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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT05042128
Registration number
NCT05042128
Ethics application status
Date submitted
25/08/2021
Date registered
13/09/2021
Titles & IDs
Public title
The ASCEND Study: Gemcitabine and Nab-Paclitaxel With CEND-1/LSTA1 or Placebo in Patients With Untreated Metastatic Pancreatic Ductal Adenocarcinoma
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Scientific title
A Randomised, Double-blinded Phase II Study of Gemcitabine and Nab-Paclitaxel With CEND-1/LSTA1 or Placebo in Patients With Untreated Metastatic Pancreatic Ductal Adenocarcinoma
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Secondary ID [1]
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CTC0304
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Universal Trial Number (UTN)
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Trial acronym
ASCEND
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Pancreatic Ductal Adenocarcinoma
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Metastatic Pancreatic Cancer
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Condition category
Condition code
Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - CEND-1/LSTA1
Treatment: Drugs - Gemcitabine Injection
Treatment: Drugs - Nab paclitaxel
Experimental: Cohort A: Standard Care + CEND1/LSTA1 (1 dose) - Participants will receive nab-paclitaxel 125mg/m2; CEND1/LSTA1 3.2mg/kg IV; and then Gemcitabine 1000mg/m2, on Day 1, 8 and 15 of each cycle. Each cycle will be 28 days.
Placebo comparator: Cohort A: Standard Care + Placebo - Participants will receive nab-paclitaxel 125mg/m2; placebo IV; and then Gemcitabine 1000mg/m2, on Day 1, 8 and 15 of each cycle. Each cycle will be 28 days.
Experimental: Cohort B: Standard Care + CEND1/LSTA1 (2 doses) - Participants will receive nab-paclitaxel 125mg/m2; CEND1/LSTA1 3.2mg/kg IV; Gemcitabine 1000mg/m2, and then +\~4hrs CEND-1/LSTA1 3.2mg/kg IV on Day 1, 8 and 15 of each cycle. Each cycle will be 28 days.
Placebo comparator: Cohort B: Standard Care + Placebo - Participants will receive nab-paclitaxel 125mg/m2; placebo IV; Gemcitabine 1000mg/m2, and then +\~4hrs matching placebo IV on Day 1, 8 and 15 of each cycle. Each cycle will be 28 days.
Treatment: Drugs: CEND-1/LSTA1
CEND-1/LSTA1 is a novel cyclic tumour-penetrating peptide iRGD (internalizing Arginylglycylaspartic acid) which may overcome poor drug delivery by activation of a complex trans-tissue transport pathway, providing an opportunity to overcome this mechanism of resistance in PDAC
Treatment: Drugs: Gemcitabine Injection
Chemotherapy drug provided as solution to be administered via IV infusion.
Treatment: Drugs: Nab paclitaxel
Chemotherapy drug provided as solution to be administered via IV infusion.
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Progression Free Survival
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Assessment method [1]
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Period of time from randomization to the date of first evidence of disease progression, the occurrence of new disease or death from any cause
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Timepoint [1]
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From date of randomization to 18 months later, or death
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Secondary outcome [1]
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Overall Survival
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Assessment method [1]
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Period of time from randomization to date of death from any cause, or the date of last known follow-up alive
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Timepoint [1]
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From date of randomization to 18 months later, or death
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Secondary outcome [2]
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Objective Tumour Response Rate
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Assessment method [2]
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The number of participants with documented partial or complete response (PR or CR) divided by the number of participants evaluable for response as defined as per the RECIST version 1.1 criteria
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Timepoint [2]
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From date of randomization to 18 months later, or death
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Secondary outcome [3]
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Patient-reported Outcomes
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Assessment method [3]
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Completion of the EORTC QLQ-C30 questionnaire. 30 questions; 28 on a 1-4 scale (Higher scores indicative of poorer quality of life), 2 on a 1-7 scale (higher scores indicative of better health/quality of life).
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Timepoint [3]
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Completed at baseline, then every 8 weeks from randomization until and at disease progression (to a maximum of 48 months).
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Secondary outcome [4]
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Patient-reported Outcomes
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Assessment method [4]
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Completion of the QLQ-PAN26 questionnaire. 26 questions on a 1-4 scale (Higher scores indicative of poorer quality of life)
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Timepoint [4]
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Completed at baseline, then every 8 weeks from randomization until and at disease progression (to a maximum of 48 months).
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Secondary outcome [5]
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Incidence of Treatment-Emergent Adverse Events (Patient Safety)
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Assessment method [5]
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Record of all adverse events (including SAEs) that patients experience
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Timepoint [5]
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From date of randomization until 30 days after final treatment visit
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Eligibility
Key inclusion criteria
* Adults, 18 years or older with histologically confirmed metastatic pancreatic ductal adenocarcinoma or poorly differentiated carcinoma.
* Measurable disease according to RECIST 1.1.
* Archival tumour tissue for tertiary correlative studies (biopsy or resection of primary or metastasis). Fine needle aspirate (FNA) or brushings will not be accepted.
* ECOG performance of 0-1 (Appendix 2)
* Adequate renal and haematological function
* Adequate hepatic function, defined as:
Bilirubin <1.5 X ULN (Upper Limit of Normal), AST or ALT = 5x ULN. If a person was recently stented with improving bilirubin, the person can be randomised with bilirubin up to 3 x ULN provided chemotherapy is not administered until within the stated thresholds.
* Willing and able to comply with all study requirements, including treatment, timing and/or nature of required assessments.
* Study treatment both planned and able to start within 7 days after randomisation
* Signed, written informed consent.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Uncontrolled metastatic disease to the central nervous system. To be eligible, known CNS metastases should have been treated with surgery and/or radiotherapy and the patient should have been receiving a stable dose of steroids for at least 2 weeks prior to randomisation, with no deterioration in neurological symptoms during this time.
* Prior chemotherapy or investigational anti-cancer therapy for metastatic pancreatic adenocarcinoma. Prior treatments with curative intent or for locally advanced disease are allowed, provided the last dose of chemotherapy was administered more than 6 months prior to randomisation.
* Prior radiotherapy or major surgery (as defined by local investigator) within 14 days of starting treatment.
* Any unresolved toxicity NCI CTCAE Grade =2 from previous anti-cancer therapy with the exception of alopecia, vitiligo and the laboratory values defined in the inclusion criteria. Participants with Grade =2 peripheral neuropathy are not allowed.
* Concurrent use of any other anti-cancer therapy including chemotherapy, targeted therapy, immunotherapy or biological agents.
* Known allergy or hypersensitivity to any of the study drugs and excipients.
* Any significant active infection, including chronic active hepatitis B, hepatitis C, or HIV. Participants with known Hepatitis B/C infection will be allowed to participate providing evidence of viral suppression has been documented and the patient remains on appropriate anti-viral therapy.
* History of prior or synchronous malignancy within 2 years prior to randomisation, except:
1. Malignancy that was treated with curative intent and for which there has been no known active disease for =2 years prior to randomisation.
2. Curatively treated non-melanoma skin cancer, cervical cancer in situ, superficial transitional cell carcinoma of the bladder, stage 1 endometrial carcinoma, prostatic intraepithelial neoplasia, low-grade papillary thyroid cancer, untreated localised very low risk or low risk prostate cancer under observation.
* Concurrent illness, including severe infection that may jeopardise the ability of the person to undergo the procedures outlined in this protocol with reasonable safety.
* Neuroendocrine pancreatic carcinoma.
* Life expectancy of less than 3 months.
* Pregnancy, lactation, or inadequate contraception. Women must be post-menopausal, infertile, or use a reliable means of contraception. Women of childbearing potential must have a negative pregnancy test done within 7 days prior to randomisation. Men must use a reliable means of contraception.
* Serious medical or psychiatric conditions that might limit the ability of the person to comply with the protocol.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Active, not recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
13/04/2022
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
1/10/2024
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Actual
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Sample size
Target
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Accrual to date
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Final
158
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Recruitment in Australia
Recruitment state(s)
NSW,QLD,SA,TAS,VIC,WA
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Recruitment hospital [1]
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Border Medical Oncology - Albury
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Recruitment hospital [2]
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Chris O'Brien Lifehouse - Camperdown
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Recruitment hospital [3]
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Monash Medical Centre - Clayton
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Recruitment hospital [4]
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Lake Macquarie Private Hospital - Gateshead
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Recruitment hospital [5]
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St George Hospital - Kogarah
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Recruitment hospital [6]
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Calvary Mater Newcastle - Newcastle
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Recruitment hospital [7]
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Newcastle Private Hospital - Newcastle
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Recruitment hospital [8]
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Prince of Wales Hospital - Sydney
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Recruitment hospital [9]
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Icon Cancer Centre Wesley - Auchenflower
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Recruitment hospital [10]
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Sunshine Coast University Hospital - Birtinya
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Recruitment hospital [11]
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Royal Brisbane and Womens Hospital - Herston
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Recruitment hospital [12]
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ICON Cancer Centre, Gold Coast University Hospital - Southport
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Recruitment hospital [13]
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Flinders Medical Centre - Adelaide
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Recruitment hospital [14]
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Queen Elizabeth Hospital - Woodville South
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Recruitment hospital [15]
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Launceston General Hospital - Launceston
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Recruitment hospital [16]
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Northern Health - Epping
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Recruitment hospital [17]
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Warringal Private Hospital - Heidelberg
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Recruitment hospital [18]
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The Alfred Hospital - Melbourne
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Recruitment hospital [19]
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Frankston Hospital - Melbourne
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Recruitment hospital [20]
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Epworth Healthcare - Richmond
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Recruitment hospital [21]
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Fiona Stanley Hospital - Murdoch
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Recruitment hospital [22]
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St John of God - Subiaco
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Recruitment postcode(s) [1]
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2640 - Albury
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Recruitment postcode(s) [2]
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2050 - Camperdown
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Recruitment postcode(s) [3]
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3168 - Clayton
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Recruitment postcode(s) [4]
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2290 - Gateshead
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Recruitment postcode(s) [5]
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2217 - Kogarah
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Recruitment postcode(s) [6]
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- Newcastle
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Recruitment postcode(s) [7]
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- Sydney
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Recruitment postcode(s) [8]
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4066 - Auchenflower
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Recruitment postcode(s) [9]
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575 - Birtinya
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Recruitment postcode(s) [10]
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4029 - Herston
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Recruitment postcode(s) [11]
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4215 - Southport
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Recruitment postcode(s) [12]
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- Adelaide
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Recruitment postcode(s) [13]
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5011 - Woodville South
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Recruitment postcode(s) [14]
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- Launceston
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Recruitment postcode(s) [15]
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3076 - Epping
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Recruitment postcode(s) [16]
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3084 - Heidelberg
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Recruitment postcode(s) [17]
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3004 - Melbourne
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Recruitment postcode(s) [18]
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- Melbourne
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Recruitment postcode(s) [19]
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3121 - Richmond
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Recruitment postcode(s) [20]
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6150 - Murdoch
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Recruitment postcode(s) [21]
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6008 - Subiaco
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Recruitment outside Australia
Country [1]
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New Zealand
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State/province [1]
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Dunedin
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Country [2]
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New Zealand
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State/province [2]
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Hamilton
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Funding & Sponsors
Primary sponsor type
Other
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Name
Australasian Gastro-Intestinal Trials Group
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Address
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Other collaborator category [1]
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Other
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Name [1]
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University of Sydney
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
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Summary
Brief summary
The purpose of the ASCEND clinical trial is to measure the effect of adding CEND-1/LSTA1, compared to placebo, to chemotherapy (gemcitabine and nab-paclitaxel) in patients who have untreated metastatic pancreatic cancer. The study will assess the duration which the cancer remained stable or improved, the number of patients who responded to treatment, overall survival, side effects and quality of life.
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Trial website
https://clinicaltrials.gov/study/NCT05042128
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Trial related presentations / publications
Dean A, Gill S, McGregor M, et al. 1528P Phase I trial of the first-in-class agent CEND-1 in combination with gemcitabine and nab-paclitaxel in patients with metastatic pancreatic cancer. Annals of Oncology 2020; 31: S941.
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Public notes
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Contacts
Principal investigator
Name
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Andrew Dean
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Address
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St John of God Hospital
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Address
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Phone
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Fax
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Email
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT05042128