Ivosidenib Plus Durvalumab and Gemcitabine/Cisplatin as First-Line Therapy in Participants With Locally Advanced or Metastatic Cholangiocarcinoma With an IDH1 Mutation

NCT ID: NCT06501625

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

PHASE1/PHASE2

Total Enrollment

52 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-12-16

Study Completion Date

2027-09-13

Brief Summary

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The objective of this study is to investigate the safety, tolerability and preliminary activity of ivosidenib in combination with durvalumab and gemcitabine/cisplatin as first-line therapy in participants with locally advanced, unresectable or metastatic cholangiocarcinoma with an IDH1 mutation. The study will begin with a safety lead-in phase (Phase 1b study) to determine the recommended combination dose (RDC) and then will transition to an expansion phase (Phase 2 study) to assess the clinical activity of ivosidenib in combination with durvalumab and gemcitabine/cisplatin at the RCD. During the treatment period participants will have study visits on days 1, 8, and 15 of Cycle 1, on days 1 and 8 of Cycle 2 to 8, and on day 1 of each additional cycle. Cycles 1 through 8 are 21 day cycles, and each following cycle is 28 days. Approximately 30 days and 90 days after treatment has ended, safety follow-up visits will occur and then participants will be followed for survival every 3 months. Study visits may include blood tests, ECG, vital signs, and a physical examination.

Detailed Description

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Conditions

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Locally Advanced, Unresectable or Metastatic Cholangiocarcinoma With an IDH1 Mutation

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SEQUENTIAL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Safety Lead-In Phase

Group Type EXPERIMENTAL

Ivosidenib

Intervention Type DRUG

Two 250 mg tablets, totaling 500 mg, administered orally once daily, taken continuously throughout treatment duration

Durvalumab (for the first 8, 21-day, cycles)

Intervention Type DRUG

1500mg intravenous (IV) infusion every 3 weeks, for a maximum of 8 (21-day) cycles

Gemcitabine (for the first 8, 21-day, cycles)

Intervention Type DRUG

1000 mg/m2 IV infusion on days 1 and 8 of every 21-day cycle, for a maximum of 8 cycles

Cisplatin (for the first 8, 21-day, cycles)

Intervention Type DRUG

25 mg/m\^2 IV infusion on days 1 and 8 of every 21-day cycle, for a maximum of 8 cycles

Durvalumab (starting from cycle 9)

Intervention Type DRUG

1500mg intravenous (IV) infusion every 4 weeks, starting from cycle 9. Cycles are 28 days long, starting Cycle 9.

Expansion Phase

Group Type EXPERIMENTAL

Durvalumab (for the first 8, 21-day, cycles)

Intervention Type DRUG

1500mg intravenous (IV) infusion every 3 weeks, for a maximum of 8 (21-day) cycles

Gemcitabine (for the first 8, 21-day, cycles)

Intervention Type DRUG

1000 mg/m2 IV infusion on days 1 and 8 of every 21-day cycle, for a maximum of 8 cycles

Cisplatin (for the first 8, 21-day, cycles)

Intervention Type DRUG

25 mg/m\^2 IV infusion on days 1 and 8 of every 21-day cycle, for a maximum of 8 cycles

Durvalumab (starting from cycle 9)

Intervention Type DRUG

1500mg intravenous (IV) infusion every 4 weeks, starting from cycle 9. Cycles are 28 days long, starting Cycle 9.

Ivosidenib Recommended Combination Dose (RCD)

Intervention Type DRUG

RCD administered orally once daily, taken continuously throughout treatment duration

Interventions

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Ivosidenib

Two 250 mg tablets, totaling 500 mg, administered orally once daily, taken continuously throughout treatment duration

Intervention Type DRUG

Durvalumab (for the first 8, 21-day, cycles)

1500mg intravenous (IV) infusion every 3 weeks, for a maximum of 8 (21-day) cycles

Intervention Type DRUG

Gemcitabine (for the first 8, 21-day, cycles)

1000 mg/m2 IV infusion on days 1 and 8 of every 21-day cycle, for a maximum of 8 cycles

Intervention Type DRUG

Cisplatin (for the first 8, 21-day, cycles)

25 mg/m\^2 IV infusion on days 1 and 8 of every 21-day cycle, for a maximum of 8 cycles

Intervention Type DRUG

Durvalumab (starting from cycle 9)

1500mg intravenous (IV) infusion every 4 weeks, starting from cycle 9. Cycles are 28 days long, starting Cycle 9.

Intervention Type DRUG

Ivosidenib Recommended Combination Dose (RCD)

RCD administered orally once daily, taken continuously throughout treatment duration

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Have a histopathological confirmed diagnosis consistent with locally advanced unresectable or metastatic cholangiocarcinoma.
* Have documented IDH1 gene-mutated cholangiocarcinoma based on local or central laboratory testing (R132C/L/G/H/S mutation variants tested).
* Have at least one evaluable and measurable lesion as defined by RECIST v1.1.
* Have adequate bone marrow function as evidenced by:
* Absolute neutrophil count ≥ 1,500/mm3 or 1.5 ×109/L
* Hemoglobin ≥ 9 g/dL
* Platelet count ≥ 100,000/mm3 or 100 × 109/L
* Have adequate hepatic function as evidenced by:
* Serum bilirubin ≤ 2.0 × the upper limit of normal (ULN); this will not apply to patients with confirmed Gilbert's syndrome. Any clinically significant biliary obstruction should be resolved before randomization
* Aspartate aminotransferase (AST), and alanine aminotransferase (ALT) ≤ 2.5 × ULN; for patients with hepatic metastases, ALT and AST ≤ 5.0 × ULN
* Have adequate renal function, defined as: creatinine clearance \> 60 mL/min per 24 hour urine or as calculated on the Cockcroft-Gault formula (using actual body weight):

Creatine CL (mL/min)= (140 - Age) × (weight in kg) × (0.85 if female)/72 × serum creatinine (mg/dL)

* Patients with Grade ≥2 neuropathy to be evaluated on a case-by-case basis after consultation with the medical monitor
* Patients with irreversible toxicity not reasonably expected to be exacerbated by treatment with ivosidenib may be included only after consultation with the medical monitor
* Participation in another interventional study at the same time or within 14 days prior to the first study medication (triple combination treatment) administration. For patients having participated to another prior interventional study, the first dose of ivosidenib should occur after a period greater than or equal to 5 half-lives or 28 days, whichever is shorter of the last dose of the prior investigational product.
* Active or prior documented autoimmune or inflammatory disorders including:
* inflammatory bowel disease (e.g., colitis or Crohn's disease)
* diverticulitis (with the exception of diverticulosis)
* systemic lupus erythematosus
* Sarcoidosis syndrome
* Wegener syndrome (granulomatosis with polyangiitis, Graves' disease, rheumatoid arthritis, hypophysitis, uveitis, etc.)

Note: in cases with no active disease for ≥ 5 years, patients may be considered for inclusion if approved by the Medical Monitor. Participants with the following conditions are eligible for the study:

* chronic skin condition that does not require systemic therapy
* vitiligo
* alopecia
* hypothyroidism (e.g., following Hashimoto syndrome) stable on hormone replacement therapy
* unmedicated celiac disease that is controlled by diet
* Have heart rate-corrected QT interval using Fridericia's formula (QTcF) of ≥ 450 msec or with other factors that increase the risk of QT prolongation or arrhythmic events (e.g., heart failure, hypokalemia, family history of long QT interval syndrome/sudden death, polymorphic ventricular arrhythmia). The Sponsor should review participants with bundle branch block and prolonged QTcF for potential inclusion.
* Have an active infection, including:
* Hepatitis B (clinical evaluation includes: presence of hepatitis B surface antigen \[HBsAg\] and/or anti-HBcAb with detectable hepatitis B virus \[HBV\] DNA ≥ 10 IU/mL)
* Hepatitis C
* Tuberculosis (clinical evaluation includes: clinical history, physical examination and/or radiographic findings, and tuberculosis testing as per local practice)
* Human immunodeficiency virus (clinical evaluation includes: positive HIV 1/2 antibodies) Note: Patients with a resolved or past HBV infection (i.e., presence of hepatitis B core antibody \[anti-HBc\] and absence of HBsAg) do not need to be excluded from the study. Patients positive for hepatitis C (HCV) antibody are eligible only if the polymerase chain reaction is negative for HCV RNA.

Exclusion Criteria

* Received treatment for locally advanced, unresectable or metastatic disease with the following exceptions:
* Treatment with up to one cycle of durvalumab plus gemcitabine/cisplatin treatment is permitted before study participation. Note: For the Safety Lead-In Phase, participants who received one prior cycle of durvalumab plus gemcitabine/cisplatin and required dose modifications for treatment-related toxicity are excluded.
* Patients who developed recurrent disease \> 6 months after surgery with curative intent, and, if given, \> 6 months after the completion of adjuvant (chemotherapy and/or radiation).
* Prior exposure to immune-mediated therapy, including, but not limited to, anti-PD-1or other anti-PD-L1, and anti-PD-L2, anti-CTLA-4 antibodies, excluding therapeutic anticancer vaccines.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Institut de Recherches Internationales Servier

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Usc Norris Comprehensive Cancer Center

Los Angeles, California, United States

Site Status RECRUITING

Northwestern Medicine

Chicago, Illinois, United States

Site Status RECRUITING

Memorial Sloan Kettering Cancer Center

New York, New York, United States

Site Status RECRUITING

Duke University

Durham, North Carolina, United States

Site Status RECRUITING

Gibbs Cancer Center

Spartanburg, South Carolina, United States

Site Status NOT_YET_RECRUITING

The University of Texas Md Anderson Cancer Center

Houston, Texas, United States

Site Status RECRUITING

Alfred Health

Melbourne, , Australia

Site Status NOT_YET_RECRUITING

Hospital de Amor - Barretos

Barretos, , Brazil

Site Status RECRUITING

Oncoclinicas Mg

Belo Horizonte, , Brazil

Site Status NOT_YET_RECRUITING

CIONC

Curitiba, , Brazil

Site Status NOT_YET_RECRUITING

Instituto Dor de Pesquisa E Ensino Sp

São Paulo, , Brazil

Site Status NOT_YET_RECRUITING

Princess Margaret Cancer Centre

Toronto, , Canada

Site Status RECRUITING

Institut Bergonie

Bordeaux, , France

Site Status RECRUITING

Hôpital Beaujon

Clichy, , France

Site Status RECRUITING

Chu Montpellier-Hopital Saint-Eloi

Montpellier, , France

Site Status RECRUITING

Charite Universitatsmedizin

Berlin, , Germany

Site Status RECRUITING

Universitätsklinikum Düsseldorf

Düsseldorf, , Germany

Site Status RECRUITING

Universitären Centrums Für Tumorerkrankungen (Uct) Der J.W. Goethe-Universität Frankfurt

Frankfurt, , Germany

Site Status RECRUITING

Medizinische Hochschule Hannover Oe 6810

Hanover, , Germany

Site Status NOT_YET_RECRUITING

Universitätsklinikum Ulm

Ulm, , Germany

Site Status NOT_YET_RECRUITING

National Cancer Center Hospital East

Kashiwa, Chiba, Japan

Site Status RECRUITING

National Cancer Center Hospital

Chūōku, , Japan

Site Status RECRUITING

Kyoto University Hospital

Kyoto, , Japan

Site Status RECRUITING

Kanagawa Cancer Center

Yokohama, , Japan

Site Status RECRUITING

Cha Bundang Medical Center

Seongnam, , South Korea

Site Status RECRUITING

Seoul National University Bundang Hospital

Seongnam, , South Korea

Site Status RECRUITING

Seoul National University Hospital

Seoul, , South Korea

Site Status RECRUITING

Severance

Seoul, , South Korea

Site Status RECRUITING

Seoul St. Mary'S Hospital

Seoul, , South Korea

Site Status RECRUITING

H. Valle de Hebron

Barcelona, , Spain

Site Status RECRUITING

Hospital Universitario Gregorio Marañón

Madrid, , Spain

Site Status RECRUITING

H. 12 de Octubre

Madrid, , Spain

Site Status RECRUITING

Hospital Universitario Fundación Jiménez Díaz

Madrid, , Spain

Site Status NOT_YET_RECRUITING

Countries

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United States Australia Brazil Canada France Germany Japan South Korea Spain

Central Contacts

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Institut de Recherches Internationales Servier (I.R.I.S.) Clinical Studies Department

Role: CONTACT

Phone: +33 1 55 72 60 00

Email: [email protected]

Other Identifiers

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2024-514261-19-00

Identifier Type: CTIS

Identifier Source: secondary_id

S095031-210

Identifier Type: -

Identifier Source: org_study_id