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RecruitingLast updated: 3 April 2024

SIRACUSA: This study aims to compare a cancer drug (called onivyde) that is manufactured at two different production sites in adults with advanced pancreatic cancerA Phase I, Randomised, Open-Label, Single-Dose, Two-Treatment, Two-Way Crossover, Two-Stage Study to Evaluate the Bioequivalence of Onivyde (Irinotecan Liposome Injection) Manufactured at Two Different Sites Administered in Combination With Anti-Cancer Agents in Adult Participants With Metastatic Pancreatic Adenocarcinoma

Clinical summary


Eligible participants with metastatic, pancreatic adenocarcinoma will receive the Test Product (TP) and Reference Product (RP) Onivyde in line with its approved indication. The order in which participants will receive them depends on the group which they are randomly assigned, this will be referred to as the crossover phase. One group will receive the RP followed by the TP, while the other group will receive the TP followed by the RP. Participants will also receive 5-fluorouracil (5-FU) and leucovorin (LV). 


Upper gastrointestinal tract Cancers Upper gastrointestinal tract





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Scientific Title

A Phase I, Randomised, Open-Label, Single-Dose, Two-Treatment, Two-Way Crossover, Two-Stage Study to Evaluate the Bioequivalence of Onivyde (Irinotecan Liposome Injection) Manufactured at Two Different Sites Administered in Combination With Anti-Cancer Agents in Adult Participants With Metastatic Pancreatic Adenocarcinoma



  • Participant must be ≥18 years of age at the time of signing the informed consent.
  • Participants who have histological or cytologically confirmed adenocarcinoma of the pancreas.
  • Participants with an initial diagnosis of progressive metastatic disease
  • Participants with a confirmed diagnosis of metastatic adenocarcinoma of the pancreas with disease progression following gemcitabine-based therapy.
  • Eastern Cooperative Oncology Group (ECOG) performance status of ≤1
  • Adequate haematological parameters
  • Adequate hepatic function
  • Adequate renal function
  • Adequate coagulation
  • No clinically significant abnormalities in urinalysis results
  • Electrocardiogram (ECG) without any clinically significant findings
  • Participants known to be infected with controlled human immunodeficiency virus (HIV)
  • Male and female participants: Contraceptive use by men or women should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies
  • Capable of giving signed informed consent


  • Have only localised advanced disease.
  • History of any second malignancy in the last 2 years.
  • Known history of central nervous system metastases
  • Clinically significant gastrointestinal disorder including hepatic disorders, bleeding, inflammation, occlusion, diarrhoea >Grade 1, malabsorption syndrome, ulcerative colitis, inflammatory bowel disease or partial bowel obstruction.
  • Concurrent illnesses that would be a relative contraindication to trial participation such as active cardiac or liver disease
  • Active infection or an unexplained fever >38.5°C on the first scheduled day of dosing
  • Neuroendocrine tumour (carcinoid, islet cell) or acinar pancreatic carcinoma
  • History of interstitial lung disease, history of slowly progressive dyspnoea and unproductive cough, sarcoidosis, silicosis, idiopathic pulmonary fibrosis, pulmonary hypersensitivity pneumonitis or multiple allergies.
  • Exposure to a non-liposomal irinotecan or SN-38 based regimen within 4 weeks prior to randomisation, or exposure to Onivyde or other irinotecan based liposomal products within 6 weeks prior to randomisation
  • Major surgery, other than diagnostic surgery, within 4 weeks prior to randomisation
  • Participants who have received a live vaccine within 4 weeks prior to randomisation.
  • Use of strong CYP3A inhibitors or inducers, or strong inhibitors of UGT1A1.
  • Investigational therapy administered within 4 weeks, or within a time interval less than at least 5 half-lives of the investigational agent, whichever is longer, prior to study intervention on Cycle 1 Day 1
  • Known low or absent dihydropyrimidine dehydrogenase (DPD) activity.
  • Homozygous for the UGT1A1*28 allele.
  • Known hypersensitivity to any of the components of Onivyde injection, other liposomal products, or any components of 5-FU, or LV
  • Presence of any contraindications outlined in the Contraindications or Warnings and Precautions sections of the IB for Onivyde, or in the prescribing information for 5-FU or LV.
  • Participants who, in the opinion of the investigator, have symptoms or signs suggestive of clinically unacceptable deterioration of the primary disease at the time of screening
  • Any other medical or social condition deemed by the investigator to be likely to interfere with a participant's ability to sign informed consent, cooperate and participate in the study, or interfere with the interpretation of the results


  • You have had treatment but your cancer has gotten worse or has not responded to the treatment you have been given.
  • Your cancer has spread to other parts of the body.


  • You have been diagnosed with a prior or secondary type of cancer.
  • You have certain types of non-cancer medical conditions.
  • You have had certain treatments, surgical procedures or drugs.
  • You have previously been treated (or are currently being treated) on a clinical trial.

Clinical trials have complex eligibility criteria.

Ask your doctor if this trial could be right for you.

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