A Phase 2 interventional study of Pembrolizumab (MK-3475) and Oxaliplatin in Biliary Tract Neoplasms, Cholangiocarcinoma and Bile Duct Cancer, sponsored by National Cancer Institute (NCI). Completed at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2021-12-03.
Sponsored by National Cancer Institute (NCI) · Phase 2, Interventional, and Treatment
Background:
Biliary tract cancers are rare but they are serious. Researchers want to see if a certain drug helps the immune system fight cancer cells. The drug is called pembrolizumab. It may work even better with two chemotherapy drugs that are widely used to treat gastrointestinal cancers.
Objective:
To study if pembrolizumab given with capecitabine and oxaliplatin (CAPOX) increases the time it takes for a person's biliary tract cancer to get worse.
Eligibility:
People age 18 and older with previously treated biliary tract cancer that has spread to other parts of the body
Design:
Participants will be screened with tests as part of their regular cancer care.
Each study cycle is 3 weeks.
For 6 cycles, participants will:
Get pembrolizumab and oxaliplatin on day 1 of each cycle. They will be given in an intravenous (IV) catheter.
Take capecitabine by mouth for 2 weeks then have 1 week without it.
Participants will complete a patient diary.
Starting with cycle 7, participants will get only pembrolizumab. They will get it once every 3 weeks.
On day 1 of every cycle, participants will have:
Physical exam
Review of symptoms and how well they do normal activities
Blood tests
Every 9 weeks, they will have a scan.
Participants may have tumor samples taken.
Participants will have a final visit about 1 month after they stop the study drug. After that, they will be contacted by phone or email yearly.
Background:
Objective:
To determine the 5-month progression free survival (PFS) of Pembrolizumab in combination with CAPOX in patients with advanced biliary tract carcinoma.
Eligibility:
Design:
The proposed study is a phase II study of Pembrolizumab in combination with CAPOX in patients with advanced biliary tract carcinoma
913 studies on the registry are indexed under Cholangiocarcinoma; 285 are open to participants now.
This study's enrollment of 11 is below the median of 50 across 686 interventional studies indexed under Cholangiocarcinoma.
Browse Cholangiocarcinoma studies →National Cancer Institute (NCI) is the lead sponsor of 3,506 studies on the registry; 334 are open to participants now.
Of its 402 completed or terminated interventional studies of FDA-regulated products, 365 (91%) have results posted.
Counted across the registry records on this site, refreshed daily.
Patients must have normal organ and marrow function as defined below:
EXCLUSION CRITERIA:
Pembrolizumab plus Oxaliplatin plus Capecitabine
Biological: Pembrolizumab (MK-3475) · Drug: Oxaliplatin · Drug: Capecitabine
200 mg will be administered as an IV infusion on Day 1 of each 21 day cycle
130mg/m(2) IV Infusion will be administered as an IV infusion on Day 1 of cycles 1-6
750 mg/m(2) will be administered orally twice a day on Days 1-14 of cycles 1-6
Progression Free Survival (PFS)
Median amount of time subject survives without disease progression for 5 months after treatment. Disease progression was assessed by the Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 and is defined as at least a 20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study). The appearance of one or more new lesions is also considered progressions.
Time frame: 5 Months
Number of Participants Obtaining a Complete Response (CR) and Partial Response (PR)
Number of participants obtaining CR and PR per the Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria of all evaluable patients. CR is disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \<10 mm. PR is at least a 30% decrease in the sum of the diameters of target lesions,taking as reference the baseline sum of diameters.
Time frame: Every 9 Weeks, until disease progression or patient is taken off the trial, whichever comes first, approximately 36 weeks.
Overall Survival
Median amount of time subject survives after therapy.
Time frame: Death, approximately 48 weeks after stopping therapy.
Number Participants With Grade 1-4 Adverse Events Unrelated, Unlikely, Possibly, Probably and Definitely Related to Pembrolizumab
Here is the number of participants with grade 1-4 adverse events unrelated, unlikely, possibly, probably and definitely related to study drug assessed by the Common Terminology Criteria for Adverse Events v4.0. Mild (Grade1), moderate (Grade 2), severe (Grade 3), and life-threatening or disabling (Grade 4).
Time frame: 30 Days After Enrollment
Number Participants With Grade 1-4 Adverse Events Unrelated, Unlikely, Possibly, Probably and Definitely Related to Oxaliplatin
Here is the number of participants with grade 1-4 adverse events unrelated, unlikely, possibly, probably and definitely related to study drug assessed by the Common Terminology Criteria for Adverse Events v4.0. Mild (Grade1), moderate (Grade 2), severe (Grade 3), and life-threatening or disabling (Grade 4).
Time frame: 30 Days After Enrollment
Number of Participants With Grade 1-4 Adverse Events Unrelated, Unlikely, Possibly, and Probably Related to Capecitabine
Here is the number of participants with grade 1-4 adverse events unrelated, unlikely, possibly, and probably related to study drug assessed by the Common Terminology Criteria for Adverse Events v4.0. Mild (Grade1), moderate (Grade 2), severe (Grade 3), and life-threatening or disabling (Grade 4).
Time frame: 30 Days After Enrollment
Number of Participants With Serious and Non-serious Adverse Events Assessed by the Common Terminology Criteria for Adverse Events (CTCAE v4.0)
Here is the number of participants with serious and non-serious adverse events assessed by the Common Terminology Criteria for Adverse Events (CTCAE v4.0). A non-serious adverse event is any untoward medical occurrence. A serious adverse event is an adverse event or suspected adverse reaction that results in death, a life-threatening adverse drug experience, hospitalization, disruption of the ability to conduct normal life functions, congenital anomaly/birth defect or important medical events that jeopardize the patient or subject and may require medical or surgical intervention to prevent one of the previous outcomes mentioned.
Time frame: Date treatment consent signed to date off study, approximately 38 months and 25 days.
| Milestone | 1/Arm 1 - Pembrolizumab Plus Oxaliplatin Plus Capecitabine |
|---|---|
| Started | 11 |
| Completed | 6 |
| Not completed | 5 |
| Withdrew: Enrolled in different study | 1 |
| Withdrew: Progressive disease | 3 |
| Withdrew: Withdrawal by subject | 1 |
Median amount of time subject survives without disease progression for 5 months after treatment. Disease progression was assessed by the Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 and is defined as at least a 20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study). The appearance of one or more new lesions is also considered progressions.
| Months | 1/Arm 1 - Pembrolizumab Plus Oxaliplatin Plus Capecitabine |
|---|---|
| Progression Free Survival (PFS) | 4.54 (2.5 to 9.6) |
Number of participants obtaining CR and PR per the Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria of all evaluable patients. CR is disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \<10 mm. PR is at least a 30% decrease in the sum of the diameters of target lesions,taking as reference the baseline sum of diameters.
| Participants | 1/Arm 1 - Pembrolizumab Plus Oxaliplatin Plus Capecitabine |
|---|---|
| Complete Response | 0 |
| Partial Response | 3 |
Median amount of time subject survives after therapy.
| Weeks | 1/Arm 1 - Pembrolizumab Plus Oxaliplatin Plus Capecitabine |
|---|---|
| Overall Survival | 43 (22 to 66) |
Here is the number of participants with grade 1-4 adverse events unrelated, unlikely, possibly, probably and definitely related to study drug assessed by the Common Terminology Criteria for Adverse Events v4.0. Mild (Grade1), moderate (Grade 2), severe (Grade 3), and life-threatening or disabling (Grade 4).
| Participants | Unrelated | Unlikely | Possibly | Probably | Definitely |
|---|---|---|---|---|---|
| Grade 1 | 9 | 11 | 10 | 3 | 0 |
| Grade 2 | 7 | 10 | 8 | 3 | 0 |
| Grade 3 | 3 | 7 | 8 | 1 | 0 |
| Grade 4 | 0 | 3 | 2 | 0 | 0 |
Here is the number of participants with grade 1-4 adverse events unrelated, unlikely, possibly, probably and definitely related to study drug assessed by the Common Terminology Criteria for Adverse Events v4.0. Mild (Grade1), moderate (Grade 2), severe (Grade 3), and life-threatening or disabling (Grade 4).
| Participants | Unrelated | Unlikely | Possibly | Probably | Definitely |
|---|---|---|---|---|---|
| Grade 1 | 9 | 11 | 11 | 7 | 4 |
| Grade 2 | 6 | 10 | 9 | 5 | 2 |
| Grade 3 | 3 | 6 | 8 | 2 | 0 |
| Grade 4 | 0 | 2 | 2 | 1 | 0 |
Here is the number of participants with grade 1-4 adverse events unrelated, unlikely, possibly, and probably related to study drug assessed by the Common Terminology Criteria for Adverse Events v4.0. Mild (Grade1), moderate (Grade 2), severe (Grade 3), and life-threatening or disabling (Grade 4).
| Participants | Unrelated | Unlikely | Possibly | Probably | Definitely |
|---|---|---|---|---|---|
| Grade 1 | 9 | 11 | 11 | 6 | 0 |
| Grade 2 | 7 | 9 | 9 | 4 | 0 |
| Grade 3 | 3 | 6 | 7 | 2 | 0 |
| Grade 4 | 0 | 2 | 2 | 1 | 0 |
Here is the number of participants with serious and non-serious adverse events assessed by the Common Terminology Criteria for Adverse Events (CTCAE v4.0). A non-serious adverse event is any untoward medical occurrence. A serious adverse event is an adverse event or suspected adverse reaction that results in death, a life-threatening adverse drug experience, hospitalization, disruption of the ability to conduct normal life functions, congenital anomaly/birth defect or important medical events that jeopardize the patient or subject and may require medical or surgical intervention to prevent one of the previous outcomes mentioned.
| Participants | 1/Arm 1 - Pembrolizumab Plus Oxaliplatin Plus Capecitabine |
|---|---|
| Number of Participants With Serious and Non-serious Adverse Events Assessed by the Common Terminology Criteria for Adverse Events (CTCAE v4.0) | 11 |
Collected over Date treatment consent signed to date off study, approximately 38 months and 25 days.. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| 1/Arm 1 - Pembrolizumab Plus Oxaliplatin Plus Capecitabine | 9/11 (81.8%) | 4/11 (36.4%) | 11/11 (100%) |
| Event | 1/Arm 1 - Pembrolizumab Plus Oxaliplatin Plus Capecitabine |
|---|---|
| DiarrheaGastrointestinal disorders | 2/11 |
| Abdominal distensionGastrointestinal disorders | 1/11 |
| AscitesGastrointestinal disorders | 1/11 |
| BloatingGastrointestinal disorders | 1/11 |
| ColitisGastrointestinal disorders | 1/11 |
| Infections and infestations - Other, unknown originInfections and infestations | 1/11 |
| Urinary tract infectionInfections and infestations | 1/11 |
| Event | 1/Arm 1 - Pembrolizumab Plus Oxaliplatin Plus Capecitabine |
|---|---|
| Lymphocyte count decreasedInvestigations | 11/11 |
| Alanine aminotransferase increasedInvestigations | 9/11 |
| Aspartate aminotransferase increasedInvestigations | 9/11 |
| Peripheral sensory neuropathyNervous system disorders | 9/11 |
| Platelet count decreasedInvestigations | 9/11 |
| AnemiaBlood and lymphatic system disorders | 8/11 |
| HypoalbuminemiaMetabolism and nutrition disorders | 8/11 |
| White blood cell decreasedInvestigations | 8/11 |
| Alkaline phosphatase increasedInvestigations | 7/11 |
| Abdominal painGastrointestinal disorders | 6/11 |
| Age, Categorical(Participants) | 1/Arm 1 - Pembrolizumab Plus Oxaliplatin Plus Capecitabine |
|---|---|
| <=18 years | 0 |
| Between 18 and 65 years | 6 |
| >=65 years | 5 |
| Age, Continuous(years) | 1/Arm 1 - Pembrolizumab Plus Oxaliplatin Plus Capecitabine |
|---|---|
| Mean | 64.32 ± 8.87 |
| Sex: Female, Male(Participants) | 1/Arm 1 - Pembrolizumab Plus Oxaliplatin Plus Capecitabine |
|---|---|
| Female | 5 |
| Male | 6 |
| Ethnicity (NIH/OMB)(Participants) | 1/Arm 1 - Pembrolizumab Plus Oxaliplatin Plus Capecitabine |
|---|---|
| Hispanic or Latino | 1 |
| Not Hispanic or Latino | 10 |
| Unknown or Not Reported | 0 |
| Race (NIH/OMB)(Participants) | 1/Arm 1 - Pembrolizumab Plus Oxaliplatin Plus Capecitabine |
|---|---|
| American Indian or Alaska Native | 0 |
| Asian | 1 |
| Native Hawaiian or Other Pacific Islander | 1 |
| Black or African American | 0 |
| White | 8 |
| More than one race | 0 |
| Unknown or Not Reported | 1 |
| Region of Enrollment(participants) | 1/Arm 1 - Pembrolizumab Plus Oxaliplatin Plus Capecitabine |
|---|---|
| United States | 11 |
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National Cancer Institute (NCI)