A Phase Ib/II Study of ATG-022 Plus Pembrolizumab With/Without Chemotherapy in Participants With Claudin (CLDN) 18.2-positive, HER2-negative, Unresectable or Metastatic Gastric or Gastroesophageal Junction AdenocarcinomaUnresectable or Metastatic Gastric or Gastroesophageal Junction Adenocarcinoma

NCT ID: NCT07327229

Last Updated: 2026-02-12

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

NOT_YET_RECRUITING

Clinical Phase

PHASE1/PHASE2

Total Enrollment

132 participants

Study Classification

INTERVENTIONAL

Study Start Date

2026-03-01

Study Completion Date

2029-04-30

Brief Summary

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This is A Phase Ib/II Study of ATG-022 Plus Pembrolizumab With/Without Chemotherapy in Participants With Claudin (CLDN) 18.2-positive, HER2-negative, Unresectable or Metastatic Gastric or Gastroesophageal Junction Adenocarcinoma

Detailed Description

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This is a phase Ib/II Study of ATG-022 plus pembrolizumab with/without chemotherapy in participants with CLDN 18.2-positive, HER2-negative, PD-L1 positive (CPS≥1), unresectable or metastatic gastric or gastroesophageal junction adenocarcinoma. Both the intervention of ATG022 + Pembrolizumab (A+P) and the intervention of ATG-022 + pembrolizumab + chemotherapy (CAPOX regimen, A+P+C) consist of a Ib and II phase.

Participants with CLDN 18.2-positive, HER2-negative, PD-L1 positive (CPS≥1) advanced or metastatic gastric or gastroesophageal junction adenocarcinoma and having progressed on or after at least one prior systemic therapy, will be enrolled in the intervention of A + P.

Participants with CLDN 18.2-positive, HER2-negative, PD-L1 positive (CPS≥1) advanced or metastatic gastric or gastroesophageal junction adenocarcinoma and having not received any prior systemic therapy, will be enrolled in the intervention of A + P + C. The study will be firstly initiated from Ib of the intervention of A+P. The initiation of the intervention of A+P+C will be based on the clinical data of A+P

Conditions

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Unresectable or Metastatic Gastric or Gastroesophageal Junction Adenocarcinoma

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SEQUENTIAL

A treatment cycle of ATG-022 will be defined as 21 days. Dosing will begin at 1.8 mg/kg Q3W with 1 subject
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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ATG-022+pembrolizumab/KEYTRUDA®

Group Type EXPERIMENTAL

ATG-022

Intervention Type DRUG

1.8mg/kg Q3W, every 21 days as one cycle

pembrolizumab/KEYTRUDA®

Intervention Type DRUG

20mg Q3W, every 21 days as one cycle

ATG-022+pembrolizumab/KEYTRUDA®+CAPOX

Group Type ACTIVE_COMPARATOR

ATG-022

Intervention Type DRUG

1.8mg/kg Q3W, every 21 days as one cycle

pembrolizumab/KEYTRUDA®

Intervention Type DRUG

20mg Q3W, every 21 days as one cycle

CAPOX

Intervention Type DRUG

Standard Dose level for CAPOX: Capecitabine 1000 mg/m2 PO BID on Day 1-14, Oxaliplatin 130 mg/m2 IV on Day 1, Cycled every 21 days (3 weeks) for 8 cycles.

Interventions

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ATG-022

1.8mg/kg Q3W, every 21 days as one cycle

Intervention Type DRUG

pembrolizumab/KEYTRUDA®

20mg Q3W, every 21 days as one cycle

Intervention Type DRUG

CAPOX

Standard Dose level for CAPOX: Capecitabine 1000 mg/m2 PO BID on Day 1-14, Oxaliplatin 130 mg/m2 IV on Day 1, Cycled every 21 days (3 weeks) for 8 cycles.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

1. Provision of signed and dated, written informed consent prior to any study-specific procedures, sampling, and analyses.
2. Aged ≥18 years as of the date of consent.
3. Histological or cytological confirmation of gastric cancer or gastroesophageal junction adenocarcinoma with CLDN 18.2 positive, HER2-negative and PD-L1 positive expression.
4. Archival tumor tissue sample within 36 months prior to participating in the study or newly obtained biopsy of a tumor lesion not previously irradiated should be provided for testing of CLDN 18.2 and PD-L1 expression for determining the criteria.
5. At least 1 measurable lesion per Response Evaluation Criteria In Solid Tumors (RECIST) v1.1 by investigators.
6. Estimated life expectancy of a minimum of 12 weeks.

Exclusion Criteria

1. Known active central nervous system metastases and/or carcinomatous meningitis. Participants with previously treated brain metastases may participate provided they are radiologically stable (i.e., without evidence of progression) for at least 4 weeks as confirmed by repeat imaging performed during the study screening, are clinically stable and have not required steroid treatment for at least 14 days before the first dose of study intervention.
2. Prior exposure to CLDN 18.2 ADC, CLDN 18.2 chimeric antigen receptor T-cell immunotherapy or agents containing MMAE.
3. Prior systemic anticancer therapy including investigational agents within 4 weeks before the first dose of study treatment or within a period during which the investigational product or systemic anticancer treatment has not been cleared from the body (e.g., a period of 5 'halflives'), whichever is the most appropriate as judged by the investigator.
4. Received any prior immunotherapy and was discontinued from that treatment due to a Grade 3 or higher irAE (except endocrine disorders that can be treated with replacement therapy) or was discontinued from that treatment due to Grade 2 myocarditis or recurrent Grade 2 pneumonitis.
5. Prior radiotherapy within 4 weeks of start of study intervention, or has radiation-related toxicities, requiring corticosteroids. Two weeks or fewer of palliative radiotherapy for non- central nervous system disease is permitted. The last radiotherapy treatment must have been performed at least 7 days before the first dose of study intervention
6. Prior a live or live-attenuated vaccine within 30 days before the first dose of study intervention. Administration of killed vaccines is allowed.
7. Prior major surgery (excluding placement of vascular access) within 28 days of the first dose of study treatment or minor surgical procedures≤7 days. No waiting is required following implantable port and catheter placement.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Merck Sharp & Dohme LLC

INDUSTRY

Sponsor Role collaborator

Antengene Biologics Limited

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Anhui Provincial Hospital

Hefei, Anhui, China

Site Status

The First Affiliated Hospital of Anhui Medical University

Hefei, Anhui, China

Site Status

Beijing Cancer hospital

Beijing, Beijing Municipality, China

Site Status

Fujian Provincial Cnacer Hospital

Fuzhou, Fujian, China

Site Status

The First Affiliated Hospital of Xiamen University

Xiamen, Fujian, China

Site Status

Gansu Provincial Cnacer Hospital

Lanzhou, Gansu, China

Site Status

Cancer Institute&Hospital Chinese Academy of Medical Sciences

Langfang, Hebei, China

Site Status

The Fourth Hospital of Hebei Medical University

Shijiazhuang, Hebei, China

Site Status

Anyang Tumor Hospital

Anyang, Henan, China

Site Status

The First Affiliated Hospital of Henan Medical Hospital

Xinxiang, Henan, China

Site Status

Henan Cnacer Hospital

Zhengzhou, Henan, China

Site Status

The First Affiliated Hospital of Zhenghzou University

Zhengzhou, Henan, China

Site Status

Hubei Cancer Hospital

Wuhan, Hubei, China

Site Status

Tongji Medical College of HUST

Wuhan, Hubei, China

Site Status

Jiangsu Province Hospital

Nanjing, Jiangsu, China

Site Status

The Second Affiliated Hospital of Soochow University

Suzhou, Jiangsu, China

Site Status

Xuzhou Central Hospital

Xuzhou, Jiangsu, China

Site Status

The First Affiliated Hospital of Nanchang University

Nanchang, Jiangxi, China

Site Status

The First Hospital of China Medical University

Shenyang, Liaoning, China

Site Status

General Hospital of Ningxia Medical University

Yinchuan, Ningxia, China

Site Status

Jinan Central Hospital

Jinan, Shandong, China

Site Status

Shandong Cancer Hospital &Institue

Jinan, Shandong, China

Site Status

The Affiliated Hospital of Qingdao University

Qingdao, Shandong, China

Site Status

Tongren Hospital Shanghai Jiaotong University School of Medicine

Shanghai, Shanghai Municipality, China

Site Status

Shanxi provincial cancer hospital

Taiyuan, Shanxi, China

Site Status

The First Hospital of Shanxi Medical University

Taiyuan, Shanxi, China

Site Status

The First Affiliated Hospital of XI'AN Jiaotong University

Xi’an, Shanxi, China

Site Status

West China Hospital, Sichuan University

Chengdu, Sichuan, China

Site Status

Tianjin Medical Universuty Cancer Institute & Hospital

Tianjin, Tianjin Municipality, China

Site Status

The First Affiliated Hospital of Xiamen University

Wenzhou, Zhejiang, China

Site Status

Countries

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China

Central Contacts

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Tingting Yu

Role: CONTACT

021-32501095

Sunny He

Role: CONTACT

13810001510

Facility Contacts

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Gang Wang

Role: primary

Kangsheng Gu

Role: primary

Lin Shen, MD

Role: primary

Rongbo Lin

Role: primary

Jiayi Li

Role: primary

Yuhua Liu

Role: primary

Yongkun Sun

Role: primary

Qun Zhao

Role: primary

Jin Xia

Role: primary

Liuzhong Yang

Role: primary

Xiaobing Chen

Role: primary

Yanru Qin

Role: primary

Xinjun Liang

Role: primary

Xianglin Yuan

Role: primary

Xiaofeng Chen

Role: primary

zhixiang Zhuang

Role: primary

Yuan Yuan

Role: primary

Xiaodong Peng

Role: primary

funan Liu

Role: primary

Ping Chen

Role: primary

Meili Sun

Role: primary

Changzheng Li

Role: primary

Jing LV

Role: primary

Jianjun Zhang

Role: primary

Jinfeng Ma, MD

Role: primary

Yusheng Wang

Role: primary

Ying Kong

Role: primary

Li Zheng, MD

Role: primary

Ting Deng

Role: primary

Yin Jin

Role: primary

Other Identifiers

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KEYNOTE-G37

Identifier Type: OTHER

Identifier Source: secondary_id

MK-3475-G37

Identifier Type: OTHER

Identifier Source: secondary_id

ATG-022-GC-001

Identifier Type: -

Identifier Source: org_study_id

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