Colecalciferol (Vitamin D3) for Metastatic pancreatic adenocarcinoma (previously untreated)

Inclusion criteria

• {"criterion_text":"- Histologically confirmed metastatic Stage IV adenocarcinoma of the pancreas\n- Patients with history of hepatitis C (HCV) infection are eligible if HCV viral load is undetectable at screening. HCV screening tests are not required unless there is a known history of HCV infection.\n- No evidence of active infection and no serious infection within the past 30 days.\n- Patient able to understand and willing to sign and date the written voluntary informed consent form at screening visit prior to any protocol-specific procedures\n- Patient affiliated to a social security regimen\n- 2.\tNo prior treatment for stage IV pancreatic adenocarcinoma (prior adjuvant or neoadjuvant treatment is not allowed)\n- Eastern Cooperative Oncology Group (ECOG) performance status 0 – 1\n- Male and female patients 18 – 75 years\n- Measurable disease determined using guidelines of Response Evaluation Criteria In Solid Tumors (RECIST version 1.1)\n- Accessible tumor tissue available for fresh biopsy\n- Expected survival >3 months\n- Men and women of child-bearing potential must agree to use adequate contraception. A female participant is eligible to participate if she is not pregnant or breastfeeding and at least one of the following conditions applies: - Is not a woman of childbearing potential (WOCBP), or - Is a WOCBP and using a contraceptive method that is highly effective (with a failure rate of <1% per year), from the screening visit to at least 4 months after the last dose of dostarlimab, and agrees not to donate eggs (ova, oocytes) for the purpose of reproduction during this period. The investigator should evaluate the effectiveness of the contraceptive method in relationship to the first dose of dostarlimab, and A WOCBP must have a negative highly sensitive pregnancy test (urine or serum, as required by local regulations) within 72 hours before the first dose of study treatment. Fertile men who are sexually active with a WOCBP must use a male condom plus spermicide during the trial and for 120 days after the last dostarlimab administration. Male patients should also refrain from sperm donation throughout this period.\n- Laboratory values ≤1 week prior to randomization must be: \tAdequate hematologic values -\tPlatelet count ≥100,000 cells/mm3 -\tAbsolute neutrophil count [ANC] ≥1,500 cells/mm3 -\tHemoglobin ≥9 g/dL or ≥90 g/L) \tAdequate hepatic function -\tAspartate aminotransferase [AST/SGOT] ≤2.5x Upper Normal Limit [UNL] (≤5x UNL if liver metastases present) -\tAlanine aminotransferase [ALT/SGPT] ≤ 2.5x Upper Normal Limit (≤5x UNL if liver metastases present) -\tBilirubin ≤1.5x UNL -\tSerum albumin > 3.0 g/dL \tAdequate renal function serum creatinine clearance CLcr ≥ 50 mL/min) (Cocroft-Gault Formula should be used for CrCl calculation) \tFor participants not taking warfarin: INR <1.5 or PT <1.5 x ULN and either PTT or aPTT <1.5 x ULN. Participants taking warfarin may be included on a stable dose with a therapeutic INR <3.5 \tUracilemia < 16 ng/ml"}

Exclusion criteria

• {"criterion_text":"- Endocrine or acinar pancreatic carcinoma\n- 10.\tHistory or current evidence on physical examination of central nervous system disease or peripheral neuropathy ≥ grade 1 Common Toxicity Criteria for Adverse Events (CTCAE) v5.0.\n- 11.\tAny significant disease which, in the investigator’s opinion, would exclude the patient from the study.\n- 12.\tPatient with a DPD deficiency or UGT1A1 homozygous 7/7; the test should be done for all patients before 5-FU administration, according to ANSM communication regarding recommendation about high risk of no testing DPD in patient before 5-FU administration\n- 13.\tHas undergone prior allogeneic hematopoietic stem cell transplantation\n- 14.\tHas had an allogeneic tissue/solid organ transplant\n- 15.\tHas a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy (in dosing exceeding 10 mg daily of prednisone equivalent)\n- 16.\tParticipant has received systemic steroid therapy (>10 mg daily prednisone or equivalent) within 7 days before the first dose of the study treatment or is receiving any other form of immunosuppressive medication. Replacement therapy (adrenal or pituitary insufficiency) is not considered a form of systemic therapy. Use of inhaled corticosteroids, local steroid injection, or steroid eye drops is allowed.\n- 17.\tParticipant has received a live vaccine within 30 days of planned start of study therapy. COVID-19 vaccines that do not contain live viruses are allowed. Note: mRNA and adenoviral-based COVID-19 vaccines are considered non-live.\n- 18.\tHistory of or serology positive for HIV\n- 19.\tPatients who have documented presence of HBsAg [or HBcAb] at Screening or within 3 months prior to first dose of study intervention are excluded. HBV screening tests are not required unless there is a known history of HBV infection.\n- Participant has cirrhosis or current unstable liver or biliary disease per investigator assessment defined by the presence of ascites, encephalopathy, coagulopathy, hypoalbuminemia, esophageal/gastric varices, or persistent jaundice. Note: Stable non-cirrhotic chronic liver disease (including Gilbert’s syndrome or asymptomatic gallstones) is acceptable if participant otherwise meets entry criteria.\n- 20.\tHas an active autoimmune disease that has required systemic treatment in the past 2 years (i.e., with use of disease-modifying agents, corticosteroids, or immunosuppressive drugs). Replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency) is not considered a form of systemic treatment and is allowed.\n- 21.\tHas a history of (non-infectious) pneumonitis/interstitial lung disease that required steroids or has current pneumonitis/interstitial lung disease\n- 22.\tHas an active infection requiring systemic therapy\n- 23.\tAllergy: Participant cannot have history of severe allergic and/or anaphylactic reactions to chimeric, human or humanized antibodies or fusion proteins, sensitivity to any of the study treatments or components thereof, or a history of drug or other allergy that contraindicates their participation.\n- 24.\tBeing deprived of liberty or under guardianship\n- 25.\tPotential participants who are pregnant, breastfeeding, or expecting to conceive children while receiving study treatment and/or unwilling to use highly effective contraception for up to 4 months after the last dose of study treatment are not eligible for the study.\n- 3.\tMajor surgical procedure, open biopsy or significant traumatic injury within 28 days prior to study treatment start. Incompletely healed wounds or anticipation of the need for major surgical procedure during the course of the study\n- Known cerebral metastases, central nervous system (CNS), or epidural tumor\n- Prior anticancer treatment for adenocarcinoma of the pancreas\n- Known dose tivity reaction to any of the components of study treatments.\n- Pregnancy (absence to be confirmed by β-hCG test) or breast-feeding period\n- 8.\tClinically relevant coronary artery disease or history of myocardial infarction in the last 6 months, or high risk of uncontrolled arrhythmia (for men: QTc ≥450 msec, for women: QTc ≥470 msec)\n- 9.\tPrevious malignancy in the last 5 years except curative treated basal cell carcinoma of the skin and/or in situ carcinoma of the cervix"}

Primary endpoints

• {"endpoint_text":"- The primary endpoint of this study is the Objective Response Rate (ORR).","definition_or_measurement_approach":"Objective Response Rate (ORR) assessed per RECIST version 1.1"}

Secondary endpoints

• {"endpoint_text":"- 1.\tTo assess the safety and tolerability of mFOLFIRINOX + dostarlimab + HD vitamin D3 according to Common Terminology Criteria for Adverse Events (CTCAE) version 5.0","definition_or_measurement_approach":"Safety and tolerability assessed using CTCAE v5.0 (type, frequency, severity of adverse events; adverse events of special interest; laboratory safety results)"}
• {"endpoint_text":"- 2.\tTo evaluate the antitumor efficacy of mFOLFIRINOX + dostarlimab + HD Vitamin D3.","definition_or_measurement_approach":"Antitumor efficacy measures include median progression-free survival (PFS), median overall survival (OS), median duration of response (DOR), clinical benefit rate per RECIST 1.1"}

France

Latest Decision Or Authorization Date

25-11-2025

Number Of Sites

7

Number Of Participants

35

Primary sponsor

Full Name

Hospital Foch

Organisation Type

Hospital/Clinic/Other health care facility

Country Of Registered Address

France