A trial to evaluate MLN0264 for the treatment of tumors of the stomach or the junction between the esophagus and the stomach and which have a protein called Guanylyl Cyclase C (GCC) present, in patients that have been treated previously but who have relapsed or in whom the cancer has spread.

• Conditions: Metastatic or Recurrent Adenocarcinoma of the Stomach or Gastroesophageal Junction Expressing Guanylyl Cyclase C (GCC); MedDRA version: 17.0Level: LLTClassification code 10066354Term: Adenocarcinoma of the gastroesophageal junctionSystem Organ Class: 100000004864; MedDRA version: 17.0Level: LLTClassification code 10001158Term: Adenocarcinoma gastric stage IV with metastasesSystem Organ Class: 100000004864; MedDRA version: 17.0Level: LLTClassification code 10001152Term: Adenocarcinoma gastric recurrentSystem Organ Class: 100000004864; Therapeutic area: Diseases [C] - Cancer [C04]

• Registration Number: EUCTR2014-000804-88-ES
• Lead Sponsor: Millennium Pharmaceuticals, Inc.

Brief Summary

Not available

Detailed Description

Not available

Study Timeline

• Study Start: 2014-08-06
• Last Update Posted: 8 February 2016

Recruitment & Eligibility

• Status: ot Recruiting
• Sex: All
• Target Recruitment: 81

Inclusion Criteria

Each patient must meet all the following inclusion criteria to be enrolled in the study:

1. Male or female patients 18 years of age or older when written informed consent is obtained.

2. Histologically confirmed metastatic or advanced inoperable adenocarcinoma of the stomach or gastroesophageal junction with IHC evidence of GCC expression indicated by an H-score of 10 or greater.

3. Treatment with 1 or more prior chemotherapies for advanced or metastatic adenocarcinoma of the stomach or gastroesophageal junction.

4. Measurable disease as defined by RECIST version 1.1 guidelines.

5. ECOG performance status of 0 or 1 within 14 days before enrollment.
6. Female patients who:

- Are postmenopausal for at least 1 year before the screening visit, OR
- Are surgically sterile, OR

- If they are of childbearing potential, agree to practice 2 effective methods ofcontraception, at the same time, from the time of signing the informed consent through 30 days after the last dose of study drug, or
- Agree to practice true abstinence, when this is in line with the preferred and usual lifestyle of the subject. (Periodic abstinence [eg, calendar, ovulation, symptothermal, postovulation methods] and withdrawal are not acceptable methods of contraception.)

Male patients, even if surgically sterilized (ie, status postvasectomy), who:
- Agree to practice effective barrier contraception during the entire study treatment period and through 4 months after the last dose of study drug, or
- Agree to practice true abstinence, when this is in line with the preferred and usual lifestyle of the subject. (Periodic abstinence [eg, calendar, ovulation, symptothermal, postovulation methods for the female partner] and withdrawal are not acceptable methods of contraception.)

7. Voluntary written consent must be given before performance of any study-related procedure not part of standard medical care, with the understanding that consent may be withdrawn by the patient at any time without prejudice to future medical care.

8. Adequate organ and hematological function as evidenced by the following laboratory values within 14 days before enrollment:
- Absolute neutrophil count (ANC) ? 1.5 x109/L
- Platelet count ? 100 x 109/L
- Hemoglobin ? 9 g/dL
- Activated partial thromboplastin time (aPTT) ? 1.5 x the upper limit of the normal range (ULN) per institutional laboratory normal range
- International normalized ratio (INR) ? 1.5 x ULN
- Serum creatinine ? 1.5 x ULN
- Total bilirubin ? 1.5 x ULN
- Albumin ? 3g/dL
- Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ? 2.5 x ULN
- Serum lipase ? 3 x ULN and serum amylase within the normal range

9. Resolution of all toxic effects of prior treatments except alopecia to Grade 0 or 1 by NCI CTCAE version 4.03.

10. Willing and able to comply with scheduled visits, treatment plan, laboratory tests, and other trial procedures.
Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range 35
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range 46

Exclusion Criteria

Patients meeting any of the following exclusion criteria are not to be enrolled in the study:

1. Radiotherapy within 4 weeks before enrollment

2. Concurrent treatment or treatment within 4 weeks of study entry with any other investigational agent or chemotherapy

3. Female patients who are lactating and breastfeeding or have a positive pregnancy test during the Screening period

4. Uncontrolled, clinically significant, symptomatic cardiovascular disease within 6 months before enrollment, including myocardial infarction, unstable angina, Grade 2 or greater peripheral vascular disease, cerebrovascular accident, transient ischemic attack, congestive heart failure, or arrhythmias not controlled by outpatient
medication

5. Treatment with any medication that has a clinically relevant potential risk of prolonging the QT interval or inducing torsades de pointes that cannot be discontinued or switched to a different medication before starting study drug

6. Patients with ECG abnormalities considered by the investigator to be clinically significant, or repeated baseline prolongation of the rate-corrected QT interval (QTc)

7. Ongoing or clinically significant active infection as judged by the investigator

8. Signs of PN ? NCI CTCAE Grade 2

9. Concomitant chemotherapy, hormonal therapy, immunotherapy, or any other form of cancer treatment

10. Use of strong cytochrome P450 (CYP) 3A4 inhibitors within 2 weeks before the first dose of study drug

11. Any preexisting medical condition of sufficient severity to prevent full compliance with the study

12. History of or current neoplasm other than gastric adenocarcinoma, except for curatively treated nonmelanoma skin cancer or in situ carcinoma of the cervix uteri

13. Known diagnosis of human immunodeficiency virus (HIV) infection

14. Symptomatic brain metastases

15. Ongoing anticoagulant therapy (eg, aspirin, coumadin, heparin)

Study & Design

• Study Type: Interventional clinical trial of medicinal product
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Main Objective: To evaluate the overall response rate of patients with recurrent or metastatic GCC-positive adenocarcinoma of the stomach or gastroesophageal junction treated with MLN0264;Secondary Objective: - To evaluate the safety profile of MLN0264<br>- To evaluate progression-free survival (PFS)<br>- To evaluate duration of response<br>- To evaluate disease control rate<br>- To evaluate overall survival<br>- To examine the pharmacokinetic profile<br>- To evaluate tumor size reduction<br>- To investigate the association between GCC expression level and antitumor effects of MLN0264<br>- To assess immunogenicity of MLN0264;Primary end point(s): ORR (complete response [CR] + PR) based on Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1;Timepoint(s) of evaluation of this end point: Screening, Day 21 of every other cycle starting with Cycle 2 (ie, Cycles 2, 4, 6, etc.), at EOT, and during Progression Free Survival Follow-up (PFSFU).