Description:
This trial studies tucatinib to find out if it is safe when given with trastuzumab and other
anti-cancer drugs (FOLFOX and CAPOX). It will look at what side effects happen when
participants take this combination of drugs. A side effect is anything the drug does other
than treating cancer. It will also look at whether tucatinib works with these drugs to treat
certain types of cancer.
The participants in this trial have HER2-positive (HER2+) cancer in their gut, stomach,
intestines, or gallbladder (gastrointestinal cancer).
Title
- Brief Title: Tucatinib Plus Trastuzumab and Oxaliplatin-based Chemotherapy for HER2+ Gastrointestinal Cancers
- Official Title: A Phase 1b/2 Dose Escalation and Expansion Study of Tucatinib in Combination With Trastuzumab and Oxaliplatin-based Chemotherapy for HER2+ Gastrointestinal Cancers
Clinical Trial IDs
- ORG STUDY ID:
SGNTUC-024
- NCT ID:
NCT04430738
Conditions
- Colorectal Carcinoma
- Gastric Adenocarcinoma
- GEJ Adenocarcinoma
- Esophageal Adenocarcinoma
- Cholangiocarcinoma
- Gallbladder Carcinoma
Interventions
Drug | Synonyms | Arms |
---|
tucatinib | TUKYSA | Cohort 1A |
trastuzumab | | Cohort 1A |
oxaliplatin | | Cohort 1A |
leucovorin | | Cohort 1A |
fluorouracil | | Cohort 1A |
capecitabine | | Cohort 1C |
Purpose
This trial studies tucatinib to find out if it is safe when given with trastuzumab and other
anti-cancer drugs (FOLFOX and CAPOX). It will look at what side effects happen when
participants take this combination of drugs. A side effect is anything the drug does other
than treating cancer. It will also look at whether tucatinib works with these drugs to treat
certain types of cancer.
The participants in this trial have HER2-positive (HER2+) cancer in their gut, stomach,
intestines, or gallbladder (gastrointestinal cancer).
Trial Arms
Name | Type | Description | Interventions |
---|
Cohort 1A | Experimental | Tucatinib + trastuzumab + FOLFOX given in 14-day cycles | - tucatinib
- trastuzumab
- oxaliplatin
- leucovorin
- fluorouracil
|
Cohort 1B | Experimental | Tucatinib + trastuzumab + FOLFOX given in 14-day cycles | - tucatinib
- trastuzumab
- oxaliplatin
- leucovorin
- fluorouracil
|
Cohort 1C | Experimental | Tucatinib + trastuzumab + CAPOX given in 21-day cycles | - tucatinib
- trastuzumab
- oxaliplatin
- capecitabine
|
Cohort 2A | Experimental | Tucatinib + trastuzumab + (FOLFOX or CAPOX) | - tucatinib
- trastuzumab
- oxaliplatin
- leucovorin
- fluorouracil
- capecitabine
|
Cohort 2B | Experimental | Tucatinib + trastuzumab + FOLFOX | - tucatinib
- trastuzumab
- oxaliplatin
- leucovorin
- fluorouracil
|
Eligibility Criteria
Inclusion Criteria:
- Participants must have unresectable or metastatic solid malignancy that is
histologically or cytologically confirmed to be one of the tumor types listed below:
- CRC
- Gastric adenocarcinoma
- GEJ adenocarcinoma
- Esophageal adenocarcinoma
- Cholangiocarcinoma
- Gallbladder carcinoma
- Participants must be candidates to receive an oxaliplatin-based regimen as part of
their standard-of-care treatment.
- Participants in phase 1b cohorts or in Cohort 2B can be receiving an oxaliplatin-based
regimen
- For phase 1b cohorts utilizing FOLFOX: up to 2 cycles of FOLFOX (≤85 mg/m2
oxaliplatin per 2-week cycle) may have been received prior to Cycle 1 Day 1 of
study treatment
- For phase 1b cohorts utilizing CAPOX: up to 2 cycles of FOLFOX (≤85 mg/m2
oxaliplatin per 2-week cycle) or one cycle of CAPOX (≤130 mg/m2 oxaliplatin per
3-week cycle) may have been received prior to Cycle 1 Day 1 of study treatment.
- For all phase 1b cohorts: if subject has received oxaliplatin in prior cycles at
higher doses than those listed above, there must be a minimum of 28 days off
treatment prior to Cycle 1 Day 1 of treatment in this study.
- For Cohort 2B prior to the first dose of study treatment:
- Subjects may have received up to 1 cycle of FOLFOX (≤85 mg/m2 oxaliplatin
per 2-week cycle) prior to Cycle 1 Day 1 but may not have received prior
oxaliplatin for metastatic disease
- Oxaliplatin received in an adjuvant setting is permitted if >6 months prior
to Cycle 1 Day 1
- At least 21 days must have elapsed from prior systemic anticancer therapy
(including hormonal and biologic therapy but excluding 1 cycle of FOLFOX),
non-central nervous system radiation, and treatment with other experimental
agents
- HER2+ disease, as determined by laboratory testing based on one of the following:
- For CRC, cholangiocarcinoma, and gallbladder carcinoma:
- HER2 amplification or overexpression from fresh or archival tumor tissue
utilizing one of the following Clinical Laboratory Improvement Amendments
(CLIA) certified or International Organization for Standardization (ISO)
tests:
- HER2 overexpression (3+ immunohistochemistry [IHC])
- HER2 (ERBB2) amplification by in situ hybridization assay (fluorescence
in situ hybridization [FISH] or chromogenic in situ hybridization
signal ratio ≥2.0 or gene copy number >6)
- HER2 (ERBB2) amplification by next generation sequencing (NGS) assay
- HER2 amplification in a CLIA certified blood-based NGS assay
- Gastric, GEJ, and esophageal adenocarcinomas must use the following criteria:
- HER2+ overexpression (IHC3+) by an FDA approved assay, from a newly obtained
biopsy or surgical specimen, evaluated following the package insert's
interpretational manual for gastric adenocarcinoma. IHC2+ is eligible if the
tumor is HER2 amplified by an FDA approved in situ hybridization assay
- Phase 1b cohorts: measurable or non-measurable disease according to RECIST v1.1 as
determined by the investigator
- Phase 2 cohorts: measurable disease according to RECIST v1.1 as determined by the
investigator
- Eastern Cooperative Oncology Group Performance Status score of 0 or 1.
Exclusion Criteria:
- History of known hypersensitivity to oxaliplatin, fluoropyrimidines, leucovorin,
trastuzumab, or compounds chemically or biologically similar to tucatinib, except for
Grade 1 or 2 infusion related reactions to oxaliplatin or trastuzumab that were
successfully managed, or known allergy to any of the excipients in the study drugs
- Treatment with oxaliplatin dose in excess of the limitations specified in the
inclusion criteria
There are additional inclusion criteria. The study center will determine if criteria for
participations are met.
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Incidence of renal dose-limiting toxicities (Cohorts 1A, 1B, and 1C) |
Time Frame: | Up to one month; 2 cycles after receiving all study treatment (each cycle is 14 days) |
Safety Issue: | |
Description: | |
Secondary Outcome Measures
Measure: | Incidence of adverse events (Cohorts 1A, 1B, and 1C) |
Time Frame: | Up to approximately 12 months |
Safety Issue: | |
Description: | |
Measure: | Change in glomerular filtration rate from baseline through 2 cycles of combination therapy (Cohorts 1A, 1B, and 1C) |
Time Frame: | Up to approximately 6 weeks |
Safety Issue: | |
Description: | |
Measure: | Pharmocokinetic (PK) parameter of tucatinib - AUClast (Cohorts 1A, 1B, and 1C) |
Time Frame: | Up to approximately 2.5 months; through predose of Cycle 6, Day 1 (each cycle is 14 days) |
Safety Issue: | |
Description: | |
Measure: | PK parameter of tucatinib - Cmax (Cohorts 1A, 1B, and 1C) |
Time Frame: | Up to approximately 2.5 months; through predose of Cycle 6, Day 1 (each cycle is 14 days) |
Safety Issue: | |
Description: | |
Measure: | PK parameter of tucatinib - Ctrough (All cohorts) |
Time Frame: | Up to approximately 2.5 months; through predose of Cycle 6, Day 1 (each cycle is 14 days) |
Safety Issue: | |
Description: | |
Measure: | PK parameter of tucatinib - Tmax (Cohorts 1A, 1B, and 1C) |
Time Frame: | Up to approximately 2.5 months; through predose of Cycle 6, Day 1 (each cycle is 14 days) |
Safety Issue: | |
Description: | |
Measure: | PK parameter of oxaliplatin - AUClast (Cohorts 1A, 1B, and 1C) |
Time Frame: | Up to 16 days; through Cycle 2, Day 2 (each cycle is 14 days) |
Safety Issue: | |
Description: | |
Measure: | PK parameter of oxaliplatin - Cmax (Cohorts 1A, 1B, and 1C) |
Time Frame: | Up to 16 days; through Cycle 2, Day 2 (each cycle is 14 days) |
Safety Issue: | |
Description: | |
Measure: | PK parameter of oxaliplatin - Tmax (Cohorts 1A, 1B, and 1C) |
Time Frame: | Up to 16 days; through Cycle 2, Day 2 (each cycle is 14 days) |
Safety Issue: | |
Description: | |
Measure: | Confirmed objective response rate (cORR) according to Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 per investigator assessment (INV) (1L gastric, esophogeal, and GEJ Phase 2 cohorts only) |
Time Frame: | Up to approximately 2.5 years |
Safety Issue: | |
Description: | cORR is defined as the proportion of participants with confirmed complete response (CR) or partial response (PR) |
Measure: | Duration of response (DOR) according to RECIST v1.1 per INV (Cohort 2A) |
Time Frame: | Up to approximately 2.5 years |
Safety Issue: | |
Description: | DOR is defined as the time from first documentation of objective response of confirmed CR or confirmed PR to the first documentation of disease progression or death from any cause, whichever occurs first. |
Measure: | Progression-free survival (PFS) according to RECIST v1.1 per INV (Cohort 2A) |
Time Frame: | Up to approximately 2.5 years |
Safety Issue: | |
Description: | PFS is defined as the time from the date of treatment initiation to the date of disease progression or death from any cause, which occurs first. |
Measure: | Overall survival (OS) (Cohort 2A) |
Time Frame: | Up to approximately 2.5 years |
Safety Issue: | |
Description: | OS is defined as the time from treatment initiation to death due to any cause |
Details
Phase: | Phase 1/Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | Seagen Inc. |
Trial Keywords
- HER2+
- HER2-positive
- Seattle Genetics
Last Updated
July 13, 2021