単独投与またはニボルマブ・化学療法と併用投与によるデニキチュグ(GS-1811)の転移性胃腺がん、胃食道接合部腺がん、食道腺がんを有する成人を対象とした研究
第2相、非盲検、多施設、無作為化試験:HER2陰性、切除不能、再発および/または転移性胃、食道胃接合部(GEJ)、食道腺癌患者を対象に、デニキツグ単剤療法またはニボルマブ併用療法または化学療法の評価
The goal of this clinical study is to learn more about the study drug, Denikitug (DEN, GS-1811), to evaluate the efficacy and safety of Denikitug Monotherapy and Denikitug-based combinations in in participants with human epidermal growth factor receptor 2 (HER2)-Negative, unresectable, recurrent, and/or metastatic, gastroesophageal junction (GEJ), and esophageal adenocarcinomas.
The primary objective of this study is to assess the effect of DEN as a monotherapy or in combination with nivolumab (NIVO) or ramucirumab (RAM) and paclitaxel (PAC) on objective response rate (ORR) as assessed by the investigator according to Response Evaluation Criteria in Solid Tumors (RECIST Version1.1).
調査の概要
研究の種類
入学 (推定)
段階
- フェーズ2
連絡先と場所
研究場所
-
-
Massachusetts
-
Boston、Massachusetts、アメリカ、02114
- Massachusetts General Hospital
-
Boston、Massachusetts、アメリカ、02215
- Dana Farber Cancer Institute (DFCI)
-
-
New York
-
Albany、New York、アメリカ、12206
- New York Oncology Hematology
-
New York、New York、アメリカ、10021
- Weill Cornell Medicine - New York Presbyterian Hospital
-
-
-
-
New South Wales
-
Camperdown、New South Wales、オーストラリア、2050
- Chris O'Brien Lifehouse
-
St Leonards、New South Wales、オーストラリア、2065
- Royal North Shore Hospital
-
-
Queensland
-
Herston、Queensland、オーストラリア、4029
- Royal Brisbane and Women's Hospital
-
-
South Australia
-
Bedford Park、South Australia、オーストラリア、5042
- Flinders Medical Centre
-
-
Western Australia
-
Nedlands、Western Australia、オーストラリア、6009
- Hollywood Private Hospital
-
-
-
-
-
Barcelona、スペイン、8035
- Hospital Universitari Vall d'Hebron
-
Madrid、スペイン、28041
- Hospital Universitario 12 de Octubre
-
Pamplona、スペイン、31008
- Hospital Universitario de Navarra
-
Valencia、スペイン、46010
- Hospital Clinico Universitario de Valencia
-
-
-
-
-
Lyon、フランス、69008
- Centre Leon Berard, department of medical oncology
-
Marseille、フランス、13009
- Institut Paoli-Calmettes, department of medical oncology
-
-
-
-
-
Seoul、韓国、03830
- Seoul National University Hospital
-
-
参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Key Inclusion Criteria:
-
Histologically or cytologically confirmed diagnosis of locally advanced, unresectable, or metastatic gastric, gastroesophageal junction (GEJ), or esophageal adenocarcinoma (EAC).
-
Human epidermal growth factor receptor 2 (HER2)-negative status, as determined by local assessment using a validated immunohistochemistry assay, in situ hybridization or other amplification testing.
-
Has had disease progression during or after first line of systemic therapy for advanced or metastatic gastric, GEJ, or EACs, which must have included at least one of the following:
- Platinum- and fluoropyrimidine-based chemotherapy.
- Therapy with an anti-programmed cell death protein 1 (PD1) or anti-programmed cell death ligand 1 (anti-PD-L1) monoclonal antibody (patients with PD-L1-positive tumors must have received prior PD-1/PD-L1-based therapy).
- Zolbetuximab or other Claudin-18 (CLDN18).2-targeted therapy, if indicated based on biomarker status.
-
Eastern Cooperative Oncology Group (ECOG) performance status score of 0-1.
-
Have adequate organ function.
-
Male individuals and female individuals of childbearing potential who engage in heterosexual intercourse must agree to use methods of contraception.
Key Exclusion Criteria:
- Active or history of autoimmune disease requiring systemic treatment within 2 years, inflammatory bowel disease (IBD) (Crohn's/ulcerative colitis), celiac disease, or noninfectious enteritis/colitis. (Physiologic hormone replacement not considered systemic treatment).
- History or current noninfectious pneumonitis/interstitial lung disease, including radiation-induced pneumonitis requiring steroids or active/recurrent pneumonitis of any etiology.
- Documented microsatellite instability-high (MSI-H) or deficient mismatch repair (dMMR) disease by local polymerase chain reaction (PCR) (microsatellite status) and/or informed consent form (ICH) (mismatch repair (MMR)) assay
- (For Part 2 only) Has known history of peripheral neuropathy ≥ Grade 2 (per National Cancer Institute(NCI)-Common Tenninology Criteria for Adverse Events (CTCAE) Version 5.0).
- (For Part 2 only) Known coagulopathy that increases the risk of bleeding, bleeding diatheses. Any other Grade 3 or higher hemorrhage/bleeding event within 28 days prior to enrollment.
Prior/Concurrent Therapy or Clinical Study Experience
- Prior treatment with DEN or other C-C chemokine receptor 8 (CCR8)-targeted agents.
- Prior Lonsurf (trifluridine-tipiracil) or paclitaxel (PAC)-based regimens in the first-line setting for advanced/metastatic gastroesophageal adenocarcinoma.
- Any systemic therapy (including investigational) targeting vascular endothelial growth factor (VEGF) or VEGF receptor (VEGFR) signaling pathways.
- Anticancer biologic within 4 weeks, orchemotherapy, targeted small molecule, or radiation therapy within 2 weeks prior to enrollment with unresolved adverse events (AE)s (Grade >2). (Observational study participants are eligible).
- Prior allogenic tissue/solid organ or stem cell transplantation. (Exception: corneal transplant not requiring systemic immunosuppression is allowed).
Note: Other protocol defined Inclusion/Exclusion criteria may apply.
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
実験的:Part 1: Arm A: DEN (Dose A) and NIVO
Participants will receive DEN Dose A as an IV infusion in combination with NIVO as an IV infusion. |
Administered Intravenously
他の名前:
Administered Intravenously |
|
実験的:Part 1: Arm B: DEN (Dose B) and NIVO
Participants will receive DEN Dose B as an IV infusion in combination with NIVO as an IV infusion. |
Administered Intravenously
他の名前:
Administered Intravenously |
|
実験的:Part 1: Arm C: DEN (Dose B)
Participants will receive DEN Dose B as an IV infusion. |
Administered Intravenously
他の名前:
|
|
実験的:Part 2: Arm D: Safety Run-in (SRI) Cohort
Participants will receive DEN in combination with ramucirumab (RAM) and paclitaxel (PAC). If dose for DEN is deemed safe during the SRI Cohort, the study will move forward into the Expansion Period. |
Administered Intravenously
他の名前:
Administered Intravenously Administered Intravenously |
|
実験的:Part 2: Arm D: Expansion Cohort
If DEN dose is deemed safe in Arm D: SRI Cohort, participants will receive DEN at recommended dose as an IV infusion in combination with RAM and PAC. |
Administered Intravenously
他の名前:
Administered Intravenously Administered Intravenously |
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Objective Response Rate (ORR)
時間枠:Up to 4 years
|
ORR is defined as the percentage of participants who have achieved complete response (CR) or partial response (PR) as assessed by the investigator according to RECIST Version 1.1. |
Up to 4 years
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
米国国立がん研究所(NCI)有害事象共通用語基準(CTCAE)第5.0版に基づく、治療下で発現した有害事象(TEAEs)を経験した参加者の割合
時間枠:最終投与後最大120日間、最長4年間の初回投与日。
|
最終投与後最大120日間、最長4年間の初回投与日。
|
|
|
NCI CTCAE v5.0に基づく臨床検査値異常を有する参加者の割合
時間枠:最終投与後最大120日までの初回投与日、最大4年まで。
|
最終投与後最大120日までの初回投与日、最大4年まで。
|
|
|
薬物動態(PK)パラメータ:DENの血清中濃度
時間枠:最長4年間
|
最長4年間
|
|
|
治療中発生した抗デニキツグ抗体(ADA)を発現した参加者の割合
時間枠:最長4年
|
最長4年
|
|
|
Duration of Response (DOR)
時間枠:Up to 4 years
|
DOR is defined as the time of first response CR or PR as assessed by investigator, per RECIST Version 1.1 until the date of first documented progressive disease (PD) or death, whichever comes first. |
Up to 4 years
|
|
Progression-Free Survival (PFS)
時間枠:Up to 4 years
|
PFS is defined as the time from date of first dose until PD or death from any cause, whichever comes first as assessed by the investigator according to RECIST Version 1.1. |
Up to 4 years
|
|
Overall Survival (OS)
時間枠:Up to 4 years
|
OS is defined as the length of time from first dose until the date of death from any cause. |
Up to 4 years
|
|
PK Parameter: Cmax for Denikitug
時間枠:Up to 4 years
|
Cmax is defined as the maximum observed concentration. |
Up to 4 years
|
|
PK Parameter: AUCall for Denikitug
時間枠:Up to 4 years
|
AUCall is defined as the cumulative areas under the curve for all time points. |
Up to 4 years
|
協力者と研究者
スポンサー
捜査官
- スタディディレクター:Gilead Study Director、Gilead Sciences
出版物と役立つリンク
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (推定)
研究の完了 (推定)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
- GS-US-742-7757
- 2025-524095-27 (その他の識別子:EU Trial (CTIS) Number)
- 2025 (米国 NIH グラント/契約)
- CTR20263204 (その他の識別子:China's Center for Drug Evaluation)
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。