Nab-Paclitaxel/Gemcitabine Followed by mFOLFOX Combined With Serplulimab and Bevacizumab Versus AG Chemotherapy Alone in Previously Untreated Advanced Pancreatic Cancer: A Randomized, Controlled, Multicenter Phase III Trial
A randomized, multicenter, Phase III trial evaluating the efficacy and safety of first-line Sequential AG-mFOLFOX chemotherapy combined with Serplulimab and Bevacizumab versus AG chemotherapy alone in advanced pancreatic cancer. The primary endpoint is Overall Survival (OS). Approximately 292 patients will be enrolled in China.
• Voluntarily agree to participate in the study and sign the informed consent;
• ≥18 years of age and ≤75 years of age on the day of signing the informed consent form, regardless of gender;
• Pancreatic ductal adenocarcinoma confirmed by pathologic histology or cytology;
• No prior systemic therapy for unresectable locally advanced or metastatic pancreatic cancer;
• Measurable lesions at baseline according to RECIST 1.1 criteria; if the subject has only 1 measurable lesion at baseline, the area of the lesion must not have received radiotherapy in the past or there must be evidence of significant progression of the lesion after completion of radiotherapy treatment;
• the ECOG physical status score was 0 or 1 and the Expected survival ≥12 weeks;
• No serious organic diseases of the heart, lungs, brain and other organs;
• Adequate organ function
∙ Bone Marrow Function: (no transfusion within 14 days prior to screening, no use of granulocyte colony stimulating factor \[G-CSF\], no use of drug correction) : i. Hemoglobin ≥90g/L; ii. Leukocytes ≥ 4.0 x 109/L, Neutrophils ≥1.5×109/L; iii. Platelet ≥80×109/L;
‣ Coagulation function: PT or APTT ≤ 1.5 x ULN in subjects not receiving anticoagulation; if subjects are receiving anticoagulation, as long as the PT is within the range of the anticoagulant drug formulation;
‣ liver function: (no albumin infusion within 14 days prior to screening): Serum total bilirubin ≤ 1.5 x ULN (with biliary obstruction, allowing enrollment of subjects undergoing biliary drainage or in the midst of stenting therapy who have a total bilirubin ≤ 2.5 x ULN). In subjects without liver metastasis, Aspartate aminotransferase (AST), alanine aminotransferase (ALT)≤2.5×ULN; In subjects with liver metastasis, ALT and AST≤5×ULN, but without elevated bilirubin;
‣ Renal function: serum creatinine ≤1.5 x ULN, creatinine clearance (CCr) ≥50 mL/min, urinary protein \<2+ (if urinary protein ≥2+, 24-hour (h) urinary protein quantification can be carried out, and 24h urinary protein quantification \<1.0 g can be enrolled)
‣ Heart function: New York College of Cardiology (NYHA) rating \< 3; Left ventricular ejection fraction ≥50%;
• Male or female patients of childbearing potential will voluntarily use an effective method of contraception, such as a double-barrier contraceptive method, condoms, oral or injectable contraceptives, and an intrauterine device (IUD), for the duration of the study and up to 6 months after the last study dose. All female patients will be considered of childbearing potential unless the female patient is naturally menopausal, artificially menopausal or sterilized;
⁃ Subject's ability and willingness to comply with visits, treatment plans, laboratory tests, and other study-related processes as specified in the study protocol.