RECRUITING

Utility of ctDNA in Early Switch of First-line mFOLFIRINOX in Metastatic Pancreatic Ductal Adenocarcinoma

Conditions

Metastatic Pancreatic Ductal Adenocarcinoma Pancreatic Ductal Adenocarcinoma

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Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

The purpose of this study is to understand whether a blood-based test called circulating tumor DNA (ctDNA) can detect whether participants are having a desired tumor shrinkage or an undesired lack of tumor shrinkage, and to study whether these levels of ctDNA can be used to make treatment decisions faster than the current standard approach, which is to wait 8 weeks after starting chemotherapy to obtain participant first imaging scans since starting chemotherapy.

Official Title

A Phase 2 Study Assessing Utility of ctDNA in Early Switch of First-line mFOLFIRINOX in Metastatic Pancreatic Ductal Adenocarcinoma

Quick Facts

Study Start:2025-11-01

Study Completion:2030-11-01

Study Type:Not specified

Phase:Not Applicable

Enrollment:Not specified

Status:RECRUITING

Study ID

NCT07096362

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Ages Eligible for Study:18 Years

Sexes Eligible for Study:ALL

Accepts Healthy Volunteers:No

Standard Ages:ADULT, OLDER_ADULT

Inclusion Criteria	Exclusion Criteria
1. Histologically confirmed, metastatic pancreatic adenocarcinoma. Patients with adenosquamous carcinoma and mixed adenocarcinoma/neuroendocrine carcinoma (MANEC) of the pancreas are eligible, but pure neuroendocrine neoplasms are excluded. 2. Treatment-naïve patients diagnosed with metastatic pancreatic adenocarcinoma. 3. Must have a detectable circulating tumor deoxyribonucleic acid (DNA) at cycle 1 day 1. 4. Patients must have a detectable circulating tumor deoxyribonucleic acid (ctDNA) quantity on Northstar Response assay at baseline. 5. At least one tumor measurable by Computed Tomography (CT) scan or Positron Emission Tomography-Computed Tomography (PET/CT) scan. Measurable disease is defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded for non-nodal lesions and short axis for nodal lesions) as \>20 mm with conventional techniques or \>10 mm with spiral CT scan. 6. Adult male and female participants (≥ 18 years of age). 7. Male or non-pregnant and non-lactating female. Men and women with intact reproductive potential must agree to use contraception. 8. Adequate biological parameters as demonstrated by the following blood counts at Screening (obtained ≤ 21 days prior to enrollment) and at Baseline-Day 0: * Absolute neutrophil count (ANC) ≥ 1.0 × 109 cells/L. * Platelet count ≥ 100,000 cells/mm3 (100 × 109 cells/L). Supportive platelet transfusions are acceptable. * Hemoglobin (Hgb) ≥ 9 g/dL. Supportive packed red blood cell transfusions are acceptable. 9. Adequate blood chemistry levels at Screening (obtained ≤ 21 days prior to enrollment) and at Baseline-Day 0: * Aspartate aminotransferase (AST) - serum glutamic-oxaloacetic transaminase (SGOT); alanine transaminase (ALT) - serum glutamic-pyruvic transaminase (SGPT) ≤ 2.5 × upper limit of normal (ULN) range, unless liver metastases are present, then ≤ 5 × ULN is allowed. * Total bilirubin ≤ 1.5 × Upper Limit of Normal. * Estimated creatinine clearance of \> 60 mL/min (per Cockcroft-Gault formula). * Albumin ≥ 3.0 g/dL. 10. Eastern Cooperative Oncology Group (ECOG) performance status from 0 to ≤ 1. 11. Must be a modified Folfirinox chemotherapy candidate. 12. For participants not qualified or able to give legal consent, consent must be obtained from their legally authorized representative (LAR).	1. Patients with pure neuroendocrine neoplasms of the pancreas. 2. Brain metastases. 3. Uncontrolled ascites. 4. Increase of ECOG to \> 1 between screening and enrollment. 5. Active, uncontrolled bacterial, viral, or fungal infection(s) requiring systemic therapy. 6. History of untreated or uncontrolled HIV and/or Hepatitis B or C infection. 7. Clinically significant, uncontrolled heart disease and/or cardiac repolarization abnormality, including any of the following: * History of myocardial infarction, angina pectoris, symptomatic pericarditis, or coronary artery bypass graft within six months prior to study entry * Documented cardiomyopathy 8. Grade 2 or greater sensory peripheral neuropathy. 9. History of chronic diarrhea. 10. Pregnant or nursing. 11. Concomitant serious medical or psychiatric illness that, in the opinion of the investigator, could compromise the patient's safety or integrity of the study data. 12. Concurrently enrolled in any other interventional clinical protocol or investigational trial involving administration of antineoplastic compounds for the treatment of metastatic pancreatic cancer. 13. Patient is unwilling or unable to comply with study procedures. 14. Patients with impaired decision-making capacity. 15. No other medical condition or reason that, in the opinion of the investigator, would preclude study participation.

Inclusion Criteria

Exclusion Criteria

1. Histologically confirmed, metastatic pancreatic adenocarcinoma. Patients with adenosquamous carcinoma and mixed adenocarcinoma/neuroendocrine carcinoma (MANEC) of the pancreas are eligible, but pure neuroendocrine neoplasms are excluded.
2. Treatment-naïve patients diagnosed with metastatic pancreatic adenocarcinoma.
3. Must have a detectable circulating tumor deoxyribonucleic acid (DNA) at cycle 1 day 1.
4. Patients must have a detectable circulating tumor deoxyribonucleic acid (ctDNA) quantity on Northstar Response assay at baseline.
5. At least one tumor measurable by Computed Tomography (CT) scan or Positron Emission Tomography-Computed Tomography (PET/CT) scan. Measurable disease is defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded for non-nodal lesions and short axis for nodal lesions) as \>20 mm with conventional techniques or \>10 mm with spiral CT scan.
6. Adult male and female participants (≥ 18 years of age).
7. Male or non-pregnant and non-lactating female. Men and women with intact reproductive potential must agree to use contraception.
8. Adequate biological parameters as demonstrated by the following blood counts at Screening (obtained ≤ 21 days prior to enrollment) and at Baseline-Day 0:
* Absolute neutrophil count (ANC) ≥ 1.0 × 109 cells/L.
* Platelet count ≥ 100,000 cells/mm3 (100 × 109 cells/L). Supportive platelet transfusions are acceptable.
* Hemoglobin (Hgb) ≥ 9 g/dL. Supportive packed red blood cell transfusions are acceptable.
9. Adequate blood chemistry levels at Screening (obtained ≤ 21 days prior to enrollment) and at Baseline-Day 0:
* Aspartate aminotransferase (AST) - serum glutamic-oxaloacetic transaminase (SGOT); alanine transaminase (ALT) - serum glutamic-pyruvic transaminase (SGPT) ≤ 2.5 × upper limit of normal (ULN) range, unless liver metastases are present, then ≤ 5 × ULN is allowed.
* Total bilirubin ≤ 1.5 × Upper Limit of Normal.
* Estimated creatinine clearance of \> 60 mL/min (per Cockcroft-Gault formula).
* Albumin ≥ 3.0 g/dL.
10. Eastern Cooperative Oncology Group (ECOG) performance status from 0 to ≤ 1.
11. Must be a modified Folfirinox chemotherapy candidate.
12. For participants not qualified or able to give legal consent, consent must be obtained from their legally authorized representative (LAR).

1. Patients with pure neuroendocrine neoplasms of the pancreas.
2. Brain metastases.
3. Uncontrolled ascites.
4. Increase of ECOG to \> 1 between screening and enrollment.
5. Active, uncontrolled bacterial, viral, or fungal infection(s) requiring systemic therapy.
6. History of untreated or uncontrolled HIV and/or Hepatitis B or C infection.
7. Clinically significant, uncontrolled heart disease and/or cardiac repolarization abnormality, including any of the following:
* History of myocardial infarction, angina pectoris, symptomatic pericarditis, or coronary artery bypass graft within six months prior to study entry
* Documented cardiomyopathy
8. Grade 2 or greater sensory peripheral neuropathy.
9. History of chronic diarrhea.
10. Pregnant or nursing.
11. Concomitant serious medical or psychiatric illness that, in the opinion of the investigator, could compromise the patient's safety or integrity of the study data.
12. Concurrently enrolled in any other interventional clinical protocol or investigational trial involving administration of antineoplastic compounds for the treatment of metastatic pancreatic cancer.
13. Patient is unwilling or unable to comply with study procedures.
14. Patients with impaired decision-making capacity.
15. No other medical condition or reason that, in the opinion of the investigator, would preclude study participation.

Contacts and Locations

Study Contact

Siudy Vasquez

CONTACT

(305) 243-2647

sxv507@med.miami.edu

Principal Investigator

Gretel Terrero, MD

PRINCIPAL_INVESTIGATOR

University of Miami

Study Locations (Sites)

University of Miami

Miami, Florida, 33136

United States

Collaborators and Investigators

Sponsor: University of Miami

Gretel Terrero, MD, PRINCIPAL_INVESTIGATOR, University of Miami

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2025-11-01

Study Completion Date2030-11-01

Study Record Updates

Study Start Date2025-11-01

Study Completion Date2030-11-01

Terms related to this study

Additional Relevant MeSH Terms

Metastatic Pancreatic Ductal Adenocarcinoma
Pancreatic Ductal Adenocarcinoma