropenic effects of chemotherapy.

Anakinra will be self-administered by the participants through out the treatment period. A treatment break of 2 days will be given prior to the surgery day.

Conditions

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Pancreatic Adenocarcinoma

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Anakinra plus Chemotherapy

Patients will receive Anakinra during both pre-operative chemotherapy with Nab-paclitaxel, gemcitabine and cisplatin, followed by surgery and post-operative chemotherapy with 5-fluorouracil, oxaliplatin, and irinotecan.

Group Type EXPERIMENTAL

Anakinra

Intervention Type DRUG

Anakinra (100 mg) twice a day (BID), daily, will be self-administered subcutaneously starting on D1 of chemotherapy. Anakinra will be held 2 days prior to surgery. A dosing diary will be given to the patient for anakinra documentation.

Interventions

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Anakinra

Anakinra (100 mg) twice a day (BID), daily, will be self-administered subcutaneously starting on D1 of chemotherapy. Anakinra will be held 2 days prior to surgery. A dosing diary will be given to the patient for anakinra documentation.

Intervention Type DRUG

Other Intervention Names

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Kineret

Eligibility Criteria

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Inclusion Criteria

* A patient will be eligible for inclusion in this study if he or she meets all of the following criteria:

1. 18 years of age or older
2. Histologically or Cytologically confirmed pancreatic ductal adenocarcinoma. Mixed subtypes of adenocarcinoma are acceptable as long as majority of cells are ductal adenocarcinoma.
3. Resectable, locally advanced or potentially resectable pancreatic adenocarcinoma
4. American Joint Committee on Cancer (AJCC) Stage I-III Pancreatic carcinoma.
5. Patient has Eastern Cooperative Oncology Group( ECOG ) Performance Status 0 to 1
6. Serum albumin ≥2.0 g/dL.
7. Adequate hematologic function as defined by:

1. Absolute neutrophil count (ANC) ≥1500/mm3;
2. Platelets ≥70,000 x 10\^3/µl;
3. Hemoglobin ≥9 g/dL (in the absence of red blood transfusion).
8. Adequate liver function, as defined by:

1. Serum total bilirubin ≤2 x ULN mg/dL, prior to initiation of treatment.
2. ALT (SGPT) and AST (SGOT) ≤2.5 x upper limit of normal (ULN).
9. Adequate renal function, as defined by serum creatinine≤ 1.5 x ULN, or creatinine clearance ≥50 mL/min
10. Women of child bearing potential and men must agree to use contraception throughout the study and for one month after the last anakinra administration.
11. Subjects must understand and sign the informed consent form
12. Patients must be accessible for treatment and follow-up.

Exclusion Criteria

* A patient will be ineligible for inclusion in this study if he or she meets any of the following criteria:

1. \<18 years of age
2. History of organ transplant.
3. Patients with islet cell neoplasms
4. Patients with stage IV pancreatic carcinoma
5. Active, uncontrolled bacterial, viral, or fungal infection(s) requiring systemic therapy
6. Known active infection with hepatitis B or hepatitis C
7. Presence of clinically significant cirrhosis as determined by the investigator
8. Known HIV positive status.
9. Current, active immunosuppressive therapy such as cyclosporine, tacrolimus, etc.
10. Major surgery or vascular device placement within 2 weeks prior to Day 1 of treatment in study
11. Prior chemotherapy or radiation for pancreatic cancer
12. History of allergy or hypersensitivity to the study drugs
13. Patient is enrolled in any outside therapeutic clinical protocol or investigational trial with an investigational drug within 5 half-lives prior to Study ID assignment
14. Previous or current treatment with anakinra, canakinumab or any other IL-1 inhibitor
15. Other malignancy within five years(except cutaneous, non-melanoma malignancies or cervical carcinoma in site), unless the probability of recurrence of the prior malignancy is \<5% as determined by the Principal Investigator based on available information.
16. Significant cardiac disease (uncontrolled congestive heart failure (CHF), myocardial infarction or significant ventricular arrhythmias) within the last six months.
17. Other severe and/or uncontrolled medical conditions (e.g: prior gastrointestinal (GI) disease or history of prior pelvic or abdominal radiation) or other conditions deemed by investigator as unsuitable for participation/enrollment
18. Peripheral sensory neuropathy \> or equal to grade 2 at baseline
19. Abnormal liver function tests as follows:

1. Total bilirubin of \> 2 x ULN
2. AST or ALT \> 5x ULN
20. Serum albumin ˂ 2.0 g/dL.
21. Abnormal hematologic function as follows :

1. Absolute neutrophil count (ANC) ˂ 1500/mm3;
2. Platelets ˂ 70,000 x 10\^3/µl;
3. Hemoglobin ˂ 9 g/dL (in the absence of red blood transfusion).
22. Pregnant or nursing women
23. No signed Informed consent form
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Baylor Research Institute

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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A. Scott Paulson, MD

Role: PRINCIPAL_INVESTIGATOR

Charles A. Sammons Cancer Center/Texas Oncology

Locations

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Baylor University Medical Center, Charles A Sammons Cancer Center

Dallas, Texas, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Page Blas, MA

Role: CONTACT

Phone: (214) 818-7879

Email: [email protected]

Joyce Ghormley

Role: CONTACT

Phone: (214) 818-8961

Email: [email protected]

Facility Contacts

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Solid Tumor Team

Role: primary

Other Identifiers

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020-476

Identifier Type: -

Identifier Source: org_study_id