ClinicalTrials.gg
CompletedNCT05630183Updated Jun 11, 2026

A Study of Botensilimab in Participants With Metastatic Pancreatic Cancer

A Phase 2 interventional study of Botensilimab and Gemcitabine in Metastatic Pancreatic Ductal Adenocarcinoma, sponsored by Agenus Inc.. Completed at 36 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-06-11.

Sponsored by Agenus Inc. · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
81
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The goal of this clinical trial is to test if the addition of botensilimab to standard chemotherapy improves the efficacy compared to just chemotherapy alone in participants with metastatic pancreatic cancer. One group of participants will only receive chemotherapy while a second group of participants will receive botensilimab and chemotherapy.

Read the detailed description

This will be a prospective, multicenter, clinical trial of botensilimab in combination with nab-paclitaxel + gemcitabine or nab-paclitaxel + gemcitabine alone. The trial will be conducted in 2 parts. Part 1 will be a safety lead-in to establish the safety and dose of botensilimab for Part 2. Part 2 will be a randomized, open-label assessment of botensilimab (at the dose level determined in Part 1).

02

Conditions studied

  • Metastatic Pancreatic Ductal Adenocarcinoma

Keywords

  • BOT
  • 1181
  • Immunotherapy
  • Pancreas
  • Gemcitabine
  • Nab-paclitaxel
03

In context

Lead sponsor

Agenus Inc. is the lead sponsor of 31 studies on the registry; 2 are open to participants now.

Of its 11 completed or terminated interventional studies of FDA-regulated products, 3 (27%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • confirmed diagnosis of pancreatic ductal adenocarcinoma. Note: fine needle aspirate/cytology of tumor in the presence of a pancreatic mass that confirms ductal adenocarcinoma is acceptable.
  • Must have had disease progression on any version of FOLFIRINOX for disease (including onivyde + oxaliplatin + 5-fluorouracil [5-FU] + leucovorin [NALIRIFOX]). Clarification: Participant with initial diagnosis of locally advanced disease may be eligible if upon retrospective review of initial scans, previously unappreciated metastases are able to be identified; Investigator must provide documentation that participant had metastatic disease at the time the participant received FOLFIRINOX. Notes: Progression on a reduced or maintenance fluoropyrimidine based regimen in the metastatic setting is allowed (for example, leucovorin + 5-FU + oxaliplatin [FOLFOX], leucovorin + 5-FU + irinotecan [FOLFIRI], 5-FU, or capecitabine), provided the participant received at least 1 dose of all of the drugs in a FOLFIRINOX regimen.
  • performance status of 0 or 1.
  • of at least 3 months.
  • on baseline imaging per 1.1 criteria.
  • A \< Grade 2 pre-existing peripheral neuropathy per National Cancer Institute , Version 5.0 (NCI CTCAE v5.0). Because NCI CTCAE v5.0 grading for peripheral neuropathy does not include guidance for "mild" neuropathy, these cases can be graded per the NCI CTCAE v5.0 grading for general adverse events which includes "mild" under Grade 1.
  • Acceptable coagulation status as indicated by an ≤ 1.5 x institutional , except participants on anticoagulation who can be included at the discretion of the investigator.
  • Adequate organ function.
  • Women of must have a negative urine or serum pregnancy test at screening (within 72 hours of first dose of study drugs).
  • Male participants with a female partner(s) of childbearing potential must agree to use highly effective measures throughout the study.

Exclusion criteria

Exclusion Criteria:

  • Received more than one prior regimen (that is, FOLFIRINOX) for their disease. (Progression on a reduced or maintenance fluoropyrimidine-based regimen in the metastatic setting is allowed. [for example, FOLFOX, FOLFIRI, 5-FU, or capecitabine], provided the participant received at least 1 dose of all of the drugs in a FOLFIRINOX regimen.)
  • History of central nervous system (CNS) metastasis or active .
  • Concurrent (present during screening) requiring treatment or history of prior malignancy active within 2 years prior to the first dose of study drugs (that is, participants with a history of prior malignancy are eligible if treatment was completed at least 2 years prior to first dose of study drugs and the participant has no evidence of disease). Participants with history of prior early-stage basal/squamous cell skin cancer or noninvasive or in situ cancers who have undergone definitive treatment at any time are also eligible.
  • Uncontrolled intercurrent illness, including but not limited to (that is, active) cardiovascular disease.
  • Active, uncontrolled infections, requiring systemic intravenous anti-infective treatment within 2 weeks prior to first dose of study drugs.
  • Major surgery within 4 weeks prior to signing of form (ICF).
  • Prior treatment with an .
  • ascites.
  • Partial or complete bowel obstruction within the last 3 months prior to signing of ICF, signs/symptoms of bowel obstruction, or known radiologic evidence of impending obstruction.
  • Clinically significant gastrointestinal disorders.
  • Treatment with one of the following classes of drugs within the delineated time window prior to first dose of study drugs:

    • Cytotoxic agent within 3 weeks or 5 half-lives (whichever is greater).
    • Monoclonal antibodies, antibody-drug conjugates, radioimmunoconjugates, or drug, within 4 weeks, or 5 half-lives, whichever is shorter.
    • Small molecule targeted therapies/tyrosine kinase inhibitors within 14 days or 5 half-lives (whichever is greater).
    • Radiotherapy within 7 days.
  • Previous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection within 10 days for mild or asymptomatic infections or 20 days for severe/critical illness prior to first dose of study drugs.
  • Received a vaccine, including SARS-CoV-2 vaccine, \< 7 days prior to first dose of study drugs.
  • Known allergy or to any of the study drugs or any of the study drug .
  • Symptomatic interstitial lung disease (ILD), history of ILD, or any lung disease which may interfere with detection and management of new immune-mediated pulmonary toxicity.
  • History of allogeneic organ transplant.
  • Psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the study.
  • Participants with a condition requiring systemic treatment with either (> 10 milligrams [mg] daily prednisone equivalent) within 14 days or another medication within 30 days prior to the first dose of study drugs. Inhaled or topical steroids, and adrenal replacement steroid doses (≤ 10 mg daily prednisone equivalent), are permitted in the absence of active disease.
  • Active autoimmune disease or history of autoimmune disease that required systemic treatment within 2 years prior to first dose of study drugs (that is, with use of disease-modifying agents or immunosuppressive drugs).
  • Pregnant or breastfeeding participants.
  • Uncontrolled infection with .
  • Known to be positive for (HBV) surface antigen, or any other positive test for HBV indicating acute or chronic infection.
  • Known active as determined by positive serology and confirmed by polymerase chain reaction.
  • Dependence on total parenteral nutrition.
  • Participants with concurrent diarrhea > grade 1 at time of randomization despite optimal treatment with standard of care pancreatic enzymes.
  • Known active or latent tuberculosis.
  • Any condition in the opinion of the principal investigator that might interfere with the participant's participation in the study or in the evaluation of the study results.
  • Unwillingness or inability to comply with procedures required in this protocol.
Terms in these criteria, in plain language(26)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Life expectancy

The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.

Measurable disease

The amount of disease can be tracked with a defined measurement, so the study can see whether it shrinks or grows. It might be a tumour measured on a scan or, in some blood cancers such as myeloma, a marker measured in blood or urine.

The criteria or the study team say which measurement counts — having no tumour visible on a scan does not by itself rule you out.

RECIST

The standard rules for measuring tumours on CT or MRI scans, to tell whether a cancer is shrinking, stable or growing during treatment.

“Measurable disease per RECIST 1.1” usually means at least one tumour 10 mm or more at its longest on a CT scan, or a lymph node 15 mm or more across its short axis.

CTCAE grade

The US National Cancer Institute’s scale of how severe an adverse event is — any unwanted medical event during a study, such as a symptom, an illness or an abnormal test result, whether or not a treatment caused it. Whether it did is judged separately.

1
Mild.
2
Moderate.
3
Severe.
4
Life-threatening.
5
Death due to the event.

“Side effects of earlier treatment resolved to grade 1 or less” means they have settled to mild or gone.

INR, PT and aPTT (clotting tests)

Blood tests of how long blood takes to clot. The INR is the prothrombin time (PT) put on a common scale; about 1 is usual for someone not taking a blood thinner.

Criteria often make an exception for people on a blood thinner such as warfarin, whose INR is raised on purpose.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Brain metastases

Cancer deposits in the brain from a cancer that started elsewhere in the body (CNS metastases include the spinal cord).

Studies differ: some leave out any brain metastases, some accept ones treated and stable for some weeks. Check what this study allows.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

PD-1, PD-L1 and checkpoint inhibitors

PD-1, PD-L1 and CTLA-4 are proteins that act as brakes on the immune system. Checkpoint inhibitors, such as pembrolizumab or nivolumab, block them so the immune system can attack a cancer.

PD-L1 can also be measured in a tumour sample. Some scores count stained tumour cells only (TPS); others also count certain immune cells (CPS). The study names the score and the minimum it uses.

Relapsed and refractory

Relapsed: the illness came back after treatment had worked. Refractory: it did not respond to treatment, or stopped responding while still on it.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Excipients

The other ingredients in a medicine besides the active drug, such as fillers, colours or preservatives.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
81 participants (actual)

Study arms

  • Experimental
    Part 1: Combination (Safety Lead-in Phase)

    Participants will receive botensilimab in combination with standard-of-care chemotherapy (nab-paclitaxel + gemcitabine).

    Drug: Botensilimab · Drug: Gemcitabine · Drug: Nab-paclitaxel

  • Experimental
    Part 2: Combination

    Participants will receive botensilimab in combination standard-of-care chemotherapy (nab-paclitaxel + gemcitabine).

    Drug: Botensilimab · Drug: Gemcitabine · Drug: Nab-paclitaxel

  • Active comparator
    Part 2: Standard of Care

    Participants will receive standard-of-care chemotherapy (nab-paclitaxel + gemcitabine).

    Drug: Gemcitabine · Drug: Nab-paclitaxel

Interventions

  • A fully human fragment crystallizable-enhanced monoclonal cytotoxic T lymphocyte antigen 4 antibody administered intravenously.

    Also known as: AGEN1181

  • Standard-of-care chemotherapy administered intravenously.

  • Standard-of-care chemotherapy administered intravenously.

06

What researchers measure

Primary outcomes

  1. Progression-free Survival as Assessed by Investigator

    Progression-free survival will be defined as the time from the date of randomization to the date of the first objectively documented tumor progression, assessed by investigator per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1), or death, whichever occurs first.

    Time frame: Up to 2 years

Secondary outcomes

  1. Number of Participants with Treatment-emergent Adverse Events

    Time frame: First study dose through up 1 year

  2. Overall Survival

    Overall survival will be defined as the time from the date of randomization to the date of death due to any cause.

    Time frame: Up to 2 years

  3. Complete Response

    Complete response will be defined by RECIST 1.1 criteria and carbohydrate antigen 19-9 down to normal limits (from at least \> 2 x upper limit of normal \[ULN\]). Cancer antigen 125 or carcinoembryonic antigen will be evaluated for non-expressors of carbohydrate antigen 19-9.

    Time frame: Up to 2 years

  4. Overall Response Rate

    Overall response rate will be defined as the proportion of participants whose best overall response is complete response or partial response assessed by investigator per RECIST v1.1.

    Time frame: Up to 2 years

  5. Duration of Response

    Duration of response will be defined as the time from the first determination of an objective response assessed by investigator per RECIST v1.1, until the first documentation of progression or death, whichever occurs first.

    Time frame: Up to 2 years

  6. Change From Baseline in Carbohydrate Antigen 19-9

    Change in carbohydrate antigen 19-9 will be evaluated until progressive disease, death, date of last tumor assessment, or start of new anti-cancer therapy. Cancer antigen 125 or carcinoembryonic antigen will be evaluated for non-expressors of carbohydrate antigen 19-9.

    Time frame: Baseline, 2 years

  7. Rates of Normalization of Carbohydrate Antigen 19-9

    Carbohydrate antigen 19-9 normalization will be defined as a value of carbohydrate antigen 19-9 down to normal limits (from at least \> 2 x ULN). Cancer antigen 125 or carcinoembryonic antigen will be evaluated for non-expressors of carbohydrate antigen 19-9.

    Time frame: Up to 2 years

07

Study locations

36 sites
  • HonorHealth
    Scottsdale, Arizona 85258, United States
  • USC Norris Comprehensive Cancer Center
    Los Angeles, California 90033, United States
  • USC Norris Oncology
    Newport Beach, California 92663, United States
  • UCLA Health - Santa Monica Cancer Care
    Santa Monica, California 90404, United States
  • Medical Oncology Hematology Consultants (MOHC) - Helen F. Graham Cancer Center
    Newark, Delaware 19713, United States
  • Florida Cancer Specialist South
    Fort Myers, Florida 33901, United States
  • Cancer Care Centers of Brevard
    Palm Bay, Florida 32909, United States
  • Florida Cancer Specialist North
    St. Petersburg, Florida 22705, United States
  • Illinois Cancer Specialists
    Arlington Heights, Illinois 60005, United States
  • Maryland Oncology Hematology
    Columbia, Maryland 21044, United States
  • Massachusetts General Hospital
    Boston, Massachusetts 02114, United States
  • Beth Israel Deaconess Medical Center
    Boston, Massachusetts 02215, United States
  • Rogel Cancer Center, University of Michigan Medicine
    Ann Arbor, Michigan 48109, United States
  • Minnesota Oncology
    Minneapolis, Minnesota 55404, United States
  • Nebraska Medicine-Nebraska Medical Center
    Omaha, Nebraska 68198, United States
  • Comprehensive Cancer Centers of Nevada - Summerlin Medical Center II*
    Las Vegas, Nevada 89144, United States
  • John Theurer Cancer Center at Hackensack
    Hackensack, New Jersey 07601, United States
  • Atlantic Health Systems, Morristown
    Morristown, New Jersey 07960, United States
  • Overlook Medical Center
    Summit, New Jersey 07901, United States
  • Weill Cornell Medicine-New York Presbyterian Hospital
    New York, New York 10021, United States
  • Memorial Sloan Kettering Cancer Center
    New York, New York 10065, United States
  • Weill Cornell Medicine Sandra and Edward Meyer Cancer Center
    New York, New York 10065, United States
  • Icahn School of Medicine at Mount Sinai Tisch Cancer Institute
    New York, New York 10128, United States
  • Oncology Hematology Care - Eastgate
    Cincinnati, Ohio 45245, United States
  • Sarah Cannon Research Institute at Tennessee Oncology
    Cincinnati, Ohio 45245, United States
  • Lifespan
    Providence, Rhode Island 02903, United States
  • Sarah Cannon Research Institute at Tennessee Oncology
    Nashville, Tennessee 37203, United States
  • Texas Oncology
    Carrollton, Texas 75010, United States
  • Baylor Charles A. Sammons Cancer Center
    Dallas, Texas 75247, United States
  • TxO - Denison Cancer Center
    Denison, Texas 75020, United States
  • The Center for Cancer & Blood Disorders: Fort Worth
    Fort Worth, Texas 76104, United States
  • Northeast Texas Cancer & Research Institute
    Tyler, Texas 75702, United States
  • Virginia Cancer Specialists
    Fairfax, Virginia 22031, United States
  • Virginia Oncology Associates - Brock Cancer Center
    Norfolk, Virginia 23502, United States
  • Shenandoah Oncology
    Winchester, Virginia 22601, United States
  • Swedish Cancer Institute
    Seattle, Washington 98104, United States
08

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Ran from Mar 2023 to primary completion in Jan 2026, 33 months.

How these figures are worked out, and which studies are left out of them.

Registered
Nov 18, 2022
First posted
Nov 29, 2022
StartActual
Mar 27, 2023
Primary completionActual
Jan 5, 2026
CompletionActual
Jan 5, 2026
Last update
Jun 11, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jun 11, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT05630183
Lead sponsor
Agenus Inc.
Responsible party
Sponsor
First posted
Nov 29, 2022
Start date
Mar 27, 2023
Primary completion
Jan 5, 2026
Completion
Jan 5, 2026
Last update
Jun 11, 2026

Study contacts

Medical Director
study director · Agenus Inc.

Oversight

FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Jun 2026. You cannot join it, but the record below documents what was studied.

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Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

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Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Studies of the drug tested here: Botensilimab

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