Clinical trial

A Phase II, Randomized Study of Atezolizumab (Anti-PD-L1 Antibody) and Trastuzumab in Combination With Capecitabine and Oxaliplatin (Xelox) in Patients With HER2 Positive Locally Advanced Resectable Gastric Cancer of Adenocarcinoma of Gastroesophageal Junction (GEJ)

Name
ML42058
Description
This is a phase II, multicenter, randomized, open-label study designed to evaluate the efficacy and safety of perioperative trastuzumab+XELOX with / without atezolizumab in participants eligible for surgery with locally advanced HER2-positive gastric cancer or adenocarcinoma of GEJ.
Trial arms
Trial start
2021-03-12
Estimated PCD
2023-05-08
Trial end
2026-08-30
Status
Active (not recruiting)
Phase
Early phase I
Treatment
Atezolizumab
Atezolizumab will be administered by IV infusion at a fixed dose of 1200 mg on Day 1 of each 21-day cycle for 3 cycles prior to surgery and 5 cycles after surgery.
Arms:
Arm A: Atezolizumab plus Trastuzumab with XELOX (Capecitabine + Oxaliplatin)
Other names:
Tecentriq
Trastuzumab
Trastuzumab will be administered as an 8 mg/kg IV loading dose and then 6 mg/kg IV on Day 1 of a 21-day cycle for 3 cycles before surgery, and administration will continue after surgery. The first administration of trastuzumab after surgery should also be given at the loading dose of 8 mg/kg.
Arms:
Arm A: Atezolizumab plus Trastuzumab with XELOX (Capecitabine + Oxaliplatin), Arm B: Trastuzumab with XELOX (Capecitabine + Oxaliplatin)
Other names:
Herceptin
Capecitabine
Capecitabine 1000 mg/m\^2 will be administered twice orally on Days 1-14, repeated every 3 weeks.
Arms:
Arm A: Atezolizumab plus Trastuzumab with XELOX (Capecitabine + Oxaliplatin), Arm B: Trastuzumab with XELOX (Capecitabine + Oxaliplatin)
Oxaliplatin
Oxaliplatin 130 mg/m\^2 will be administered by IV on Day 1 of a 21-day cycle.
Arms:
Arm A: Atezolizumab plus Trastuzumab with XELOX (Capecitabine + Oxaliplatin), Arm B: Trastuzumab with XELOX (Capecitabine + Oxaliplatin)
Size
41
Primary endpoint
Pathological Complete Regression (pCR) Rate
Completion of neoadjuvant systemic therapy (up to approximately 16 months)
Eligibility criteria
Inclusion Criteria: * Histologically confirmed gastric cancer or adenocarcinoma of GEJ * HER2-positive status defined as either IHC score of 3+ or IHC 2+ with amplification proven by in situ hybridization (ISH) as assessed by local review based on pretreatment endoscopic biopsies. * Clinical stage at presentation: cT3/T4a/T4b, or N+, M0 as determined by AJCC staging system, 8th edition * Availability of pretreatment tumor specimen for biomarker analysis by central lab * Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 * Life expectancy \>= 12 weeks * Adequate hematologic and end-organ function * For female patients of childbearing potential, agreement (by patient) to remain abstinent (refrain from heterosexual intercourse) or to use highly effective form(s) of contraception during the treatment period and to continue its use for at least i) 5 months after the last dose of atezolizumab, ii) 7 months after the last dose of trastuzumab, or iii) 6 months after the last dose of capecitabine or oxaliplatin, whichever is longer. * For men: agreement to remain abstinent (refrain from heterosexual intercourse) or use a condom, and agreement to refrain from donating sperm Exclusion Criteria: * Stage IV (metastatic) or unresectable gastric/GEJ cancer determined by investigators * Prior systemic therapy for treatment of gastric cancer * History of malignancy other than GC within 5 years prior to screening, with the exception of malignancies with a negligible risk of metastasis or death * Cardiopulmonary dysfunction * Dyspnea at rest * Active or history of autoimmune disease or immune deficiency with the following exceptions: (a) Patients with a history of autoimmune-mediated hypothyroidism who are on thyroid-replacement hormone are eligible for the study. (b) Patients with controlled Type 1 diabetes mellitus who are on an insulin regimen are eligible for the study. (c) Patients with eczema, psoriasis, lichen simplex chronicus, or vitiligo with dermatologic manifestations only are eligible for the study provided allof following conditions are met: (i) Rash must cover \< 10% of body surface area (ii) Disease is well controlled at baseline and requires only low-potency topical corticosteroids (iii) No occurrence of acute exacerbations of the underlying condition requiring psoralen plus ultraviolet A radiation, methotrexate, retinoids, biologic agents, oral calcineurin inhibitors, or high-potency or oral corticosteroids within the previous 12 months * History of idiopathic pulmonary fibrosis, organizing pneumonia, drug-induced pneumonitis, idiopathic pneumonitis, or evidence of active pneumonitis on screening chest CT scan * Active tuberculosis * Patients with active hepatitis B * Patients with active hepatitis C
Protocol
{'studyType': 'INTERVENTIONAL', 'phases': ['PHASE2'], 'designInfo': {'allocation': 'RANDOMIZED', 'interventionModel': 'PARALLEL', 'primaryPurpose': 'TREATMENT', 'maskingInfo': {'masking': 'NONE'}}, 'enrollmentInfo': {'count': 41, 'type': 'ACTUAL'}}
Updated at
2024-02-08

1 organization

3 products

1 drug

2 indications

Organization
Hoffmann La Roche
Indication
Stomach Cancer