Experimental combo aims to overcome drug resistance in metastatic cancers
NCT ID NCT04150042
First seen Jun 27, 2026 · Last updated Jun 27, 2026
Summary
This early-stage trial is testing a combination of two chemotherapy drugs (melphalan and BCNU) plus vitamins B12b and C, followed by an infusion of the patient's own stem cells. The goal is to see if this approach is safe for people with metastatic pancreatic or breast cancer, especially those with BRCA or PALB2 mutations. The study involves 24 participants and uses a dose-escalation plan for vitamin C to find the safest dose.
What this could mean
Our plain-language read of the trial. This is informational only, not medical advice or a prediction.
- Active substance
- Melphalan, BCNU (carmustine), vitamin B12b (hydroxocobalamin), vitamin C (ascorbic acid), and autologous hematopoietic stem cells
- What this could lead to
- If this trial shows safety, it could point toward a new treatment option for people with metastatic pancreatic or breast cancer who have specific genetic mutations.
- What could go wrong
- This is a very early phase 1 trial with only 24 participants, focused on safety, not effectiveness. The treatment involves strong chemotherapy with serious risks like liver damage, lung problems, and kidney injury.
This is an AI summary of the original study and may miss details. Read our disclaimer.
Study facts
What this study's own registry entry says, in plain language.
- Phase
-
Phase 1
The first testing in people. Mainly checks safety and dose, usually in a small group.
- Participants
-
About 24 people
The number the study aims to enrol. It can still change while the study runs.
- Started
-
Jan 2021
- Expected to finish
-
Dec 2028
An estimate. End dates often move.
- Lead sponsor
-
A company
The lead sponsor is a pharmaceutical, biotech, or medical-device company.
Who can take part
This study's own entry requirements. Only the study team can say for certain whether you qualify.
- Ages
-
18 years and older
- Sex
-
Anyone
- Healthy volunteers
-
Not accepted
This study is not open to healthy volunteers. The entry requirements below say who it is open to.
Show the full entry requirements Hide the full entry requirements
Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.
Inclusion Criteria * Age ≥ 18 years. * Pancreatic or breast cancer, as described below. * Stage IV (based on AJCC staging guidelines) at the time of enrollment. a. Note that potential subjects with stage IV cancer that have had a complete response from prior chemotherapy are still potentially eligible. * Expected survival time ≥ 6 months, as determined by the investigator. * Life expectancy not severely limited by diseases other than malignancy, as determined by the investigator. * Karnofsky score ≥ 60%. * No chemotherapy within 2 weeks of enrollment. * Prior surgical resection or ablation of the primary tumor is allowed but not required. * If post-surgical, the subject must be at least 28 days post-op with the surgical wounds healed and significant complications resolved. * Potential subjects who have received previous chemotherapy and/or PARP inhibitors may be enrolled. * Measurable or non-measurable disease by the revised response evaluation criteria in solid tumors (RECIST) v.1.1. * For potential subjects with a germline BRCA1, BRCA2, or PALB2 mutation: a. The mutation must be known to be deleterious or suspected to cause functional impairment as assessed by a CLIA-certified laboratory according to the variant classification criteria described in the study protocol. * For potential subjects with somatic BRCA1, BRCA2, or PALB2 mutations: 1. The mutation must be a known or suspected deleterious mutation as assessed by a CLIA-certified laboratory according to the variant classification criteria described in the study protocol. 2. There must be biallelic loss or inactivation of the mutated BRCA1, BRCA2, or PALB2 gene as assessed by a CLIA-certified laboratory. 3. The Genetics Review Committee for this trial, which is comprised of a core group of investigators and whose actions are performed in accordance with the committee's charter, must agree that the biallelic mutations are deleterious or suspected deleterious. * For subjects without a BRCA1, BRCA2, or PALB2 mutation 1. Subject must have received at least 16 weeks of first-line (platinum-based\*) chemotherapy with no evidence of treatment failure, where treatment failure is defined as growing tumors, new lesions, or a steadily rising tumor marker during or within eight weeks of completion of the first line therapy. 2. \* Subjects can also have been treated with FOLFIRINOX but switched to FOLFIRI due to oxaliplatin side effects. * For potential subjects with pancreatic cancer: 1. Pancreatic ductal adenocarcinoma or pancreatic acinar cell carcinoma. 2. If the potential subject has had surgical resection of the primary tumor, then there must be no evidence of disease progression between the time of surgical resection of the primary tumor and screening for enrollment if the patient is seeking enrollment in the immediate post-surgery period. * For potential subjects with breast cancer: 1. Adenocarcinoma of the breast. 2. HER2-negative cancer as per American Society of Clinical Oncology/College of American Pathologists human epidermal growth factor receptor 2 (HER2) testing in breast cancer guidelines. 3. Male or female sex. * Histological or cytological confirmation of the primary cancer diagnosis is required. * Metastatic disease must be histologically or cytologically confirmed unless in the clinical judgment of the investigator a biopsy is not needed for diagnostic purposes. * Female participants of childbearing potential must agree to do one of the following from the time of signing of the informed consent through 6 months after the last dose of melphalan: 1. Simultaneously practice two effective barrier methods of contraception. Oral and injectable contraceptives are not allowed. Barrier methods of birth control (e.g., diaphragm and spermicide, or condom and spermicide) are required. 2. Practice true abstinence when this is in line with the preferred and usual lifestyle of the subject. Periodic abstinence (e.g., calendar, ovulation, symptothermal, post-ovulation methods, and withdrawal) are not acceptable methods of contraception. * Male participants: 1. Unless the male is in a monogamous relationship with a female that does not have child-bearing potential, male subjects (even if surgically sterilized) must agree to do one of the following from the time of signing of the informed consent through 6 months after the last dose of melphalan: 1. Practice effective barrier contraception, plus a second method of effective contraception. 2. Practice true abstinence when this is in line with the preferred and usual lifestyle of the subject. Periodic abstinence (e.g., calendar, ovulation, symptothermal, post-ovulation methods, and withdrawal) are not acceptable methods of contraception. Exclusion Criteria * Rapid disease progression or clinical features concerning for onset of rapid symptomatic deterioration, as determined by the investigator. * Biliary tract obstruction. * Current cholangitis. A biliary stent in situ does not otherwise exclude protocol participation. * A history of only one episode of cholangitis and fewer than 30 days have passed since discontinuation of antibiotic treatment. * A history of multiple episodes of cholangitis and after discussion between the site study team and sponsor medical monitor and careful evaluation for suitability the patient is deemed to be unsuitable for the trial due to risk of recurring cholangitis. * Portal hypertension. * Sinistral portal hypertension. * Obliteration or significant obstruction of the major veins or arteries (e.g., portal vein, superior mesenteric artery, superior mesenteric vein). * Clinically significant malignant ascites or malignant pleural effusion, as determined by the investigator. * Metastatic lesion to the heart or eye. * Chemotherapy for an indication other than treatment of the current cancer within the past 1 year with a more than 30% risk of recurrence as determined by the investigator. * Known or suspected metastatic involvement of the central nervous system. * Left ventricular ejection fraction less than 45% by Multigated Acquisition Scan or echocardiogram (or significantly below the lower limit of normal for the specific test). * Clinically significant structural heart disease or vascular disease. * Myocardial infarction within 6 months prior to enrollment; New York Heart Association (NYHA) Class III or IV heart failure; angina; uncontrolled ventricular arrhythmias; or electrocardiographic evidence of acute ischemia or active conduction system abnormalities. * Clinically significant prolongation of QTc (Bazett formula) on EKG, defined as \> 0.45 s in males and \> 0.47 s in females. * Severe hypertension, which is defined as the presence of any of the following: 1. History of hypertensive crisis, hypertensive emergency, or malignant hypertension within the last year. 2. Sustained or persistent systolic BP \> 165 mm Hg or diastolic \> 110 mm Hg. * Other clinically significant cardiovascular disease. * NOTE: 1. A past history of severe hypertension that is well-controlled with therapy or that was addressed by removal of the cause (e.g., removal of a medicine that caused the severe hypertension) is not an exclusion criterion. 2. The presence of a pacemaker is not a contraindication and is not considered an exclusion criterion * History or evidence of interstitial lung disease (e.g., pneumonitis or pulmonary fibrosis). * If a smoker, refusal to stop smoking for the duration of the trial. * FEV1 or DLCO (adjusted for hemoglobin) \< 50% of predicted. * Total bilirubin \> 2x upper normal limit, except that potential subjects with Gilbert's Disease are permitted to exceed 2x upper normal limit. * ALT or AST \> 2.5x upper normal limit. * Alkaline phosphatase \> 2.5x upper normal limit, in conjunction with elevated GGT. * Albumin \< 3.0 g/dl. * Clinical evidence of sinusoidal obstruction syndrome. * Corrected creatinine clearance consistently \< 50 ml/min/1.73 m\^2. * Clinically significant renal disease. * Hemolytic anemia. * Family history of catalase deficiency or history or evidence of a severe adverse reaction to hydrogen peroxide consistent with catalase deficiency, unless testing has demonstrated that the patient is not catalase-deficient. * Evidence of bone marrow insufficiency or failure, in the judgment of the investigator. * A hemoglobin \< 9 g/dL. * G6PD deficiency as measured by quantitative enzyme levels below the normal reference range in blood. * Pre-existing bleeding diathesis or coagulopathy. * Potential subject is pregnant. * Breast feeding and unwilling to stop. * Wilson's disease. * Primary or secondary hemochromatosis. * Hgb A1c \> 9%. * Hyperuricemia that is not responsive to therapy. * Plasma oxalate greater than 10 µM, which is not responsive to measures to reduce the level below 10 µM. * History of clinically significant elevation of plasma oxalic acid or complications related to oxalic acid. * Prior or current hepatitis B or C. * HIV infection or seropositivity for HIV. * Active, clinically significant bacterial, viral, or fungal infection. * History of colonization with a multidrug-resistant "superbug" that poses a high risk of an untreatable infection in the setting of neutropenia. * Uncontrolled seizure disorder. * If a potential subject has received radiation, then any of the following: 1. A volume ≥ 700 ml of normal liver received a dose ≥ 10 Gy. 2. The mean dose to normal liver (i.e., liver minus gross tumor volume) was ≥ 10 Gy. 3. The mean dose to normal lung (i.e., lung minus gross tumor volume) was ≥ 4 Gy. * History of significant allergy or other contraindication to BCNU, melphalan, vitamin B12b, vitamin C, pegfilgrastim, or Neupogen, or to any excipient in those drugs. * Use of any of the following cytochrome P450 2b6 (CYP2b6) inducers within 21 days of the planned date of BCNU treatment: phenobarbital, carbamazepam, rifampicin, phenytoin, sulfinpyrazone, or verapamil. * Disulfiram (Antabuse) use within 30 days of the planned ethanol administration. * Current chronic use of immunosuppressive agents (e.g., methotrexate, cyclosporine, corticosteroids). * Prior bone marrow stem cell transplant. * Except for adjuvant therapy for breast cancer or pancreatic cancer, prior radiation therapy to the brain, kidneys, pelvis, or GI tract or treatment with yttrium-90. * Prior treatment with bleomycin or BCNU. * Prior treatment, within 30 days of enrollment, with a drug that has not been FDA-approved for any indication (cancer or otherwise). * Subject has not fully recovered (i.e., there remain toxicities \> Grade 1) from the reversible effects of prior chemotherapy, with the exception of chemotherapy-induced alopecia and grade 2 peripheral neuropathy, unless in the opinion of the principal investigator the effects are not of clinical significance. * Any concurrent anticancer treatment. * Serious underlying medical or psychiatric illness or another condition that in the clinical judgment of the principal investigator is likely to interfere with the potential subject completing participation in the trial, based on safety concerns or otherwise. * Inability or unwillingness to adhere to the study protocol. * Unwillingness to receive ethanol.
Get updates
Get notified about this study
Sign up to get updates when this study changes or when new studies for Adenocarcinoma of the breast are added.
Genom att skicka in godkänner du våra Användarvillkor
Conditions
The condition(s) this trial relates to.
As listed by the trial registrant
The condition terms exactly as the trial's registrant entered them.
How to take part
Only the study team decides who joins. These are the ways to reach them.
-
The study's own enquiry address
This study publishes an address for enquiries. See it below .
-
The places running it
1 site. The list below names each one and where it is.
-
The official record
ClinicalTrials.gov lists the study team's own contact details, including names and phone numbers. We don't republish those.
-
A doctor treating you
A doctor who knows your case can contact a study site on your behalf, and can tell you whether this study is worth pursuing at all.
Contacts and locations
Show contact details
Enter your email to view the contact information for this study.
Genom att skicka in godkänner du våra Användarvillkor
Study contacts
-
Contact
Email: •••••@•••••
Locations
-
Massachusetts General Hospital
COMPLETEDBoston, Massachusetts, 02114, United States
-
Memorial Sloan Kettering Cancer Center
RECRUITINGNew York, New York, 10065, United States
More trials for these conditions
Other studies related to the condition(s) this trial covers.
- Gut bacteria may hold clues to why some cancer treatments work better
- Can a blood test before pancreatic surgery predict a dangerous leak?
- New chemo cocktail targets pancreatic cancer at every stage
- Bacteria-Based immunotherapy targets pancreatic tumors in first human test
- Daily pill giredestrant put to the test for sticking with breast cancer treatment
- Can a new radiation machine cut breath holds for cancer patients?