The initial intent of the study was to be a multi-center single-arm open-label Simon's two-stage Phase II clinical trial of first-line mFOLFOX6 + trastuzumab + avelumab in metastatic HER2-amplified gastric and esophageal adenocarcinomas. Accrual will halt after completion of Stage I (enrollment of 18 patients). This decision is not due to safety issues. Subjects currently on treatment will continue until criteria as defined in the protocol is met.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
18
Oxaliplatin 85 mg/m2
Leucovorin 400 mg/m2
5 fluorouracil 400 mg/m2 bolus and 2400 mg/m2 continuous infusion
Trastuzumab 6 mg/kg loading dose C1D1 then 4 mg/kg Day 1
Avelumab 800 mg
City of Hope
Duarte, California, United States
Winship Cancer Insititute of Emory University
Atlanta, Georgia, United States
Northwestern University Feinberg School of Medicine
Chicago, Illinois, United States
University of Iowa Hospital and Clinics
Iowa City, Iowa, United States
Atlantic Health System
Morristown, New Jersey, United States
Roswell Park Cancer Institute
Buffalo, New York, United States
University of North Carolina at Chapel Hill
Chapel Hill, North Carolina, United States
Best Objective Response Rate (bORR)
Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST): Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), \>=30% decrease in the sum of the longest diameter(LD) of target lesions; Progressive Disease (PD): \>= 20% increase in tumor burden relative to nadir or the appearance of one or more new lesions; Stable Disease (SD): Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum LD since the treatment started. The bORR will be defined as the percentage of subjects whose best response by 24 weeks are either a CR or PR according to RECIST 1.1. For confirmed response, PR or CR need to be confirmed by repeat assessments that should be performed no less than 4 weeks. Otherwise, it will be considered as an unconfirmed response.
Time frame: 24 weeks
Progression Free Survival (PFS)
Per RECIST 1.1: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), \>=30% decrease in the sum of the longest diameter(LD) of target lesions; Progressive Disease (PD): \>= 20% increase in tumor burden relative to nadir or the appearance of one or more new lesions; Stable Disease (SD): Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum LD since the treatment started. Progression Free Survival (PFS) will be defined as the time from the start date of treatment to the date of documented progression as determined by RECIST 1.1 or death from any cause.
Time frame: Time of treatment start until the criteria for disease progression or death, up to a maximum of 11 months.
Progression Free Survival by iRECIST(iPFS)
Immune-RECIST Criteria(iRECIST): Complete Response(iCR), Disappearance of all measurable and non-measurable lesions; Partial Response (iPR), \>=30% decrease in tumor burden relative to baseline; Unconfirmed Progressive Disease (iUPD), \>= 20% increase in the sum of the LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions; Confirmed Progressive Disease (iCPD), confirmation of iUPD (by further growth) at the next assessment; Stable Disease (iSD), neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum LD since the treatment started. iPFS will be defined as the time from the start date of treatment to the date of documented progression as determined by iRECIST criteria or death from any cause.
Time frame: Time of treatment start until the criteria for disease progression or death, up to a maximum of 11 months.
Overall Survival (OS)
Overall Survival (OS) will be defined as the time from start of treatment to the date of death from any cause, or date of last contact (censored).
Time frame: Time of treatment start until death or date of last contact, up to a maximum of 20 months
Disease Control Rate (DCR)
Disease Control Rate (DCR) will be defined as the total number of patients whose best responses are either a CR, PR, or SD divided by the number of response evaluable patients. Patients with best response of SD will need to maintain SD by 24 weeks to be considered to have received clinical benefit from the treatment regimen.
Time frame: Up to a maximum of 11 months.
Number of Participants With Grade 3-4 Treatment Related Adverse Events
The frequency and severity of all grade 3-4 treatment related adverse events are reported by CTCAE v5.
Time frame: AE had been recorded from time of signed informed consent until 30 days after discontinuation of study drug(s) and/or until a new anti-cancer treatment starts, whichever occurs first, up to a maximum of 20 months.
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.