Description:
DESTINY-Gastric03 will investigate the safety, tolerability, pharmacokinetics,
immunogenicity, and preliminary antitumor activity of trastuzumab deruxtecan (T-DXd) alone or
in combination with chemotherapy and/or durvalumab in HER2-positive advanced/metastatic
gastric/gastroesophageal junction (GEJ) adenocarcinoma patients.
Study hypotheses: Combination of T-DXd with cytotoxic chemotherapy and/or durvalumab
administered to subjects at the recommended phase 2 dose will show manageable safety and
tolerability and preliminary anti-tumor efficacy so as to permit further clinical testing.
T-DXd in combination with cytotoxic chemotherapy or immune checkpoint inhibitor administered
to HER2-positive gastric/GEJ cancer patients who have not received prior treatment for
advanced/metastatic disease will show preliminary evidence of anti-tumour activity and the
potential to become a therapeutic option for this patient population.
Title
- Brief Title: Ph1b/2 Study of the Safety and Efficacy of T-DXd Combinations in Advanced HER2+ Gastric Cancer (DESTINY-Gastric03)
- Official Title: A Phase 1b/2 Multicenter, Open-label, Dose-escalation and Dose-expansion Study to Evaluate the Safety, Tolerability, Pharmacokinetics, Immunogenicity, and Antitumor Activity of Trastuzumab Deruxtecan (T-DXd) Monotherapy and Combinations in Adult Participants With HER2 Overexpressing Gastric Cancer (DESTINY-Gastric03)
Clinical Trial IDs
- ORG STUDY ID:
D967LC00001
- NCT ID:
NCT04379596
Conditions
Interventions
Drug | Synonyms | Arms |
---|
Fluorouracil (5-FU) | | Arm 1A |
Capecitabine | | Arm 1B |
Durvalumab | MEDI4736 | Arm 1C |
Oxaliplatin | | Arm 1D(a) |
Trastuzumab | | Arm 2A |
Trastuzumab deruxtecan | DS-8201a | Arm 1A |
Cisplatin | | Arm 2A |
Purpose
DESTINY-Gastric03 will investigate the safety, tolerability, pharmacokinetics,
immunogenicity, and preliminary antitumor activity of trastuzumab deruxtecan (T-DXd) alone or
in combination with chemotherapy and/or durvalumab in HER2-positive advanced/metastatic
gastric/gastroesophageal junction (GEJ) adenocarcinoma patients.
Study hypotheses: Combination of T-DXd with cytotoxic chemotherapy and/or durvalumab
administered to subjects at the recommended phase 2 dose will show manageable safety and
tolerability and preliminary anti-tumor efficacy so as to permit further clinical testing.
T-DXd in combination with cytotoxic chemotherapy or immune checkpoint inhibitor administered
to HER2-positive gastric/GEJ cancer patients who have not received prior treatment for
advanced/metastatic disease will show preliminary evidence of anti-tumour activity and the
potential to become a therapeutic option for this patient population.
Trial Arms
Name | Type | Description | Interventions |
---|
Arm 1A | Experimental | T-DXd and 5-fluorouracil (5-FU) | - Fluorouracil (5-FU)
- Trastuzumab deruxtecan
|
Arm 1B | Experimental | T-DXd and capecitabine | - Capecitabine
- Trastuzumab deruxtecan
|
Arm 1C | Experimental | T-DXd and durvalumab | - Durvalumab
- Trastuzumab deruxtecan
|
Arm 1D(a) | Experimental | T-DXd, 5-FU, and oxaliplatin | - Fluorouracil (5-FU)
- Oxaliplatin
- Trastuzumab deruxtecan
|
Arm 1D(b) | Experimental | T-DXd, capecitabine, and oxaliplatin | - Capecitabine
- Oxaliplatin
- Trastuzumab deruxtecan
|
Arm 1E(a) | Experimental | T-DXd, 5-FU, and durvalumab | - Fluorouracil (5-FU)
- Durvalumab
- Trastuzumab deruxtecan
|
Arm 1E(b) | Experimental | T-DXd, capecitabine, and durvalumab | - Capecitabine
- Durvalumab
- Trastuzumab deruxtecan
|
Arm 2A | Active Comparator | Trastuzumab, 5-FU or capecitabine, and cisplatin or oxaliplatin | - Fluorouracil (5-FU)
- Capecitabine
- Oxaliplatin
- Trastuzumab
- Cisplatin
|
Arm 2B | Experimental | T-DXd monotherapy | |
Arm 2C | Experimental | T-DXd, 5-FU or capecitabine, and oxaliplatin | - Fluorouracil (5-FU)
- Capecitabine
- Oxaliplatin
- Trastuzumab deruxtecan
|
Arm 2D | Experimental | T-DXd, 5-FU or capecitabine, and durvalumab | - Fluorouracil (5-FU)
- Capecitabine
- Durvalumab
- Trastuzumab deruxtecan
|
Eligibility Criteria
Inclusion criteria:
1. Male and female participants must be at least 18 years of age
2. Disease Characteristics:
Locally advanced, unresectable, or metastatic disease Pathologically documented
adenocarcinoma of the stomach or GEJ with HER2 overexpression (IHC 3+ or ICH 2+/ISH+)
3. For Part 1, progression on or after at least one prior trastuzumab containing Regimen.
For Part 2, previously untreated for unresectable or metastatic adenocarcinoma of the
stomach or GEJ with HER2 overexpression.
4. Has measurable target disease assessed by the Investigator based on RECIST version 1.1
5. Has protocol defined adequate organ function including cardiac, renal and hepatic
function
6. If of reproductive potential, agrees to use a highly effective form of contraception
or avoid intercourse during and upon completion of the study.
Exclusion criteria:
1. History of active primary immunodeficiency, known HIV, active HBV or HCV infection.
2. Uncontrolled intercurrent illness.
3. History of non-infectious pneumonitis/ILD, current ILD, or where suspected ILD that
cannot be ruled out by imaging at screening.
4. Lung-specific intercurrent clinically significant severe illnesses.
5. Uncontrolled infection requiring intravenous (IV) antibiotics, antivirals, or
antifungals.
6. Pleural effusion, ascites or pericardial effusion that requires drainage, peritoneal
shunt, or Cell-free and Concentrated Ascites Reinfusion Therapy (CART).
7. Has spinal cord compression or clinically active central nervous system metastases.
Maximum Eligible Age: | 130 Years |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Part 1: Occurrence of adverse events (AEs) and serious adverse events (SAEs) |
Time Frame: | Safety will be assessed for approximately 24 months from informed consent. |
Safety Issue: | |
Description: | Occurrence of AEs and SAEs graded according to NCI CTCAE v5.0 |
Secondary Outcome Measures
Measure: | Part 1: Objective Response Rate (ORR) |
Time Frame: | An average of approximately 12 months. |
Safety Issue: | |
Description: | Confirmed ORR per RECIST 1.1 is the percentage of patients with Complete Response or Partial Response that is subsequently confirmed. |
Measure: | Part 2: Occurrence of adverse events (AEs) and serious adverse events (SAEs) |
Time Frame: | Safety will be assessed for approximately 24 months from informed consent. |
Safety Issue: | |
Description: | Occurrence of AEs and SAEs graded according to NCI CTCAE v5.0 |
Measure: | Duration of Response (DoR) |
Time Frame: | An average of approximately 18 months. |
Safety Issue: | |
Description: | DOR is defined as the time from the date of first documented response until the date of documented progression or death |
Measure: | Disease Control Rate (DCR) |
Time Frame: | An average of approximately 18 months. |
Safety Issue: | |
Description: | DCR is the percentage of subjects who have a best overall response of complete response (CR) or partial response (PR) or stable disease (SD) |
Measure: | Progression Free Survival (PFS) |
Time Frame: | An average of approximately 18 months. |
Safety Issue: | |
Description: | PFS is the time from date of first dose until the date of objective disease progression or death |
Measure: | Overall survival (OS) |
Time Frame: | An average of approximately 30 months. |
Safety Issue: | |
Description: | OS is the time from date of first dose until death due to any cause |
Measure: | Serum concentration of T-DXd, total anti-HER2 antibody, and MAAA-1181a in all arms |
Time Frame: | An average of approximately 24 months. |
Safety Issue: | |
Description: | Individual participant data and descriptive statistics will be provided for serum concentration data at each time point for each dose level for T-DXd, total anti-HER2 antibody, MAAA-1181a |
Measure: | Serum concentration of durvalumab in study arms including T-DXd in combination with durvalumab |
Time Frame: | An average of approximately 24 months. |
Safety Issue: | |
Description: | Individual participant data and descriptive statistics will be provided for serum concentration data at each time point for durvalumab. |
Measure: | Presence of ADAs for T-DXd and durvalumab (in study arms including T-DXd and durvalumab) |
Time Frame: | An average of approximately 24 months. |
Safety Issue: | |
Description: | Individual participant data and descriptive statistics will be provided for data at each time point for each dose level for T-DXd and durvalumab. |
Details
Phase: | Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | AstraZeneca |
Trial Keywords
- Gastric Cancer
- Carcinoma
- HER2
- Trastuzumab
- Deruxtecan
- T-DXd
- DS-8201a
Last Updated
August 6, 2021