A Study to Learn About the Medicine Ponsegromab in Adults With Cancer of the Pancreas Which has Spread and Caused Significant Body Weight Loss and Fatigue

Overview

Sponsor-declared trial summary

Key facts

Sponsor

Pfizer Inc.

Participant type

Patients

Age range

18-64 years, 65+ years

Gender

Male and Female

Therapeutic area

Diseases [C] - Nutritional and Metabolic Diseases [C18]

Trial duration

20 May 2026 → ongoing

Decision date (initial)

2025-12-16

Transition trial

No

Low-intervention

No

Rare-disease indication

No

Vulnerable population

Yes

Funding sources

Pfizer Inc

External identifiers

EU CT number

2025-522093-36-00

ClinicalTrials.gov

NCT06989437

Trial design

CTIS Part I — objectives, methods, condition coding

Main objective

Scope: Therapy, Pharmacodynamic, Safety, Pharmacokinetic, Pharmacogenetic, Efficacy

1. To evaluate the effect of ponsegromab compared with placebo on body weight.
2. To evaluate the effect of ponsegromab compared with placebo on the appetiterelated symptoms as measured by FAACT-5IASS
3. Primary (OLE): To evaluate the effect of ponsegromab on body weight

Secondary objectives 17

1. To evaluate the effect of ponsegromab compared with placebo on physical activity as measured by a wearable DHT watch
2. To evaluate the effect of ponsegromab compared with placebo on overall survival
3. To evaluate the effect of ponsegromab compared with placebo on body weight.
4. To evaluate the effect of ponsegromab compared with placebo on physical activity as measured by a wearable DHT watch
5. To evaluate the effect of ponsegromab compared with placebo on the PFS
6. To evaluate the effect of ponsegromab compared with placebo on the ORR
7. To evaluate the effect of ponsegromab compared with placebo on the DCR
8. To evaluate the effect of ponsegromab compared with placebo to estimate the DOR
9. To evaluate the effect of ponsegromab compared with placebo on body composition
10. To characterize the safety and tolerability of ponsegromab compared with placebo
11. To evaluate the effect of ponsegromab compared with placebo on physical function and fatigue
12. To evaluate the effect of ponsegromab compared with placebo on body weight, appetite, physical activity, physical function, and fatigue over time
13. To evaluate the tolerability of ponsegromab compared with placebo
14. To evaluate the effect of ponsegromab compared with placebo on chemotherapy administration
15. To evaluate the impact of ponsegromab compared with placebo on tumor size
16. To evaluate effect of ponsegromab compared with placebo on ECOG PS.
17. OLE: To characterize the safety and tolerability of repeated SC administrations of ponsegromab

Conditions and MedDRA coding

Cancer cachexia

Regulatory references

Scientific advice from competent authorities

Food And Drug Administration, European Medicines Agency

Plan to share IPD

Yes

IPD plan description

Pfizer will provide access to individual de-identified participant data and related study documents (e.g. protocol, Statistical Analysis Plan (SAP), Clinical Study Report (CSR)) upon request from qualified researchers, and subject to certain criteria, conditions, and exceptions. Further details on Pfizer's data sharing criteria and process for requesting access can be found at: https://www.pfizer.com/science/clinical_trials/trial_data_and_results/data_requests

Eligibility criteria

Principal inclusion / exclusion criteria as submitted by sponsor

Inclusion criteria 6

1. Aged ≥18 years of age (or the minimum age of consent in accordance with local regulations if >18 years) at the Screening Visit.
2. Documented histologic or cytologic active diagnosis of mPDAC (locally advanced disease is not eligible) • Measurable disease; participant has one or more metastatic tumors measurable by CT scan (or MRI, if patient is allergic to CT contrast media) according to RECIST v 1.1. and: • Completed 1 × 28-day cycle of first-line systemic nab-paclitaxel and gemcitabine chemotherapy or 2 × 14-day cycles of FOLFIRINOX chemotherapy and must be prior to receiving the next cycle of nab-paclitaxel plus gemcitabine chemotherapy or FOLFIRINOX chemotherapy.
3. Cachexia as defined by Fearon criteria (see Section 8.1.1 for details on documented body weight from medical records): • BMI < 20 kg/m2 and involuntary weight loss of > 2% within 6 months prior to screening • Involuntary weight loss of >5% over the past 6 months prior to screening irrespective of BMI
4. Participants who are assessed by the investigator to have: • an ECOG PS ≤1 and • a life expectancy of ≥4 months.
5. Evidence of personally signed and dated ICD indicating that the participant has been informed of and comprehended all pertinent aspects of the trial.
6. Participant has been evaluated and determined that available anticachexic treatments have either been administered with no positive effect or the participant is not suitable for these treatments.

Exclusion criteria 23

1. Medical Conditions: Current active reversible causes of decreased food intake, as determined by the investigator. These causes may include, but are not limited to: • NCI CTCAE Grade 3 or 4 oral mucositis • NCI CTCAE Grade 3 or 4 GI disorders (nausea, vomiting, diarrhea, and constipation) • Mechanical obstructions interfering with the participant's ability to eat
2. History of any secondary malignancy in the last 2 years, except for adequately treated basal cell or squamous cell skin cancer or carcinoma in situ.
3. Neuroendocrine (carcinoid, islet cell) or acinar pancreatic carcinoma.
4. Symptomatic brain metastasis or leptomeningeal disease.
5. Prior/Concomitant Therapy: Participants must have received no previous radiotherapy, surgery, chemotherapy or investigational therapy for the treatment of metastatic disease. Prior treatment with chemotherapy in the adjuvant setting is allowed, provided at least 6 months have elapsed since completion of the last dose and no persistence of treatment-related toxicities are present.
6. Current use of any prohibited concomitant medication(s) within 4 weeks or 5 half-lives (whichever is longer) prior to the first dose of study intervention. Refer to Section 6.9 for full details of prohibited and permitted medications.
7. Prior/Concurrent Clinical Study Experience: Previous administration with an IP (drug, biologic agents, or vaccine) either within 30 days (or as determined by the local requirement) or 5 half lives, whichever is longer, preceding the first dose of study intervention used in this study through the duration of the study.
8. Previous participation in a clinical study evaluating ponsegromab (including exposure to placebo).
9. Diagnostic Assessments: Renal disease requiring dialysis or eGFR <30 mL/min/1.73m2 calculated using 2021 CKD-EPI equation described in Section 10.8.2.1.
10. History of severe liver disease or cirrhosis, unrelated to metastatic cancer. Potential participants with the following liver function test abnormalities will also be excluded; results may be confirmed by a single repeat test, if necessary: • Total bilirubin ≥1.5 × ULN (For Gilbert’s syndrome, direct bilirubin >ULN is exclusionary) • AST 3 × ULN (AST  5× ULN if there is liver involvement by the tumor) • ALT 3 × ULN (ALT 5× ULN if there is liver involvement by the tumor) • Alkaline phosphatase 3 x ULN (Alkaline phosphatase 5× ULN if there is liver involvement by the tumor and/or in case of bone metastases, or if considered related to prior surgery eg, pancreaticoduodenectomy).
11. Baseline standard 12-lead ECG that demonstrates clinically relevant abnormalities that may affect participant safety or interpretation of study results (eg, QTcF >470 ms).
12. Neuroendocrine (carcinoid, islet cell) or acinar pancreatic carcinoma.
13. Left ventricular ejection fraction <50% on echocardiogram (or MUGA scan).
14. Other Exclusion Criteria: Current adherence to a calorie-restricted diet with the intention of weight loss within 6 months prior to Screening/Visit 1
15. Investigator site staff directly involved in the conduct of the study and their family members, site staff otherwise supervised by the investigator, and sponsor and sponsor delegate employees directly involved in the conduct of the study and their family members.
16. Any prior or current clinical diagnosis of heart failure, irrespective of left ventricular ejection fraction or New York Heart Association classification.
17. Cachexia caused by reasons other than mPDAC, as determined by the investigator, including, but not limited to: •Severe COPD requiring use of home O2 •Active, uncontrolled or untreated AIDS
18. Undergoing major surgery (central venous access placement, endoscopic retrograde cholangiopancreatography with or without biliary stent placement, and tumor biopsies are not considered major surgery) within 4 weeks prior to randomization. Participants must have recovered from acute effects of surgery prior to screening. Participants should not have plans to undergo major surgical procedures during the study.
19. Clinically significant ascites that requires medical intervention or underwent a paracentesis within 4 weeks prior to randomization.
20. Any medical or psychiatric condition including recent (within the past year) or active suicidal ideation/behavior or laboratory abnormality that may increase the risk of study participation or, in the investigator’s judgment, make the participant inappropriate for the study.
21. History of allergic or anaphylactic reaction to any therapeutic or diagnostic monoclonal antibody (IgG protein) or molecules made of components of monoclonal antibody.
22. Participants who have a history of allergy or hypersensitivity to any of the chemotherapeutics or any of their excipients, or participants who exhibit any of the events outlined in the Contraindications or Special Warnings and Precautions sections of the chemotherapeutic prescribing Information.
23. Current or chronic HBV or HCV infection as evidenced by HBsAg and anti-hepatitis C antibody positivity, respectively, or known seropositivity for HIV.

Endpoints

Primary and secondary outcome measures (English text)

Primary endpoints 3

1. Percent change from baseline in body weight at Week 12.
2. Change from baseline in FAACT-5IASS subscale scores at Week 12.
3. Percent change from baseline body weight, in the open-label extension.

Secondary endpoints 17

1. Change from baseline at Week 12 in physical activity as measured by time spent in non-sedentary activity
2. Overall survival, defined as the time from randomization to occurrence of all-cause death
3. Change from baseline in body weight (kg) at Week 12
4. Change from baseline at Week 12 in physical activity as measured by total vector magnitude
5. PFS, as determined by BICR assessment per RECIST 1.1
6. ORR, as determined by BICR assessment per RECIST 1.1
7. DCR, as determined by BICR assessment per RECIST 1.1
8. DOR, as determined by BICR assessment per RECIST 1.1
9. Change from baseline in body composition as measured by CT scan at Week 12 and and all other collected time points. CT (or MRI) based measures will include: •LSMI •Skeletal muscle area and radiodensity at third lumbar vertebra (L3) •Intermuscular adipose area and radiodensity at L3 •Subcutaneous adipose area and radiodensity at L3 •Visceral adipose area and radiodensity at L3
10. Incidence of: •TEAEs •SAEs •AEs leading to permanent discontinuation from study intervention or study •Clinical laboratory abnormalities •Vital Sign abnormalities •ECG abnormalities
11. Change from baseline at Week 12: •PROMIS®-Physical Function (version 8c, 7-day) •PROMIS®-Fatigue (version 7a)
12. Change from baseline at all collected time points: •Body weight (and percent change) •FAACT Total and Sub-scale Scores (including FAACT-5IASS) •Time spent in non-sedentary activity • Total vector magnitude •PROMIS®-Physical Function (version 8c, 7-day) •PROMIS®-Fatigue (version 7a)
13. Occurrence and severity of the symptomatic AEs including diarrhea, nausea, vomiting, decreased appetite, fatigue, and mouth sores by maximum grade as assessed by the NCI PRO CTCAE. •Overall side-effect impact as assessed by FACIT-GP5
14. Occurrence of chemotherapy dosing changes (including dose reductions, dosing interruptions, and permanent treatment discontinuations) due to occurrence of the AEs of nausea, vomiting, diarrhea, appetite decreased, or fatigue
15. Tumor status as determined by BICR assessment per RECIST 1.1 using CT scan (or MRI) at Week 12 and all other collected time points
16. Change from baseline at Week 12 and all other collected time points on ECOG PS
17. OLE: Incidence of: •TEAEs •SAEs •AEs leading to permanent discontinuation from study intervention or study •Clinical laboratory test abnormalities •Vital Sign abnormalities

Investigational products

Investigational medicinal products (IMPs), comparators, placebo, auxiliary

Test 1

Placebo 1

Auxiliary 1

Sponsors and contacts

Sponsor organisations, regulatory contacts, third parties

Pfizer Inc.

Sponsor organisation

Pfizer Inc.

Address

66 Hudson Boulevard East

City

New York

Postcode

10001-2189

Country

United States

Scientific contact point

Organisation

Pfizer Inc.

Contact name

Clinical Medical Lead

Public contact point

Organisation

Pfizer Inc.

Contact name

Clinical Medical Lead

Third parties 5

Locations

8 EU/EEA countries · 48 investigational sites

By country

Investigational sites

Country notifications

Trial-start, recruitment-start, end and early-termination notifications submitted per Member State

Results and documents

Annex IV summary of results, Annex V layperson summary, and all documents registered in CTIS for this trial

Documents 133 files

Public protocol annexes, IB summaries, regulatory submissions and post-authorisation documents registered in CTIS.

Application history

2 submissions — initial application plus substantial / non-substantial modifications