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NCT02301143: LAPACT

Phase 2 Nab® -Paclitaxel (Abraxane®) Plus Gemcitabine in Subjects With Locally Advanced Pancreatic Cancer (LAPC)

Completed Phase 2 Results posted Last updated 20 March 2019
What this trial tests

Phase 2 trial testing nab-Paclitaxel in Pancreatic Neoplasms in 107 participants. Completed in 26 April 2018.

Timeline
21 April 2015
Primary endpoint
21 November 2017
26 April 2018

Quick facts

Lead sponsorCelgene
PhasePhase 2
StatusCompleted
Study typeINTERVENTIONAL
Allocationna
Designsingle group
Maskingnone
Primary purposetreatment
Enrollment107
Start date21 April 2015
Primary completion21 November 2017
Estimated completion26 April 2018
Sites42 locations across France, Italy, Canada, United States, Spain

Drugs / interventions tested

Conditions studied

Sponsor

Celgene — full company profile →

Who can join

18 and older, any sex, with Pancreatic Neoplasms. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Kaplan-Meier Estimates for Time to Treatment Failure (TTF) Primary · Day 1 of study treatment up to 28.75 months; (maximum time for the last tumor assessment)

TTF was defined as the time after the first dose of study therapy to discontinuation of study therapy due to disease progression, death by any cause, or the start of a new non-protocol-defined anticancer therapy/surgery. If a participant does not progress, die or start a new non-protocol-defined anticancer therapy, the participant was censored on the last tumor assessment date. Tumor evaluations of CT or MRI scans were assessed by the investigative sites and response determined according to Response Evaluation Criteria in Solid Tumors (RECIST) guidelines, version 1.1. The definition for prog

GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine9.07.26 – 10.05
Disease Control Rate (DCR): Percentage of Participants With Complete (CR) or Partial Response (PR), or Stable Disease (SD) for ≥ 16 Weeks According to RECIST Version 1.1 Secondary · Day 1 of study treatment up to the end of investigator choice period plus 28 days; up to 76.9 weeks

DCR was defined as the percentage of participants with a CR or PR or SD from of date of first treatment to 16 weeks. Tumor assessments after start of non-protocol-defined anticancer therapy were excluded. RECIST 1.1 Definition: * CR: disappearance of all target and non-target lesions; any pathological lymph nodes (target or non-target) must have reduction in short axis to \< 10 mm and no new lesions diagnosed. * PR: a \>= 30% decrease in the sum of diameters of target lesions from baseline; no evidence of progression in any of the non-target lesions diagnosed at baseline; and no new lesions

GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine77.670.3 – 83.5
Overall Response Rate (ORR): Percentage of Participants With Complete (CR) or Partial Response (PR) According to RECIST Version 1.1 Secondary · Day 1 of study treatment up to the end of investigator choice period plus 28 days; up to 76.9 weeks

ORR was defined as the percentage of participants that achieved a combined incidence of complete (CR) and partial response (PR) using RECIST 1.1 guidelines as assessed by the investigator. Assessments after new non-protocol-defined anticancer therapy are excluded. For participants who had resectable surgery in Investigator Choice period, assessments after surgical intervention are excluded. RECIST 1.1 Definition: * CR: disappearance of all target and non-target lesions; any pathological lymph nodes (target or non-target) must have reduction in short axis to \< 10 mm and no new lesions diagno

GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine39.331.8 – 47.2
Kaplan-Meier Estimate of Progression-Free Survival (PFS) Secondary · Day 1 of study treatment up to 28.75 months (maximum time for the last tumor assessment)

Progression-free Survival (PFS) was defined as the time from the date of the first dose to the date of disease progression or death (by any cause), whichever is earlier. The analysis day was calculated from enrollment date for one participant who was not treated. Participants who have no disease progression or have not died were censored to last tumor assessment date with progression-free. The definition for progressive disease (PD) was at least a 20% increase in the sum of diameters of target lesions from nadir; the sum must also demonstrate an absolute increase of \>= 5 mm; the progression

GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine10.99.26 – 11.63
Kaplan-Meier Estimates for Overall Survival (OS) Secondary · Day 1 of study treatment up to 31.34 months (maximum time for survival follow-up)

Overall survival was defined as the time from the date of first dose of study therapy to the date of death (by any cause). Participants who were alive at the end of study or clinical data cut were censored on the last known time that the participant was alive or the clinical cutoff date, whichever was earlier. Median and its 90% confidence interval of OS were estimated using the method of Brookmeyer and Crowley

GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine18.814.95 – 24.02
Participant Counts in Response Categories Using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30): Global Health Status and 5 Functioning Scales Secondary · Baseline (Day -1), Day 1 of each cycle, for up to 19 cycles each cycle consisting of 28 days and the 28-day follow-up visit

The European Organization for Research and Treatment of Cancer Quality-of-Life questionnaire (EORTC QLQ-C30) is a validated health-related quality of life (HRQoL) measure. The EORTC QLQ-C30 is composed of both multi-item scales and single-item measures, including 5 functional scales, 3 symptom scales, 6 single symptom items, and 1 global health status / quality of life scale. No item occurs in more than one scale. All reported measures are transformed to a 0 - 100 scale. In the Global Health Status and 5 functional scales, 0 = worst possible quality of life/health status and 100 = best possibl

Global Health Status: Improved
GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine43
Global Health Status: Stable
GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine34
Global Health Status: Worsened
GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine18
Physical Functioning Scale: Improved
GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine20
Physical Functioning Scale: Stable
GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine66
Physical Functioning Scale: Worsened
GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine9
Role Functioning Scale: Improved
GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine36
Role Functioning Scale: Stable
GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine46
Participant Counts in Response Categories Using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30): Symptom Scales and Single Symptom Items Secondary · Baseline (Day -1), Day 1 of each cycle, for up to 19 cycles each cycle consisting of 28 days and the 28-day follow-up visit

The European Organization for Research and Treatment of Cancer Quality-of-Life questionnaire (EORTC QLQ-C30) is a validated health-related quality of life (HRQoL) measure. The EORTC QLQ-C30 is composed of both multi-item scales and single-item measures, including 5 functional scales, 3 symptom scales, 6 single symptom items, and 1 global health status / quality of life scale. No item occurs in more than one scale. All reported measures are transformed to a 0 to 100 scale. In the symptom scales and single symptom items, 0 = optimal health state and 100 = worst possible health state. The best sc

Symptom Scale-Fatigue: Improved
GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine46
Symptom Scale-Fatigue: Stable
GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine24
Symptom Scale-Fatigue: Worsened
GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine25
Scale-Nausea+Vomiting: Improved
GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine29
Scale-Nausea+Vomiting: Stable
GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine64
Scale-Nausea+Vomiting: Worsened
GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine2
Symptom Scale-Pain: Improved
GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine62
Symptom Scale-Pain: Stable
GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine29
Participant Counts in Response Categories Using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire For Pancreatic Cancer (EORTC-QLQ PAN26): Six Summary Scales Secondary · Baseline (Day -1), Day 1 of each cycle, for up to 19 cycles each cycle consisting of 28 days and the 28-day follow-up visit

The EORTC pancreatic cancer module is a validated tool intended for patients at all disease stages undergoing surgical resection, palliative surgical intervention, endoscopic palliation or palliative chemotherapy. The module includes 26 questions, organized into 7 scales and 10 individual item scores. All reported measures are transformed to a 0 to 100 scale. Six summary scales reported are: - Pancreatic Pain - Digestive Symptoms - Altered Bowel Habits - Hepatic Scale - Body Image - Sexuality Scores of 0 = optimal health state and 100 = worst possible health state. The best score on treatment

Pancreatic Pain Scale: Improved
GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine62
Pancreatic Pain Scale: Stable
GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine33
Pancreatic Pain Scale: Worsened
GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine0
Digestive Symptom Scale: Improved
GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine49
Digestive Symptom Scale: Stable
GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine36
Digestive Symptom Scale: Worsened
GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine10
Altered Bowel Habits Scale: Improved
GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine28
Altered Bowel Habits Scale: Stable
GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine53
Participant Counts in Response Categories Using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire For Pancreatic Cancer (EORTC-QLQ PAN26): Satisfaction With Health Care Scale Secondary · Baseline (Day -1), Day 1 of each cycle, for up to 19 cycles each cycle consisting of 28 days and the 28-day follow-up visit

The EORTC pancreatic cancer module is a validated tool intended for patients at all disease stages undergoing surgical resection, palliative surgical intervention, endoscopic palliation or palliative chemotherapy. The module includes 26 questions, organized into 7 scales and 10 individual item scores. The summary scale for Satisfaction with Health Care is reported. All reported measures are transformed to a 0 to 100 scale. Scores of 0 = not satisfied, worst possible health state and 100 = extremely satisfied, best possible health state. The best score on treatment is the best score from all po

Satisfaction with Health Care Scale: Improved
GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine42
Satisfaction with Health Care Scale: Stable
GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine40
Satisfaction with Health Care Scale: Worsened
GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine13
Participant Counts in Response Categories Using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire For Pancreatic Cancer (EORTC-QLQ PAN26): 10 Individual Item Scores Secondary · Baseline (Day -1), Day 1 of each cycle, for up to 19 cycles each cycle consisting of 28 days and the 28-day follow-up visit

The EORTC pancreatic cancer module is a validated tool intended for patients at all disease stages undergoing surgical resection, palliative surgical intervention, endoscopic palliation or palliative chemotherapy. The module includes 26 questions, organized into 7 scales and 10 individual item scores. The 10 individual item scores are reported. All reported measures are transformed to a 0 to 100 scale. Scores of 0 = best possible health state and 100 = worst possible health state. The best score on treatment is the best score from all post-baseline visits and is compared to the baseline to get

Abdominal Bloating: Improved
GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine50
Abdominal Bloating: Stable
GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine42
Abdominal Bloating: Worsened
GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine3
Taste Changes: Improved
GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine20
Taste Changes: Stable
GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine54
Taste Changes: Worsened
GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine21
Indigestion: Improved
GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine41
Indigestion: Stable
GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine47
Participants With Treatment Emergent Adverse Events (TEAEs) Secondary · Day 1 of study drug up to end of the study; up to 31.3 months

TEAEs are defined as any adverse event (AE) that begin or worsen on or after the start of study drug or procedure of the study period through the maximum duration of the period plus 28 days. The severity of AEs was graded based on National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE), Version 4.0 and the scale: Grade 1 = Mild Grade 2 = Moderate Grade 3 = Severe Grade 4 = Life threatening Grade 5 = Death. Relation to study drug was determined by the investigator. A treatment-related TEAE is defined as TEAE which was considered to be related to one or both of the study

>= 1 TEAE
GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine (Induction Period)105
Nab-Paclitaxel Plus Gemcitabine (Overall)105
>=1 related TEAE
GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine (Induction Period)102
Nab-Paclitaxel Plus Gemcitabine (Overall)103
>=1 TEAE of severity grade 3 or higher
GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine (Induction Period)85
Nab-Paclitaxel Plus Gemcitabine (Overall)90
>=1 related TEAE of severity grade 3 or higher
GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine (Induction Period)72
Nab-Paclitaxel Plus Gemcitabine (Overall)75
>=1 serious TEAE
GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine (Induction Period)38
Nab-Paclitaxel Plus Gemcitabine (Overall)39
>= 1 related serious TEAE
GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine (Induction Period)14
Nab-Paclitaxel Plus Gemcitabine (Overall)14
>=1 TEAE leading to discontinuation of IP
GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine (Induction Period)25
Nab-Paclitaxel Plus Gemcitabine (Overall)28
>=1 related TEAE leading to discontinuation of IP
GroupValue95% CI
Nab-Paclitaxel Plus Gemcitabine (Induction Period)15
Nab-Paclitaxel Plus Gemcitabine (Overall)18

Adverse events — posted to ClinicalTrials.gov

Time frame: Day 1 of study drug up to end of the study; up to 31.3 months. Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Nab-Paclitaxel Plus Gemcitabine (Induction Period)
Serious: 38/106 (36%)
Deaths: 42/106
Nab-Paclitaxel Plus Gemcitabine (Overall)
Serious: 39/106 (37%)
Deaths: 67/106

Serious adverse events (44 terms)

ReactionSystemNab-Paclitaxel Plus Gemcit…Nab-Paclitaxel Plus Gemcit…
PyrexiaGeneral disorders
PneumoniaInfections and infestations
Febrile neutropeniaBlood and lymphatic system disorders
Atrial fibrillationCardiac disorders
Abdominal painGastrointestinal disorders
CellulitisInfections and infestations
Neutropenic sepsisInfections and infestations
SepsisInfections and infestations
Blood bilirubin increasedInvestigations
DehydrationMetabolism and nutrition disorders
PresyncopeNervous system disorders
Obstructive uropathyRenal and urinary disorders
Interstitial lung diseaseRespiratory, thoracic and mediastinal disorders
PneumonitisRespiratory, thoracic and mediastinal disorders
Pulmonary embolismRespiratory, thoracic and mediastinal disorders
HypotensionVascular disorders
Jugular vein thrombosisVascular disorders
NeutropeniaBlood and lymphatic system disorders
Acute coronary syndromeCardiac disorders
Cardiac arrestCardiac disorders
ConstipationGastrointestinal disorders
DiarrhoeaGastrointestinal disorders
Obstruction gastricGastrointestinal disorders
PancreatitisGastrointestinal disorders
VomitingGastrointestinal disorders
Other adverse events (62 terms — click to expand)

ReactionSystemNab-Paclitaxel Plus Gemcit…Nab-Paclitaxel Plus Gemcit…
AlopeciaSkin and subcutaneous tissue disorders
FatigueGeneral disorders
AnaemiaBlood and lymphatic system disorders
DiarrhoeaGastrointestinal disorders
NauseaGastrointestinal disorders
Oedema peripheralGeneral disorders
Decreased appetiteMetabolism and nutrition disorders
NeutropeniaBlood and lymphatic system disorders
PyrexiaGeneral disorders
AstheniaGeneral disorders
DysgeusiaNervous system disorders
ConstipationGastrointestinal disorders
VomitingGastrointestinal disorders
Peripheral sensory neuropathyNervous system disorders
ThrombocytopeniaBlood and lymphatic system disorders
Platelet count decreasedInvestigations
Neuropathy peripheralNervous system disorders
CoughRespiratory, thoracic and mediastinal disorders
Alanine aminotransferase increasedInvestigations
Neutrophil count decreasedInvestigations
StomatitisGastrointestinal disorders
Abdominal painGastrointestinal disorders
ChillsGeneral disorders
Aspartate aminotransferase increasedInvestigations
Back painMusculoskeletal and connective tissue disorders
HeadacheNervous system disorders
Blood alkaline phosphatase increasedInvestigations
AnxietyPsychiatric disorders
DyspnoeaRespiratory, thoracic and mediastinal disorders
White blood cell count decreasedInvestigations
HypokalaemiaMetabolism and nutrition disorders
Weight decreasedInvestigations
HyperglycaemiaMetabolism and nutrition disorders
MyalgiaMusculoskeletal and connective tissue disorders
DizzinessNervous system disorders
PruritusSkin and subcutaneous tissue disorders
DehydrationMetabolism and nutrition disorders
HypoalbuminaemiaMetabolism and nutrition disorders
ParaesthesiaNervous system disorders
InsomniaPsychiatric disorders

Most-reported serious reactions: Pyrexia, Pneumonia, Febrile neutropenia, Atrial fibrillation, Abdominal pain, Cellulitis, Neutropenic sepsis, Sepsis.

Data from ClinicalTrials.gov NCT02301143 adverse events section.

Sponsor's own description

This clinical study is in subjects who are 18 years old or older with locally advanced pancreatic cancer who have not received prior treatment for their pancreatic cancer. The study treats all subjects with nab-Paclitaxel plus gemcitabine for approximately 6 months of treatment. Subjects who complete the treatment will choose, with their treating physicians, what additional treatment should be given: more nab-Paclitaxel plus gemcitabine, Chemoradiation therapy, or surgery to treat the locally advanced pancreatic cancer.

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Nab-paclitaxel plus gemcitabine in patients with locally advanced pancreatic cancer (LAPACT): a multicentre, open-label phase 2 study.
    Philip PA, Lacy J, Portales F, Sobrero A, et al · · 2020 · cited 171× · PMID 31953079 · DOI 10.1016/s2468-1253(19)30327-9
  2. Pancreatic cancer: optimizing treatment options, new, and emerging targeted therapies.
    Chiorean EG, Coveler AL. · · 2015 · cited 133× · PMID 26185420 · DOI 10.2147/dddt.s60328
  3. Consensus, debate, and prospective on pancreatic cancer treatments.
    Wang J, Yang J, Narang A, He J, et al · · 2024 · cited 56× · PMID 39390609 · DOI 10.1186/s13045-024-01613-x
  4. Natural compounds-based nanomedicines for cancer treatment: Future directions and challenges.
    Andreani T, Cheng R, Elbadri K, Ferro C, et al · · 2024 · cited 38× · PMID 39003425 · DOI 10.1007/s13346-024-01649-z
  5. Tailor-Made Nanomaterials for Diagnosis and Therapy of Pancreatic Ductal Adenocarcinoma.
    Hu X, Xia F, Lee J, Li F, et al · · 2021 · cited 27× · PMID 33854877 · DOI 10.1002/advs.202002545
  6. <i>nab</i>-Paclitaxel for the treatment of pancreatic cancer.
    Kim G. · · 2017 · cited 24× · PMID 28356771 · DOI 10.2147/cmar.s127840
  7. Tumor Treating Fields (TTFields) Therapy Concomitant with Taxanes for Cancer Treatment.
    Vergote I, Macarulla T, Hirsch FR, Hagemann C, et al · · 2023 · cited 11× · PMID 36765594 · DOI 10.3390/cancers15030636
  8. Nanovectors for anti-cancer drug delivery in the treatment of advanced pancreatic adenocarcinoma.
    Hsueh CT, Selim JH, Tsai JY, Hsueh CT. · · 2016 · cited 9× · PMID 27610018 · DOI 10.3748/wjg.v22.i31.7080

Verify or expand the search:

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Drug Landscape aggregates and links these public records for informational use only. Always verify against the primary source before clinical or regulatory decisions. Canonical URL: https://druglandscape.com/trial/NCT02301143.

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