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NCT02558894

Phase II Study of MEDI4736 Monotherapy or in Combinations With Tremelimumab in Metastatic Pancreatic Ductal Carcinoma

Completed Phase 2 Results posted Last updated 2 August 2018
What this trial tests

Phase 2 trial testing MEDI4736 monotherapy in Metastatic Pancreatic Ductal Adenocarcinoma in 65 participants. Completed in 15 June 2017.

Timeline
16 November 2015
Primary endpoint
15 June 2017
15 June 2017

Quick facts

Lead sponsorAstraZeneca
PhasePhase 2
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingnone
Primary purposetreatment
Enrollment65
Start date16 November 2015
Primary completion15 June 2017
Estimated completion15 June 2017
Sites21 locations across Netherlands, Germany, South Korea, Canada, United States, Spain

Drugs / interventions tested

Conditions studied

Sponsor

AstraZeneca — full company profile →

Who can join

18 and older, any sex, with Metastatic Pancreatic Ductal Adenocarcinoma. 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.

Objective Response Rate (ORR) in All Patients Using Investigator Assessments According to Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) Primary · From date of first infusion until confirmed disease progression or death (up to approximately 18 months for the data analysis cut-off)

ORR was defined as the percentage of patients with at least one visit response of confirmed complete response (CR) or partial response (PR). CR was defined as disappearance of all target lesions (TLs) since baseline. Any pathological lymph nodes selected as TLs must have had reduction in short axis to \<10 millimeters (mm). PR was defined as at least a 30% decrease in the sum of diameters of TLs, taking as reference the baseline sum of diameters. A confirmed response meant that a response of CR/PR was recorded at 1 visit and confirmed by repeat imaging, preferably at the next regularly schedul

Confirmed responses only
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab3.10.08 – 16.22
Durvalumab (MEDI4736) Monotherapy00 – 10.58
Confirmed and unconfirmed responses
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab3.10.08 – 16.22
Durvalumab (MEDI4736) Monotherapy6.10.74 – 20.23
Progression-free Survival (PFS) Using Investigator Assessments According to RECIST 1.1 Secondary · From date of first infusion until confirmed disease progression or death (up to approximately 18 months for the data analysis cut-off)

PFS was defined as the time from the date of randomisation until the date of objective disease progression or death (by any cause in the absence of progression) regardless of whether the patient had withdrawn from randomised therapy or had received another anti-cancer therapy prior to progression. Results are reported as median time from randomisation to PFS, calculated using the Kaplan-Meier technique.

GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab1.51.2 – 1.5
Durvalumab (MEDI4736) Monotherapy1.51.3 – 1.5
PFS Rate at 3 Months and at 6 Months Secondary · From date of first infusion until confirmed disease progression or death (up to 3 months and 6 months)

PFS was defined as the time from the date of randomisation until the date of objective disease progression or death (by any cause in the absence of progression) regardless of whether the patient had withdrawn from randomised therapy or had received another anti-cancer therapy prior to progression. PFS rates were calculated using Kaplan-Meier estimates of the cumulative probability of PFS. The PFS rate at 3 months and 6 months was equivalent to the percentage of patients with PFS after 3 months and 6 months, respectively.

PFS rate at 3 months
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab9.42.4 – 22.3
Durvalumab (MEDI4736) Monotherapy10.93.0 – 24.7
PFS rate at 6 months
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab9.42.4 – 22.3
Durvalumab (MEDI4736) Monotherapy3.60.3 – 15.4
Overall Survival (OS) Secondary · From date of first infusion until death (up to approximately 18 months for the data analysis cut-off)

OS was defined as the time from the date of randomisation until death due to any cause. Results are reported as median OS, calculated using the Kaplan-Meier technique.

GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab3.12.2 – 6.1
Durvalumab (MEDI4736) Monotherapy3.62.7 – 6.1
Survival Status, Presented as OS Rate, at 6 Months and at 12 Months Secondary · From date of first infusion until death (up to 6 months and 12 months)

OS was defined as the time from the date of randomisation until death due to any cause. OS rates were calculated using Kaplan-Meier estimates of the cumulative probability of survival at each indicated time period. The OS rate at 6 months and 12 months was equivalent to the percentage of patients with OS after 6 months and 12 months, respectively.

Survival rate at 6 months
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab36.220.0 – 52.7
Durvalumab (MEDI4736) Monotherapy34.919.2 – 51.1
Survival rate at 12 months
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab8.81.8 – 22.8
Durvalumab (MEDI4736) Monotherapy6.31.1 – 18.4
Best Objective Response (BoR) Using Investigator Assessments According to RECIST 1.1 Secondary · From date of first infusion until confirmed disease progression or death (up to approximately 18 months for the data analysis cut-off)

BoR was calculated based on the overall visit responses from each RECIST assessment. It was the best response a patient had following date of first dosing but prior to starting any subsequent cancer therapy and prior to RECIST progression or last evaluable assessment in absence of RECIST progression. Categorisation of BoR was based on RECIST using the following response categories: CR and PR for status of 'Response'; Stable Disease (SD) ≥6 weeks, Progressive Disease (PD) and Not Evaluable (NE) for status of 'Non-response'. SD was defined as neither sufficient shrinkage to qualify for PR nor su

Response: Total
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab1
Durvalumab (MEDI4736) Monotherapy0
Response: CR
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab0
Durvalumab (MEDI4736) Monotherapy0
Response: PR
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab1
Durvalumab (MEDI4736) Monotherapy0
Non-response: Total
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab31
Durvalumab (MEDI4736) Monotherapy33
Non-response: Stable disease ≥6 weeks
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab5
Durvalumab (MEDI4736) Monotherapy7
Non-response: Progression of disease
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab26
Durvalumab (MEDI4736) Monotherapy25
Non-response: Not evaluable
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab0
Durvalumab (MEDI4736) Monotherapy1
Disease Control Rate (DCR) Using Investigator Assessments According to RECIST 1.1 Secondary · From date of first infusion until confirmed disease progression or death (up to 3 months, 6 months and 12 months)

DCR at 3 months was defined as the percentage of patients who have a BoR of CR or PR in the first 3 months or who have demonstrated SD for a minimum interval of 13 weeks following the start of treatment. DCR at 6 months was defined as the percentage of patients who have a BoR of CR or PR in the first 6 months or who have demonstrated SD for a minimum interval of 26 weeks following the start of treatment. DCR at 12 months was defined as the percentage of patients who have a BoR of CR or PR in the first 12 months or who have demonstrated SD for a minimum interval of 52 weeks following the start

At 3 months
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab9.41.98 – 25.02
Durvalumab (MEDI4736) Monotherapy6.10.74 – 20.23
At 6 months
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab6.30.77 – 20.81
Durvalumab (MEDI4736) Monotherapy00.00 – 10.58
At 12 months
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab3.10.08 – 16.22
Durvalumab (MEDI4736) Monotherapy00.00 – 10.58
Pharmacokinetics (PK) of Durvalumab (MEDI4736) Secondary · Blood samples were collected pre-dose on Day 1 (Week 0), Week 4, Week 12 and Week 24, post-dose on Day 1, Week 12 and Week 24, and additionally at 3 months after the last dose (follow-up).

To evaluate PK, blood samples were collected pre- and post-dose and durvalumab (MEDI4736) concentrations in serum were determined. On Day 1 of Cycles 1, 4 and 7 (Weeks 0, 12 and 24), PK samples were collected pre-dose (within 60 minutes prior to treatment with any IP) and post-dose at the end of infusion (within 10 minutes of end of infusion of durvalumab and within 10 minutes of end of infusion of tremelimumab \[for patients receiving durvalumab plus tremelimumab\]). On Day 1 of Cycle 2 (Week 4), PK samples were collected pre-dose (within 60 minutes prior to treatment with any IP) only. The 3

Cycle 1, Day 1, pre-infusion (Day 1)
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab217.338± 345.4913
Cycle 1, Day 1, post-infusion (Day 1)
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab566.078± 151.4199
Durvalumab (MEDI4736) Monotherapy562.218± 152.3811
Cycle 2, Day 1, pre-infusion (Day 29)
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab100.417± 39.7229
Durvalumab (MEDI4736) Monotherapy98.668± 36.5072
Cycle 4, Day 1, pre-infusion (Day 85)
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab236.205± 98.8964
Durvalumab (MEDI4736) Monotherapy228.450± 36.8395
Cycle 4, Day 1, post-infusion (Day 85)
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab825.818± 322.8247
Durvalumab (MEDI4736) Monotherapy760.456± 100.6974
Cycle 7, Day 1, pre-infusion (Day 169)
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab166.736± 47.3872
Durvalumab (MEDI4736) Monotherapy152.706± NA
Cycle 7, Day 1, post-infusion (Day169)
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab918.270± 98.4286
Durvalumab (MEDI4736) Monotherapy825.578± NA
3-month follow-up
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab38.456± NA
Durvalumab (MEDI4736) Monotherapy19.684± 20.2664
PK of Tremelimumab Secondary · Blood samples were collected pre-dose on Day 1 (Week 0), Week 4 and Week 12, post-dose on Day 1 and Week 12, and additionally at 3 months after the last dose (follow-up).

To evaluate PK, blood samples were collected pre- and post-dose and tremelimumab concentrations in serum were determined. On Day 1 of Cycles 1 and 4 (Weeks 0 and 12), PK samples were collected pre-dose (within 60 minutes prior to treatment with any IP) and post-dose at the end of infusion (within 10 minutes of end of infusion of tremelimumab). On Day 1 of Cycle 2 (Week 4), PK samples were collected pre-dose (within 60 minutes prior to treatment with any IP) only. The 3-month follow-up sample for tremelimumab was relative to the respective last dose. Results are reported as mean pre- or post-do

Cycle 1, Day 1, pre-infusion (Day 1)
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab13.114± 11.7182
Cycle 1, Day 1, post-infusion (Day 1)
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab24.477± 6.3516
Cycle 2, Day 1, pre-infusion (Day 29)
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab4.880± 2.2623
Cycle 4, Day 1, pre-infusion (Day 85)
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab8.753± 4.9962
Cycle 4, Day 1, post-infusion (Day 85)
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab21.150± 5.8997
Presence of Antidrug Antibodies (ADAs) for Durvalumab (MEDI4736) Secondary · Immunogenicity samples were collected on Day 1 (Week 0), Week 4, Week 12 and Week 24, and additionally at 3 months and 6 months after the last dose (follow-up).

ADA prevalence was the proportion of the ADA evaluable set who had an ADA positive result at any point in time, baseline or post-baseline. ADA incidence (treatment-emergent ADA) was the sum of both treatment-induced (post-baseline ADA positive only) and treatment-boosted ADA positive patients as a proportion of the evaluable patient population. Treatment-boosted ADA was defined as baseline positive ADA titre boosted to a 4-fold or higher level following IP administration. Persistently positive was defined as positive at ≥2 post-baseline assessments (with ≥16 weeks between first and last positi

ADA prevalence
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab1
Durvalumab (MEDI4736) Monotherapy5
ADA incidence
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab0
Durvalumab (MEDI4736) Monotherapy3
ADA pos post-baseline and pos at baseline
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab0
Durvalumab (MEDI4736) Monotherapy0
ADA pos post-baseline and not detected at baseline
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab0
Durvalumab (MEDI4736) Monotherapy3
ADA not detected post-baseline and pos at baseline
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab1
Durvalumab (MEDI4736) Monotherapy2
Treatment-boosted ADA
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab0
Durvalumab (MEDI4736) Monotherapy0
Persistent positive
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab0
Durvalumab (MEDI4736) Monotherapy3
Transient positive
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab0
Durvalumab (MEDI4736) Monotherapy0
Presence of ADAs for Tremelimumab Secondary · Immunogenicity samples were collected on Day 1 (Week 0), Week 4 and Week 12, and additionally at 3 months and 6 months after the last dose (follow-up).

ADA prevalence was the proportion of the ADA evaluable set who had an ADA positive result at any point in time, baseline or post-baseline. ADA incidence (treatment-emergent ADA) was the sum of both treatment-induced (post-baseline ADA positive only) and treatment-boosted ADA positive patients as a proportion of the evaluable patient population. Treatment-boosted ADA was defined as baseline positive ADA titre boosted to a 4-fold or higher level following IP administration. Persistently positive was defined as positive at ≥2 post-baseline assessments (with ≥16 weeks between first and last positi

ADA prevalence
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab2
ADA incidence
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab0
ADA pos post-baseline and pos at baseline
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab1
ADA pos post-baseline and not detected at baseline
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab0
ADA not detected post-baseline and pos at baseline
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab1
Treatment-boosted ADA
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab0
Persistent positive
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab0
Transient positive
GroupValue95% CI
Durvalumab (MEDI4736) Plus Tremelimumab1

Adverse events — posted to ClinicalTrials.gov

Time frame: Treatment-emergent adverse event (TEAE) data is reported for the treatment period (up to 12 months) + follow-up (up to 90 days). Overall timeframe: up to approximately 15 months.. Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Durvalumab (MEDI4736) Plus Tremelimumab
Serious: 11/32 (34%)
Deaths: 19/32
Durvalumab (MEDI4736) Monotherapy
Serious: 9/32 (28%)
Deaths: 16/32

Serious adverse events (25 terms)

ReactionSystemDurvalumab (MEDI4736) Plus…Durvalumab (MEDI4736) Mono…
DiarrhoeaGastrointestinal disorders
AscitesGastrointestinal disorders
PyrexiaGeneral disorders
CholangitisHepatobiliary disorders
Acute kidney injuryRenal and urinary disorders
Abdominal distensionGastrointestinal disorders
Gastrointestinal haemorrhageGastrointestinal disorders
HaematemesisGastrointestinal disorders
HaematocheziaGastrointestinal disorders
Intestinal obstructionGastrointestinal disorders
Large intestine perforationGastrointestinal disorders
VomitingGastrointestinal disorders
AstheniaGeneral disorders
FatigueGeneral disorders
Autoimmune hepatitisHepatobiliary disorders
BacteraemiaInfections and infestations
Enterococcal sepsisInfections and infestations
InfectionInfections and infestations
SepsisInfections and infestations
Muscular weaknessMusculoskeletal and connective tissue disorders
MyositisMusculoskeletal and connective tissue disorders
Rheumatoid arthritisMusculoskeletal and connective tissue disorders
Endometrial cancerNeoplasms benign, malignant and unspecified (incl cysts and polyps)
Pulmonary embolismRespiratory, thoracic and mediastinal disorders
EmbolismVascular disorders
Other adverse events (40 terms — click to expand)

ReactionSystemDurvalumab (MEDI4736) Plus…Durvalumab (MEDI4736) Mono…
FatigueGeneral disorders
Decreased appetiteMetabolism and nutrition disorders
ConstipationGastrointestinal disorders
DyspepsiaGastrointestinal disorders
PyrexiaGeneral disorders
DiarrhoeaGastrointestinal disorders
NauseaGastrointestinal disorders
VomitingGastrointestinal disorders
HypothyroidismEndocrine disorders
AstheniaGeneral disorders
DyspnoeaRespiratory, thoracic and mediastinal disorders
PruritusSkin and subcutaneous tissue disorders
Abdominal painGastrointestinal disorders
AscitesGastrointestinal disorders
Feeling coldGeneral disorders
Oedema peripheralGeneral disorders
HypophagiaMetabolism and nutrition disorders
Cancer painNeoplasms benign, malignant and unspecified (incl cysts and polyps)
InsomniaPsychiatric disorders
CoughRespiratory, thoracic and mediastinal disorders
RashSkin and subcutaneous tissue disorders
Deep vein thrombosisVascular disorders
ThyroiditisEndocrine disorders
Dry mouthGastrointestinal disorders
FlatulenceGastrointestinal disorders
Gastrooesophageal reflux diseaseGastrointestinal disorders
CholangitisHepatobiliary disorders
GingivitisInfections and infestations
Weight decreasedInvestigations
ArthralgiaMusculoskeletal and connective tissue disorders
Back painMusculoskeletal and connective tissue disorders
MyalgiaMusculoskeletal and connective tissue disorders
DizzinessNervous system disorders
HeadacheNervous system disorders
AnxietyPsychiatric disorders
Confusional statePsychiatric disorders
Dry skinSkin and subcutaneous tissue disorders
Nail ridgingSkin and subcutaneous tissue disorders
Rash maculo-papularSkin and subcutaneous tissue disorders
HypotensionVascular disorders

Most-reported serious reactions: Diarrhoea, Ascites, Pyrexia, Cholangitis, Acute kidney injury, Abdominal distension, Gastrointestinal haemorrhage, Haematemesis.

Data from ClinicalTrials.gov NCT02558894 adverse events section.

Sponsor's own description

A Phase II Open-Label, Multi-Center Study of MEDI4736 Evaluated as Single Agent or in Combination with Tremelimumab in Patients with Metastatic Pancreatic Ductal Adenocarcinoma.

Publications & conference data

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

  1. Combination strategies with PD-1/PD-L1 blockade: current advances and future directions.
    Yi M, Zheng X, Niu M, Zhu S, et al · · 2022 · cited 1018× · PMID 35062949 · DOI 10.1186/s12943-021-01489-2
  2. Durvalumab With or Without Tremelimumab for Patients With Metastatic Pancreatic Ductal Adenocarcinoma: A Phase 2 Randomized Clinical Trial.
    O'Reilly EM, Oh DY, Dhani N, Renouf DJ, et al · · 2019 · cited 565× · PMID 31318392 · DOI 10.1001/jamaoncol.2019.1588
  3. Pancreatic Ductal Adenocarcinoma: Current and Evolving Therapies.
    Adamska A, Domenichini A, Falasca M. · · 2017 · cited 429× · PMID 28640192 · DOI 10.3390/ijms18071338
  4. Improvement of the anticancer efficacy of PD-1/PD-L1 blockade via combination therapy and PD-L1 regulation.
    Wu M, Huang Q, Xie Y, Wu X, et al · · 2022 · cited 336× · PMID 35279217 · DOI 10.1186/s13045-022-01242-2
  5. The molecular biology of pancreatic adenocarcinoma: translational challenges and clinical perspectives.
    Wang S, Zheng Y, Yang F, Zhu L, et al · · 2021 · cited 252× · PMID 34219130 · DOI 10.1038/s41392-021-00659-4
  6. An update on treatment options for pancreatic adenocarcinoma.
    Lambert A, Schwarz L, Borbath I, Henry A, et al · · 2019 · cited 155× · PMID 31598142 · DOI 10.1177/1758835919875568
  7. Strategies for Increasing Pancreatic Tumor Immunogenicity.
    Johnson BA, Yarchoan M, Lee V, Laheru DA, et al · · 2017 · cited 136× · PMID 28373364 · DOI 10.1158/1078-0432.ccr-16-2318
  8. Mechanisms of T-Cell Exhaustion in Pancreatic Cancer.
    Saka D, Gökalp M, Piyade B, Cevik NC, et al · · 2020 · cited 106× · PMID 32823814 · DOI 10.3390/cancers12082274

Verify or expand the search:

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Trials testing the same drug.

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Data sources for this page

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/NCT02558894.

Primary sources · FDA · ClinicalTrials.gov · EMA · SEC EDGAR · ChEMBL · Wikidata · full sourcing