A Phase 1 interventional study of Lm-LLO-TT in Pancreas Cancer, Duct Cell Adenocarcinoma, Pancreatic Cancer and Advanced Pancreatic Adenocarcinoma, sponsored by Loki Therapeutics, Inc.. Recruiting at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-11-06.
Sponsored by Loki Therapeutics, Inc. · Phase 1, Interventional, and Treatment
ClinicalTrials.gov Brief Summary
This Phase 1, open-label, first-in-human study is designed to evaluate the safety, tolerability, and recommended dose of intraperitoneal (IP) administration of Lm-LLO-TT in combination with low-dose gemcitabine in adults with previously treated, unresectable or metastatic pancreatic ductal adenocarcinoma (PDAC). Up to 18 participants will be enrolled.
Lm-LLO-TT is a live attenuated Listeria monocytogenes-based immunotherapy engineered to express a tetanus toxoid antigen. The study will assess the safety of administering Lm-LLO-TT directly into the peritoneal cavity and characterize its use in combination with low-dose gemcitabine.
Eligible participants will receive a tetanus toxoid booster vaccination during screening and undergo placement of an intraperitoneal access port before treatment. Participants will receive a single loading dose of Lm-LLO-TT followed by five cycles of low-dose gemcitabine and low-dose Lm-LLO-TT administered over approximately 17 days. Participants will be monitored for adverse events, laboratory abnormalities, dose-limiting toxicities, and disease outcomes throughout the study.
The primary objective is to assess safety and tolerability and to determine the maximum tolerated dose and recommended dose for future clinical studies. Secondary objectives include evaluation of anti-tumor activity. Exploratory objectives include assessment of immune biomarkers, changes in pancreatic cancer-related symptoms, and changes in pain medication use.
Participants will undergo tumor imaging assessments following treatment and during follow-up. A post-treatment tumor biopsy will be required for the first 10 enrolled participants and optional for subsequent participants. Participants will be followed for safety, disease status, and survival for up to 6 months after treatment initiation.
This is a Phase 1, open-label, first-in-human, dose-escalation study designed to evaluate the safety, tolerability, maximum tolerated dose (MTD), and recommended Phase 2 dose (RP2D) of intraperitoneal (IP) administration of Lm-LLO-TT in combination with low-dose gemcitabine in participants with previously treated unresectable or metastatic pancreatic ductal adenocarcinoma (PDAC). Up to 18 participants will be enrolled. The study will use a Bayesian Optimal Interval (BOIN) dose-escalation design to identify the MTD and RP2D of Lm-LLO-TT for future clinical development.
PDAC is associated with poor clinical outcomes and limited treatment options in the advanced disease setting. Lm-LLO-TT is a live attenuated Listeria monocytogenes-based immunotherapy engineered to express a tetanus toxoid (TT) antigen linked to listeriolysin O (LLO). This study will evaluate the safety and biologic activity of administering Lm-LLO-TT directly into the peritoneal cavity in combination with low-dose gemcitabine.
Eligible participants are adults with histologically confirmed PDAC and measurable disease according to RECIST version 1.1 who have received at least one prior systemic treatment regimen for unresectable or metastatic disease or have a contraindication to standard therapies. Participants must have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2, adequate organ function, and a life expectancy greater than 3 months.
During screening, participants will undergo tetanus toxoid immunity testing. All participants will receive a tetanus toxoid booster vaccination before treatment initiation. Tetanus antibody titers will be evaluated before and after the booster vaccination, and evidence of an immune response to tetanus toxoid is required for enrollment. Participants will also undergo placement of an intraperitoneal access port before the first administration of study treatment.
Treatment begins with a single escalating loading dose of Lm-LLO-TT administered intraperitoneally on Day 1. Beginning on Day 2, participants will receive low-dose intraperitoneal gemcitabine followed the next day by low-dose intraperitoneal Lm-LLO-TT. This alternating schedule will be repeated for a total of five gemcitabine/Lm-LLO-TT treatment cycles over approximately 17 days.
The dose-escalation component evaluates escalating loading doses of Lm-LLO-TT while maintaining fixed doses of low-dose gemcitabine and low-dose Lm-LLO-TT. Participants will be enrolled sequentially into dose cohorts, and safety data including dose-limiting toxicities (DLTs) will be reviewed throughout the study. Escalation and de-escalation decisions will follow the protocol-defined BOIN design rules.
The primary objective of the study is to evaluate the safety and tolerability of intraperitoneal Lm-LLO-TT administered in combination with low-dose gemcitabine and to determine the MTD and RP2D. Safety evaluations include adverse event monitoring, physical examinations, vital signs, clinical laboratory assessments, electrocardiograms, and assessment of DLTs.
Secondary objectives include evaluation of preliminary anti-tumor activity. Tumor response will be assessed according to RECIST version 1.1 criteria. Secondary endpoints include objective response rate, disease control rate, and progression-free survival.
Exploratory objectives include assessment of pharmacodynamic and immune biomarkers associated with treatment. Blood samples will be collected for evaluation of circulating biomarkers, including circulating tumor DNA and markers associated with immune responses and tumor microenvironment modulation. Tumor tissue obtained during post-treatment biopsy procedures will be evaluated for immune cell infiltration, tetanus toxoid expression, and other tumor microenvironment biomarkers.
The first 10 enrolled participants will undergo a mandatory post-treatment tumor biopsy approximately 20 to 30 days following completion of treatment. Post-treatment biopsy will be optional for participants enrolled thereafter. Imaging assessments of the chest, abdomen, and pelvis will be performed at approximately Day 20 to 30 following treatment and repeated at approximately 4 and 6 months after treatment initiation.
Additional exploratory assessments will evaluate changes in pancreatic cancer-related symptoms, including pain, nausea, vomiting, and fatigue, as well as changes in concomitant pain medication use among participants who report pain at baseline.
Participants will be monitored for bacterial shedding through urine and fecal sample collection during the treatment and follow-up periods. Participants will also be monitored for safety events of special interest, including infection-related events associated with administration of live attenuated bacterial therapy.
Following completion of treatment, participants will enter a follow-up period that includes safety evaluations, disease assessments, laboratory testing, biomarker assessments, and survival follow-up. Participants will be followed for up to 6 months after initiation of study treatment.
Data generated from this study will be used to characterize the safety profile, determine the recommended dose for future studies, evaluate preliminary anti-tumor activity, and inform the further clinical development of intraperitoneal Lm-LLO-TT in combination with low-dose gemcitabine for the treatment of advanced pancreatic ductal adenocarcinoma.
3,896 studies on the registry are indexed under Pancreatic Neoplasms; 1,007 are open to participants now.
This study's planned enrollment of 18 is below the median of 47 across 2,932 interventional studies indexed under Pancreatic Neoplasms.
Browse Pancreatic Neoplasms studies →This is the only study on the registry with Loki Therapeutics, Inc. as lead sponsor.
Counted across the registry records on this site, refreshed daily.
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.
Able and willing to provide written . Adults aged 18 years or older. confirmed pancreatic ductal adenocarcinoma (PDAC) with per v1.1.
Previously treated with at least one for or unresectable disease, including a fluoropyrimidine-based or gemcitabine-based regimen, or have a to these therapies.
No radiation therapy, targeted therapy, or chemotherapy within 14 days prior to first study treatment; no immunotherapy or biologic therapy within 28 days prior to first study treatment.
Recovery to ≤ Grade 2 from toxicities of prior therapy. Performance Status 0-2. Estimated greater than 3 months. Adequate organ function, including adequate hematologic, hepatic, and renal function.
Participants with treated may be enrolled if clinically stable for at least 1 month.
Willing to comply with study procedures and requirements. Participants with may be enrolled if receiving antiretroviral therapy and is >400 cells/µL.
Participants with may be enrolled if viral load is undetectable and appropriately treated; participants with may be enrolled following curative treatment.
Demonstrated tetanus toxoid (TT) immune responsiveness, either at baseline or following administration of a tetanus toxoid booster during screening.
Exclusion Criteria:
Candidate for curative-intent surgical resection.
Surgery within 2 weeks prior to first study treatment.
Evidence of hepatic cirrhosis or clinically/radiographically significant ascites.
Blood transfusion within 14 days prior to study treatment or requirement for frequent blood transfusions (>2 per month).
Treatment with systemically active within 28 days before study treatment (except low-dose dexamethasone ≤2 mg/day or prednisone ≤10 mg/day).
Systemic antibiotic therapy within 14 days prior to first dose of Lm-LLO-TT.
Receipt of another product or vaccine within 28 days prior to first study treatment.
Receipt of any vaccine other than the protocol-required tetanus toxoid booster within 4 weeks before study treatment or during the initial DLT evaluation period.
Major surgery, significant traumatic injury, unhealed surgical wounds, or planned surgery requiring general anesthesia within 28 days before study treatment.
Active, uncontrolled , , , or HTLV-1 infection, or \<400 cells/µL.
Presence of implanted prosthetic devices, including orthopedic prostheses, pacemakers, or prosthetic heart valves.
Chronic therapy for or rheumatologic conditions.
Pregnant or breastfeeding individuals.
Active uncontrolled bacterial infection requiring intravenous antibiotics, fever >38.1°C, or unexplained fever within 7 days before Day 1.
History of Guillain-Barré syndrome within 6 weeks of a previous tetanus toxoid vaccination or prior Arthus-type reaction to tetanus vaccine.
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.
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.
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.
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.
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.
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.
Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.
A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.
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.
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.
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.
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.
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.
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.
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.
The number of CD4 cells, a type of white blood cell, in a given amount of blood. It is used to follow how well the immune system is doing in HIV.
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 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.
The New York Heart Association’s four classes of how much heart failure limits physical activity.
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.
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.
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.
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.
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.
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.
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.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Metastases
Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Contraindication
A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
CD4 count
The number of CD4 cells, a type of white blood cell, in a given amount of blood. It is used to follow how well the immune system is doing in HIV.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
NYHA class (heart failure)
The New York Heart Association’s four classes of how much heart failure limits physical activity.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Low dose
Biological: Lm-LLO-TT
Biological: Lm-LLO-TT
Middle dose
Biological: Lm-LLO-TT
Lm-LLO-TT is a live attenuated Listeria monocytogenes-based immunotherapy expressing tetanus toxoid and listeriolysin O, developed to stimulate tumor-directed immune responses through activation of tetanus-specific memory T cells.
Safety and tolerability
Incidence of dose-limiting toxicities (DLTs) and treatment-emergent adverse events to determine the maximum tolerated dose (MTD) and recommended Phase 2 dose (RP2D) of intraperitoneal Lm-LLO-TT in combination with low-dose gemcitabine
Time frame: Day 1 to Day 45
Objective Response Rate
Percentage of participants with complete response or partial response as assessed by RECIST v1.1.
Time frame: Up to 6 months
Disease Control Rate (DCR)
Percentage of participants with complete response, partial response, or stable disease as assessed by RECIST v1.1.
Time frame: Day 1 to 6 months
Progression-Free Survival (PFS)
Time from first study treatment to documented disease progression or death.
Time frame: Day 1 to 6 months
Plan to share: No — Individual participant data (IPD) collected during this study, including de-identified participant-level data and supporting study documents, will not be made available to other researchers. The study is an early-phase, first-in-human clinical trial of a proprietary investigational product and no plan currently exists for sharing individual participant data.
No publications or documents are linked to this record.
Started Oct 2026 (actual). Primary completion is estimated for Oct 2028, 24 months after the start.
Of 171 industry-sponsored phase 1 interventional studies under Pancreatic Neoplasms, half reached primary completion within 44 months of starting (the median), counting those still running; a quarter within 31 and three quarters within 62. This study's planned 24 months is below that.
Counting every sponsor, half of 379 studies reached it within 45 months; a quarter within 32 and three quarters within 67.
How these figures are worked out, and which studies are left out of them.
From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗
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