E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Metastatic or Locally Advanced, Treatment-naïve, HER2-Positive Gastric or Gastroesophageal Junction Cancer |
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E.1.1.1 | Medical condition in easily understood language |
Gastric Cancer or Gastroesophageal Junction Cancer |
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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 | 23.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10066896 |
E.1.2 | Term | HER2 positive gastric cancer |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10017758 |
E.1.2 | Term | Gastric cancer |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10066354 |
E.1.2 | Term | Adenocarcinoma of the gastroesophageal junction |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
Cohort A:
To evaluate the safety and tolerability of margetuximab + INCMGA00012 in patients with untreated locally advanced or metastatic GC or gastroesophageal junction (GEJ) cancer that is HER2 IHC 3+ and PD-L1+ by IHC staining.
To evaluate the ORR of margetuximab plus INCMGA00012 for non-MSI-H patients in the response evaluable population (REP) using independent and Investigator-assessed radiology reviews.
Cohort B, Part 1:
To select the best margetuximab, chemotherapy and CPI-containing combination regimen for further evaluation in Part 2, based on evaluation of safety and ORR in the primary response evaluable population (PREP) of patients with GC or GEJ cancer, irrespective of PD-L1 status.
Cohort B, Part 2:
To compare the OS of patients treated with the margetuximab, chemotherapy and CPI-containing arm selected from Cohort B Part 1 to that of patients treated with trastuzumab plus chemotherapy (control arm) in the primary efficacy population. |
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E.2.2 | Secondary objectives of the trial |
Cohort A:
To determine duration of response (DoR), disease control rate (DCR), progression-free survival (PFS) using independent and Investigator-assessed radiology review, and OS for non-MSI-H patients.
Cohort B, Part 1:
To evaluate PFS, OS, DoR, and DCR of each treatment arm.
To evaluate the ORR, DoR, DCR, PFS, and OS in the double-positive (HER2 3+ and PD-L1+) and non-MSI-H population in the margetuximab and chemotherapy arm
Cohort B Part 2:
To evaluate PFS, DoR, ORR and DCR of each treatment arm. To evaluate OS in the intent-to-treat (ITT), and non-PEP populations.
To evaluate the ORR, PFS, DoR, DCR and OS in the double-positive (HER2 3+ and PD-L1+) and non-MSI-H population in the margetuximab and CPI-containing arm.
-Please refer to protocol for further details. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Histologically confirmed diagnosis of previously untreated locally advanced unresectable or metastatic HER2+ GC or GEJ adenocarcinoma
- Cohort A: HER2-positive (by IHC 3+) and PD-L1-positive (by IHC with 22C3 CPS ≥ 1%), per central review.
- Cohort B: HER2-positive (by IHC 3+ or IHC 2+ in combination with FISH+) by local review. PD -L1 status is not required for enrollment.
-Prior systemic perioperative treatment is allowed; however the patient must have had a disease-free interval of at least 6 months from end of chemo/surgery.
-Patients receiving perioperative anti-HER2 therapy require testing of HER2 status for eligibility.
2. Availability of formalin-fixed, paraffin-embedded tumor specimen, unstained slides or contemporaneous biopsy for tumor target testing
3. Eastern Cooperative Oncology Group performance status of 0 or 1, verified within 3 days of Day 1
4. Life expectancy ≥ 6 months
5. At least one radiographically measurable target lesion
6. Acceptable laboratory parameters and adequate organ function |
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E.4 | Principal exclusion criteria |
1. Other malignancy that is progressing or required treatment within the past 5 years, with certain exceptions
-Patients with known MSI-H status
2. History of allogeneic stem cell or tissue/solid organ transplant
3. Central nervous system metastases
4. Clinically significant cardiovascular disease, gastrointestinal disorders, pulmonary compromise
5. Prior neoadjuvant or adjuvant treatment with immunotherapy |
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E.5 End points |
E.5.1 | Primary end point(s) |
1) Incidence of Adverse Events of margetuximab plus INCMGA00012 as assessed by CTCAE v5.0
-Evaluation of adverse events and serious adverse events (Cohort A)
2) Objective response rate (ORR) for non-microsatellite instability-high (non-MSI-H) patients (Cohort A)
- Proportion of non MSI-H patients with best overall response of complete response (CR) plus partial response (PR) per RECIST 1.1 (Cohorts A and B)
3) Overall survival
-Time from randomization to death from any cause (Cohort B)
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
1) Time Frame: 6 month intervals
2) Time Frame: 3 years
3) Time Frame: Up to 3 years
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E.5.2 | Secondary end point(s) |
1) Progression-free survival
-Time from start of study treatment to the first documented disease progression per RECIST v1.1 or death due to any cause, whichever occurs first. (Cohorts A and B)
2) Duration of response
-Time from the date of initial response (CR or PR) to the date of first documented progression or death from any cause, whichever occurs first (Cohorts A and B)
3) Disease control rate
-Percentage of patients who experienced response of CR, PR or stable disease for at least 3 months from start of study treatment (Cohorts A and B)
4) Patient reported quality of life
-Quality of life as assessed using the Functional Assessment of Cancer Therapy - Gastric Questionnaire (FACT-Ga) (Cohort B) on a scale of 0 to 184. Lower scores correlate with worse quality of life and higher scores correlate with better quality of life.
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
1) Time Frame: Up to 3 years
2) Time Frame: Up to 3 years
3) Time Frame: Up to 3 years
4) Time Frame: Up to 3 years |
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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 | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | Yes |
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) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | Yes |
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) | Yes |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 5 |
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 | 11 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 70 |
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 |
China |
Korea, Republic of |
Singapore |
Taiwan |
United States |
Germany |
Italy |
Netherlands |
Poland |
Spain |
United Kingdom |
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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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The end of study is reached when the number of deaths required for final survival analysis for Cohort B is achieved and the study database is locked for the final survival analysis of Cohort B, which will be basis for the final clinical study report (CSR), or the closure of study by study Sponsor. |
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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 | 4 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 6 |
E.8.9.2 | In all countries concerned by the trial months | 8 |
E.8.9.2 | In all countries concerned by the trial days | 0 |