ClinicalTrials.gg
Not yet recruitingNCT07773363Updated Aug 19, 2026

Retlirafusp Alfa Plus Apatinib and Chemotherapy as Second-Line Treatment for Pancreatic Cancer

A Phase 2 interventional study of Retlirafusp Alfa and Apatinib in Pancreatic Cancer, sponsored by Tang-Du Hospital. Not yet recruiting. Open to participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2026-08-19.

Sponsored by Tang-Du Hospital · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
37
Allocation
Non-randomized
Ages
18 Years to 75 Years
Sex
All
01

Study summary

This is a prospective, open-label, single-arm clinical study designed to evaluate the efficacy and safety of retlirafusp alfa combined with apatinib and chemotherapy as second-line treatment in patients with unresectable locally advanced or metastatic pancreatic cancer who have experienced disease progression after first-line systemic therapy. Approximately 37 participants will be enrolled. The primary endpoint is progression-free survival (PFS). Secondary endpoints include overall survival (OS), objective response rate (ORR), disease control rate (DCR), duration of response (DOR), and safety.

Read the detailed description

Pancreatic cancer is an aggressive malignancy with a poor prognosis. Most patients are diagnosed with unresectable locally advanced or metastatic disease, and treatment options after progression on first-line systemic therapy remain limited.

Pancreatic cancer is characterized by an immunosuppressive tumor microenvironment and dense desmoplastic stroma. TGF-β contributes to immune suppression and stromal remodeling, while PD-L1-mediated signaling promotes immune evasion. Retlirafusp alfa is a bifunctional fusion protein targeting PD-L1 and TGF-β receptor II (TGF-βRII), designed to simultaneously inhibit PD-L1/PD-1 signaling and TGF-β signaling.

This prospective, open-label, single-arm study will evaluate the efficacy and safety of retlirafusp alfa combined with apatinib and fluoropyrimidine-based chemotherapy, with the specific chemotherapy regimen selected by the investigator, as second-line treatment for patients with unresectable locally advanced or metastatic pancreatic cancer after progression on first-line systemic therapy.

Approximately 37 participants will be enrolled. Study treatment will continue until disease progression, unacceptable toxicity, withdrawal of informed consent, or other treatment discontinuation criteria are met. The primary endpoint is progression-free survival (PFS). Secondary endpoints include overall survival (OS), objective response rate (ORR), disease control rate (DCR), duration of response (DOR), and safety.

02

Conditions studied

  • Pancreatic Cancer

Keywords

  • Pancreatic Cancer
  • Retlirafusp Alfa
  • Apatinib
  • Second-Line Treatment
03

In context

Pancreatic Neoplasms

3,896 studies on the registry are indexed under Pancreatic Neoplasms; 1,007 are open to participants now.

This study's planned enrollment of 37 is below the median of 47 across 2,932 interventional studies indexed under Pancreatic Neoplasms.

Browse Pancreatic Neoplasms studies →

Lead sponsor

Tang-Du Hospital is the lead sponsor of 167 studies on the registry; 78 are open to participants now.

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

04

Who can participate

Ages eligible
18 Years to 75 Years
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

  1. Age 18 to 75 years, male or female.
  2. or cytologically confirmed unresectable locally advanced or pancreatic cancer.
  3. Performance Status of 0 or 1.
  4. Disease progression after systemic therapy.
  5. At least one according to 1.1, as assessed by the investigator.
  6. Availability of 10 archived tumor tissue sections and 10 mL of peripheral blood.
  7. Adequate organ function.
  8. Women of must have a negative serum or urine pregnancy test within 7 days before enrollment, must not be breastfeeding, and must agree to use effective during the study and for 6 months after the end of study treatment. Male participants must also agree to use effective contraception during the study and for 6 months after the end of study treatment.
  9. Voluntary participation in the study, provision of written , and willingness and ability to comply with study procedures and follow-up.

Exclusion criteria

Exclusion Criteria:

  1. Known to the drug or any of its .
  2. Major surgery, open , or significant traumatic injury within 4 weeks before study treatment.
  3. Participation in another investigational drug clinical study within 4 weeks before enrollment.
  4. History of other within the past 5 years, except for malignancies that have been definitively treated and are considered cured.
  5. Any of the following medical conditions: Untreated or symptomatic or spinal cord compression. Other active malignancy requiring concurrent treatment.

    Active disease or immunodeficiency, or a history of such conditions, including autoimmune hepatitis, interstitial pneumonia, uveitis, rheumatoid arthritis, inflammatory bowel disease, hypophysitis, vasculitis, or nephritis. Exceptions include stable conditions not requiring systemic therapy, such as type 1 diabetes mellitus, hypothyroidism requiring only hormone replacement therapy, or skin diseases not requiring systemic treatment, such as vitiligo, psoriasis, or alopecia. History of substance abuse or psychiatric disorders that may interfere with study participation.

  6. Severe and/or uncontrolled medical conditions, including: Uncontrolled hypertension, defined as systolic blood pressure ≥150 mmHg or diastolic blood pressure ≥100 mmHg. Grade ≥1 myocardial ischemia or myocardial infarction; arrhythmia, including ≥450 ms in males or ≥470 ms in females; congestive heart failure of class ≥II; or \<50%. Decompensated diabetes mellitus or other conditions contraindicating high-dose therapy. Exacerbation of (COPD) or other severe respiratory disease requiring hospitalization. Active or uncontrolled severe infection (≥Grade 2 according to ). Uncontrolled pleural effusion, pericardial effusion, or ascites requiring repeated drainage. Cirrhosis, decompensated liver disease, active hepatitis, or chronic hepatitis requiring antiviral treatment. Renal dysfunction with urine protein ≥++ on urinalysis and confirmed 24-hour urinary protein >1.0 g.
  7. Severe infection within 4 weeks before the first dose, including infectious complications, bacteremia, or severe pneumonia requiring hospitalization or intravenous antibiotics, antifungal agents, or antiviral therapy; or unexplained fever >38.5°C during screening or before the first dose.
  8. Active brain metastases or at enrollment.
  9. Acute pancreatitis meeting diagnostic criteria or subclinical pancreatitis requiring recent intervention.
  10. Any other condition that, in the investigator's judgment, may prevent the participant from complying with study procedures, restrictions, or requirements.
Terms in these criteria, in plain language(25)

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.

Line of therapy

A line of therapy is one course of treatment, which may combine several drugs. First-line is the first course given; second-line follows when that stops working or is not tolerated.

“Two prior lines” means two courses that count separately under the study’s rules — not simply two drugs. Ask the study team if you are unsure how yours are counted.

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.

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.

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.

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.

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.

Excipients

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

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

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.

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.

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.

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.

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.

QT and QTc

On an ECG, the QT interval is the time the heart’s lower chambers take to activate electrically and recover in each beat. QTc is that time adjusted for heart rate (QTcF by Fridericia’s formula, QTcB by Bazett’s). Some medicines lengthen it, and a long QTc can raise the risk of a dangerous heart rhythm.

The study may name a correction formula and a limit in milliseconds, often around 450–480.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

LVEF (left ventricular ejection fraction)

The share of blood the heart’s main pumping chamber (the left ventricle) pushes out with each beat, measured by an echocardiogram (heart ultrasound) or a MUGA scan. About 50–70% is normal.

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.

COPD

Chronic obstructive pulmonary disease: long-term lung disease that makes it hard to breathe out, including emphysema and chronic bronchitis.

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.

Leptomeningeal disease

Cancer that has spread to the leptomeninges, the thin layers covering the brain and spinal cord, and the fluid between them. It is not the same as brain metastases.

Criteria often treat it separately, and many studies leave it out even where treated brain metastases are allowed.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Non-randomized
Intervention model
Single group
Masking
None (open label)
Enrollment
37 participants (estimated)

Study arms

  • Experimental
    Retlirafusp Alfa + Apatinib + Chemotherapy

    Participants will receive retlirafusp alfa combined with apatinib and fluoropyrimidine-based chemotherapy selected at the investigator's discretion as second-line treatment for unresectable locally advanced or metastatic pancreatic cancer. Treatment will continue until disease progression, unacceptable toxicity, withdrawal of informed consent, or other criteria for treatment discontinuation are met.

    Drug: Retlirafusp Alfa · Drug: Apatinib · Drug: Fluoropyrimidine-Based Chemotherapy

Interventions

  • Retlirafusp alfa will be administered in combination with apatinib and fluoropyrimidine-based chemotherapy as second-line treatment for locally advanced or metastatic pancreatic cancer.

  • Apatinib will be administered in combination with retlirafusp alfa and fluoropyrimidine-based chemotherapy as second-line treatment for locally advanced or metastatic pancreatic cancer.

  • DrugFluoropyrimidine-Based Chemotherapy

    Fluoropyrimidine-based chemotherapy selected at the investigator's discretion will be administered in combination with retlirafusp alfa and apatinib as second-line treatment for locally advanced or metastatic pancreatic cancer.

06

What researchers measure

Primary outcomes

  1. Progression-free survival

    Progression-free survival (PFS) is defined as the time from the first administration of study treatment to the date of disease progression, as assessed by the investigator, or death from any cause, whichever occurs first.

    Time frame: Progression-free survival (PFS) will be assessed by the investigator according to RECIST 1.1, for up to 2 years after the first administration of study treatment.

Secondary outcomes

  1. Overall Survival

    Overall survival (OS) is defined as the time from the first administration of study treatment to death from any cause.

    Time frame: Up to 3 years after the first administration of study treatment.

  2. Objective response rate

    Per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1) using Investigator assessments, is defined as the number (%) of patients with response of Complete Response or Partial Response, will be assessed up to 1 years.

    Time frame: Data obtained up until progression, or the last evaluable assessment in the absence of progression, will be assessed up to 1 years

  3. Duration of Response

    Duration of Response(DoR)refers to the time from the first assessment as CR or PR to the first assessment as PD or (due to any reason) death.

    Time frame: Duration of Response(DoR)analysis based on investigator assessment per RECIST 1.1, and will be assessed up to 1 years.

07

Study locations

No study locations are listed for this record.

08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Start is estimated for Aug 2026; primary completion for Dec 2027, 16 months later.

Of 324 non-industry phase 2 interventional studies under Pancreatic Neoplasms, half reached primary completion within 60 months of starting (the median), counting those still running; a quarter within 36 and three quarters within 80. This study's planned 16 months is below that.

Counting every sponsor, half of 393 studies reached it within 57 months; a quarter within 35 and three quarters within 80.

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

Registered
Aug 14, 2026
First posted
Aug 19, 2026
StartEst.
Aug 30, 2026
Primary completionEst.
Dec 30, 2027
CompletionEst.
Dec 30, 2028
Last update
Aug 19, 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 Aug 19, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07773363
Lead sponsor
Tang-Du Hospital
Responsible party
Sponsor
First posted
Aug 19, 2026
Start date
Aug 30, 2026 (estimated)
Primary completion
Dec 30, 2027 (estimated)
Completion
Dec 30, 2028 (estimated)
Last update
Aug 19, 2026

Study contacts

Jie Min, Dr
Contact
Minjie1504@163.com
13709202616

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is not yet recruiting, as verified in Aug 2026. You cannot join it, but the record below documents what was studied.

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Discussion

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Studies of the drugs tested here: SHR-1701 · Apatinib

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