Abemaciclib and Pembrolizumab in Locally Advanced Unresectable or Metastatic Gastroesophageal Adenocarcinoma: Big Ten Cancer Research Consortium BTCRC-GI18-149

NCT03997448 | Terminated Phase 2 Results DMC FDA Drug

• 1 other identifier: BTCRC-GI18-149
• Study Type: interventional
• Target: 3
• Locations: 1 country
• Sites: 4

Brief Summary

This study will test the combination of abemaciclib with pembrolizumab in patients with gastric, gastroesophageal junction, or esophageal adenocarcinoma that is metastatic or cannot be surgically removed, and who have progressed on, or were unable to tolerate, at least 2 earlier courses of treatment for their advanced disease.

Conditions

Gastroesophageal Cancer; Adenocarcinoma

Outcome Measures

Primary Outcomes (1)

• Progression-Free Survival(PFS)

  Progression free survival is defined as the time of treatment initiation until the criteria for disease progression per RECIST1.1 are met or until the date of a death event (any cause). Progressive disease is defined as at least a 20% increase in the sum of the diameters of target lesions,taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study). In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5mm. (Note: the appearance of one or more new lesions is also considered progressions).

  From C1D1 until death or up to a maximum of 5 months

Secondary Outcomes (6)

• PFS Per irRECIST

  From C1D1 until death or up to a maximum of 5 months

• Progression-Free Survival Rate at 6 Months Per RECIST 1.1 and irRECIST

  From C1D1 until death or up to a maximum of 6 months

• Objective Response Rate

  From C1D1 until death or up to a maximum of 5 months

• Disease Control Rate

  From C1D1 until death or up to a maximum of 5 months

• Overall Survival

  From C1D1 until death or up to a maximum of 5 months

Study Arms (1)

Abemaciclib and Pembrolizumab

EXPERIMENTAL

Abemaciclib 150mg days 1-21, and Pembrolizumab 200mg IV, Day 1

Drug: Pembrolizumab; Drug: Abemaciclib

Interventions

Pembrolizumab DRUG

Pembrolizumab 200mg IV

Abemaciclib and Pembrolizumab

Abemaciclib DRUG

Abemiciclib 150mg PO

Abemaciclib and Pembrolizumab

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients with histologically confirmed metastatic or locally advanced unresectable gastric, gastroesophageal junction or esophageal adenocarcinoma.
• Be willing and able to provide written informed consent for the trial.
• Age \>= 18 years at the time of consent.
• Prior treatment with at least two lines of systemic therapy for advanced disease. Patients who have received neoadjuvant or adjuvant therapy or definitive chemoradiation and had recurrence during or within 6 months of completion of all treatments may count adjuvant therapy as one chemotherapy line.
• Presence of measurable disease based on RECIST 1.1 as determined by local site investigator/radiology assessment.
• ECOG PS 0-1.
• Patients must have discontinued all previous treatments for cancer (including cytotoxic chemotherapy, molecularly targeted therapy, radiotherapy, and investigational therapy).
• Patients who received chemotherapy must have recovered (CTCAE Grade ≤1) from the acute effects of chemotherapy except for residual alopecia or Grade 2 peripheral neuropathy. A washout period of at least 21 days is required between last systemic therapy dose and treatment initiation per protocol.
• A washout period of at least 14 days is required between end of radiotherapy and treatment initiation.
• The patient is able to swallow oral medications.
• Demonstrate adequate organ function as defined in the table in the protocol.
• Females of childbearing potential must have a negative serum pregnancy test within 7 days prior to registration. NOTE: Females are considered of child bearing potential unless they are surgically sterile (have undergone a hysterectomy, bilateral tubal ligation, or bilateral oophorectomy) or they are naturally postmenopausal for at least 12 consecutive months.
• Females of childbearing potential must be willing to abstain from heterosexual activity or to use 2 forms of effective methods of contraception from the time of informed consent until 60 days after treatment discontinuation. The two contraception methods can be comprised of two barrier methods, or a barrier method plus a hormonal method.
• Men who are not surgically sterile (vasectomy) must agree to use an acceptable method of contraception. Male subjects with female sexual partners who are pregnant, possibly pregnant, or who could become pregnant during the study must agree to use condoms from the first dose of study drug through at least 60 days after the last dose of study drug. Total abstinence for the same time period is an acceptable alternative.
• As determined by the enrolling physician or protocol designee, ability of the subject to understand and comply with study procedures for the entire length of the study.

You may not qualify if:

• Active autoimmune disease that has required systemic treatment in past 2 years (i.e. with use of disease modifying agents, corticosteroids or immunosuppressive drugs). Replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of systemic treatment.
• History of prior therapy with CDK4 or CDK6 inhibitors or prior immune checkpoint inhibitors.
• Patients with known microsatellite instability will be excluded.
• Diagnosis of immunodeficiency or is receiving systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior to the first dose of trial treatment. The use of physiologic doses of corticosteroids may be approved after consultation with the study PI.
• Serious preexisting medical condition(s) that would preclude participation in this study (for example, interstitial lung disease, severe dyspnea at rest or requiring oxygen therapy, history of major surgical resection involving the stomach or small bowel, or a preexisting chronic condition resulting in baseline Grade 2 or higher diarrhea).
• Symptomatic central nervous system metastasis. Screening of asymptomatic patients is not required for enrollment.
• Personal history of any of the following conditions: syncope of cardiovascular etiology, ventricular arrhythmia of pathological origin (including, but not limited to, ventricular tachycardia and ventricular fibrillation), or sudden cardiac arrest.
• Known additional malignancy that progressed or required active treatment within the last 2 years. Exceptions include curatively treated basal cell and squamous cell carcinoma of the skin, curatively resected in situ cervical and/or breast cancers, in situ or intramucosal pharyngeal cancer, and Gleason 6 prostate cancer with PSA \<10.
• Patients who have received a live vaccine within 30 days of planned start of pembrolizumab.
• Note: The killed virus vaccines used for seasonal influenza vaccines for injection are allowed; however intranasal influenza vaccines (e.g., FluMist®) are live attenuated vaccines, and are not allowed.
• History of (non-infectious) pneumonitis that required steroids or current pneumonitis.
• Active infection requiring systemic therapy.
• Patients who are pregnant or breastfeeding or expecting to conceive or father children within the projected duration of the trial, starting with the screening visit through 60 days after the last dose of pembrolizumab or abemaciclib. (NOTE: breast milk cannot be stored for future use while the mother is being treated on study.)

Sponsors & Collaborators

• Nataliya Uboha: lead
• Eli Lilly and Company: collaborator

Study Sites (4)

Indiana University Melvin and Bren Simon Cancer Center

Indianapolis, Indiana, 46202, United States

Location

Univerisy of Iowa Hospital and Clinics

Iowa City, Iowa, 52242, United States

Location

Rutgers Cancer Institute of NewJjersey

New Brunswick, New Jersey, 08903, United States

Location

University of Wisconsin

Madison, Wisconsin, 53705, United States

Location

MeSH Terms

Conditions

Adenocarcinoma

Interventions

pembrolizumab; abemaciclib

Condition Hierarchy (Ancestors)

Carcinoma; Neoplasms, Glandular and Epithelial; Neoplasms by Histologic Type; Neoplasms

Results Point of Contact

• Title: Clinical Data Analyst
• Organization: Hoosier Cancer Research Network

amajumdar@hoosiercancer.org

3179212050

Study Officials

• Nataliya Uboha, MD, PhD

  University of Wisconsin, Madison

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: phase 2
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Faculty, University of Wisconsin School of Medicine and Public Health

Study Record Dates

• First Submitted: June 24, 2019
• First Posted: June 25, 2019
• Study Start: August 26, 2019
• Primary Completion: January 30, 2020
• Study Completion: January 30, 2020
• Last Updated: February 20, 2024
• Results First Posted: February 20, 2024

Record last verified: 2024-02

Locations

US (4)