Pancreatic Cancer Research

Clinical trialPhase 3Completed

Study of Efficacy and Safety of NIS793 in Combination With Standard of Care (SOC) Chemotherapy in First-line Metastatic Pancreatic Ductal Adenocarcinoma (mPDAC) - daNIS-2

A Randomized, Double-blind, Phase III Study, Comparing NIS793 in Combination With Gemcitabine and Nab-paclitaxel Versus (vs.) Placebo Combined With Gemcitabine and Nab-paclitaxel for First Line Treatment of Metastatic Pancreatic Ductal Adenocarcinoma (mPDAC) - daNIS-2

Outcome
Outcome unknown
Phase
Phase 3
Status
Completed
Study type
Interventional
Start
30 September 2021
Expected end
13 August 2024
Enrollment
511 participants
Sites
113
Primary outcomes
Safety run-in Part: Percentage of Participants With Dose Limiting Toxicities (DLTs) During the First Cycle (4 Weeks) of Treatment.; Randomized Part: Overall Survival (OS)
Sponsor
Industry
Results posted
2026-05-19
Last update
19 May 2026

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Brief summary public domain (ClinicalTrials.gov)

The purpose of this study was to evaluate the efficacy and safety of NIS793 in combination with gemcitabine/nab-paclitaxel versus gemcitabine/nab-paclitaxel and placebo in first-line metastatic pancreatic ductal adenocarcinoma (mPDAC). This study aimed to explore whether blockade of Transforming Growth Factor β (TGFβ) in combination with gemcitabine/nab-paclitaxel could reduce fibrosis in PDAC, restore chemo-sensitivity and ultimately lead to improvements in overall survival (OS) and other clinically relevant outcomes.

Detailed description public domain (ClinicalTrials.gov)

This was a randomized, double-blind, multicenter, two- group, phase III study that consisted of two parts: a Safety Run-in part and a Randomized part. The decision to open the randomized part of the study was based on dose confirmation and available safety, relevant PK, and other clinical and laboratory data from the Safety Run-in part. The open-label Safety Run-in part was conducted to confirm the recommended phase 3 dose (RP3D) of NIS793 in combination with gemcitabine and nab-paclitaxel. The safety run-in part started with one treatment regimen - NIS793 (2100 mg intravenous (i.v.) every 2 weeks (Q2W)) in combination with gemcitabine and nab-paclitaxel during the DLT assessment period. Dose limiting toxicity assessment period is defined as first cycle (i.e. 28 days, or 4 weeks) of dosing of the study treatment. The Randomized part randomized participants 1:1 to one of the two treatment groups: * Investigational group (Arm A); combination of NIS793, gemcitabine and nab-paclitaxel * Control group (Arm B): combination of placebo, gemcitabine and nab-paclitaxel Participants were stratified at randomization by Eastern Cooperative Oncology Group Performance Status (ECOG-PS) (0 or 1), presence of liver metastasis (yes vs. no), and region (North America, Europe and Australia vs. other countries). Cross-over to the other treatment group was not allowed during the study duration. The study treatment was administered as a 28-day treatment cycle. NIS793 was administered at a flat dose as confirmed in the Safety Run-in part on day 1 and 15 (e.g., 2100 mg i.v. Q2W or 2100 mg i.v. Q4W, if Q2W was considered as not tolerable in Safety Run-in part). Gemcitabine (1000 mg/m² on days 1, 8 and 15) and nab-paclitaxel (125 mg/m² on days 1, 8 and 15) were administered as per label. As of 7-Jul-2023, the administration of NIS793/placebo was stopped for all participants following the recommendation from Data Monitoring Committee (DMC). Following the recommendation to stop administration of NIS793/placebo, the DMC encouraged to continue administration of gemcitabine/nab-paclitaxel to all participants per investigator's assessment, and the collection of additional follow-up data to better characterize the safety of NIS793 in combination with gemcitabine/nab-paclitaxel. The study was considered complete when each participant completed at least 12 months of follow-up from randomization date, died, withdrew consent, or was lost to follow-up, whichever occurred first or, in the event of an early study termination. At which time, any study participant continuing with standard of care chemotherapy (gemcitabine + nab-paclitaxel) was transitioned off the study.

Posted results (ClinicalTrials.gov registry) · primary outcome public domain (ClinicalTrials.gov)

Safety run-in Part: Percentage of Participants With Dose Limiting Toxicities (DLTs) During the First Cycle (4 Weeks) of Treatment. [Up to 4 weeks]. Count Of Participants, Participants. Safety run-in Part: NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=18): 0.

Posted results (ClinicalTrials.gov registry) · primary outcome public domain (ClinicalTrials.gov)

Randomized Part: Overall Survival (OS) [From randomization up to death, assessed up to approximately 34 months]. Median, Months (95% Confidence Interval). Randomized Part (Arm A): NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=245): 9.2 (8.1 to 10.5); Randomized Part (Arm B): Placebo Plus (Gemcitabine and Nab-paclitaxel) (n=245): 11.2 (9.6 to 12.1).

Posted results (ClinicalTrials.gov registry) · secondary outcome public domain (ClinicalTrials.gov)

Percentage of Participants With Adverse Events (AEs) [Up to approximately 32 months]. Count Of Participants, Participants. Adverse Events (AEs): Safety run-in Part: NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=21): 21; Randomized Part (Arm A): NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=239): 239; Randomized Part (Arm B): Placebo Plus (Gemcitabine and Nab-paclitaxel) (n=241): 239. Serious Adverse Events (SAEs): Safety run-in Part: NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=21): 13; Randomized Part (Arm A): NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=239): 144; Randomized Part (Arm B): Placebo Plus (Gemcitabine and Nab-paclitaxel) (n=241): 110. Fatal SAEs: Safety run-in Part: NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=21): 0; Randomized Part (Arm A): NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=239): 12; Randomized Part (Arm B): Placebo Plus (Gemcitabine and Nab-paclitaxel) (n=241): 8. AEs leading to discontinuation: Safety run-in Part: NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=21): 2; Randomized Part (Arm A): NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=239): 46; Randomized Part (Arm B): Placebo Plus (Gemcitabine and Nab-paclitaxel) (n=241): 50. AEs leading to dose adjustment/interruption: Safety run-in Part: NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=21): 16; Randomized Part (Arm A): NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=239): 205; Randomized Part (Arm B): Placebo Plus (Gemcitabine and Nab-paclitaxel) (n=241): 208. AEs requiring additional therapy: Safety run-in Part: NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=21): 21; Randomized Part (Arm A): NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=239): 231; Randomized Part (Arm B): Placebo Plus (Gemcitabine and Nab-paclitaxel) (n=241): 227.

Posted results (ClinicalTrials.gov registry) · secondary outcome public domain (ClinicalTrials.gov)

Percentage of Participants With Dose Interruptions and Dose Reductions of NIS793 in Combination With Gemcitabine and Nab-paclitaxel [Up to approximately 32 months]. Count Of Participants, Participants. With no dose interruption: Safety run-in Part: NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=21): 5; Randomized Part (Arm A): NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=239): 92; Randomized Part (Arm B): Placebo Plus (Gemcitabine and Nab-paclitaxel) (n=241): 82. With at least one dose interruption: Safety run-in Part: NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=21): 16; Randomized Part (Arm A): NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=239): 147; Randomized Part (Arm B): Placebo Plus (Gemcitabine and Nab-paclitaxel) (n=241): 159. With no dose reduction: Safety run-in Part: NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=21): 21; Randomized Part (Arm A): NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=239): 237; Randomized Part (Arm B): Placebo Plus (Gemcitabine and Nab-paclitaxel) (n=241): 241. With at least one dose reduction: Safety run-in Part: NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=21): 0; Randomized Part (Arm A): NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=239): 2; Randomized Part (Arm B): Placebo Plus (Gemcitabine and Nab-paclitaxel) (n=241): 0.

Posted results (ClinicalTrials.gov registry) · secondary outcome public domain (ClinicalTrials.gov)

Dose Intensity of NIS793 in Combination With Gemcitabine and Nab-paclitaxel [Up to approximately 32 months]. Mean, mg/cycle (Standard Deviation). Safety run-in Part: NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=21): 3669.2 (528.07); Randomized Part (Arm A): NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=239): 3134.1 (573.15); Randomized Part (Arm B): Placebo Plus (Gemcitabine and Nab-paclitaxel) (n=241): 3183.4 (593.92).

Posted results (ClinicalTrials.gov registry) · secondary outcome public domain (ClinicalTrials.gov)

Progression-Free Survival (PFS) [From enrollment (run-in part) or randomization (randomized part) up to disease progression or death, assessed up to approximately 34 months]. Median, Months (95% Confidence Interval). Safety run-in Part: NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=21): 5.4 (3.6 to 7.3); Randomized Part (Arm A): NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=245): 4.6 (3.7 to 5.4); Randomized Part (Arm B): Placebo Plus (Gemcitabine and Nab-paclitaxel) (n=245): 5.4 (5.3 to 6.6).

Posted results (ClinicalTrials.gov registry) · secondary outcome public domain (ClinicalTrials.gov)

Overall Response Rate (ORR) [Up to approximately 34 months]. Number, Percentage of participants (95% Confidence Interval). Safety run-in Part: NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=21): 19.0 (5.4 to 41.9); Randomized Part (Arm A): NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=245): 21.6 (16.6 to 27.3); Randomized Part (Arm B): Placebo Plus (Gemcitabine and Nab-paclitaxel) (n=245): 25.3 (20.0 to 31.2).

Posted results (ClinicalTrials.gov registry) · secondary outcome public domain (ClinicalTrials.gov)

Disease Control Rate (DCR) [Up to approximately 34 months]. Number, Percentage of participants (95% Confidence Interval). Safety run-in Part: NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=21): 76.2 (52.8 to 91.8); Randomized Part (Arm A): NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=245): 66.9 (60.7 to 72.8); Randomized Part (Arm B): Placebo Plus (Gemcitabine and Nab-paclitaxel) (n=245): 72.2 (66.2 to 77.8).

Posted results (ClinicalTrials.gov registry) · secondary outcome public domain (ClinicalTrials.gov)

Duration of Response (DOR) [Up to approximately 34 months]. Median, Months (95% Confidence Interval). Safety run-in Part: NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=4): 8.6 (3.5 to NA) [NA: Not estimable due to insufficient number of participants with events]; Randomized Part (Arm A): NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=53): 6.2 (4.7 to 7.4); Randomized Part (Arm B): Placebo Plus (Gemcitabine and Nab-paclitaxel) (n=62): 5.6 (5.0 to 7.2).

Posted results (ClinicalTrials.gov registry) · secondary outcome public domain (ClinicalTrials.gov)

Time to Response (TTR) [From enrollment (run-in part) or randomization (randomized part) up to first documented response, assessed up to approximately 34 months]. Median, Months (95% Confidence Interval). Safety run-in Part: NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=21): NA (NA to NA) [NA: Not estimable due to number of events censored]; Randomized Part (Arm A): NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=245): NA (NA to NA) [NA: Not estimable due to number of events censored]; Randomized Part (Arm B): Placebo Plus (Gemcitabine and Nab-paclitaxel) (n=245): NA (NA to NA) [NA: Not estimable due to number of events censored].

Posted results (ClinicalTrials.gov registry) · secondary outcome public domain (ClinicalTrials.gov)

Safety run-in Part: Trough Concentration (Ctrough) of NIS793 in Combination With Gemcitabine and Nab-paclitaxel [Cycles 1 and 3 Day 15 (0 hour (pre-dose)), Cycles 2, 4, 6 and 12 Day 1 (0 hour (pre-dose)). 1 cycle = 28 days.]. Mean, ng/mL (Standard Deviation). Cycle 1 Day 15: Safety run-in Part: NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=19): 230000 (250000). Cycle 2 Day 1: Safety run-in Part: NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=19): 207000 (82400). Cycle 3 Day 1: Safety run-in Part: NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=19): 300000 (123000). Cycle 3 Day 15: Safety run-in Part: NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=19): 309000 (130000). Cycle 4 Day 1: Safety run-in Part: NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=19): 370000 (148000). Cycle 6 Day 1: Safety run-in Part: NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=19): 425000 (86800). Cycle 12 Day 1: Safety run-in Part: NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=19): 553000 (NA) [NA: Not estimable due to insufficient number of participants with events].

Posted results (ClinicalTrials.gov registry) · secondary outcome public domain (ClinicalTrials.gov)

Safety run-in Part: Maximum Concentration (Cmax) of NIS793 in Combination With Gemcitabine and Nab-paclitaxel [Cycles 1 and 3 Day 1: 0 hour (pre-dose) and 1 hour. 1 cycle = 28 days.]. Mean, ng/mL (Standard Deviation). Cycle 1 Day 1: Safety run-in Part: NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=17): 549000 (193000). Cycle 3 Day 1: Safety run-in Part: NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=17): 837000 (394000).

Posted results (ClinicalTrials.gov registry) · secondary outcome public domain (ClinicalTrials.gov)

Safety run-in Part: Time to Reach Maximum Concentration (Tmax) of NIS793 in Combination With Gemcitabine and Nab-paclitaxel [Cycles 1 and 3 Day 1: 0 hour (pre-dose) and 1 hour. 1 cycle = 28 days.]. Median, Hour (Full Range). Cycle 1 Day 1: Safety run-in Part: NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=17): 1.12 (0.583 to 5.00). Cycle 3 Day 1: Safety run-in Part: NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=17): 0.883 (0.5 to 4.17).

Posted results (ClinicalTrials.gov registry) · secondary outcome public domain (ClinicalTrials.gov)

Randomized Part (Chinese Participants With Intensive PK Sampling): Trough Concentration (Ctrough) of NIS793 in Combination With Gemcitabine and Nab-paclitaxel [Cycle 1 Day 15, Cycle 3 Day 1, Cycle 3 Day 15, Cycle 4 Day 1 and Cycle 6 Day 1: 0 hour (pre-dose). 1 cycle = 28 days.]. Mean, ng/mL (Standard Deviation). Cycle 1 Day 15: 0 hour (pre-dose): Randomized Part (Arm A): NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=20): 149000 (36400). Cycle 3 Day 1: 0 hour (pre-dose): Randomized Part (Arm A): NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=20): 366000 (114000). Cycle 3 Day 15: 0 hour (pre-dose): Randomized Part (Arm A): NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=20): 380000 (187000). Cycle 4 Day 1: 0 hour (pre-dose): Randomized Part (Arm A): NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=20): 371000 (131000). Cycle 6 Day 1: 0 hour (pre-dose): Randomized Part (Arm A): NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=20): 493000 (221000).

Posted results (ClinicalTrials.gov registry) · secondary outcome public domain (ClinicalTrials.gov)

Randomized Part (Chinese Participants With Intensive PK Sampling): Maximum Concentration (Cmax) of NIS793 in Combination With Gemcitabine and Nab-paclitaxel [Cycles 1 and 3 Day 1: 0 hour (pre-dose) and 1 hour. 1 cycle = 28 days.]. Mean, ng/mL (Standard Deviation). Cycle 1 Day 1: Randomized Part (Arm A): NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=23): 691000 (113000). Cycle 3 Day 1: Randomized Part (Arm A): NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=23): 978000 (131000).

Posted results (ClinicalTrials.gov registry) · secondary outcome public domain (ClinicalTrials.gov)

Randomized Part (Chinese Participants With Intensive PK Sampling): Time to Reach Maximum Concentration (Tmax) of NIS793 in Combination With Gemcitabine and Nab-paclitaxel [Cycles 1 and 3 Day 1: 0 hour (pre-dose) and 1 hour. 1 cycle = 28 days.]. Median, Hour (Full Range). Cycle 1 Day 1: Randomized Part (Arm A): NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=23): 1.52 (0.583 to 7.00). Cycle 3 Day 1: Randomized Part (Arm A): NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=23): 3.98 (0.567 to 7.75).

Posted results (ClinicalTrials.gov registry) · secondary outcome public domain (ClinicalTrials.gov)

Randomized Part (Chinese Participants With Intensive PK Sampling): Area Under the Curve From Time Zero to the Last Measurable Concentration Sampling Time (AUClast) of NIS793 in Combination With Gemcitabine and Nab-paclitaxel [Cycles 1 Day 1: 0 hour (pre-dose) and 1 hour. 1 cycle = 28 days.]. Geometric Mean, h*ng/mL (Geometric Coefficient of Variation). Randomized Part (Arm A): NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=23): 48900000 (104.3).

Posted results (ClinicalTrials.gov registry) · secondary outcome public domain (ClinicalTrials.gov)

Randomized Part (Chinese Participants With Intensive PK Sampling): Area Under the Curve Calculated to the End of a Dosing Interval (Tau) at Steady-state (AUCtau) of NIS793 in Combination With Gemcitabine and Nab-paclitaxel [Cycles 3 Day 1: 0 hour (pre-dose) and 1 hour. 1 cycle = 28 days.]. Geometric Mean, h*ng/mL (Geometric Coefficient of Variation). Randomized Part (Arm A): NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=7): 159000000 (25.5).

Posted results (ClinicalTrials.gov registry) · secondary outcome public domain (ClinicalTrials.gov)

Randomized Part (Participants Without Intensive PK Sampling): Trough Concentration (Ctrough) of NIS793 in Combination With Gemcitabine and Nab-paclitaxel [Cycles 2, 3, 4, 6 and 12 Day 1 (0 hour (pre-dose)). 1 cycle = 28 days.]. Mean, ng/mL (Standard Deviation). Cycle 2 Day 1: 0 hour (pre-dose): Randomized Part (Arm A): NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=129): 249000 (105000). Cycle 3 Day 1: 0 hour (pre-dose): Randomized Part (Arm A): NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=129): 331000 (133000). Cycle 4 Day 1: 0 hour (pre-dose): Randomized Part (Arm A): NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=129): 335000 (138000). Cycle 6 Day 1: 0 hour (pre-dose): Randomized Part (Arm A): NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=129): 334000 (136000). Cycle 12 Day 1: 0 hour (pre-dose): Randomized Part (Arm A): NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=129): 302000 (63600).

Posted results (ClinicalTrials.gov registry) · secondary outcome public domain (ClinicalTrials.gov)

Randomized Part (Participants Without Intensive PK Sampling): Maximum Concentration (Cmax) of NIS793 in Combination With Gemcitabine and Nab-paclitaxel [Cycles 1 and 3: Day 1 (0 hour (pre-dose)). 1 cycle = 28 days.]. Mean, ng/mL (Standard Deviation). Cycle 1 Day 1: 0 hour (pre-dose): Randomized Part (Arm A): NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=152): 625000 (185000). Cycle 3 Day 1: 0 hour (pre-dose): Randomized Part (Arm A): NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=152): 807000 (228000).

Posted results (ClinicalTrials.gov registry) · secondary outcome public domain (ClinicalTrials.gov)

Randomized Part (Participants Without Intensive PK Sampling): Time to Reach Maximum Concentration (Tmax) of NIS793 in Combination With Gemcitabine and Nab-paclitaxel [Cycles 1 and 3: Day 1 (0 hour (pre-dose)). 1 cycle = 28 days.]. Median, Hour (Full Range). Cycle 1 Day 1: 0 hour (pre-dose): Randomized Part (Arm A): NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=152): 1.08 (0.5 to 5.17). Cycle 3 Day 1: 0 hour (pre-dose): Randomized Part (Arm A): NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=152): 0.833 (0.5 to 2.83).

Posted results (ClinicalTrials.gov registry) · secondary outcome public domain (ClinicalTrials.gov)

Randomized Part: Anti-drug Antibodies (ADA) Against NIS793 Prevalence at Baseline [Baseline]. Count Of Participants, Participants. ADA-negative sample at baseline: Randomized Part (Arm A): NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=196): 196. ADA-positive sample at baseline: Randomized Part (Arm A): NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=196): 0.

Posted results (ClinicalTrials.gov registry) · secondary outcome public domain (ClinicalTrials.gov)

Randomized Part: Anti-drug Antibodies (ADA) Against NIS793 Incidence on Treatment [From date of first study drug intake up to approximately 34 months]. Count Of Participants, Participants. Treatment-boosted ADA-positive: Randomized Part (Arm A): NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=196): 0. Treatment-induced ADA-positive: Randomized Part (Arm A): NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=196): 0. ADA-negative: Randomized Part (Arm A): NIS793 Plus (Gemcitabine and Nab-paclitaxel) (n=196): 196.