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.
This is a Phase II non-randomized, single arm, open label study of abemaciclib in combination with pembrolizumab in patients with unresectable or metastatic gastric, gastroesophageal junction, or esophageal adenocarcinoma who have received at least two lines of prior therapy. Treatment will be administered in 21-day cycles. Pembrolizumab will be administered intravenously (IV) at a dose of 200 mg on day 1 of each cycle. Abemaciclib will be taken orally twice a day on each day of the cycle, 150 mg per dose. Treatment will continue until disease progression or development of unacceptable toxicities.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
3
Pembrolizumab 200mg IV
Abemiciclib 150mg PO
Indiana University Melvin and Bren Simon Cancer Center
Indianapolis, Indiana, United States
Univerisy of Iowa Hospital and Clinics
Iowa City, Iowa, United States
Rutgers Cancer Institute of NewJjersey
New Brunswick, New Jersey, United States
University of Wisconsin
Madison, Wisconsin, United States
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).
Time frame: From C1D1 until death or up to a maximum of 5 months
PFS Per irRECIST
A measurement from the date of the start of treatment until the criteria for disease progression is met as defined by irRECIST or death occurs.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. The appearance of new lesions is not considered PD but are to be included in the sum diameters. Confirmation required at least 4 weeks after the first irPD assessment provided the patient is considered clinically stable.
Time frame: 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
6 months PFS rate is defined as the proportion of subjects who have experienced no progressive disease or death at a 6 month time point from time of treatment initiation using RECIST and irRECIST criteria. Progressive disease per RECIST 1.1 and irRECIST 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. Per RECIST 1.1, the appearance of one or more new lesions is also considered progression. Per irRECIST, confirmation is required at least 4 weeks after the first irPD assessment provided the patient is considered clinically stable.
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Time frame: From C1D1 until death or up to a maximum of 6 months
Objective Response Rate
Objective response rate is the proportion of all subjects with confirmed PR or CR according to RECIST 1.1 and irRECIST criteria, from the start of treatment until disease progression/recurrence (taking as reference for progressive disease the smallest measurements recorded since the start of treatment).Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by MRI: Complete Response (CR/irCR), Disappearance of all target lesions; Partial Response (PR/irPR), \>=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR
Time frame: From C1D1 until death or up to a maximum of 5 months
Disease Control Rate
The disease control rate is the proportion of all subjects with stable disease (SD) for 16 weeks, or partial response (PR), or complete response (CR) according to RECIST 1.1, from the start of treatment until disease progression/recurrence (taking as reference for progressive disease the smallest measurements recorded since the start of treatment). RECIST and irRECIST criteria will be applied. Partial response is defined as at least a 30% decrease in the sum of the diameters of target lesions, taking as reference the baseline sum diameters. Complete response is defined as disappearance of all target lesions. Any pathological lymph nodes(whether target or non-target) must have reduction in short axis to \<10 mm. Stable disease is defined neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study.
Time frame: From C1D1 until death or up to a maximum of 5 months
Overall Survival
Overall survival is defined by the duration of subject's survival from the start of treatment till death from any cause or off- study.
Time frame: From C1D1 until death or up to a maximum of 5 months
Number of Participants With Specified Safety and Tolerability of Abemaciclib in Combination With Pembrolizumab
Safety and tolerability of abemaciclib in combination with pembrolizumab in patients with advanced, unresectable or metastatic gastric, gastroesophageal junction, or esophageal adenocarcinoma, assessed by NCI Common Terminology Criteria for Adverse Events (CTCAE) version 5.
Time frame: From C1D1 until death or up to a maximum of 5 months