A Study to Evaluate the Efficacy and Safety of Sintilimab Plus Apatinib and Chemotherapy in Patients With HER-2 Negative Microsatellite Stability (MSS) Advanced or Metastatic Gastric (GC) or Gastroesophageal Junction (GEJ) Cancer

NCT05216237 | Unknown Phase 2 DMC

• 1 other identifier: AHQU-2022001
• Study Type: interventional
• Target: 31
• Locations: 1 country
• Sites: 1

Brief Summary

To evaluate the efficacy and safety of Sintilimab combined with apatinib and chemotherapy as First-line or second-line Therapy in Treatment of HER-2 negative MSS Advanced or Metastatic GC or GEJ Cancer. At the same time, the correlation between tissue programmed death ligand-1(PD-L1) expression and blood circulating tumor cell(CTC) counts and the efficacy of immune combination therapy was also explored.

Conditions

Gastric Cancer; Chemotherapy; Immunotherapy

Keywords

Gastric Cancer; Chemotherapy; Immunotherapy; Microsatellite stability

Outcome Measures

Primary Outcomes (1)

• Objective Response Rate (ORR)

  per Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1

  36 months

Secondary Outcomes (4)

• Progression-free Survival (PFS)

  36 months

• Disease Control Rate (DCR)

  36 months

• Duration of Response (DoR)

  36 months

• Adverse events (AEs)

  36 months

Study Arms (1)

Treatment of HER-2 Negative MSS Advanced Gastric

EXPERIMENTAL

Sintilimab Plus Apatinib and Chemotherapy in Patients with Previously Untreated HER-2 negative MSS Advanced or Metastatic GC or GEJ Cancer

Drug: Sintilimab 200 mg, intravenously (IV) every 3 weeks(Q3W)

Interventions

Sintilimab 200 mg, intravenously (IV) every 3 weeks(Q3W) DRUG

for 2-6 cycles followed by Sindilizumab plus Tegafur gimeracil oteracil potassium capsules.

Also known as: Apatinib 250 mg twice daily (BID) by continous oral adminstration for 14 days, followed by a recovery period of 7 days;, Tegafur gimeracil oteracil potassium capsules twice daily (BID) by continous oral adminstration for 14 days, every 3 weeks(Q3W), Oxaliplatin 85 mg/m^2, IV every 3 weeks(Q3W)

Treatment of HER-2 Negative MSS Advanced Gastric

Eligibility Criteria

• Age: 18 Years - 75 Years
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients with inoperable advanced, recurrent or metastatic gastric and gastroesophageal junction adenocarcinoma confirmed by histology, and HER-2 negative by immunohistochemistry. HER-2 negative was defined as immunohistochemistry 0-1 + or 2 + but fish results were negative.
• According to recist1 1 measurement standard at least one or more target lesions can be measured.
• Patients with microsatellite stability (MSS type) or normal mismatch repair protein (PMMR) confirmed by immunohistochemistry or second-generation sequencing..
• Aged 18-75.
• The performance status of the Eastern Cooperative Oncology Group (ECOG) is 0-1 points.
• Life expectancy is more than 3 months.
• The blood routine examination was basically normal within 1 week before enrollment (taking the normal value in the laboratory of each research center as the standard). The white blood cell count (WBC) ≥ 2.5 × 10\^9 / L or neutrophil count (ANC) ≥ 1.5 × 10\^9/L; Platelet count (PLT) ≥ 100 × 10\^9/L； Hemoglobin ≥ 9.0 g / dl. Patients can receive blood transfusion or erythropoietin treatment to meet this standard.
• The liver and kidney function, nail function and coagulation function were basically normal within 1 week before enrollment (based on the normal values in the laboratories of each research center). Total bilirubin (TBIL) ≤ 1.5 × Upper limit of normal value (ULN); alanine aminotransferase (SGPT / ALT) ≤ 2.5 × ULN (patients with liver metastasis) ≤ 5 × ULN);Aspartate aminotransferase (SGOT / AST) ≤ 2.5 × ULN (patients with liver metastasis) ≤ 5 × ULN);Creatinine clearance rate (CCR) ≥ 60 ml / min; Urinary protein \< 2 +; If urinary protein ≥ 2 +, 24-hour urinary protein must be ≤ 1g; Thyroid stimulating hormone (TSH) ≤ upper limit of normal value (ULN); in case of abnormality, T3 and T4 levels shall be measured; if T3 and T4 levels are normal, they can be selected. International normalized ratio (INR) ≤ 1.5, prothrombin time (PT) and activated partial thromboplastin time (APTT) ≤ 1.5 × ULN。
• The patient is willing and able to comply with the provisions of the study protocol during the study.
• Before entering the study, during the study and within 6 months after the end of treatment, patients with fertility must take effective contraceptive measures (hormone or barrier contraception; abstinence).
• The subject agreed not to participate in another intervention study when receiving the study drug in this study. Subjects ended the last study for more than 1 month.
• Subjects who have received adjuvant or neoadjuvant therapy (including chemotherapy, radiotherapy or chemoradiotherapy) of GC / GEJ must complete the last dose of treatment at least 6 months before the first study treatment. Palliative radiotherapy is allowed, but it must be completed 2 weeks before the start of study treatment.

You may not qualify if:

• Patients who have received chemotherapy, radiotherapy or biological therapy within two weeks. Received any investigational drug within 4 weeks before the start of study treatment.
• Pregnant or lactating women; women with fertility have a positive pregnancy test or no pregnancy test at the time of screening.
• Severe / uncontrolled intermittent disease / infection.
• Obvious cardiovascular disease (history of congestive heart failure \> NYHA class II, unstable angina pectoris or myocardial infarction, unstable angina pectoris or myocardial infarction, or severe arrhythmia in the past six months).
• History or evidence of hereditary bleeding syndrome or coagulation disease with bleeding risk, history of thrombotic disease and active gastrointestinal bleeding.
• There have been arterial thromboembolism events in the past 6 months, including transient ischemic attack and cerebrovascular accident.
• Patients with previous malignant tumors, unless the previous malignant tumors have been diagnosed and treated for more than 5 years, and there is no evidence of recurrence.
• Patients with neuropathy \> grade 3 at screening.
• Patients with QTc \> 500msec during screening.
• Patients with meningeal disease and no other measurable brain metastasis were excluded.
• Have received bevacizumab, sorafenib, sunitinib or other VEGF pathway targeted therapy.
• Have a history of severe hemoptysis.
• Having a mental illness or social situation can hinder study compliance.
• A severe nonunion wound, ulcer, or bone fracture.
• Major surgery, open biopsy or major trauma within 28 days before enrollment, and minor surgery within 7 days before enrollment.

Sponsors & Collaborators

• Jiuda Zhao: lead
• Lanzhou University Second Hospital: collaborator

Study Sites (1)

Affiliated Hospital of Qinghai University

Xining, Qinghai, 810000, China

RECRUITING

MeSH Terms

Conditions

Stomach Neoplasms

Interventions

sintilimab; apatinib; BID protein, human; Oxaliplatin

Condition Hierarchy (Ancestors)

Gastrointestinal Neoplasms; Digestive System Neoplasms; Neoplasms by Site; Neoplasms; Digestive System Diseases; Gastrointestinal Diseases; Stomach Diseases

Intervention Hierarchy (Ancestors)

Coordination Complexes; Organic Chemicals

Central Study Contacts

Zhao Jiuda, MD

CONTACT

+86 13327661976; jiudazhao@126.com

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: Professor

Model Details: Patients who meet the inclusion criteria will receive with sintilimab combined with apatinib and chemotherapy(Oxaliplatin plus Tegafur gimeracil oteracil potassium capsules). At the same time, tumor samples were collected for tissue PD-L1 detection and blood samples for CTC detection according to the wishes of patients. Patients underwent contrast-enhanced thoracoabdominal and pelvic Computer Tomography(CT) at baseline and every 6 weeks after enrollment. Patients with stable or remission after 2 to 6 cycles of combined treatment can reduce the evaluation frequency to once every 12 weeks during the maintenance treatment period.

Study Record Dates

• First Submitted: January 19, 2022
• First Posted: January 31, 2022
• Study Start: February 15, 2022
• Primary Completion: June 1, 2024
• Study Completion: June 1, 2025
• Last Updated: April 11, 2022

Record last verified: 2022-04

Locations

CN (1)