Uno studio sulla sicurezza e l'efficacia di ZW25 (Zanidatamab) più chemioterapia combinata nei tumori gastrointestinali che esprimono HER2, tra cui l'adenocarcinoma gastroesofageo, il cancro delle vie biliari e il cancro del colon-retto
Studio di fase 2 sulla chemioterapia combinata di prima linea ZW25 Plus nei tumori gastrointestinali (GI) che esprimono HER2, tra cui l'adenocarcinoma gastroesofageo (GEA), il cancro del tratto biliare (BTC) e il cancro del colon-retto (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).
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
Intervento / Trattamento
Intervento / Trattamento
Descrizione dettagliata
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.
Tipo di studio
Tipo di studio
Iscrizione (Effettivo)
Iscrizione
Fase
Fase
- Fase 2
Accesso esteso
Accesso esteso
Non più disponibile
- Disponibile: l'accesso esteso è attualmente disponibile per questo trattamento sperimentale e i pazienti che non partecipano allo studio clinico potrebbero essere in grado di accedere al farmaco, al biologico o al dispositivo medico in fase di studio.
- Non più disponibile: l'accesso esteso era disponibile per questo intervento in precedenza, ma non è attualmente disponibile e non sarà disponibile in futuro.
- Temporaneamente non disponibile: l'accesso esteso non è attualmente disponibile per questo intervento, ma dovrebbe esserlo in futuro.
- Approvato per il marketing: l'intervento è stato approvato dalla Food and Drug Administration degli Stati Uniti per l'uso da parte del pubblico.
Contatti e Sedi
Luoghi di studio
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Ontario
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Ottawa, Ontario, Canada, K1H 8L6
- The Ottawa Hospital Cancer Centre
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Toronto, Ontario, Canada, M5G 2C1
- Princess Margaret Cancer Center
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Santiago, Chile, 8241479
- Icegclinic Research & Care
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Santiago, Chile, 8420383
- Centro Internacional de Estudios Clínicos
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Santiago, Chile, 7500653
- Centro de Investigacion Clinica SAGA
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Santiago, Chile, 8320000
- CECIM Biocinetic
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Busan, Corea del Sud, 49241
- Pusan National University
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Seoul, Corea del Sud, 03080
- Seoul National University Hospital
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Seoul, Corea del Sud, 05505
- Asan Medical Center
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Seoul, Corea del Sud, 03722
- Severance Hospital
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Seoul, Corea del Sud, 02841
- Korea University Anam Hospital
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Gyeonggi-do
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Seongnam-si, Gyeonggi-do, Corea del Sud, 13620
- Seoul National University Bundang Hospital
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California
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Los Angeles, California, Stati Uniti, 90033
- USC/Norris Comprehensive Cancer Center
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Newport Beach, California, Stati Uniti, 92663
- Hoag Memorial Hospital Presbyterian
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Florida
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Tampa, Florida, Stati Uniti, 33612
- H. Lee Moffitt Cancer Center
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Illinois
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Chicago, Illinois, Stati Uniti, 60637
- University of Chicago
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Michigan
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Grand Rapids, Michigan, Stati Uniti, 49503
- The Cancer and Hematology Centers
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Nebraska
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Omaha, Nebraska, Stati Uniti, 68114
- Nebraska Methodist Hospital
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New York
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New York, New York, Stati Uniti, 10065
- Memorial Sloan Kettering Cancer Center
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Pennsylvania
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Philadelphia, Pennsylvania, Stati Uniti, 19111
- Fox Chase Cancer Center
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Tennessee
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Nashville, Tennessee, Stati Uniti, 37203
- Sarah Cannon Research Institute
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Texas
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Houston, Texas, Stati Uniti, 77030
- MD Anderson Cancer Center
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Washington
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Seattle, Washington, Stati Uniti, 98101
- Virginia Mason Medical Center
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Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
Accetta volontari sani
Sessi ammissibili allo studio
Descrizione
Inclusion:
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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
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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
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An Eastern Cooperative Oncology Group (ECOG) Performance Status score of 0 or 1
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Adequate organ function
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Adequate cardiac left ventricular function, as defined by a LVEF >/= institutional standard of normal
Exclusion:
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Prior treatment with a HER2-targeted agent
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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).
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Patients with certain contraindications to bevacizumab cannot be enrolled on the mFOLFOX6-2 with bevacizumab arm.
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Palliative radiotherapy is allowed if completed at least 2 weeks prior to first study treatment dosing
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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)
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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.
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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
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Peripheral neuropathy > Grade 1 per NCI-CTCAE v5.0
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Clinically significant interstitial lung disease
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Prior or concurrent malignancy whose natural history or treatment has the potential to interfere with the safety or efficacy assessment of the investigational regimen
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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)
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: Non randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Nessuno (etichetta aperta)
Numero di armi
Armi e interventi
Gruppo di partecipanti / ArmGruppo di partecipanti / Arm |
Intervento / TrattamentoIntervento / Trattamento |
|---|---|
|
Sperimentale: ZW25 + FP
ZW25 plus fluorouracil (5-FU) and cisplatin |
Administered IV
Administered IV |
|
Sperimentale: ZW25 + mFOLFOX6
ZW25 plus 5-FU, leucovorin, and oxaliplatin |
Administered IV
Administered IV Administered IV |
|
Sperimentale: ZW25 + XELOX
ZW25 plus capecitabine and oxaliplatin |
Administered IV
Administered orally twice daily (PO bid) |
|
Sperimentale: ZW25 + mFOLFOX6 with bevacizumab
ZW25 plus 5-FU, leucovorin, oxaliplatin, and bevacizumab |
Administered IV Administered IV
Administered IV Administered IV |
|
Sperimentale: ZW25 + CisGem
ZW25 plus cisplatin and gemcitabine |
Administered IV Administered IV |
Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Number of Participants Reporting Dose-limiting Toxicities (DLTs) (Part 1)
Lasso di tempo: Cycle 1 of treatment for all Part 1 treatment regimens (each cycle is 21 days for the XELOX, FP, and CisGem regimens; 28 days for the mFOLFOX6 regimens)
|
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. |
Cycle 1 of treatment for all Part 1 treatment regimens (each cycle is 21 days for the XELOX, FP, and CisGem regimens; 28 days for the mFOLFOX6 regimens)
|
|
Number of Participants Reporting Treatment-emergent Adverse Events (Part 1; Parts 1 and 2)
Lasso di tempo: From the start of dosing of any study drug through 30 days after last study treatment or prior to beginning the next course of anticancer therapy, whichever occurs sooner, up to approximately 68 months
|
AEs were graded using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) version 5.0 (v5.0). |
From the start of dosing of any study drug through 30 days after last study treatment or prior to beginning the next course of anticancer therapy, whichever occurs sooner, up to approximately 68 months
|
|
Number of Participants Reporting Grade 3 or Higher Laboratory Abnormalities (Parts 1 and 2)
Lasso di tempo: From the start of dosing of any study drug through 30 days after last study treatment or prior to beginning the next course of anticancer therapy, whichever occurs sooner, up to approximately 68 months
|
Grades of laboratory abnormalities were defined using National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE), version 5.0. |
From the start of dosing of any study drug through 30 days after last study treatment or prior to beginning the next course of anticancer therapy, whichever occurs sooner, up to approximately 68 months
|
|
Confirmed Objective Response Rate (ORR) (Parts 1 and 2)
Lasso di tempo: From time from confirmed best response (CR or PR) to documented PD per RECIST 1.1 or death from any cause, whichever occurs first, up to approximately 68 months
|
Number of participants who achieved a confirmed 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 |
From time from confirmed best response (CR or PR) to documented PD per RECIST 1.1 or death from any cause, whichever occurs first, up to approximately 68 months
|
Misure di risultato secondarie
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Disease Control Rate (Parts 1 and 2)
Lasso di tempo: From time from best response (CR, PR, SD) to documented PD per RECIST 1.1 or death from any cause, whichever occurred first, up to approximately 68 months
|
Number of participants who achieved a best response of CR, PR, or stable disease (SD) during treatment per RECIST 1.1. Results are presented separately for the GEA and BTC cancer groups based on Parts 1 and 2 combined and for the CRC cancer group based on Part 1 only. |
From time from best response (CR, PR, SD) to documented PD per RECIST 1.1 or death from any cause, whichever occurred first, up to approximately 68 months
|
|
Duration of Response (Parts 1 and 2)
Lasso di tempo: From time from the first objective response (CR or PR) to documented PD per RECIST 1.1 or death from any cause, whichever occurred first, up to approximately 68 months
|
Median duration of response (in months) and range (minimum, maximum) are reported. Results are presented separately for the GEA and BTC cancer groups based on Parts 1 and 2 combined and for the CRC cancer group based on Part 1 only. |
From time from the first objective response (CR or PR) to documented PD per RECIST 1.1 or death from any cause, whichever occurred first, up to approximately 68 months
|
|
Clinical Benefit Rate (Parts 1 and 2)
Lasso di tempo: From time from the response (SD ≥ 24 weeks, CR or PR) to documented PD per RECIST 1.1 or death from any cause, whichever occurs first, up to approximately 68 months
|
Number of participants with SD for ≥ 24 weeks or a confirmed, best overall response of CR or PR per RECIST 1.1. Results are presented separately for the GEA and BTC cancer groups based on Parts 1 and 2 combined and for the CRC cancer group based on Part 1 only. |
From time from the response (SD ≥ 24 weeks, CR or PR) to documented PD per RECIST 1.1 or death from any cause, whichever occurs first, up to approximately 68 months
|
|
Progression-free Survival (Parts 1 and 2)
Lasso di tempo: From the time from the first dose of study treatment to the date of documented disease progression (per RECIST 1.1), clinical progression, or death from any cause, whichever occurred first, up to approximately 68 months
|
Median progression-free survival (in months) and range (minimum, maximum) are reported. Results are presented separately for the GEA and BTC cancer groups based on Parts 1 and 2 combined and for the CRC cancer group based on Part 1 only. |
From the time from the first dose of study treatment to the date of documented disease progression (per RECIST 1.1), clinical progression, or death from any cause, whichever occurred first, up to approximately 68 months
|
|
Overall Survival (Parts 1 and 2)
Lasso di tempo: From the time from the date of first dose of study treatment until the date of death from any cause, up to approximately 68 months
|
Median overall survival (in months) and range (minimum, maximum) are reported. Results are presented separately for the GEA and BTC cancer groups based on Parts 1 and 2 combined and for the CRC cancer group based on Part 1 only. |
From the time from the date of first dose of study treatment until the date of death from any cause, up to approximately 68 months
|
|
Incidence of Postbaseline Anti-drug Antibodies (ADAs) (Parts 1 and 2)
Lasso di tempo: Cycle 1 Day 1 up to 30 days after last dose, up to approximately 68 months (for ZW25 combined with XELOX, FP, or CisGem, each treatment cycle is 21 days; for ZW25 in combination with FOLFOX6 with or without bevacizumab, each treatment cycle is 28 days)
|
Number of participants who develop postbaseline ADAs are reported. Results are presented separately for the GEA and BTC cancer groups based on Parts 1 and 2 combined and for the CRC cancer group based on Part 1 only. |
Cycle 1 Day 1 up to 30 days after last dose, up to approximately 68 months (for ZW25 combined with XELOX, FP, or CisGem, each treatment cycle is 21 days; for ZW25 in combination with FOLFOX6 with or without bevacizumab, each treatment cycle is 28 days)
|
|
End of Infusion Concentration of ZW25 (Parts 1 and 2)
Lasso di tempo: Cycle 1 predose up to end of treatment, up to 68 months (for ZW25 combined with XELOX, FP, or CisGem, each treatment cycle is 21 days; for ZW25 in combination with FOLFOX6 with or without bevacizumab, each treatment cycle is 28 days)
|
Pharmacokinetic (PK) parameters were assessed using noncompartmental procedures. |
Cycle 1 predose up to end of treatment, up to 68 months (for ZW25 combined with XELOX, FP, or CisGem, each treatment cycle is 21 days; for ZW25 in combination with FOLFOX6 with or without bevacizumab, each treatment cycle is 28 days)
|
|
Maximum Serum Concentration of ZW25 (Parts 1 and 2)
Lasso di tempo: Cycle 1 predose up to end of treatment, up to 68 months (for ZW25 combined with XELOX, FP, or CisGem, each treatment cycle is 21 days; for ZW25 in combination with FOLFOX6 with or without bevacizumab, each treatment cycle is 28 days)
|
Pharmacokinetic (PK) parameters were assessed using noncompartmental procedures. |
Cycle 1 predose up to end of treatment, up to 68 months (for ZW25 combined with XELOX, FP, or CisGem, each treatment cycle is 21 days; for ZW25 in combination with FOLFOX6 with or without bevacizumab, each treatment cycle is 28 days)
|
|
Trough Concentration of ZW25 (Parts 1 and 2)
Lasso di tempo: Cycle 1, Day 15; Cycle 2, Days 1 and 15; Cycle 3, Days 1 and 15; Cycle 4, Day 1, and Cycle 6, Day 1 (for ZW25 combined with XELOX, FP, or CisGem, each cycle is 21 days; for ZW25 combined with FOLFOX6 with or without BEV, each cycle is 28 days)
|
Pharmacokinetic (PK) parameters were assessed using noncompartmental procedures. |
Cycle 1, Day 15; Cycle 2, Days 1 and 15; Cycle 3, Days 1 and 15; Cycle 4, Day 1, and Cycle 6, Day 1 (for ZW25 combined with XELOX, FP, or CisGem, each cycle is 21 days; for ZW25 combined with FOLFOX6 with or without BEV, each cycle is 28 days)
|
|
Number of Participants Reporting Treatment-emergent Adverse Events (Part 1; Parts 1 and 2)
Lasso di tempo: From the start of dosing of any study drug through 30 days after last study treatment or prior to beginning the next course of anticancer therapy, whichever occurs sooner, up to approximately 68 months.
|
Adverse events (AEs) were graded using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) version 5.0 (v5.0). |
From the start of dosing of any study drug through 30 days after last study treatment or prior to beginning the next course of anticancer therapy, whichever occurs sooner, up to approximately 68 months.
|
|
Number of Participants Reporting Grade 3 or Higher Laboratory Abnormalities (Parts 1 and 2)
Lasso di tempo: From the start of dosing of any study drug through 30 days after last study treatment or prior to beginning the next course of anticancer therapy, whichever occurs sooner, up to approximately 68 months.
|
Number of participants who experienced a maximum severity of Grade 3 or higher postbaseline laboratory abnormality, including either hematology or chemistry. Grades are defined using National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE), version 5.0. |
From the start of dosing of any study drug through 30 days after last study treatment or prior to beginning the next course of anticancer therapy, whichever occurs sooner, up to approximately 68 months.
|
Collaboratori e investigatori
Sponsor
Sponsor
Investigatori
Investigatori
- Direttore dello studio: Jazz Medical Director, Jazz Pharmaceuticals
Pubblicazioni e link utili
Studiare le date dei record
Studia le date principali
Inizio studio (Effettivo)
Inizio studio
Completamento primario (Effettivo)
Completamento primario
Completamento dello studio (Effettivo)
Completamento dello studio
Date di iscrizione allo studio
Primo inviato
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Primo Inserito
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento pubblicato
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Parole chiave
- Capecitabina
- Cancro colorettale
- LEI2
- Immunoterapia
- Cisplatino
- Chemioterapia
- Colangiocarcinoma extraepatico
- Oxaliplatino
- 5-FU
- Anticorpo bispecifico
- Anticorpo biparatopico
- Cancro delle vie biliari
- XELOX
- FP
- Colangiocarcinoma intraepatico
- Adenocarcinoma gastroesofageo
- Tumori gastrici
- Tumori esofagei
- Cistifellea
- Tumori della giunzione gastroesofagea (GEJ).
- mFOLFOX6
- Leucovorin (acido folinico)
- Tumori gastrointestinali
Termini MeSH pertinenti aggiuntivi
- Neoplasie per sede
- Malattie intestinali
- Neoplasie per tipo istologico
- Neoplasie dell'apparato digerente
- Malattie dell'apparato digerente
- Malattie gastrointestinali
- Malattie dello stomaco
- Neoplasie intestinali
- Malattie del retto
- Neoplasie della testa e del collo
- Malattie delle vie biliari
- Neoplasie, ghiandolari ed epiteliali
- Adenocarcinoma
- Malattie del colon
- Malattie esofagee
- Carcinoma
- Neoplasie
- Neoplasie allo stomaco
- Neoplasie delle vie biliari
- Neoplasie colorettali
- Neoplasie esofagee
- Neoplasie gastrointestinali
- Colangiocarcinoma
- Aminoacidi, peptidi e proteine
- Proteine
- Prodotti chimici organici
- Composti eterociclici, 1-anello
- Composti eterociclici
- Composti eterociclici, 2 anelli
- Composti eterociclici, anello fuso
- Acidi nucleici, nucleotidi e nucleosidi
- Enzimi e coenzimi
- Anticorpi, monoclonali, umanizzati
- Anticorpi, monoclonali
- Anticorpi
- Immunoglobuline
- Immunoproteine
- Proteine del sangue
- Globuline sieriche
- Globuline
- Prodotti chimici inorganici
- Composti di cloro
- Composti di azoto
- Complessi di coordinamento
- Deossictidina
- Citidina
- Nucleosidi di pirimidina
- Pirimidine
- Nucleosidi
- Formyltetraidrofolates
- Tetraidrofolati
- Acido folico
- Pterins
- Pteridine
- Uracile
- Pirimidinoni
- Coenzimi
- Composti di platino
- Deossiribonucleosidi
- Capecitabina
- Oxaliplatino
- Bevacizumab
- Gemcitabina
- Fluorouracile
- Leucovorina
- Cisplatino
- Zanidatamab
Altri numeri di identificazione dello studio
Altri numeri di identificazione dello studio
- ZWI-ZW25-201
Piano per i dati dei singoli partecipanti (IPD)
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Informazioni su farmaci e dispositivi, documenti di studio
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Studia un dispositivo regolamentato dalla FDA degli Stati Uniti
Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .