Utidelone Capsule Combined With Fluoropyrimidine- and Platinum-containing Therapy in First-line Treatment of Patients With Gastric or Gastroesophageal Junction Adenocarcinoma

NCT ID: NCT06841679

Last Updated: 2025-11-25

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

RECRUITING

Clinical Phase

PHASE2/PHASE3

Total Enrollment

778 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-08-28

Study Completion Date

2030-09-01

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

This is a multi-national, open-label, randomized, seamless phase II/III clinical study of UTD2 combined with fluoropyrimidine- and platinum-containing therapy to evaluate the efficacy and safety in patients with locally advanced or metastatic gastric or gastroesophageal junction adenocarcinoma untreated with systemic treatment in advanced setting.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Gastric or Gastroesophageal Junction Adenocarcinoma

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Cohort 1

UTD2 40 mg/m2/d, po, qd, d1-5, q3w combined with CAPOX/FOLFOX with or without a PD-1 inhibitor ( tislelizumab, or pembrolizumab, or nivolumab )

Group Type EXPERIMENTAL

Utidelone Capsule

Intervention Type DRUG

UTD2 40 mg/m2/d, po, qd, day 1-5, q3w

Fluoropyrimidine- and Platinum-containing Therapy

Intervention Type DRUG

CAPOX: Capecitabine 1700 mg/m2/d, po, bid, d1-14,q3w, Oxaliplatin 130 mg/m2, iv, d1, q3w. After completing 6 times (18 weeks) of oxaliplatin treatment, the investigator may decide whether to continue oxaliplatin treatment for up to 8 times (24 weeks) based on the participant's benefits and safety.

FOLFOX: Oxaliplatin 85 mg/m2, iv, d1, q2w. Folinic Acid 400 mg/m2, iv, d1, q2w, 5-FU 400 mg/m2 IV bolus d1 then 5-FU 2400 mg/m2 IV infusion over 46 to 48 hours, q2w. After completing 9 times (18 weeks) of treatment with oxaliplatin combined with folinic acid and 5-FU, the investigator may decide whether to continue FOLFOX treatment for up to 12 times (24 weeks) based on the participant's benefits and safety.

PD-1 inhibitor

Intervention Type DRUG

Whether to combine a PD-1 inhibitor will depend on the locally approved indications for the PD-1 inhibitor. If the participant's condition meets the locally approved indications for PD-1 inhibitors, the investigator may determine, in accordance with clinical guidelines, that the participant is eligible to receive treatment with UTD2 combined with fluoropyrimidine- and platinum-containing therapy, with or without a PD-1 inhibitor.

If a PD-1 inhibitor is administered in combination, tislelizumab (200 mg), or pembrolizumab (200 mg), or nivolumab (360 mg), iv, day1, q3w. Alternatively, the investigator may select the dosage and administration cycle of other locally approved PD-1 inhibitors in accordance with the locally approved package inserts. The PD-1 inhibitor will be given up to 2 years.

Cohort 2

UTD2 50 mg/m2/d, po, qd, d1-5, q3w combined with CAPOX/FOLFOX with or without a PD-1 inhibitor ( tislelizumab, or pembrolizumab, or nivolumab )

Group Type EXPERIMENTAL

Utidelone Capsule

Intervention Type DRUG

50 mg/m2/d, po, qd, day 1-5, q3w

Fluoropyrimidine- and Platinum-containing Therapy

Intervention Type DRUG

CAPOX: Capecitabine 1700 mg/m2/d, po, bid, d1-14,q3w, Oxaliplatin 130 mg/m2, iv, d1, q3w. After completing 6 times (18 weeks) of oxaliplatin treatment, the investigator may decide whether to continue oxaliplatin treatment for up to 8 times (24 weeks) based on the participant's benefits and safety.

FOLFOX: Oxaliplatin 85 mg/m2, iv, d1, q2w. Folinic Acid 400 mg/m2, iv, d1, q2w, 5-FU 400 mg/m2 IV bolus d1 then 5-FU 2400 mg/m2 IV infusion over 46 to 48 hours, q2w. After completing 9 times (18 weeks) of treatment with oxaliplatin combined with folinic acid and 5-FU, the investigator may decide whether to continue FOLFOX treatment for up to 12 times (24 weeks) based on the participant's benefits and safety.

PD-1 inhibitor

Intervention Type DRUG

Whether to combine a PD-1 inhibitor will depend on the locally approved indications for the PD-1 inhibitor. If the participant's condition meets the locally approved indications for PD-1 inhibitors, the investigator may determine, in accordance with clinical guidelines, that the participant is eligible to receive treatment with UTD2 combined with fluoropyrimidine- and platinum-containing therapy, with or without a PD-1 inhibitor.

If a PD-1 inhibitor is administered in combination, tislelizumab (200 mg), or pembrolizumab (200 mg), or nivolumab (360 mg), iv, day1, q3w. Alternatively, the investigator may select the dosage and administration cycle of other locally approved PD-1 inhibitors in accordance with the locally approved package inserts. The PD-1 inhibitor will be given up to 2 years.

Cohort 3

UTD2 60 mg/m2/d, po, qd, d1-5, q3w combined with CAPOX/FOLFOX with or without a PD-1 inhibitor ( tislelizumab, or pembrolizumab, or nivolumab )

Group Type EXPERIMENTAL

Utidelone Capsule

Intervention Type DRUG

60 mg/m2/d, po, qd, day 1-5, q3w

Fluoropyrimidine- and Platinum-containing Therapy

Intervention Type DRUG

CAPOX: Capecitabine 1700 mg/m2/d, po, bid, d1-14,q3w, Oxaliplatin 130 mg/m2, iv, d1, q3w. After completing 6 times (18 weeks) of oxaliplatin treatment, the investigator may decide whether to continue oxaliplatin treatment for up to 8 times (24 weeks) based on the participant's benefits and safety.

FOLFOX: Oxaliplatin 85 mg/m2, iv, d1, q2w. Folinic Acid 400 mg/m2, iv, d1, q2w, 5-FU 400 mg/m2 IV bolus d1 then 5-FU 2400 mg/m2 IV infusion over 46 to 48 hours, q2w. After completing 9 times (18 weeks) of treatment with oxaliplatin combined with folinic acid and 5-FU, the investigator may decide whether to continue FOLFOX treatment for up to 12 times (24 weeks) based on the participant's benefits and safety.

PD-1 inhibitor

Intervention Type DRUG

Whether to combine a PD-1 inhibitor will depend on the locally approved indications for the PD-1 inhibitor. If the participant's condition meets the locally approved indications for PD-1 inhibitors, the investigator may determine, in accordance with clinical guidelines, that the participant is eligible to receive treatment with UTD2 combined with fluoropyrimidine- and platinum-containing therapy, with or without a PD-1 inhibitor.

If a PD-1 inhibitor is administered in combination, tislelizumab (200 mg), or pembrolizumab (200 mg), or nivolumab (360 mg), iv, day1, q3w. Alternatively, the investigator may select the dosage and administration cycle of other locally approved PD-1 inhibitors in accordance with the locally approved package inserts. The PD-1 inhibitor will be given up to 2 years.

Arm A

UTD2 po, on d1-5, q3w (dose decided after the phase II) in combination with CAPOX

Group Type EXPERIMENTAL

Oxaliplatin

Intervention Type DRUG

130 mg/m2/d, iv, day1, q3w, oxaliplatin will be given up to 6 cycles

Utidelone Capsule

Intervention Type DRUG

UTD2 po, on d1-5, q3w (dose decided after the phase II)

Capecitabine

Intervention Type DRUG

Capecitabine 1700 mg/m2/d po, bid, d1-14,q3w

Arm B

CAPOX

Group Type ACTIVE_COMPARATOR

Oxaliplatin

Intervention Type DRUG

130 mg/m2/d, iv, day1, q3w, oxaliplatin will be given up to 6 cycles

Capecitabine

Intervention Type DRUG

Capecitabine, 2000 mg/m2/d, po, bid, d1-14, q3w

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Utidelone Capsule

UTD2 40 mg/m2/d, po, qd, day 1-5, q3w

Intervention Type DRUG

Utidelone Capsule

50 mg/m2/d, po, qd, day 1-5, q3w

Intervention Type DRUG

Utidelone Capsule

60 mg/m2/d, po, qd, day 1-5, q3w

Intervention Type DRUG

Fluoropyrimidine- and Platinum-containing Therapy

CAPOX: Capecitabine 1700 mg/m2/d, po, bid, d1-14,q3w, Oxaliplatin 130 mg/m2, iv, d1, q3w. After completing 6 times (18 weeks) of oxaliplatin treatment, the investigator may decide whether to continue oxaliplatin treatment for up to 8 times (24 weeks) based on the participant's benefits and safety.

FOLFOX: Oxaliplatin 85 mg/m2, iv, d1, q2w. Folinic Acid 400 mg/m2, iv, d1, q2w, 5-FU 400 mg/m2 IV bolus d1 then 5-FU 2400 mg/m2 IV infusion over 46 to 48 hours, q2w. After completing 9 times (18 weeks) of treatment with oxaliplatin combined with folinic acid and 5-FU, the investigator may decide whether to continue FOLFOX treatment for up to 12 times (24 weeks) based on the participant's benefits and safety.

Intervention Type DRUG

Oxaliplatin

130 mg/m2/d, iv, day1, q3w, oxaliplatin will be given up to 6 cycles

Intervention Type DRUG

Utidelone Capsule

UTD2 po, on d1-5, q3w (dose decided after the phase II)

Intervention Type DRUG

PD-1 inhibitor

Whether to combine a PD-1 inhibitor will depend on the locally approved indications for the PD-1 inhibitor. If the participant's condition meets the locally approved indications for PD-1 inhibitors, the investigator may determine, in accordance with clinical guidelines, that the participant is eligible to receive treatment with UTD2 combined with fluoropyrimidine- and platinum-containing therapy, with or without a PD-1 inhibitor.

If a PD-1 inhibitor is administered in combination, tislelizumab (200 mg), or pembrolizumab (200 mg), or nivolumab (360 mg), iv, day1, q3w. Alternatively, the investigator may select the dosage and administration cycle of other locally approved PD-1 inhibitors in accordance with the locally approved package inserts. The PD-1 inhibitor will be given up to 2 years.

Intervention Type DRUG

Capecitabine

Capecitabine 1700 mg/m2/d po, bid, d1-14,q3w

Intervention Type DRUG

Capecitabine

Capecitabine, 2000 mg/m2/d, po, bid, d1-14, q3w

Intervention Type DRUG

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Participants must meet the following criteria to be eligible for the study:

1. Sign the informed consent form (ICF) to participate with accordance with GCP, ICH and local regulations and are willing to adhere to the study protocol.
2. Male and female aged ≥ 18 years as of the date of baseline visit.
3. Participant must have unresectable locally advanced or metastatic GC or GEJ and have histologically/pathologic confirmed predominant adenocarcinoma. The documentation of GEJ involvement can include biopsy, endoscopy, or imaging.
4. Phase II Study: No restriction on PD-L1 expression. Phase III study: Participant must have tumor with PD-L1 Combined Positive Score (CPS) \< 1 by immunohistochemical (IHC). IHC results from site are acceptable.
5. Participant must have at least one measurable lesion per RECIST 1.1 criteria.
6. Participant must not receive previously systemic treatment in the advanced setting. Previously neoadjuvant/adjuvant therapy for GC or GEJ with no progression after 6 months from completion is allowed. Palliative radiotherapy is allowed.
7. Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1.
8. Participant with adequate hematological function (CTCAE v5.0 Grade ≤ 1) within 1 week before enrollment (based on routine laboratory values at each site) and who have not received recombinant human granulocyte colony-stimulating factor (rhG-CSF) or blood products/erythropoietin (EPO) within 14 days before enrollment.

* White blood cell count (WBC) ≥ 3.0 × 109/L;
* Absolute neutrophil count (ANC) ≥ 1.5 × 109/L;
* Platelet count (PLT) ≥ 100 × 109/L;
* Hemoglobin (Hb) ≥ 9.0 g/dL.
9. Participant with adequate liver and renal function (CTCAE v5.0 Grade ≤ 1) within 1 week before enrollment (based on routine laboratory values at each site).

* Total bilirubin (TBIL) ≤ 1.5 × upper limit of normal (ULN);
* Alanine aminotransferase (ALT) ≤ 3 × ULN (≤ 5 × ULN in patients with hepatic metastases);
* Aspartate aminotransferase (AST) ≤ 3 × ULN (≤ 5 × ULN in patients with hepatic metastases);
* Creatinine clearance (Ccr) ≥ 50 mL/min.
10. Female Participants of childbearing potential must agree to use highly effective contraceptive methods during the study and within 6 months after the last dose of the investigational product. Female patients of childbearing potential shall have a negative serum or urine pregnancy test at screening and be willing to have additional pregnancy tests as required throughout the study. Women of non-childbearing potential (WONCBP) must not donate ova from signing informed consent until at least 6 months after the last administration of the investigational product. Please refer to Appendix 1. Males must be surgically sterile (\> 6 months since vasectomy with confirmation of no viable sperm), or if engaged in sexual relations (intercourse) with a WOCBP, either his partner must be surgically sterile (eg, hysterectomy, bilateral salpingectomy, bilateral oophorectomy), or an acceptable, highly effective contraceptive method must be used from Screening until 6 months after last IMP administration; or Males with same-sex partners (abstinence from penile-vaginal intercourse) or who are abstinent from heterosexual intercourse are not required to use contraception when this is their preferred and usual lifestyle; or Males must not donate sperm from the first dose of IMP until at least 90 days after the last dose of IMP.

Exclusion Criteria

* Participants will be excluded from the study for any of the following reasons:

1. Known HER2-positive tumor (HER2-positive is defined as having an IHC score of 3 +, or IHC2 + and positive HER2 expression by in situ hybridization (ISH) (refer to ASCO/CAP guidelines 2020).
2. Participants with other malignancies over the past 5 years, except for cured skin basal cell carcinoma, in-situ carcinoma of the cervix, or papillary thyroid cancer.
3. Participants who have received radiotherapy or other investigational drug or investigational therapy within 4 weeks prior to the first dose of investigational product.
4. Participants who have undergone major surgery (except biopsy) had significant trauma within 4 weeks prior to the first dose of investigational product or required elective surgery during the study.
5. Participants with pre-existing \> Grade 1 peripheral sensory neuropathy (NCI CTCAE 5.0).
6. Participants with known hypersensitivity to any components of the investigational product.
7. Participants who are pregnant (positive pregnancy test) or lactating.
8. Adverse events due to previous anti-tumor therapy have not recovered to CTCAE v5.0 Grade ≤ 1 (except for alopecia and other toxicities judged by the investigator to have no safety risk).
9. Participants with esophageal obstruction, pyloric obstruction, intestinal obstruction, or inability to eat on their own after gastrointestinal resection, or other factors that cause difficulty swallowing and inability to take oral drugs.
10. Participants with symptomatic/uncontrollable central nervous system metastases or meningeal metastases, including but not limited to those with confirmed metastatic disease progression by examination within 2 months after radiotherapy or other local treatment, or who are ineligible for enrollment as judged by the investigator.
11. Participants with uncontrollable bone metastases, i.e., existing or recent fracture risk, recent need for surgery or local radiotherapy, or other crisis conditions as judged by the investigator.
12. Participants with uncontrolled pleural effusion, pericardial effusion, or ascites requiring repeated drainage (once monthly or more frequently).
13. Participants with an active infection and who currently require systematic anti-infective therapy.
14. Participants with known history of human immunodeficiency virus (HIV) infection with an exception that if they have not had an opportunistic infection within the past 12 months, they are eligible.
15. Participants who are HBV DNA positive or HCV RNA positive (who are HBsAg negative, or HCV antibody negative could be eligible without testing for HBV DNA or HCV RNA).
16. Participants with a history of severe cardiovascular and cerebrovascular diseases, including but not limited to:

* Patients with severe cardiac rhythm or conduction abnormalities, such as ventricular arrhythmia requiring clinical intervention or second/third-degree atrioventricular block; patients with a mean corrected QT interval (QTcF) \> 470 msec obtained from three 12-lead electrocardiograms (ECGs) at rest.
* Patients who have had an acute coronary syndrome, congestive heart failure, aortic dissection, stroke, or other Grade ≥ 3 cardio-cerebrovascular events within 3 months before the first dose.
* Patients with clinically uncontrollable hypertension.
* Symptomatic Cerebral Infarction
* Patients with other cardiac disorders that put the patients at a high risk as judged by the investigator.
17. Participants with uncontrolled diabetes mellitus.
18. Participants with a mental disorder or poor compliance.
19. Participants also participate in another interventional clinical study or receive other study treatments (patients who have discontinued other investigational treatments and are only in the follow-up period are allowed to be enrolled in this study).
20. Participants requiring concomitant use of strong CYP3A4 inhibitors or inducers or medications that prolong the QT interval within 14 days prior to the first dose of study treatment and during the study.
21. Participants with a history of other systemic severe diseases or abnormal laboratory findings that would, in the Investigator's judgment, be inappropriate for this study.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Beijing Biostar Pharmaceuticals Co., Ltd.

INDUSTRY

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Bioresearch Partner

Hialeah, Florida, United States

Site Status NOT_YET_RECRUITING

AnYang Tumor Hospital

Anyang, , China

Site Status RECRUITING

Sun Yat-sen University Cancer Center

Guangzhou, , China

Site Status RECRUITING

Jinan Municipal Central Hospital

Jinan, , China

Site Status RECRUITING

Shandong First Medical University Affiliated Tumor Hospital

Jinan, , China

Site Status RECRUITING

Liaoning Cancer Hospital

Shenyang, , China

Site Status RECRUITING

Shanxi Cancer Hospital

Taiyuan, , China

Site Status NOT_YET_RECRUITING

Tianjin Medical University Cancer Institute & Hospital

Tianjin, , China

Site Status NOT_YET_RECRUITING

Union Hospital, Tongji Medical College, Huazhong University of Science and Technology

Wuhan, , China

Site Status NOT_YET_RECRUITING

Henan Cancer Hospital

Zhengzhou, , China

Site Status RECRUITING

Countries

Review the countries where the study has at least one active or historical site.

United States China

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Rongguo Qiu

Role: CONTACT

010-56315388

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

BG02-2404

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.