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临床试验/NCT06282575
NCT06282575招募中3 期

An Open-label Randomized Trial of the Efficacy and Safety of Zanidatamab With Standard-of-care Therapy Against Standard-of-care Therapy Alone for Advanced HER2-positive Biliary Tract Cancer

Jazz Pharmaceuticals427 个研究点 分布在 9 个国家目标入组 286 人开始时间: 2024年7月19日最近更新:
干预措施
相关药物

试验速览

阶段
3 期
状态
招募中
入组人数
286
试验地点
427
主要终点
Progression Free Survival (PFS) in participants with Immunohistochemistry (IHC) 3+ tumors

研究概览

简要总结

The purpose of this study is to evaluate the efficacy and safety of Zanidatamab plus CisGem (Cisplatin and Gemcitabine) with or without the addition of a programmed death protein 1/ligand-1 (PD-1/L1) inhibitor (physician's choice of either Durvalumab or Pembrolizumab, where approved under local regulations) as first line of treatment for participants with human epidermal growth factor receptor 2 (HER2)-positive biliary tract cancer.

研究设计

研究类型
Interventional
分配方式
Randomized
干预模型
Parallel
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

  • Histologically- or cytologically-confirmed Biliary Tract Cancer (BTC), including Gallbladder Cancer (GBC), Intrahepatic Cholangiocarcinoma (ICC), or Extrahepatic Cholangiocarcinoma (ECC).
  • Locally advanced unresectable or metastatic BTC and not eligible for curative resection, transplantation, or ablative therapies.
  • Received no more than 2 cycles of systemic therapy which is limited to Cisplatin and Gemcitabine (CisGem) with or without a PD-1/L1 inhibitor (physician's choice of durvalumab or pembrolizumab, where approved under local regulations) for advanced unresectable or metastatic disease.
  • HER2-positive disease (defined as IHC 3+; or IHC 2+/ ISH+) by IHC and in situ Hybridization (ISH) assay (in participants with IHC 2+ tumors) at a central laboratory on new biopsy tissue or archival tissue from the most recent biopsy.
  • Assessable (measurable or non-measurable) disease as defined by Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1), per investigator assessment.
  • Male or female ≥ 18 years or age (or the legal age of adulthood per country-specific regulations).
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 or
  • Adequate organ function
  • Females of childbearing potential must have a negative pregnancy test result.
  • Females of childbearing potential and males with a partner of childbearing potential must be willing to use 2 methods of birth control.

排除标准

  • Prior treatment with a HER2-targeted agent
  • Prior treatment with checkpoint inhibitors, other than durvalumab or pembrolizumab
  • The following BTC histologic subtypes are excluded: small cell cancer, neuroendocrine tumors, lymphoma, sarcoma, mixed tumor histology, and mucinous cystic neoplasms detected in the biliary tract region.
  • Use of systemic corticosteroids.
  • Brain metastases
  • Severe chronic or active infections
  • History of allogeneic organ transplantation.
  • Active or prior autoimmune inflammatory conditions
  • History of interstitial lung disease or non-infectious pneumonitis.
  • Participation in another clinical trial with an investigational medicinal product within the last 3 months.
  • Females who are breastfeeding
  • Any other medical, social, or psychosocial factors that, in the opinion of the investigator, could impact safety or compliance with study procedures.
  • Use of phenytoin

研究组 & 干预措施

Zanidatamab with Standard-of-care Therapy Arm

Experimental

Zanidatamab plus standard of care treatment of CisGem with or without a PD-1/L1 inhibitor. PD-1/L1 inhibitor will be physician's choice of either Durvalumab or Pembrolizumab, where approved under local regulations.

干预措施: Zanidatamab (Drug)

Zanidatamab with Standard-of-care Therapy Arm

Experimental

Zanidatamab plus standard of care treatment of CisGem with or without a PD-1/L1 inhibitor. PD-1/L1 inhibitor will be physician's choice of either Durvalumab or Pembrolizumab, where approved under local regulations.

干预措施: Cisplatin (Drug)

Zanidatamab with Standard-of-care Therapy Arm

Experimental

Zanidatamab plus standard of care treatment of CisGem with or without a PD-1/L1 inhibitor. PD-1/L1 inhibitor will be physician's choice of either Durvalumab or Pembrolizumab, where approved under local regulations.

干预措施: Gemcitabine (Drug)

Standard-of-care Therapy Arm

Active Comparator

Standard of care treatment of CisGem with or without a PD-1/L1 inhibitor. PD-1/L1 inhibitor will be physician's choice of either Durvalumab or Pembrolizumab, where approved under local regulations.

干预措施: Cisplatin (Drug)

Standard-of-care Therapy Arm

Active Comparator

Standard of care treatment of CisGem with or without a PD-1/L1 inhibitor. PD-1/L1 inhibitor will be physician's choice of either Durvalumab or Pembrolizumab, where approved under local regulations.

干预措施: Pembrolizumab (Drug)

Standard-of-care Therapy Arm

Active Comparator

Standard of care treatment of CisGem with or without a PD-1/L1 inhibitor. PD-1/L1 inhibitor will be physician's choice of either Durvalumab or Pembrolizumab, where approved under local regulations.

干预措施: Durvalumab (Drug)

Standard-of-care Therapy Arm

Active Comparator

Standard of care treatment of CisGem with or without a PD-1/L1 inhibitor. PD-1/L1 inhibitor will be physician's choice of either Durvalumab or Pembrolizumab, where approved under local regulations.

干预措施: Gemcitabine (Drug)

Zanidatamab with Standard-of-care Therapy Arm

Experimental

Zanidatamab plus standard of care treatment of CisGem with or without a PD-1/L1 inhibitor. PD-1/L1 inhibitor will be physician's choice of either Durvalumab or Pembrolizumab, where approved under local regulations.

干预措施: Durvalumab (Drug)

Zanidatamab with Standard-of-care Therapy Arm

Experimental

Zanidatamab plus standard of care treatment of CisGem with or without a PD-1/L1 inhibitor. PD-1/L1 inhibitor will be physician's choice of either Durvalumab or Pembrolizumab, where approved under local regulations.

干预措施: Pembrolizumab (Drug)

结局指标

主要结局

Progression Free Survival (PFS) in participants with Immunohistochemistry (IHC) 3+ tumors

时间窗: Up to 52 months

PFS is defined as the time from the date of randomization to the date of documented disease progression, or death from any cause.

次要结局

  • Number of participants achieving Confirmed objective response rate (cORR)(Up to 68 months)
  • Overall survival (OS) in participants with IHC 3+ tumors(Up to 68 months)
  • OS for all participants(Up to 68 months)
  • Progression Free Survival for all participants(Up to 68 months)
  • Duration of response (DOR)(Up to 68 months)
  • Number of Patients reporting Treatment-Emergent Adverse Events (TEAE)(Up to 68 months)
  • Maximum serum concentration of Zanidatamab(Up to 68 months)
  • Number of participants who develop Anti-drug antibodies (ADAs) to Zanidatamab(Up to 68 months)
  • TDD for participants with IHC 3+ tumors in patient-reported symptoms scores as measured by the EORTC QLQ-BIL21 (Pain, Jaundice, Abdominal Pain and Pruritis)(Up to 68 months)
  • TDD for all participants in patient-reported symptoms scores as measured by the EORTC QLQ-BIL21 (Pain, Jaundice, Abdominal Pain, and Pruritis)(Up to 68 months)
  • Time to definitive deterioration (TDD) for participants with IHC 3+ tumors in patient-reported Physical Functioning (PF) domain score as measured by the EORTC QLQ-C30(Up to 68 months)
  • TDD for all participants in patient-reported PF domain score as measured by the EORTC QLQ-C30(Up to 68 months)

研究者

申办方类型
Industry
责任方
Sponsor

研究点 (427)

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相关资讯

FDA Grants Accelerated Approval to Zanidatamab for HER2-Positive Biliary Tract Cancer• The FDA granted accelerated approval to zanidatamab for pretreated, unresectable or metastatic HER2-positive biliary tract cancer on November 20, 2024. • The approval was based on the phase 2b HERIZON-BTC-01 trial, which showed a 52% overall response rate in patients treated with zanidatamab. • Zanidatamab is a HER2-directed bispecific antibody, marking the first accelerated approval of a HER2-targeted agent for this difficult-to-treat cancer. • A confirmatory phase 3 trial, HERIZON-BTC-302, is underway to investigate zanidatamab plus standard-of-care therapy in the frontline setting.last yearZiihera (Zanidatamab-hrii) Receives NCCN Recommendation for Biliary Tract Cancers• Jazz Pharmaceuticals' Ziihera (zanidatamab-hrii) has been added as a category 2A treatment option in the NCCN Clinical Practice Guidelines for biliary tract cancers. • The FDA granted accelerated approval to Ziihera in November 2024 for HER2-positive biliary tract cancer, based on a 52% objective response rate. • Ziihera is the first and only dual HER2-targeted bispecific antibody and chemotherapy-free treatment for patients with biliary tract cancer. • A confirmatory Phase 3 trial, HERIZON-BTC-302, is ongoing to evaluate zanidatamab in combination with standard-of-care therapy for HER2-positive BTC.last yearFDA Approves Zanidatamab (Ziihera) for HER2-Positive Biliary Tract Cancer• The FDA has granted accelerated approval to zanidatamab-hrii (Ziihera) for adults with previously treated, unresectable or metastatic HER2-positive biliary tract cancer. • The approval was based on the HERIZON-BTC-01 trial, which demonstrated a 52% objective response rate and a 14.9-month average duration of treatment with zanidatamab. • Zanidatamab, developed by Zymeworks Inc. and Jazz Pharmaceuticals, offers a new targeted therapy option for biliary tract cancers, where chemotherapy is currently a common treatment. • Ongoing phase 3 trials are evaluating zanidatamab in combination with standard-of-care for first-line treatment and in other HER2-positive cancers like gastroesophageal adenocarcinomas and metastatic breast cancer.last yearFDA Approves Zanidatamab (Ziihera) for HER2-Positive Biliary Tract Cancer• The FDA has granted accelerated approval to zanidatamab-hrii (Ziihera) for previously treated, unresectable or metastatic HER2-positive biliary tract cancer. • This approval marks the first HER2-targeted therapy specifically for this disease, addressing a significant unmet need in biliary tract cancer treatment. • The approval was based on the phase 2b HERIZON-BTC-01 trial, which demonstrated an objective response rate of 52% and a median duration of response of 14.9 months. • Ongoing phase 3 trials are evaluating zanidatamab in combination with chemotherapy and PD-1/PD-L1 inhibitors as a first-line treatment for advanced HER2+ biliary tract cancer.last yearZanidatamab Gains NCCN Recommendation and Companion Diagnostic Approval for HER2+ Biliary Tract Cancer- Zanidatamab, a bispecific antibody targeting HER2, has been added to the NCCN guidelines as a category 2A treatment option for HER2-positive biliary tract cancer (BTC). - The FDA approved PATHWAY anti-HER2/neu (4B5) Rabbit Monoclonal Primary Antibody test as a companion diagnostic to identify BTC patients eligible for zanidatamab. - HERIZON-BTC-01 trial data demonstrated a 52% objective response rate and a median duration of response of 14.9 months with zanidatamab in pretreated HER2+ BTC. - Ongoing phase 3 HERIZON-BTC-302 trial is evaluating zanidatamab plus standard-of-care therapy vs standard-of-care alone in the first-line treatment of HER2-positive BTC.last year

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