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临床试验/NCT07723534
NCT07723534尚未招募2 期

A Single Arm Phase II Trial of Zolbetuximab in Combination With mFOLFOX6 or CAPOX Chemotherapy in Claudin 18.2 Overexpressed Advanced or Metastatic Biliary Tract Cancers

Midhun Malla1 个研究点 分布在 1 个国家目标入组 32 人开始时间: 2026年8月1日最近更新:
适应症
干预措施
相关药物

试验速览

阶段
2 期
状态
尚未招募
发起方
入组人数
32
试验地点
1
主要终点
Progression free survival (PFS) rate

研究概览

简要总结

Subjects will receive zolbetuximab with either CAPOX every 3 weeks or mFOLFOX6 every 2 weeks. The chemotherapy regimen chosen, mFOLFOX6 or CAPOX is per the treating investigator discretion and subject preference.

Study treatment will continue for a maximum of 2 years, or until disease progression per RECIST 1.1, intolerable side effects, or investigator/subject preference. Disease evaluation will occur every 8 to 9 weeks.

研究设计

研究类型
Interventional
分配方式
Na
干预模型
Single Group
主要目的
Treatment
盲法
None

入排标准

年龄范围
18 Years 至 —(Adult, Older Adult)
性别
All
接受健康志愿者

入选标准

  • Age ≥ 18 years at the time of informed consent.
  • Eastern Cooperative Oncology Group (ECOG) Performance Status of 0-1 at the time of registration.
  • Histological or cytological confirmation of biliary tract carcinoma per American Joint Committee on Cancer (AJCC) staging manual v
  • Radiologically confirmed locally advanced/unresectable (per treating investigator) or metastatic disease.
  • Evaluable disease per RECIST 1.
  • Expression of Claudin 18.2 (CLDN18.2) in ≥ 75% of tumor cells demonstrating moderate to strong membranous staining as determined by central immunohistochemical testing (IHC) from a CLIA certified lab using the VENTANA CLDN18 (43-14A) antibody (Roche Diagnostics). NOTE: A paraffin block or at least 5 unstained glass "positively charged" slides with 4-microns formalin-fixed, paraffin-embedded tissue are required for testing. Tissue must be from diagnosis via standard biopsy or surgery. Specimens that are from fine-needle aspirate (FNA), cytology, or metastatic bone lesions do not qualify for CLDN18.2 staining. If archival tissue is not available and the subject is undergoing a standard of care biopsy, part of that tissue may be used for testing. If tissue for Claudin 18.2 testing is not available, the subject is not eligible for the trial.
  • Receipt of only one prior line of systemic therapy for advanced disease. NOTE: Patients who received a single dose of mFOLFOX6 or CAPOX chemotherapy prior to registration may still be eligible for the trial, provided the tissue for CLDN18.2 for testing was obtained prior to the cycle of chemotherapy.
  • Prior cancer treatment must be completed at least 14 days prior to start of study treatment.
  • Recovery from all adverse events of the prior systemic therapy (other than alopecia) to grade ≤ 1 or baseline. NOTE: Known peripheral sensory neuropathy ≤ Grade 1 is allowed if the absence of deep tendon reflexes is the sole neurological abnormality.
  • Demonstrate adequate organ function at the time of screening as defined below.
  • Hematological
  • Platelets (Plt) ≥ 100,000 /mm3
  • Absolute Neutrophil Count (ANC) ≥ 1500 K/mm3
  • Hemoglobin (Hgb) ≥ 9 g/dL
  • Calculated creatinine clearance ≥ 50 mL/min (Cockcroft-Gault formula will be used to calculate creatinine clearance)
  • Total bilirubin ≤ 2 g/dl
  • Aspartate aminotransferase (AST) ≤ 2.5 × ULN without liver metastases and ≤ 5x ULN if liver metastases are present
  • Alanine aminotransferase (ALT) ≤ 2.5 × ULN without liver metastases and ≤ 5x ULN if liver metastases are present
  • Coagulation
  • International Normalized Ratio (INR) or Prothrombin Time (PT) Activated Partial Thromboplastin Time (aPTT) ≤ 1.5 × ULN except for subjects receiving anticoagulation therapy.
  • Albumin ≥ 2.5 g/dL

排除标准

  • Receipt of 5-fluorouracil or capecitabine in the adjuvant setting within 6 months prior to registration or patients who progressed on FOLFOX or CAPOX regimens in the past.
  • Previous treatment with Claudin 18.2 directed treatment.
  • Active infection requiring systemic therapy. NOTE: Subjects receiving prophylactic antibiotics (e.g., to prevent a urinary tract infection or chronic obstructive pulmonary disease exacerbation) are eligible for the study.
  • Pregnant or breastfeeding. NOTE: breast milk cannot be stored for future use while the subject is being treated on study.
  • Active central nervous system (CNS) metastases. NOTE: A subject with prior brain metastasis may be considered if they have completed their treatment for brain metastasis at least 4 weeks prior to registration, have been off corticosteroids (≤ 10 mg/day oral prednisone or equivalent) for ≥ 2 weeks, and are asymptomatic.
  • Known immediate or delayed hypersensitivity, intolerance or contraindication to any component of study treatment or other monoclonal antibody.
  • Known dihydropyrimidine dehydrogenase (DPD) deficiency. NOTE: Screening for DPD deficiency may be conducted per local requirements but is not required.
  • Treatment with any investigational drug within 7 days prior to registration.
  • Known additional malignancy that is progressing or requires active treatment, with the exception of patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or antitumor assessment of the investigational regimen.
  • Subject has significant cardiovascular disease, including any of the following:
  • Congestive heart failure (defined as New York Heart Association [NYHA] Class III or IV), myocardial infarction, unstable angina, coronary angioplasty, coronary stenting, coronary artery bypass graft, cerebrovascular accident (CVA), or hypertensive crisis within 6 months prior to registration
  • History of clinically significant ventricular arrhythmias (i.e., sustained ventricular tachycardia, ventricular fibrillation, or Torsades de Pointes)
  • History or family history of congenital long QT syndrome
  • Cardiac arrhythmias requiring anti-arrhythmic medications (Subjects with rate controlled atrial fibrillation for > 28 days prior to registration are eligible.)
  • Major surgical procedure ≤ 28 days prior to registration.
  • Co-morbid systemic illnesses or other severe concurrent disease which, in the judgment of the investigator, would make the patient inappropriate for entry into this study or interfere significantly with the proper assessment of safety and toxicity of the prescribed regimen.
  • Known psychiatric illness or social situations such as incarceration that would preclude study compliance, per investigator judgment.

研究组 & 干预措施

Zolbetuximab and CAPOX or mFOLFOX6

Experimental

Subjects will receive zolbetuximab with CAPOX every 3 weeks or with mFOLFOX6 every 2 weeks.

干预措施: CAPOX (Drug)

Zolbetuximab and CAPOX or mFOLFOX6

Experimental

Subjects will receive zolbetuximab with CAPOX every 3 weeks or with mFOLFOX6 every 2 weeks.

干预措施: Zolbetuximab (Drug)

Zolbetuximab and CAPOX or mFOLFOX6

Experimental

Subjects will receive zolbetuximab with CAPOX every 3 weeks or with mFOLFOX6 every 2 weeks.

干预措施: mFOLFOX6 (Drug)

结局指标

主要结局

Progression free survival (PFS) rate

时间窗: 6 months

PFS will be defined as the percentage of evaluable patients alive and progression-free (radiologically per RECIST 1.1 or clinically per treating investigator discretion) at 6 months from date of registration.

次要结局

  • Median Progression Free Survival (PFS)(24 months)
  • Overall Survival (OS)(24 months)
  • Objective Response Rate (ORR)(24 months)
  • Disease Control Rate (DCR)(24 months)
  • Adverse Events(24 months)

研究者

发起方
Midhun Malla
申办方类型
Other
责任方
Sponsor Investigator
主要研究者

Midhun Malla

Sponsor-Investigator

Hoosier Cancer Research Network

研究点 (1)

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