Biomarker-Integrated Umbrella, Advanced Gastric Cancer

NCT ID: NCT02951091

Last Updated: 2024-12-30

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

400 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-01-01

Study Completion Date

2024-03-31

Brief Summary

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In-depth understanding of molecular characteristics of gastric cancer enabled us to realize personalized medicine with targeted agents in gastric cancer treatment.

The investigators initiated open-label, randomized, controlled phase II, multi-arm trial comparing targeted therapy based on tumor molecular profiling with standard paclitaxel therapy as second line treatment.

Detailed Description

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In-depth understanding of molecular characteristics of gastric cancer enabled us to realize personalized medicine with targeted agents in gastric cancer treatment.The investigators initiated open-label, randomized, controlled phase II, multi-arm trial comparing targeted therapy based on tumor molecular profiling with standard paclitaxel therapy as second line treatment.

Conditions

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Gastric Cancer

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Biomarker-integrated multi-arm with shared standard of care (SOC) control arm
Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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biomarker group

400 Her-2 (-) metastatic/recurrent gastric cancer patients will be centrally screened for druggable targets \[Epstein-Barr virus, Microsatellite instability, HER2, EGFR, c-MET, and PTEN\] by immunohistochemistry and in situ hybridization during first line chemotherapy. At the time of second line treatment, patients will be randomized to the biomarker vs control group as 4: 1 ratio. The biomarker group will be offered for entry into a specific protocol based on their molecular cohort and treated with specific targeted agents in combination with weekly paclitaxel; 1) EGFR cohort (EGFR 2+ or EGFR 3+) for pan-ERBB inhibitor (afatinib), 2)PTEN loss cohort (PTEN score less than 100) for PIK3CB inhibitor (GSK2636771), 3) PD-L1 positive, MSI-high, or EBV positive cases for nivolumab, 4) none for weekly paclitaxel.

Group Type EXPERIMENTAL

biomarker screening

Intervention Type OTHER

immunohistochemistry and in situ hybridization

control group

Patients will be randomized to the biomarker vs control group (standard of care; paclitaxel) as 4:1 ratio.

Group Type ACTIVE_COMPARATOR

biomarker screening

Intervention Type OTHER

immunohistochemistry and in situ hybridization

Interventions

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biomarker screening

immunohistochemistry and in situ hybridization

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

1. Histologically or cytologically confirmed locally advanced or metastatic gastric cancer and gastroesophageal junction cancer
2. Eastern Cooperative Oncology Group performance status of 0 to 1
3. Male or female; ≥ 19 years of age
4. On or progression after 1st line palliative chemotherapy
5. Subjects with evaluable lesion (using RECIST 1.1 criteria)
6. Subjects who meet the following criteria:

* Absolute neutrophil count ≥ 1000 /µL
* Platelet count ≥ 75,000/ µL
* Serum creatinine \< 1.5 x upper limit of normal or Creatinine clearance ≥60 mL/min
* aspartate aminotransferase and alanine transaminase 3 x upper limit of normal

Exclusion Criteria

* Evidence of any other significant clinical disorder or laboratory finding that makes it undesirable for the patient to participate in the study
Minimum Eligible Age

19 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Yonsei University

OTHER

Sponsor Role lead

Responsible Party

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Sun Young Rha

professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Sun Young Rha, Ph.D

Role: PRINCIPAL_INVESTIGATOR

Severance Hospital

Locations

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Severance Hospital, Yonsei University Health System, Yonsei Cancer Center

Seoul, , South Korea

Site Status

Countries

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South Korea

References

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Lee CK, Kim HS, Jung M, Kim H, Bae WK, Koo DH, Jeung HC, Park SR, Hwang IG, Zang DY, Lee HW, Park S, Nam CM, Chung HC, Rha SY. Open-Label, Multicenter, Randomized, Biomarker-Integrated Umbrella Trial for Second-Line Treatment of Advanced Gastric Cancer: K-Umbrella Gastric Cancer Study. J Clin Oncol. 2024 Jan 20;42(3):348-357. doi: 10.1200/JCO.23.00971. Epub 2023 Oct 26.

Reference Type DERIVED
PMID: 37883723 (View on PubMed)

Other Identifiers

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4-2015-0616

Identifier Type: -

Identifier Source: org_study_id