DS-8201a in Human Epidermal Growth Factor Receptor 2 (HER2)-Expressing Gastric Cancer [DESTINY-Gastric01]

NCT ID: NCT03329690

Last Updated: 2022-03-18

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

233 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-11-02

Study Completion Date

2020-12-11

Brief Summary

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The primary purpose of this trial is to compare the efficacy and safety of DS-8201a and physician's choice treatment in HER2-overexpressing advanced gastric or gastroesophageal junction adenocarcinoma patients who have progressed on two prior treatment regimens including fluoropyrimidine agent, platinum agent, and trastuzumab.

Detailed Description

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Conditions

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Neoplasm, Gastrointestinal

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Two randomized investigative arms will run in parallel (DS-8201a and Physician's Choice), with participants who have disease progression after two previous regimens.

Two non-randomized exploratory arms will run with HER2 treatment-naive participants.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Parallel: DS-8201a

Participants with HER2-overexpressing (IHC 3+ or IHC 2+/ISH+) advanced gastric or gastroesophageal junction adenocarcinoma, whose disease has progressed on two prior regimens, will receive DS-8201a once every 3 weeks.

Group Type EXPERIMENTAL

DS-8201a

Intervention Type DRUG

DS-8201a is comprised of an antibody component conjoined to a drug component in a lyophilized powder, which is made into solution for intravenous administration.

Parallel: Physician's Choice

Participants with HER2-overexpressing (IHC 3+ or IHC 2+/ISH+) advanced gastric or gastroesophageal junction adenocarcinoma, whose disease has progressed on two prior regimens, will receive monotherapy prescribed by the physician before enrollment.

Group Type ACTIVE_COMPARATOR

Physician's Choice

Intervention Type DRUG

Either:

Irinotecan monotherapy (Starting dosage and usage is 150 mg/m2 biweekly, with dose reduction permitted)

Paclitaxel monotherapy (Starting dosage and usage is 80 mg/m2 weekly, with dose reduction permitted)

Exploratory: Naïve HER2 IHC 2+/ISH-

A maximum of 20 non-randomized participants with HER2 IHC 2+/ISH- advanced gastric or gastroesophageal junction adenocarcinoma will receive DS-8201a once every three weeks.

Group Type OTHER

DS-8201a

Intervention Type DRUG

DS-8201a is comprised of an antibody component conjoined to a drug component in a lyophilized powder, which is made into solution for intravenous administration.

Exploratory: Naïve HER2 IHC 1+

A maximum of 20 non-randomized patients with HER2 IHC 1+ advanced gastric or gastroesophageal junction adenocarcinoma will receive DS-8201a once every 3 weeks.

Group Type OTHER

DS-8201a

Intervention Type DRUG

DS-8201a is comprised of an antibody component conjoined to a drug component in a lyophilized powder, which is made into solution for intravenous administration.

Interventions

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DS-8201a

DS-8201a is comprised of an antibody component conjoined to a drug component in a lyophilized powder, which is made into solution for intravenous administration.

Intervention Type DRUG

Physician's Choice

Either:

Irinotecan monotherapy (Starting dosage and usage is 150 mg/m2 biweekly, with dose reduction permitted)

Paclitaxel monotherapy (Starting dosage and usage is 80 mg/m2 weekly, with dose reduction permitted)

Intervention Type DRUG

Other Intervention Names

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Experimental product Standard of Care

Eligibility Criteria

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Inclusion Criteria

1. Has a pathologically documented locally advanced or metastatic adenocarcinoma of gastric or gastroesophageal junction
2. Progression on and after at least 2 prior regimens
3. Has an adequate tumor sample
4. Has measurable disease based on Response Evaluation Criteria In Solid Tumors (RECIST) version 1.1

Exclusion Criteria

1. Has a medical history of myocardial infarction, symptomatic congestive heart failure (CHF) (NYHA classes II-IV), unstable angina or serious cardiac arrhythmia
2. Has a QTc prolongation to \> 450 millisecond (ms) in males and \> 470 ms in females
3. Has a medical history of clinically significant lung disease
4. Is suspected to have certain other protocol-defined diseases based on imaging at screening period
5. Has history of any disease, metastatic condition, drug/medication use or other condition that might, per protocol or in the opinion of the investigator, compromise:

1. safety or well-being of the participant or offspring
2. safety of study staff
3. analysis of results
Minimum Eligible Age

20 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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AstraZeneca

INDUSTRY

Sponsor Role collaborator

Daiichi Sankyo Co., Ltd.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Global Clinical Leader

Role: STUDY_DIRECTOR

Daiichi Sankyo

Locations

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Aichi Cancer Center Hospital

Nagoya, Aichi-ken, Japan

Site Status

Hirosaki University Hospital

Hirosaki, Aomori, Japan

Site Status

National Cancer Center Hospital East

Kashiwa, Chiba, Japan

Site Status

National Hospital Organization Shikoku Cancer Center

Matsuyama, Ehime, Japan

Site Status

Japan Community Health Care Organization Kyushu Hospital

Kitakyushu, Fukuoka, Japan

Site Status

Gunma Prefectural Cancer Center

Ōta, Gunma, Japan

Site Status

Kure Medical Center

Kure, Hiroshima, Japan

Site Status

Hokkaido University Hospital

Sapporo, Hokkaido, Japan

Site Status

Hyogo Cancer Center

Akashi, Hyōgo, Japan

Site Status

Kansai Rosai Hospital

Amagasaki, Hyōgo, Japan

Site Status

Kobe City Medical Center General Hospital

Kobe, Hyōgo, Japan

Site Status

Ibaraki Prefectural Central Hospital

Kasama, Ibaraki, Japan

Site Status

Kanazawa University Hospital

Kanazawa, Ishikawa-ken, Japan

Site Status

Iwate Medical University Hospital

Shiwa-gun, Iwate, Japan

Site Status

Kagawa University Hospital

Kita, Kagawa-ken, Japan

Site Status

St. Marianna University School of Medicine Hospital

Kawasaki, Kanagawa, Japan

Site Status

The Kitasato Institute Kitasato University Hospital

Sagamihara, Kanagawa, Japan

Site Status

Yokohama City University Medical Center

Yokohama, Kanagawa, Japan

Site Status

Kanagawa Cancer Center

Yokohama, Kanagawa, Japan

Site Status

Japanese Red Cross Kyoto Daini Hospital

Kamigyō-ku, Kyoto, Japan

Site Status

Miyagi Cancer Center

Natori-shi, Miyagi, Japan

Site Status

Osaki Citizen Hospital

Ōsaki, Miyagi, Japan

Site Status

Osaka University Hospital

Suita, Osaka, Japan

Site Status

Toyonaka Municipal Hospital

Toyonaka, Osaka, Japan

Site Status

Tochigi Cancer Center

Utsunomiya, Tochigi, Japan

Site Status

Tokyo Metropolitan Komagome Hospital

Bunkyō-Ku, Tokyo, Japan

Site Status

National Cancer Center Hospital

Chuo Ku, Tokyo, Japan

Site Status

The Cancer Institute Hospital of Japanese Foundation for Cancer Research

Koto-Ku, Tokyo, Japan

Site Status

Showa University Koto Toyosu Hospital

Koto-Ku, Tokyo, Japan

Site Status

Toranomon Hospital

Minato-Ku, Tokyo, Japan

Site Status

Chiba Cancer Center

Chiba, , Japan

Site Status

Fukui Prefectural Hospital

Fukui, , Japan

Site Status

National Hospital Organization Kyushu Cancer Center

Fukuoka, , Japan

Site Status

Kyushu University Hospital

Fukuoka, , Japan

Site Status

Gifu University Hospital

Gifu, , Japan

Site Status

Hiroshima City Asa Citizens Hospital

Hiroshima, , Japan

Site Status

Hiroshima Prefectural Hospital

Hiroshima, , Japan

Site Status

Kochi Health Sciences Center

Kochi, , Japan

Site Status

Niigata Cancer Center Hospital

Niigata, , Japan

Site Status

Okayama University Hospital

Okayama, , Japan

Site Status

Local Incorporated Administrative Agency Osaka City Hospital Organization Osaka City General Hospital

Osaka, , Japan

Site Status

Osaka International Cancer Institute

Osaka, , Japan

Site Status

Osaka General Medical Center

Osaka, , Japan

Site Status

Kindai University Hospital

Osaka, , Japan

Site Status

Saitama Cancer Center

Saitama, , Japan

Site Status

Shizuoka Cancer Center

Shizuoka, , Japan

Site Status

Shizuoka General Hospital

Shizuoka, , Japan

Site Status

Keio University Hospital

Tokyo, , Japan

Site Status

National Cancer Center

Ilsan, Gyeonggi-do, South Korea

Site Status

Chungbuk National University Hospital

Cheongju-si, North Chungcheong, South Korea

Site Status

Inje University Haeundae Paik Hospital

Busan, , South Korea

Site Status

Dong-A University Hospital

Busan, , South Korea

Site Status

Kyungpook National University Chilgok Hospital

Daegu, , South Korea

Site Status

Chonnam National University Hwasun Hospital

Gwangju, , South Korea

Site Status

Gachon University Gil Medical Center

Incheon, , South Korea

Site Status

Chonbuk National University Hospital

Jeonju, , South Korea

Site Status

Seoul National University Bundang Hospital

Seongnam, , South Korea

Site Status

Korea University Anam Hospital

Seoul, , South Korea

Site Status

Seoul National University Hospital

Seoul, , South Korea

Site Status

Yonsei Cancer Center, Severance Hospital, Yonsei University Health System

Seoul, , South Korea

Site Status

Asan Medical Center

Seoul, , South Korea

Site Status

Gangnam Severance Hospital

Seoul, , South Korea

Site Status

Samsung Medical Center

Seoul, , South Korea

Site Status

The Catholic University of Korea, Seoul St. Mary's Hospital

Seoul, , South Korea

Site Status

Chung-Ang University Hospital

Seoul, , South Korea

Site Status

Korea University Guro Hospital

Seoul, , South Korea

Site Status

Countries

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Japan South Korea

References

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Shitara K, Bang YJ, Iwasa S, Sugimoto N, Ryu MH, Sakai D, Chung HC, Kawakami H, Yabusaki H, Lee J, Saito K, Kawaguchi Y, Kamio T, Kojima A, Sugihara M, Yamaguchi K; DESTINY-Gastric01 Investigators. Trastuzumab Deruxtecan in Previously Treated HER2-Positive Gastric Cancer. N Engl J Med. 2020 Jun 18;382(25):2419-2430. doi: 10.1056/NEJMoa2004413. Epub 2020 May 29.

Reference Type RESULT
PMID: 32469182 (View on PubMed)

Yamaguchi K, Bang YJ, Iwasa S, Sugimoto N, Ryu MH, Sakai D, Chung HC, Kawakami H, Yabusaki H, Lee J, Shimoyama T, Lee KW, Saito K, Kawaguchi Y, Kamio T, Kojima A, Sugihara M, Shitara K. Trastuzumab Deruxtecan in Anti-Human Epidermal Growth Factor Receptor 2 Treatment-Naive Patients With Human Epidermal Growth Factor Receptor 2-Low Gastric or Gastroesophageal Junction Adenocarcinoma: Exploratory Cohort Results in a Phase II Trial. J Clin Oncol. 2023 Feb 1;41(4):816-825. doi: 10.1200/JCO.22.00575. Epub 2022 Nov 15.

Reference Type DERIVED
PMID: 36379002 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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173727

Identifier Type: REGISTRY

Identifier Source: secondary_id

DESTINY-G01

Identifier Type: OTHER

Identifier Source: secondary_id

DS8201-A-J202

Identifier Type: -

Identifier Source: org_study_id

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