E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Gastric Neoplasm malignant
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E.1.1.1 | Medical condition in easily understood language |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 15.0 |
E.1.2 | Level | HLT |
E.1.2 | Classification code | 10017812 |
E.1.2 | Term | Gastric neoplasms malignant |
E.1.2 | System Organ Class | 10017947 - Gastrointestinal disorders |
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E.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
Primary evaluation of the safety, tolerability and feasibility regarding specific postoperative complications of an adjuvant treatment with catumaxomab administered after curative tumor resection subsequent to a neoadjuvant chemotherapy. Relevant efficacy parameters (e.g., DFS, OS) will be assessed during a post-treatment follow-up period of two years. |
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E.2.2 | Secondary objectives of the trial |
Secondary safety endpoints: − Frequency, relationship and seriousness of adverse events (AEs) − Clinically relevant laboratory results (hematology with differential blood count, clinical chemistry, coagulation tests and determination of cytokines, procalcitonin, and anti-catumaxomab antibodies by DABA) − Vital functions (SBP/DBP, HR, T°) Efficacy endpoints: − Surgical resection rate − Chemotherapeutic response rate (using the RECIST-guidance) − Overall survival (OS) defined as the time from study enrolment until death − Disease-free survival (DFS) defined as the time from study enrolment to the point of diagnosis of recurrent disease or death, whatever occurred first |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Signed and dated informed consent 2. Male or female patient at an age of 18 years or older 3. Patient has a primary diagnosis of a histologically confirmed gastric adenocarcinoma (including GE junction Siewert-Type 2 or 3) 4. TNM-staging at screening of T2/T3/T4, N+/-, M0 5. Intended curative subtotal or total gastrectomy ('en-bloc'-R0-resection considering the standard D2-scheme) 6. Karnofsky index >= 70 7. Negative pregnancy blood test at screening but not more than 72 hours prior to the start of chemotherapy, for women of childbearing potential
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E.4 | Principal exclusion criteria |
1. Exposure to prior cancer therapy (surgery, chemo- or radio-therapy) or planned adjuvant chemo- or radiotherapy of the current gastric cancer before "End-of-Treatment" visit (EOT = 1 month after last catumaxomab administration) 2. Prior diagnosis of any malignancy not cured by surgery alone less than 5 years before study entry (except cervix carcinoma in situ and adequately treated non-melanomatous skin cancer) 3. Previous use of non-humanized monoclonal mouse or rat antibodies 4. Known or suspected hypersensitivity or allergy to catumaxomab or to similar antibodies or to any of the planned ECX chemotherapeutic drugs 5. Known dihydropyrimidine-dehydrogenase (DPDH) deficiency 6. Known contraindications to any of the planned ECX-chemotherapeutics 7. Presence of distant metastases 8. Presence of constant immunosuppressive therapy 9. Presence of bilateral pleural effusion or hypalbuminemia associated with hypovolemia and hypotension 10. Presence of symptomatic pyloric stenosis (defined as excessive vomiting and weight loss > 10% within the last 3 months) 11. Presence of any acute or chronic systemic infection 12. Presence of a bowel obstruction within the last 30 days 13. Pre-existing heart failure > NYHA class II 14. Inadequate renal function (Creatinine >1.5 x ULN or Creatinine Clearance < 60 ml/min/kg according to the Cockroft Formula) 15. Inadequate hepatic function (AST or ALT > 2.5 x ULN or Bilirubin > 1.5 x ULN) 16. Inadequate bone marrow function with Platelets < 100 000 cells/mm3 or absolute neutrophil count (ANC) < 1500 cells/mm3 17. Left ventricular ejection fraction (LVEF) below normal institutional ranges as measured by echocardiogram or any clinically significant abnormality detected by echocardiogram 18. Pregnant or nursing woman, or woman of childbearing potential who is not using an adequate and effective contraceptive method during the study and at least three months after the last i.p.-infusion (i.e., oral or injectable contraceptives, intrauterine devices, double-barrier method, contraceptive patch, male partner sterilization or condoms) 19. Any further condition which according to the investigator results in an undue risk to the patient during participation in the present study 20. The patient planned to be enrolled is an employee of any involved study investigator or of any involved institution including the study sponsor 21. Parallel participation in another clinical trial or previously in this study 22. Treatment with another investigational product during this study or during the last 30 days prior to study start
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary study endpoint will be the rate of all specific postoperative complications newly observed during a period of 30 days after surgery in those study patients who received at least one dose of catumaxomab. The events below will be regarded as specific postoperative complications: - Any death - Any abscess requiring an intervention (e.g., surgery or drainage) - Symptomatic cholecystitis verified by ultrasound or CT-scan - Symptomatic pancreatitis verified by CT-scan and at least one of the following objective diagnostic measurements/measures: - Serum amylase > = 3 x ULN - Serum lipase > = 3 x ULN - Pulmonary infection verified by chest X-ray or CT-scan - Abdominal hemorrhage requiring any therapy - Anastomosis insufficiency requiring surgery - Ileus with grade IV clinical symptoms or requiring any surgical therapy - Thromboembolism verified by at least one of the following objective diagnostic measures: - Positive V/Q scan ('high probability' according to PIOPED-criteria22) - Angiography - CT-scan The assessment on the postoperative complications by documentation of the postoperative outcome will be performed by the local investigator based on the clinical symptoms observed after surgery.
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
All specific postoperative complications newly observed during a period of 30 days after surgery in those study patients who received at least one dose of catumaxomab. |
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E.5.2 | Secondary end point(s) |
Safety endpoints: - Frequency, relationship and seriousness of adverse events (AEs). - Clinically relevant laboratory results (hematology with differential blood count, clinical chemistry, coagulation tests and determination of cytokines, procalcitonin, and anti-catumaxomab antibodies by DABA) - Vital functions (SBP/DBP, HR, T°) Efficacy endpoints: - Surgical resection rate - Chemotherapeutic response rate (using the RECIST-guidance) - Overall survival (OS) - Disease-free survival (DFS)
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Safety: All AEs until EOT. Labaratory results: Pre-treatment at screening, pre-infusion of the day of surgery and of the postoperative days 7, 10, 13 and 16 prior to i.p.-infusion. Vital functions: Pre-treatment at screening, pre-infusion of the day of surgery prior to operation and of the postoperative days 7, 10, 13 and 16 prior to the i.p.-infusion. Efficacy endpoints: - Overall survival (OS) at 3, 6, 9, 12, 18 and 24 months after EOT, time from study enrolment until death - Disease-free survival (DFS) at 3, 6, 9, 12, 18 and 24 months after EOT, time from study enrolment to the point of diagnosis of recurrent disease or death, whichever occurred first
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Information not present in EudraCT |
E.8.2.2 | Placebo | Information not present in EudraCT |
E.8.2.3 | Other | Information not present in EudraCT |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 10 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 25 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
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E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 5 |
E.8.9.1 | In the Member State concerned months | 6 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 5 |
E.8.9.2 | In all countries concerned by the trial months | 6 |
E.8.9.2 | In all countries concerned by the trial days | 0 |