Description:
This study is being done to see if tucatinib with trastuzumab, ramucirumab and paclitaxel
works better than ramucirumab and paclitaxel to treat HER2-positive (HER2+) cancer of the gut
(stomach or gastroesophageal cancer). This study will also 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.
Study treatment will be given in 28-day cycles.
In the Phase 2 part of the trial, participants and their doctors will know what drugs are
being given (open-label). In the Phase 3 part, the study is "blinded." This means that
participants, their doctor, and the study sponsor will not know which drugs are being given.
Title
- Brief Title: Tucatinib, Trastuzumab, Ramucirumab, and Paclitaxel Versus Paclitaxel and Ramucirumab in Previously Treated HER2+ Gastroesophageal Cancer
- Official Title: A Randomized, Double-blind, Placebo-controlled, Active Comparator Phase 2/3 Study of Tucatinib in Combination With Trastuzumab, Ramucirumab, and Paclitaxel in Subjects With Previously Treated, Locally-advanced Unresectable or Metastatic HER2+ Gastric or Gastroesophageal Junction Adenocarcinoma (GEC)
Clinical Trial IDs
- ORG STUDY ID:
SGNTUC-022
- NCT ID:
NCT04499924
Conditions
- Gastric Adenocarcinoma
- Gastroesophageal Junction Adenocarcinoma
- Esophageal Adenocarcinoma
Interventions
Drug | Synonyms | Arms |
---|
tucatinib | TUKYSA, ONT-380, ARRY-380 | Arm 3A |
trastuzumab | | Arm 3A |
ramucirumab | CYRAMZA | Arm 3A |
paclitaxel | | Arm 3A |
Purpose
This study is being done to see if tucatinib with trastuzumab, ramucirumab and paclitaxel
works better than ramucirumab and paclitaxel to treat HER2-positive (HER2+) cancer of the gut
(stomach or gastroesophageal cancer). This study will also 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.
Study treatment will be given in 28-day cycles.
In the Phase 2 part of the trial, participants and their doctors will know what drugs are
being given (open-label). In the Phase 3 part, the study is "blinded." This means that
participants, their doctor, and the study sponsor will not know which drugs are being given.
Trial Arms
Name | Type | Description | Interventions |
---|
Phase 2 Arm | Experimental | Tucatinib + trastuzumab + ramucirumab + paclitaxel | - tucatinib
- trastuzumab
- ramucirumab
- paclitaxel
|
Arm 3A | Experimental | Tucatinib + trastuzumab + ramucirumab + paclitaxel | - tucatinib
- trastuzumab
- ramucirumab
- paclitaxel
|
Arm 3B | Active Comparator | Ramucirumab + paclitaxel + tucatinib placebo + trastuzumab placebo | |
Arm 3C | Experimental | Tucatinib + ramucirumab + paclitaxel + trastuzumab placebo | - tucatinib
- ramucirumab
- paclitaxel
|
Eligibility Criteria
Inclusion Criteria:
- Histologically or cytologically confirmed diagnosis of locally-advanced unresectable
or metastatic HER2+ gastric or gastroesophageal junction adenocarcinoma (GEC)
- HER2+ disease documented since progression of the most recent line of systemic
therapy, as follows:
- Phase 2 paclitaxel dose optimization stage:
- HER2 amplification in a blood-based NGS assay performed at a central
laboratory, or
- HER2 overexpression/amplification immunohistochemistry (IHC) and in situ
hybridization (ISH) (IHC3+ or IHC2+/ISH+) assay of a tumor tissue sample
- Phase 2 dose expansion stage:
- Cohort 2A: HER2 amplification in a blood-based NGS assay performed at a
central laboratory
- Cohort 2B: No HER2 amplification by blood-based NGS assay, but HER2
overexpression/amplification by IHC and ISH (IHC3+ or IHC2+/ISH+) assay of a
tumor tissue sample
- Phase 3: HER2 amplification in a blood-based NGS assay performed at a central
laboratory
- History of prior treatment with a HER2-directed antibody
- Progressive disease during or after first-line therapy for locally-advanced
unresectable or metastatic GEC
- Phase 2: Measurable disease according to RECIST version 1.1
- Phase 3: Measurable or non-measurable disease according to RECIST version 1.1
- Eastern Cooperative Oncology Group (ECOG) performance status score of 0 or 1
- Life expectancy of at least 3 months, in the opinion of the investigator
Exclusion Criteria:
- Subjects with squamous cell or undifferentiated GEC
- Having received more than 1 line of prior systemic therapy for locally-advanced
unresectable or metastatic disease
- Having received taxanes ≤12 months prior to enrollment, prior treatment with
ramucirumab, or prior treatment with tucatinib, lapatinib, neratinib, afatinib, or any
other investigational anti-HER2 and/or anti-EGFR tyrosine kinase inhibitor, or with
T-DM1, T-Dxd, or any other HER2-directed antibody-drug conjugate
- Phase 2 paclitaxel dose optimization stage only: history of prior partial or total
gastrectomy
- Unable to swallow pills
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Overall survival (OS) (Phase 3 only) |
Time Frame: | 60 months |
Safety Issue: | |
Description: | OS is defined as the time from randomization to death due to any cause |
Secondary Outcome Measures
Measure: | Confirmed objective response rate (ORR) per RECIST version 1.1 according to investigator assessment (Phases 2 and 3) |
Time Frame: | 36 months |
Safety Issue: | |
Description: | ORR is defined as the proportion of subjects with best overall response of CR or PR |
Measure: | ORR per RECIST version 1.1 according to investigator assessment (Phases 2 and 3) |
Time Frame: | 36 months |
Safety Issue: | |
Description: | ORR is defined as the proportion of subjects with best overall response of CR or PR |
Measure: | Duration of response (DOR) per RECIST version 1.1 according to investigator assessment (Phases 2 and 3) |
Time Frame: | 36 months |
Safety Issue: | |
Description: | DOR is defined as the time from first documentation of objective response of CR or PR to the first documentation of disease progression or death from any cause |
Measure: | Disease control rate (DCR) per RECIST version 1.1 according to investigator assessment (Phases 2 and 3) |
Time Frame: | 36 months |
Safety Issue: | |
Description: | DCR is defined as subjects with CR, PR, or stable disease (SD or non-CR/non-progressive disease) |
Measure: | PFS per RECIST v1.1 according to blinded independent central review (BICR) assessment (Phase 3 only) |
Time Frame: | 36 months |
Safety Issue: | |
Description: | PFS is defined as the time from randomization to the date of disease progression or death from any cause |
Measure: | Confirmed ORR per RECIST version 1.1 according to BICR assessment (Phase 3 only) |
Time Frame: | 36 months |
Safety Issue: | |
Description: | ORR is defined as the proportion of subjects with best overall response of CR or PR |
Measure: | ORR per RECIST version 1.1 according to BICR assessment (Phase 3 only) |
Time Frame: | 36 months |
Safety Issue: | |
Description: | ORR is defined as the proportion of subjects with best overall response of CR or PR |
Measure: | DOR per RECIST version 1.1 according to BICR assessment (Phase 3 only) |
Time Frame: | 36 months |
Safety Issue: | |
Description: | DOR is defined as the time from first documentation of objective response of CR or PR to the first documentation of disease progression or death from any cause |
Measure: | DCR per RECIST version 1.1 according to BICR assessment (Phase 3 only) |
Time Frame: | 36 months |
Safety Issue: | |
Description: | DCR is defined as subjects with CR, PR, or stable disease (SD or non-CR/non-progressive disease) |
Measure: | Incidence of AEs (Phase 3 only) |
Time Frame: | 36 months |
Safety Issue: | |
Description: | An adverse event is any untoward medical occurrence in a subject or clinical investigational subject administered a medicinal product and which does not necessarily have a causal relationship with this treatment. |
Measure: | Incidence of laboratory abnormalities (Phase 3 only) |
Time Frame: | 36 months |
Safety Issue: | |
Description: | To be summarized using descriptive statistics. |
Measure: | Incidence of dose modifications (Phase 3 only) |
Time Frame: | 36 months |
Safety Issue: | |
Description: | |
Measure: | PFS per RECIST version 1.1 according to investigator assessment (Phase 2 only) |
Time Frame: | 18 months |
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 |
Measure: | Area under the plasma concentration-time curve (AUC) to the time of the last quantifiable concentration (AUClast) of tucatinib (Phase 2 only) |
Time Frame: | 1 month |
Safety Issue: | |
Description: | Pharmacokinetic (PK) parameter |
Measure: | AUC to AUClast of paclitaxel (Phase 2 only) |
Time Frame: | 1 month |
Safety Issue: | |
Description: | PK parameter |
Measure: | Maximum observed concentration (Cmax) of tucatinib (Phase 2 only) |
Time Frame: | 1 month |
Safety Issue: | |
Description: | PK parameter |
Measure: | Cmax of paclitaxel (Phase 2 only) |
Time Frame: | 1 month |
Safety Issue: | |
Description: | PK parameter |
Measure: | Time of Cmax (Tmax) of tucatinib (Phase 2 only) |
Time Frame: | 1 month |
Safety Issue: | |
Description: | PK parameter |
Measure: | Tmax of paclitaxel (Phase 2 only) |
Time Frame: | 1 month |
Safety Issue: | |
Description: | PK parameter |
Measure: | Trough concentration (Ctrough) of tucatinib (Phase 2 only) |
Time Frame: | 18 months |
Safety Issue: | |
Description: | PK parameter |
Measure: | Ctrough of paclitaxel (Phase 2 only) |
Time Frame: | 18 months |
Safety Issue: | |
Description: | PK parameter |
Measure: | Metabolic ratio of tucatinib based on AUC (MRAUC) (Phase 2 only) |
Time Frame: | 1 month |
Safety Issue: | |
Description: | PK parameter |
Measure: | MRAUC of paclitaxel (Phase 2 only) |
Time Frame: | 1 month |
Safety Issue: | |
Description: | PK parameter |
Measure: | Time to deterioration of GEC symptoms as assessed by the European Organisation for Research and Treatment or Cancer (EORTC) quality of life questionnaire (QLQ)-C30 and EORTC QLQ-OG25 questionnaires. |
Time Frame: | 36 months |
Safety Issue: | |
Description: | The EORTC questionnaires measure aspects of health-related quality of life (HRQoL). Time to deterioration will be assessed in specific pre-specified single items from either the EORTC QLQ-C30 or EORTC QLQ OG25 and deterioration is defined as a 10-point increase from baseline in the symptom scales and a 10-point decrease from baseline for overall HRQoL. |
Measure: | Change from baseline in health-related quality of life (HRQoL) |
Time Frame: | 36 months |
Safety Issue: | |
Description: | |
Measure: | Utility index values as assessed by the EQ-5D-5L |
Time Frame: | 36 months |
Safety Issue: | |
Description: | The EQ-5D-5L questionnaire is used as a preference based measurement of HRQoL outcomes. Data will be summarized using descriptive statistics. |
Details
Phase: | Phase 2/Phase 3 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | Seagen Inc. |
Trial Keywords
- HER2+
- HER2-positive
- GEA
- GEC
- GEJ
- Seattle Genetics
Last Updated
August 24, 2021