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A Study of RC48-ADC Combination Therapies as First-line Treatment in Advanced Metastatic Gastric Cancer

Registration Number
NCT05980481
Lead Sponsor
RemeGen Co., Ltd.
Brief Summary

This is a Phase II/III, randomized, multicenter, open-label clinical trial designed to evaluate safety and efficacy of RC48-ADC combine with Toripalimab and chemotherapy or RC48-ADC combine with Toripalimab and Trastuzumab as first-line treatment in human epidermal growth factor receptor 2 (HER2)-expression participants with locally advanced or metastatic gastric cancer.

Detailed Description

This is a Phase II/III, randomized, multicenter, open-label clinical trial designed to evaluate safety and efficacy of RC48-ADC combine with Toripalimab and chemotherapy or RC48-ADC combine with Toripalimab and Trastuzumab as first-line treatment in human epidermal growth factor receptor 2 (HER2)-expression participants with locally advanced or metastatic gastric cancer. The HER2-expression is defined as: the HER2 IHC 3+ or 2+, or 1+.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
130
Inclusion Criteria
  • Voluntary agreement to provide written informed consent.
  • Age:18-70 years(including 18 and 70).
  • Predicted survival ≥ 12 weeks.
  • Eastern Cooperative Oncology Group (ECOG) performance status score of 0 or 1.
  • Adequate organ function.
  • All subjects must have inoperable, advanced or metastatic gastric or or gastroesophageal adenocarcinoma.
  • Subject must be previously untreated with systemic treatment; Subject that received neoadjuvant chemotherapy with recurrence >6 months from completion of therapy are permitted;
  • HER2-expressing status determined by laboratory to be IHC 1+, 2+ or 3+.
Exclusion Criteria
  • Active central nervous system (CNS) metastases.
  • Known active hepatitis B, active hepatitis C, or human immunodeficiency virus (HIV) infection.
  • History of other malignancy within the previous 5 years, except for appropriately treated carcinoma in situ of the cervix, thyroid cancer ,etal.
  • Known hypersensitivity to antibody-drug conjugate(ADC) or PD-(L)1 or any of its components.
  • Assessed by the investigator to be unable or unwilling to comply with the requirements of the protocol.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
RC48-ADC+Toripalimab+TrastuzumabTrastuzumab InjectionParticipants with HER2 positive(IHC2+FISH+ or IHC3+) will receive of RC48-ADC every 2 weeks (Q2W), Toripalimab 2 weeks (Q2W) and Trastuzumab every 3 weeks (Q3W) , as one treatment period until investigator assessed loss of clinical benefit, unacceptable toxicity, investigator or participant decision to withdraw from therapy, or death (whichever occurs first).
Toripalimab+Trastuzumab+CAPOXTrastuzumab InjectionParticipants with HER2 positive(IHC2+FISH+ or IHC3+) will receive of Toripalimab 2 weeks (Q2W) , Trastuzumab every 3 weeks (Q3W) and CAPOX every 3 weeks (Q3W) , as one treatment period until investigator assessed loss of clinical benefit, unacceptable toxicity, investigator or participant decision to withdraw from therapy, or death (whichever occurs first).
RC48-ADC+Toripalimab+CAPOX(HER2-low)RC48-ADCParticipants with HER2-low (IHC1+) will receive of RC48-ADC every 2 weeks (Q2W), Toripalimab 2 weeks (Q2W) and CAPOX every 3 weeks (Q3W) , as one treatment period until investigator assessed loss of clinical benefit, unacceptable toxicity, investigator or participant decision to withdraw from therapy, or death (whichever occurs first). Oxaliplatin only in the first 3 treatment cycles, 6 study dosing sessions were completed.
RC48-ADC+Toripalimab+CAPOX(HER2-low)CapecitabineParticipants with HER2-low (IHC1+) will receive of RC48-ADC every 2 weeks (Q2W), Toripalimab 2 weeks (Q2W) and CAPOX every 3 weeks (Q3W) , as one treatment period until investigator assessed loss of clinical benefit, unacceptable toxicity, investigator or participant decision to withdraw from therapy, or death (whichever occurs first). Oxaliplatin only in the first 3 treatment cycles, 6 study dosing sessions were completed.
Toripalimab+CAPOX(HER2-low)Oxaliplatin injectionParticipants with HER2-low (IHC1+) will receive of Toripalimab 2 weeks (Q2W) and CAPOX every 3 weeks (Q3W) , as one treatment period until investigator assessed loss of clinical benefit, unacceptable toxicity, investigator or participant decision to withdraw from therapy, or death (whichever occurs first). Oxaliplatin only in the first 3 treatment cycles, 6 study dosing sessions were completed.
Toripalimab+CAPOX(HER2-low)ToripalimabParticipants with HER2-low (IHC1+) will receive of Toripalimab 2 weeks (Q2W) and CAPOX every 3 weeks (Q3W) , as one treatment period until investigator assessed loss of clinical benefit, unacceptable toxicity, investigator or participant decision to withdraw from therapy, or death (whichever occurs first). Oxaliplatin only in the first 3 treatment cycles, 6 study dosing sessions were completed.
RC48-ADC+Toripalimab+CAPOXOxaliplatin injectionParticipants with HER2 positive(IHC2+FISH+ or IHC3+) will receive of RC48-ADC every 2 weeks (Q2W), Toripalimab 2 weeks (Q2W) and CAPOX every 3 weeks (Q3W) , as one treatment period until investigator assessed loss of clinical benefit, unacceptable toxicity, investigator or participant decision to withdraw from therapy, or death (whichever occurs first).
RC48-ADC+Toripalimab+TrastuzumabRC48-ADCParticipants with HER2 positive(IHC2+FISH+ or IHC3+) will receive of RC48-ADC every 2 weeks (Q2W), Toripalimab 2 weeks (Q2W) and Trastuzumab every 3 weeks (Q3W) , as one treatment period until investigator assessed loss of clinical benefit, unacceptable toxicity, investigator or participant decision to withdraw from therapy, or death (whichever occurs first).
Toripalimab+Trastuzumab+CAPOXOxaliplatin injectionParticipants with HER2 positive(IHC2+FISH+ or IHC3+) will receive of Toripalimab 2 weeks (Q2W) , Trastuzumab every 3 weeks (Q3W) and CAPOX every 3 weeks (Q3W) , as one treatment period until investigator assessed loss of clinical benefit, unacceptable toxicity, investigator or participant decision to withdraw from therapy, or death (whichever occurs first).
RC48-ADC+Toripalimab+CAPOXRC48-ADCParticipants with HER2 positive(IHC2+FISH+ or IHC3+) will receive of RC48-ADC every 2 weeks (Q2W), Toripalimab 2 weeks (Q2W) and CAPOX every 3 weeks (Q3W) , as one treatment period until investigator assessed loss of clinical benefit, unacceptable toxicity, investigator or participant decision to withdraw from therapy, or death (whichever occurs first).
RC48-ADC+Toripalimab+CAPOXCapecitabineParticipants with HER2 positive(IHC2+FISH+ or IHC3+) will receive of RC48-ADC every 2 weeks (Q2W), Toripalimab 2 weeks (Q2W) and CAPOX every 3 weeks (Q3W) , as one treatment period until investigator assessed loss of clinical benefit, unacceptable toxicity, investigator or participant decision to withdraw from therapy, or death (whichever occurs first).
RC48-ADC+Toripalimab+CAPOX(HER2-low)Oxaliplatin injectionParticipants with HER2-low (IHC1+) will receive of RC48-ADC every 2 weeks (Q2W), Toripalimab 2 weeks (Q2W) and CAPOX every 3 weeks (Q3W) , as one treatment period until investigator assessed loss of clinical benefit, unacceptable toxicity, investigator or participant decision to withdraw from therapy, or death (whichever occurs first). Oxaliplatin only in the first 3 treatment cycles, 6 study dosing sessions were completed.
Toripalimab+CAPOX(HER2-low)CapecitabineParticipants with HER2-low (IHC1+) will receive of Toripalimab 2 weeks (Q2W) and CAPOX every 3 weeks (Q3W) , as one treatment period until investigator assessed loss of clinical benefit, unacceptable toxicity, investigator or participant decision to withdraw from therapy, or death (whichever occurs first). Oxaliplatin only in the first 3 treatment cycles, 6 study dosing sessions were completed.
RC48-ADC+Toripalimab+CAPOXToripalimabParticipants with HER2 positive(IHC2+FISH+ or IHC3+) will receive of RC48-ADC every 2 weeks (Q2W), Toripalimab 2 weeks (Q2W) and CAPOX every 3 weeks (Q3W) , as one treatment period until investigator assessed loss of clinical benefit, unacceptable toxicity, investigator or participant decision to withdraw from therapy, or death (whichever occurs first).
RC48-ADC+Toripalimab+TrastuzumabToripalimabParticipants with HER2 positive(IHC2+FISH+ or IHC3+) will receive of RC48-ADC every 2 weeks (Q2W), Toripalimab 2 weeks (Q2W) and Trastuzumab every 3 weeks (Q3W) , as one treatment period until investigator assessed loss of clinical benefit, unacceptable toxicity, investigator or participant decision to withdraw from therapy, or death (whichever occurs first).
RC48-ADC+Toripalimab+CAPOX(HER2-low)ToripalimabParticipants with HER2-low (IHC1+) will receive of RC48-ADC every 2 weeks (Q2W), Toripalimab 2 weeks (Q2W) and CAPOX every 3 weeks (Q3W) , as one treatment period until investigator assessed loss of clinical benefit, unacceptable toxicity, investigator or participant decision to withdraw from therapy, or death (whichever occurs first). Oxaliplatin only in the first 3 treatment cycles, 6 study dosing sessions were completed.
Toripalimab+Trastuzumab+CAPOXToripalimabParticipants with HER2 positive(IHC2+FISH+ or IHC3+) will receive of Toripalimab 2 weeks (Q2W) , Trastuzumab every 3 weeks (Q3W) and CAPOX every 3 weeks (Q3W) , as one treatment period until investigator assessed loss of clinical benefit, unacceptable toxicity, investigator or participant decision to withdraw from therapy, or death (whichever occurs first).
Toripalimab+Trastuzumab+CAPOXCapecitabineParticipants with HER2 positive(IHC2+FISH+ or IHC3+) will receive of Toripalimab 2 weeks (Q2W) , Trastuzumab every 3 weeks (Q3W) and CAPOX every 3 weeks (Q3W) , as one treatment period until investigator assessed loss of clinical benefit, unacceptable toxicity, investigator or participant decision to withdraw from therapy, or death (whichever occurs first).
Primary Outcome Measures
NameTimeMethod
Objective remission rate (ORR)Up to approximately 2 years

The objective response rate will be mainly analyzed by according to the RECIST 1.1 standard tumor evaluation by the investigator will be performed).

Secondary Outcome Measures
NameTimeMethod
Safety(adverse event)Up to approximately 2 years

to evaluate safety including adverse event rate and adverse event grade.

Duration of relief (DOR)Up to approximately 2 years

DOR is defined as the time from the first documented objective response (CR or PR) to the first documented disease progression or death

Progression-free survival (PFS), evaluated by the investigatorUp to approximately 2 years

Progression-free survival (PFS) refers to the time from the date of randomization to the first researcher's evaluation of disease progression or death (calculated by the event that occurred first). The disease progression will be evaluated by the researchers according to the RECIST 1.1 standard.

Overall survival (OS)Up to approximately 2 years

Overall survival (OS) refers to the time from the date of randomization to the date of death of the subject.

Disease Control Rate(DCR)Up to approximately 2 years

DCR is the proportion of subjects with optimal overall response to achieve objective remission or stable disease over the course of the study

Trial Locations

Locations (1)

Beijing Cancer Hospital

🇨🇳

Beijing, China

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