A Phase 1 Study of Gemcitabine, Nab-Paclitaxel, and Bosentan in Patients With Unresectable Pancreatic Cancer
This phase I trial studies the side effects and best dose of bosentan and how well it works when given together with gemcitabine and nab-paclitaxel for the treatment of pancreatic cancer that cannot be removed by surgery (unresectable). Bosentan may block the hormone endothelin and prevent the growth and spread of pancreatic cancer. Drugs used in chemotherapy, such as gemcitabine and nab-paclitaxel, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Giving bosentan with chemotherapy (gemcitabine and nab-paclitaxel) may work better in treating patients with pancreatic cancer compared to chemotherapy alone.
• Adult patients with unresectable pancreatic carcinoma
• Patients must be a candidate to receive one of the following chemotherapy combinations as determined by the treating physician:
⁃ Arm A2: gemcitabine plus nab-paclitaxel given every 2 weeks (arm A1 is closed per this amendment)
⁃ Arm B: mFOLFIRINOX given every 2 weeks
• Willingness to permit study team to obtain and use archival tissue, if already existing, or, be willing to undergo a fresh tumor biopsy if clinically possible (exceptions may be provided by study PI if medically unsafe to perform biopsy).
• Weight ≥ 40 kg
• ANC ≥ 1500/mm3; platelets ≥ 100,000/mm3
• AST, ALT ≤ 1.5 x ULN. Patients with liver metastases ≤ 3 x ULN
• Total serum bilirubin ≤ 1.5 x ULN
• Creatinine clearence ≥ 60 mL/min