Phase I/II Study of LDE225 With Gemcitabine and Nab-paclitaxel in Patients With Pancreatic Cancer

Growing body of evidence suggests that the stroma is not only a mechanical barrier that may prevent efficient delivery of various anticancer therapies to the tumor, but also constitutes a dynamic compartment of pancreatic tumors that is critically involved in tumor formation, progression and metastasis. Thus, targeting both tumor stroma and cancer cells could be a lucrative strategy to increase the efficacy of our therapeutic approach. In the present study we want to explore the safety and activity of the chemotherapy combination: Gemcitabine + nab-paclitaxel + LDE225. LDE225 is a hedgehog inhibitor with promising antitumor activity in several cancer models, including pancreatic cancer. One of the main activities is also the degradation of the tumor matrix. Patients with locally advanced or metastatic pancreatic cancer will be treated with fixed doses of gemcitabine + nab-paclitaxel, the same doses used in the recently presented phase III study (von Hoff American Society of Clinical Oncology ASCO 2013). In the phase I part of the study LDE225 will be added according to standard dose escalation strategy for phase I studies, and at the maximum tolerated dose (MTD) patients will be treated in the phase II part of the study.