- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03929666
A Safety and Efficacy Study of ZW25 (Zanidatamab) Plus Combination Chemotherapy in HER2-expressing Gastrointestinal Cancers, Including Gastroesophageal Adenocarcinoma, Biliary Tract Cancer, and Colorectal Cancer
March 4, 2024 updated by: Jazz Pharmaceuticals
Phase 2 Study of ZW25 Plus First-line Combination Chemotherapy in HER2-Expressing Gastrointestinal (GI) Cancers, Including Gastroesophageal Adenocarcinoma (GEA), Biliary Tract Cancer (BTC), and Colorectal Cancer (CRC)
This is a multicenter, global, Phase 2, open-label, 2-part, first-line study to investigate the safety, tolerability, and anti-tumor activity of ZW25 (zanidatamab) plus standard first-line combination chemotherapy regimens for selected gastrointestinal (GI) cancers.
Eligible patients include those with unresectable, locally advanced, recurrent or metastatic HER2-expressing gastroesophageal adenocarcinoma (GEA), biliary tract cancer (BTC), or colorectal cancer (CRC).
Study Overview
Status
Active, not recruiting
Detailed Description
Part 1 of the study will first evaluate the safety and tolerability of ZW25 plus standard first-line combination chemotherapy (XELOX, FP, or mFOLFOX6 for GEA; mFOLFOX6 with or without bevacizumab for CRC; and CisGem for BTC) and will confirm the recommended dosage (RD) of ZW25 when administered in combination with each of these multi-agent chemotherapy regimens.
Then, Part 2 of the study will evaluate the anti-tumor activity of ZW25 plus combination chemotherapy in HER2-expressing GEA, BTC, and CRC.
Study Type
Interventional
Enrollment (Actual)
74
Phase
- Phase 2
Expanded Access
Available outside the clinical trial.
See expanded access record.
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Clinical Trial Disclosure & Transparency
- Phone Number: 215-832-3750
- Email: ClinicalTrialDisclosure@JazzPharma.com
Study Locations
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Ontario
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Toronto, Ontario, Canada, M5G 2C1
- Princess Margaret Cancer Center
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Santiago, Chile, 8331143
- CeCim Biocinetic
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Santiago, Chile, 7500653
- Centro de Estudios Clínicos SAGA SpA
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Santiago, Chile, 8241479
- Icegclinic Research & Care
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Santiago, Chile, 8330008
- Meditek Ltda
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Busan, Korea, Republic of, 49241
- Pusan National University
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Seoul, Korea, Republic of, 03080
- Seoul National University Hospital
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Seoul, Korea, Republic of, 03722
- Severance Hospital
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Seoul, Korea, Republic of, 05505
- Asan Medical Center
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Seoul, Korea, Republic of, 02841
- Korea University Anam Hospital
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Gyeonggi-do
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Seongnam-si, Gyeonggi-do, Korea, Republic of, 13620
- Seoul National University Bundang Hospital
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California
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Los Angeles, California, United States, 90033
- USC/Norris Comprehensive Cancer Center
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Florida
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Tampa, Florida, United States, 33612
- H. Lee Moffitt Cancer Center
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Illinois
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Chicago, Illinois, United States, 60637
- University of Chicago
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Michigan
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Kalamazoo, Michigan, United States, 49007
- Cancer and Hematology Centers of Western Michigan
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Nebraska
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Omaha, Nebraska, United States, 68114
- Nebraska Methodist Hospital
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New York
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New York, New York, United States, 10065
- Memorial Sloan Kettering Cancer Center
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Pennsylvania
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Philadelphia, Pennsylvania, United States, 19111
- Fox Chase Cancer Center
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Tennessee
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Nashville, Tennessee, United States, 37203
- Sarah Cannon Research Institute
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Texas
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Houston, Texas, United States, 77030
- MD Anderson Cancer Center
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Washington
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Seattle, Washington, United States, 98101
- Virginia Mason Medical Center
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Description
Inclusion:
Disease diagnosis:
- Part 1:
- GEA: Unresectable, locally advanced, recurrent or metastatic HER2-expressing GEA (IHC 3+ or 2+ with or without gene amplification based upon local assessment or central assessment)
- BTC: Unresectable, locally advanced, recurrent or metastatic HER2-expressing BTC (including intrahepatic cholangiocarcinoma [ICC], extrahepatic cholangiocarcinoma [ECC], or gallbladder cancer [GBC]) (IHC 3+ with or without gene amplification; or IHC 0, 1+ or 2+ with gene amplification, based upon central assessment)
- CRC: Unresectable, locally advanced, recurrent or metastatic HER2-expressing CRC (IHC 3+ with or without gene amplification; or IHC 0, 1+ or 2+ with gene amplification, based upon central assessment). Patients will be required to be extended RAS (KRAS and NRAS) and BRAF wild-type based upon central assessment.
- Part 2:
- GEA: Unresectable, locally advanced, recurrent or metastatic HER2-expressing GEA (IHC 3+, or IHC 2+ and FISH+ by central assessment)
- BTC: Same as Part 1
- CRC: Same as Part 1
Tumor measurements as per Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1:
- Part 1: Measurable or non-measurable disease
- Part 2: Measurable disease
- An Eastern Cooperative Oncology Group (ECOG) Performance Status score of 0 or 1
- Adequate organ function
- Adequate cardiac left ventricular function, as defined by a LVEF >/= institutional standard of normal
Exclusion:
- Prior treatment with a HER2-targeted agent
Prior systemic anti-cancer therapy (including investigational products) except prior adjuvant/neoadjuvant therapy, which must be completed at least 6 months prior to first study treatment dosing. For subjects with BTC and CRC the following additional exceptions apply:
- BTC: patients may have started therapy for advanced disease but may not have received more than one cycle of any standard gemcitabine-based chemotherapy regimen.
- CRC: patients may have started therapy for advanced disease but may not have received more than one cycle of 5-FU-based chemotherapy (< 1 month of therapy).
- Patients with certain contraindications to bevacizumab cannot be enrolled on the mFOLFOX6-2 with bevacizumab arm.
- Palliative radiotherapy is allowed if completed at least 2 weeks prior to first study treatment dosing
- Untreated known brain metastases (patients with treated brain metastases who are off steroids, off antiseizure medications, and stable for at least 1 month at the time of screening are eligible)
- Clinically significant cardiac disease, such as ventricular arrhythmia requiring therapy, uncontrolled hypertension or any history of symptomatic congestive heart failure (CHF). Patients with known myocardial infarction or unstable angina within 6 months prior to randomization are also excluded.
- QTc Fridericia (QTcF) > 470 ms. For patients with longer QTcF on initial electrocardiogram (ECG), follow-up ECG may be performed in triplicate to determine eligibility
- Peripheral neuropathy > Grade 1 per NCI-CTCAE v5.0
- Clinically significant interstitial lung disease
- Prior or concurrent malignancy whose natural history or treatment has the potential to interfere with the safety or efficacy assessment of the investigational regimen
- Active hepatitis B or hepatitis C infection or infection with Human Immunodeficiency Virus (HIV)-1 or HIV-2 (Exception: patients with well controlled HIV [e.g., CD4 > 350/mm3 and undetectable viral load] are eligible)
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: ZW25 + FP
ZW25 plus fluorouracil (5-FU) and cisplatin
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Administered IV
Administered IV
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Experimental: ZW25 + mFOLFOX6
ZW25 plus 5-FU, leucovorin, and oxaliplatin
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Administered IV
Administered IV
Administered IV
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Experimental: ZW25 + XELOX
ZW25 plus capecitabine and oxaliplatin
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Administered IV
Administered orally twice daily (PO bid)
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Experimental: ZW25 + mFOLFOX6 with bevacizumab
ZW25 plus 5-FU, leucovorin, oxaliplatin, and bevacizumab
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Administered IV
Administered IV
Administered IV
Administered IV
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Experimental: ZW25 + CisGem
ZW25 plus cisplatin and gemcitabine
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Administered IV
Administered IV
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Incidence of dose-limiting toxicities (DLTs) (Part 1)
Time Frame: Up to 6 weeks
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Number of participants who experienced a DLT.
DLTs include adverse events considered to be related to study treatment, including the evaluated dose level of ZW25, any component or combination of the components of a chemotherapy regimen, or the combination of ZW25 plus a chemotherapy regimen.
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Up to 6 weeks
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Incidence of adverse events (Part 1)
Time Frame: Up to 11 months
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Number of participants who experienced an adverse event
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Up to 11 months
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Incidence of lab abnormalities (Part 1)
Time Frame: Up to 11 months
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Number of participants who experienced a maximum severity of Grade 3 or higher post-baseline laboratory abnormality, including either hematology and chemistry.
Grades are defined using National Cancer Institute's Common Terminology Criteria for Adverse Events (CTCAE), version 5.0.
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Up to 11 months
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Objective response rate (ORR) (Part 2)
Time Frame: Up to 10 months
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Number of participants who achieved a best response of either complete response (CR) or partial response (PR) during treatment according to the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1
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Up to 10 months
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Objective response rate (ORR) (Part 1)
Time Frame: Up to 10 months
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Number of participants who achieved a best response of either CR or PR during treatment per RECIST 1.1
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Up to 10 months
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Disease control rate (Parts 1 and 2)
Time Frame: Up to 10 months
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Number of participants who achieved a best response of CR, PR, or stable disease (SD) during treatment per RECIST 1.1
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Up to 10 months
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Duration of response (Parts 1 and 2)
Time Frame: Up to 2 years
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Median duration of response (in months) and range (minimum, maximum)
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Up to 2 years
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Clinical benefit rate (Parts 1 and 2)
Time Frame: Up to 2 years
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Number of participants with SD for ≥ 24 weeks or a confirmed, best overall response of CR or PR per RECIST 1.1
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Up to 2 years
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Progression-free survival (Parts 1 and 2)
Time Frame: Up to 2 years
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Median progression-free survival (in months) and range (minimum, maximum)
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Up to 2 years
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Overall survival (Parts 1 and 2)
Time Frame: Up to 2 years
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Median overall survival (in months) and range (minimum, maximum)
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Up to 2 years
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Incidence of anti-drug antibodies (ADAs) (Parts 1 and 2)
Time Frame: Up to 11 months
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Number of participants who develop ADAs
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Up to 11 months
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End of infusion concentration of ZW25 (Parts 1 and 2)
Time Frame: Up to 11 months
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Up to 11 months
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Maximum serum concentration of ZW25 (Parts 1 and 2)
Time Frame: Up to 11 months
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Up to 11 months
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Trough concentration of ZW25 (Parts 1 and 2)
Time Frame: Up to 11 months
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Up to 11 months
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Incidence of adverse events (Part 2)
Time Frame: Up to 11 months
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Number of participants who experienced an adverse event
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Up to 11 months
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Incidence of lab abnormalities (Part 2)
Time Frame: Up to 11 months
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Number of participants who experienced a maximum severity of Grade 3 or higher post-baseline laboratory abnormality, including either hematology and chemistry.
Grades are defined using National Cancer Institute's CTCAE, version 5.0.
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Up to 11 months
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Study Director: Phillip Garfin, MD, PhD, Jazz Pharmaceuticals
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
August 29, 2019
Primary Completion (Estimated)
November 28, 2025
Study Completion (Estimated)
October 30, 2026
Study Registration Dates
First Submitted
February 22, 2019
First Submitted That Met QC Criteria
April 23, 2019
First Posted (Actual)
April 29, 2019
Study Record Updates
Last Update Posted (Actual)
March 5, 2024
Last Update Submitted That Met QC Criteria
March 4, 2024
Last Verified
March 1, 2024
More Information
Terms related to this study
Keywords
- Capecitabine
- Colorectal cancer
- HER2
- Immunotherapy
- Cisplatin
- Chemotherapy
- Extrahepatic cholangiocarcinoma
- Oxaliplatin
- 5-FU
- Bispecific antibody
- Biparatopic antibody
- Biliary tract cancer
- XELOX
- FP
- Intrahepatic cholangiocarcinoma
- Gastroesophageal adenocarcinoma
- Gastric cancers
- Esophageal cancers
- Gall bladder
- Gastroesophageal junction (GEJ) cancers
- mFOLFOX6
- Leucovorin (folinic acid)
- Gastrointestinal cancers
Additional Relevant MeSH Terms
- Digestive System Diseases
- Neoplasms by Histologic Type
- Neoplasms
- Neoplasms by Site
- Carcinoma
- Neoplasms, Glandular and Epithelial
- Digestive System Neoplasms
- Gastrointestinal Diseases
- Colonic Diseases
- Intestinal Diseases
- Intestinal Neoplasms
- Rectal Diseases
- Biliary Tract Diseases
- Colorectal Neoplasms
- Adenocarcinoma
- Gastrointestinal Neoplasms
- Biliary Tract Neoplasms
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Antimetabolites, Antineoplastic
- Antimetabolites
- Antineoplastic Agents
- Immunosuppressive Agents
- Immunologic Factors
- Protective Agents
- Antineoplastic Agents, Immunological
- Angiogenesis Inhibitors
- Angiogenesis Modulating Agents
- Growth Substances
- Growth Inhibitors
- Micronutrients
- Vitamins
- Antidotes
- Vitamin B Complex
- Fluorouracil
- Capecitabine
- Oxaliplatin
- Bevacizumab
- Leucovorin
- Gemcitabine
Other Study ID Numbers
- ZWI-ZW25-201
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Yes
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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