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A Study of Ipatasertib (GDC-0068) in Combination With Fluoropyrimidine Plus Oxaliplatin in Participants With Advanced or Metastatic Gastric or Gastroesophageal Junction Cancer

Phase 2
Completed
Conditions
Gastric Cancer
Interventions
Registration Number
NCT01896531
Lead Sponsor
Genentech, Inc.
Brief Summary

This multicenter, randomized, double-blind, placebo-controlled study will evaluate the efficacy of ipatasertib in combination with oxaliplatin, 5-fluorouracil, and leucovorin (modified FOLFOX6 \[mFOLFOX6\]) chemotherapy in participants with advanced or metastatic gastric or gastroesophageal junction (GEJ) cancer. Participants will be randomized to receive either ipatasertib or placebo orally daily on Days 1 to 7 of each 14-day cycle in combination with mFOLFOX6 on Day 1 of each cycle.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
153
Inclusion Criteria
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
  • Histologically documented, inoperable locally advanced or metastatic or recurrent gastric/GEJ adenocarcinoma, not amenable to curative therapy
  • Measurable disease, according to RECIST v1.1
  • Life expectancy greater than or equal to (>/=) 12 weeks
  • Adequate hematologic and organ function
Exclusion Criteria
  • Previous chemotherapy for inoperable locally advanced or metastatic gastric/GEJ adenocarcinoma. Participants may have received prior neoadjuvant or adjuvant chemotherapy and/or radiation treatment for locally advanced gastric/GEJ adenocarcinoma, provided all treatments were completed >/= 6 months prior to randomization.
  • Known human epidermal growth factor receptor 2 (HER2)-positive gastric/GEJ adenocarcinoma
  • Radiation treatment within 28 days of randomization. Participants who have received palliative radiation treatment to peripheral sites (eg, bone metastases) within 28 days of randomization may be enrolled in the study if they have recovered from all acute, reversible effects and with notification of the Medical Monitor.
  • Previous therapy for gastric/GEJ adenocarcinoma with Akt, phosphatidylinositol 3-kinase (PI3K), and/or mammalian target of rapamycin (mTOR) inhibitors
  • Major surgical procedure, open biopsy, or significant traumatic injury within 28 days prior to randomization or anticipation of need for a major surgical procedure during the course of the study

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Ipatasertib + mFOLFOX6IpatasertibParticipants will receive oral ipatasertib on Days 1 to 7 of each 14-day cycle in combination with mFOLFOX6, administered on Day 1 of each cycle.
Ipatasertib + mFOLFOX6LeucovorinParticipants will receive oral ipatasertib on Days 1 to 7 of each 14-day cycle in combination with mFOLFOX6, administered on Day 1 of each cycle.
Ipatasertib + mFOLFOX65-FluorouracilParticipants will receive oral ipatasertib on Days 1 to 7 of each 14-day cycle in combination with mFOLFOX6, administered on Day 1 of each cycle.
Placebo + mFOLFOX6PlaceboParticipants will receive the placebo equivalent to ipatasertib on Days 1 to 7 of each 14-day cycle in combination with mFOLFOX6, administered on Day 1 of each cycle.
Ipatasertib + mFOLFOX6OxaliplatinParticipants will receive oral ipatasertib on Days 1 to 7 of each 14-day cycle in combination with mFOLFOX6, administered on Day 1 of each cycle.
Placebo + mFOLFOX65-FluorouracilParticipants will receive the placebo equivalent to ipatasertib on Days 1 to 7 of each 14-day cycle in combination with mFOLFOX6, administered on Day 1 of each cycle.
Placebo + mFOLFOX6LeucovorinParticipants will receive the placebo equivalent to ipatasertib on Days 1 to 7 of each 14-day cycle in combination with mFOLFOX6, administered on Day 1 of each cycle.
Placebo + mFOLFOX6OxaliplatinParticipants will receive the placebo equivalent to ipatasertib on Days 1 to 7 of each 14-day cycle in combination with mFOLFOX6, administered on Day 1 of each cycle.
Primary Outcome Measures
NameTimeMethod
Progression-Free Survival (PFS) in All Randomized Participants and Participants With PTEN Loss Tumors at Primary AnalysisScreening, at the end of Cycle 4 (cycle = 14 days) and every fourth cycle thereafter until disease progression or death, whichever occurred first, assessed up to approximately 1.75 years

PFS was defined as the time from randomization to the first occurrence of disease progression (as determined using RECIST Version 1.1 and assessed by the investigator), or death from any cause on study. Progressive disease (PD): At least a 20% increase in the sum of diameters of target lesions, and the sum must also demonstrate an absolute increase of at least 5 mm or progression of non-target lesions. Death on study was defined as death from any cause within 30 days of the last dose of study treatment regimen. Kaplan-Meier estimates were used for evaluation.

Secondary Outcome Measures
NameTimeMethod
Overall Survival (OS)Baseline up to end of study (up to approximately 7.5 years)

OS was defined as the time from the date of randomization to the date of death from any cause. Kaplan-Meier estimates were used for evaluation.

Objective Response Rate (ORR)Screening, at the end of Cycle 4 (cycle = 14 days) and every fourth cycle thereafter until disease progression or death, whichever occurred first, up to end of study (up to approximately 7.5 years)

Objective Response Rate was defined as the percentage of participants achieving either a complete response (CR) or a partial response (PR) based on the investigator assessment using RECIST v 1.1. CR: disappearance of all target lesions and all pathological lymph nodes below 10 mm. Partial response (PR): At least a 30% decrease in the sum of diameters of target lesions.

Duration of Objective Tumor ResponseScreening, at the end of Cycle 4 (cycle = 14 days) and every fourth cycle thereafter until disease progression or death, whichever occurred first, up to end of study (up to approximately 7.5 years)

Duration of objective tumor response in participants with measurable soft tissue disease at baseline was defined as the time from first observation of an objective tumor response until first observation of disease progression, as assessed by the investigator per modified RECIST Version 1.1. PD: At least a 20% increase in the sum of diameters of target lesions, and the sum must also demonstrate an absolute increase of at least 5 mm or progression of non-target lesions.

Number of Participants With Adverse Events (AEs)Baseline until end of study (up to approximately 7.5 years)

An adverse event is any untoward medical occurrence in a subject administered a pharmaceutical product and which does not necessarily have to have a causal relationship with the treatment. An adverse event can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding, for example), symptom, or disease temporally associated with the use of a pharmaceutical product, whether or not considered related to the pharmaceutical product. Preexisting conditions which worsen during a study are also considered as adverse events. Death on study was defined as death from any cause within 30 days of the last dose of study treatment regimen.

Serum Concentration of IpatasertibDay 1 at 1 hour and 4 hours post-dose; Day 5, pre-dose and 2 hours post-dose

Trial Locations

Locations (34)

Univ of Calif, Los Angeles; Hematology/Oncology

🇺🇸

Los Angeles, California, United States

Massachusetts General Hospital;Oncology

🇺🇸

Boston, Massachusetts, United States

Azienda Ospedaliero Universitaria Pisana; Uff. Sperim. Clin. U.O. Farmaceutica

🇮🇹

Pisa, Toscana, Italy

Institut Gustave Roussy; Departement Oncologie Medicale

🇫🇷

Villejuif, France

St Vincent'S Hospital; Oncology

🇰🇷

Suwon, Korea, Republic of

Universitatsklinik Heidelberg; Universitätshautklinik und Nationales Centrum für Tumorerkrankungen

🇩🇪

Heidelberg, Germany

Gleneagles Medical Centre

🇲🇾

Penang, Malaysia

Mount Vernon Hospital; Centre For Cancer Treatment

🇬🇧

Northwood, United Kingdom

Asan Medical Center; Medical Oncology

🇰🇷

Seoul, Korea, Republic of

Charité-Universitätsm. Berlin; Med. Klinik mit Schwerpunkt Hämatologie, Onkologie und Tumorimmunolo.

🇩🇪

Berlin, Germany

HOSPITAL DE MADRID NORTE SANCHINARRO- CENTRO INTEGRAL ONCOLOGICO CLARA CAMPAL; Servicio de Oncologia

🇪🇸

Madrid, Spain

IRCCS Istituto Oncologico Veneto (IOV); Oncologia Medica Seconda

🇮🇹

Padova, Veneto, Italy

Oncocare Cancer Centre

🇸🇬

Singapore, Singapore

Hospital Clinico Universitario de Valencia

🇪🇸

Valencia, Spain

Royal Marsden Hospital; Dept of Med-Onc

🇬🇧

London, United Kingdom

Hospital Univ Vall d'Hebron; Servicio de Oncologia

🇪🇸

Barcelona, Spain

The Royal Marsden Hospital

🇬🇧

Sutton, United Kingdom

Hospital Universiti Sains Malaysia [Neurology]

🇲🇾

Kubang Kerian, Kelantan, Malaysia

IRCCS Istituto Nazionale Per La Ricerca Sul Cancro (IST); Oncologia Medica A

🇮🇹

Genova, Liguria, Italy

University Malaya Medical Centre; Clinical Oncology Unit,

🇲🇾

Kuala Lumpur, Malaysia

Gachon Medical School Gil Medical Centre; Internal Medicine

🇰🇷

Incheon, Korea, Republic of

Yonsei Uni College of Medicine, Severance Hospital; Internal Medicine Dept.

🇰🇷

Seoul, Korea, Republic of

Kyungpook National University Hospital

🇰🇷

Daegu, Korea, Republic of

Medizinische Hochschule Hannover; Zentrum Innere Medizin; Abt. Hämatologie u. Onkologie

🇩🇪

Hannover, Germany

Seoul National University Bundang Hospital

🇰🇷

Seongnam-si, Korea, Republic of

Seoul National University Hosp; Dept Internal Med Hem Onc

🇰🇷

Seoul, Korea, Republic of

Samsung Medical Center

🇰🇷

Seoul, Korea, Republic of

National Cancer Centre; Medical Oncology

🇸🇬

Singapore, Singapore

University of Texas M.D. Anderson Cancer Center

🇺🇸

Houston, Texas, United States

National Taiwan Uni Hospital; Dept of Oncology

🇨🇳

Taipei, Taiwan

National Cheng Kung Univ Hosp

🇨🇳

Tainan, Taiwan

Chang Gung Medical Foundation - Linkou; Division of Hematology- Oncology

🇨🇳

Taoyuan, Taiwan

Sarah Cannon Research Institute

🇬🇧

London, United Kingdom

Queen Mary Hospital; Dept. of Clinical Oncology

🇭🇰

Hong Kong, Hong Kong

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