Paclitaxel and Ramucirumab +/- Zanidatamab in HER2 Postive Advanced Gastroesophageal Adenocarcinoma

NCT ID: NCT06043427

Last Updated: 2025-08-12

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

RECRUITING

Clinical Phase

PHASE2

Total Enrollment

168 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-04-16

Study Completion Date

2026-06-30

Brief Summary

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This study is being done to answer the following question:

Can the chance of gastroesophageal cancer growing or spreading be lowered by adding a drug called zanidatamab to the usual combination of drugs?

We are doing this study because we want to find out if this approach is better or worse than the usual approach for this type of cancer. The usual approach is defined as care most people get for gastroesophageal cancer

Detailed Description

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The purpose of this study is to compare the usual approach alone to using zanidatamab plus the usual approach. The addition of zanidatamab to the usual approach could shrink cancer. But, it could also cause side effects.

This study will help the study doctors find out if this different approach is better than the usual approach. To decide if it is better, the study doctors will be looking to see if adding zanidatamab to the usual approach reduces the risk of cancer getting worse by at least 37% compared to the usual approach.

Conditions

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Gastroesophageal Adenocarcinoma

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Paclitaxel and Ramucriumab

Group Type ACTIVE_COMPARATOR

Paclitaxel

Intervention Type DRUG

80 mg/m²

Ramucirumab

Intervention Type DRUG

8 mg/kg

Zanidatamab + Paclitaxel and Ramucirumab

Group Type EXPERIMENTAL

Paclitaxel

Intervention Type DRUG

80 mg/m²

Ramucirumab

Intervention Type DRUG

8 mg/kg

Zanidatamab

Intervention Type DRUG

Dose and schedule to be assigned at enrollment

Interventions

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Paclitaxel

80 mg/m²

Intervention Type DRUG

Ramucirumab

8 mg/kg

Intervention Type DRUG

Zanidatamab

Dose and schedule to be assigned at enrollment

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Participants must have histologically or pathologically confirmed gastroesophageal adenocarcinoma (stomach, gastroesophageal junction or esophagus) that is unresectable or metastatic and which must be HER2 positive as confirmed by central testing using FDA-approved HER2 assay. HER2 positive is defined as IHC 3+, or IHC 2+ and FISH positive.
* Participants must have received and failed at least one prior trastuzumab-containing regimen in combination with platinum-based chemotherapy for treatment of locally advanced or metastatic disease. Failure is defined as demonstrated objective disease progression (radiologic) on the most recently administered HER2 targeting agent.
* Participants must have presence of measurable or evaluable disease as defined by Response Evaluation Criteria in Solid Tumours (RECIST 1.1).
* Participants must be considered a suitable candidate for, and able to receive chemotherapy for advanced disease with paclitaxel and ramucirumab.
* Participants must consent to the provision of samples of blood, serum and plasma in order that the specific correlative marker assays may be conducted.
* Participants must consent to provision of, and investigator(s) must confirm access to a representative formalin fixed paraffin embedded (FFPE) block of tumour tissue/ or a predetermined number of freshly cut slides of representative tumour tissue of adequate amount and quality in order that the central HER2 testing may be done
* Participants must be ≥ 18 years of age.
* Participants must have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
* Participants must have a life expectancy of at least 12 weeks at the time of study entry
* Imaging investigations including CT/MRI of chest/abdomen/pelvis or other scans as necessary to document all sites of disease must be done within 28 days prior to randomization
* Participants must have adequate cardiac function by ECHO or MUGA defined as EF ≥ 50%. This is to be performed within 4 weeks (preferred) but no more than 8 weeks prior to randomization
* Participants must have adequate normal organ and marrow function
* Participant is able (i.e. sufficiently fluent) and willing to complete the quality of life and/or health utility questionnaires in either English or French
* Participant consent must be appropriately obtained in accordance with applicable local and regulatory requirements.
* Participant must be accessible for treatment and follow-up. Investigators must assure themselves the participants enrolled on this trial will be available for complete documentation of the treatment, adverse events, and follow-up.
* In accordance with CCTG policy, protocol treatment is to begin within 2 working days of participant enrollment
* Participants of childbearing potential must have agreed to use a highly effective contraceptive method for the entire period of study treatment and for at least 7 months after discontinuing study therapy.

Exclusion Criteria

* Participants with a history of other malignancies except: adequately treated non-melanoma skin cancer, curatively treated in-situ cancer of the cervix, or other solid tumours curatively treated with no evidence of disease for ≥ 5 years. Patients with a history of other malignancies detected at an early stage and whom the investigator believes have been curatively treated and are at a low risk of recurrence MAY be eligible
* Participants receiving therapy in a concurrent clinical study. Patients must agree not to participate in other clinical studies during their participation in this trial while on study treatment
* Participants with active or uncontrolled intercurrent illness
* Participants with human immunodeficiency virus infection (positive HIV 1/2 antibodies), active hepatitis B infection (positive HBV surface antigen (HBsAg)) or positive for hepatitis C (HCV) antibody may be considered for enrollment, if infection is adequately controlled in the opinion of the investigator.
* Any active disease condition which would render the protocol treatment dangerous or impair the ability of the patient to receive protocol therapy
* Any condition (e.g. psychological, geographical, etc.) that does not permit compliance with the protocol
* Any unresolved toxicity (CTCAE grade 2 or greater) from previous anti-cancer therapy which in the opinion of the investigator puts the participant at higher than expected risk during protocol treatment. However, participants with irreversible toxicity that is not reasonably expected to be exacerbated by the investigational products in the Investigator's opinion may be included.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Jazz Pharmaceuticals

INDUSTRY

Sponsor Role collaborator

Canadian Cancer Trials Group

NETWORK

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Elena Elimova

Role: STUDY_CHAIR

University Health Network, Princess Margaret Cancer Centre, Toronto ON Canada

Locations

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Arthur J.E. Child Comprehensive Cancer Centre

Calgary, Alberta, Canada

Site Status RECRUITING

BCCA - Vancouver

Vancouver, British Columbia, Canada

Site Status RECRUITING

CancerCare Manitoba

Winnipeg, Manitoba, Canada

Site Status RECRUITING

QEII Health Sciences Centre

Halifax, Nova Scotia, Canada

Site Status RECRUITING

Royal Victoria Regional Health Centre

Barrie, Ontario, Canada

Site Status RECRUITING

Juravinski Cancer Centre at Hamilton Health Sciences

Hamilton, Ontario, Canada

Site Status RECRUITING

Kingston Health Sciences Centre

Kingston, Ontario, Canada

Site Status RECRUITING

Waterloo Regional Health Network (WRHN)

Kitchener, Ontario, Canada

Site Status RECRUITING

London Health Sciences Centre Research Inc.

London, Ontario, Canada

Site Status RECRUITING

Lakeridge Health Oshawa

Oshawa, Ontario, Canada

Site Status RECRUITING

Ottawa Hospital Research Institute

Ottawa, Ontario, Canada

Site Status RECRUITING

Odette Cancer Centre

Toronto, Ontario, Canada

Site Status RECRUITING

St. Michael's Hospital

Toronto, Ontario, Canada

Site Status RECRUITING

University Health Network

Toronto, Ontario, Canada

Site Status RECRUITING

CHUM-Centre Hospitalier de l'Universite de Montreal

Montreal, Quebec, Canada

Site Status RECRUITING

Centre Integre Universitaire De Sante Et De Services

Montreal, Quebec, Canada

Site Status RECRUITING

Allan Blair Cancer Centre

Regina, Saskatchewan, Canada

Site Status RECRUITING

Saskatoon Cancer Centre

Saskatoon, Saskatchewan, Canada

Site Status RECRUITING

Countries

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Canada

Central Contacts

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Chris O'Callaghan

Role: CONTACT

613-533-6430

Facility Contacts

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Hatim Karachiwala

Role: primary

Howard Lim

Role: primary

604 877-6000 ext. 672699

James T. Paul

Role: primary

204 787-2108

Stephanie Snow

Role: primary

902 473-3739

Dawn Ng

Role: primary

705 728-9090 ext. 43340

Oren Levine

Role: primary

905 387-9495 ext. 63123

Brooke Wilson

Role: primary

Anupam Batra

Role: primary

Daniel Breadner

Role: primary

519 685-8600

Amin Kay

Role: primary

Rachel Goodwin

Role: primary

613 737-8899 ext. 70185

Michael Raphael

Role: primary

416 480-5000

Suneil Khanna

Role: primary

416 864-5734

Elena Elimova

Role: primary

416 946-4501 ext. 2520

Moustapha Tehfe

Role: primary

514 890-8000 ext. 25381

Setareh Samimi

Role: primary

514 338-2150

Muhammad Salim

Role: primary

306 766-2691

Adnan Zaidi

Role: primary

306 655-2710

Other Identifiers

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GA4

Identifier Type: -

Identifier Source: org_study_id

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