Primary Objectives: Part 1: to confirm the recommended tusamitamab ravtansine loading dose Q2W in combination with ramucirumab in advanced gastric or gastroesophageal junction (GEJ) adenocarcinoma population Part 2: to assess the antitumor activity of tusamitamab ravtansine loading dose Q2W in combination with ramucirumab in advanced gastric or GEJ adenocarcinoma Secondary Objectives: * To assess safety and tolerability * To assess durability of response (DOR) * To assess progression-free survival (PFS) * To assess the disease control rate (DCR) * To assess the pharmacokinetics (PK) * To assess the immunogenicity
34 weeks (up to 4 weeks for screening, a median of 18 weeks for treatment, and a median of 12 weeks for end-of-treatment assessments and the safety follow-up visit).
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
35
Pharmaceutical Form: Concentrate for solution for infusion Route of Administration: Intravenous Infusion
Pharmaceutical Form: Concentrate for solution for infusion Route of Administration: Intravenous Infusion
Investigational Site Number : 0560002
Brussels, Belgium
Investigational Site Number : 0560003
Edegem, Belgium
Investigational Site Number : 0560001
Leuven, Belgium
Investigational Site Number : 3920002
Kashiwa-shi, Chiba, Japan
Investigational Site Number : 3920004
Matsuyama, Ehime, Japan
Investigational Site Number : 3920001
Sapporo, Hokkaido, Japan
Investigational Site Number : 3920003
Sunto-gun, Shizuoka, Japan
Investigational Site Number : 6430003
Pushkin, Saint- Petersburg, Sankt-Peterburg, Russia
Investigational Site Number : 6430001
Arkhangelsk, Russia
Investigational Site Number : 4100002
Seoul, Seoul-teukbyeolsi, South Korea
...and 11 more locations
Part 1: Number of Participants With Study-Drug Related Dose Limiting Toxicities (DLTs)
The following AEs occurred during the first 2 cycles of treatment, unless due to disease progression or to a cause obviously unrelated to study drug, were considered DLTs: * Grade 4 neutropenia for 7 or more consecutive days. * Grade 3 to 4 neutropenia complicated by fever (temperature \>=38.5 degree Celsius on more than 1 occasion) or microbiologically or radiographically documented infection. * Grade \>=3 thrombocytopenia associated with clinically significant bleeding requiring clinical intervention. * Grade 4 non-hematologic AE. * Grade \>=3 keratopathy. In addition, any other AE that the Investigators and sponsor deemed to be dose limiting, regardless of its grade, was also considered as DLT.
Time frame: From Cycle 1 Day 1 to Cycle 2 Day 14; approximately 28 days
Objective Response Rate (ORR)
The ORR was defined as percentage of participants with confirmed complete response (CR) or partial response (PR) as best overall response (BOR) determined per Response Evaluation Criteria in Solid Tumors (RECIST) version (v) 1.1. The CR was defined as disappearance of all target lesions. The PR was defined as at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters.
Time frame: Tumor assessments performed at Baseline (Day 1), then every 6 weeks (±7 days) thereafter, approximately 88.1 weeks
Number of Participants With Treatment-Emergent Adverse Events (TEAEs) and Treatment Emergent Serious Adverse Events (TESAEs)
An AE was any untoward medical occurrence in a participant or clinical study participant, temporally associated with the use of study drug, whether or not considered related to the study drug. A SAE was defined as any untoward medical occurrence that, at any dose: resulted in death or was life-threatening or required inpatient hospitalization or prolongation of existing hospitalization or resulted in persistent disability/incapacity or congenital anomaly/birth defect. TEAE was defined as AEs that developed, worsened, or became serious during the treatment-emergent period.
Time frame: From the first study drug administration (Day 1) up to 30 days after the last study drug administration, approximately 120 weeks
Duration of Response (DOR)
The DOR was defined as the time from first documented evidence of CR or PR until progressive disease (PD) determined per RECIST v1.1 or death from any cause, whichever occured first. The PD was defined as at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study.
Time frame: Tumor assessments performed at Baseline (Day 1), then every 6 weeks (±7 days) thereafter, approximately 88.1 weeks
Progression-free Survival (PFS)
The PFS was defined as the time from the first study drug administration to the date of the first documented disease progression or death due to any cause, whichever came first as per RECIST v1.1.
Time frame: Tumor assessments performed at Baseline (Day 1), then every 6 weeks (±7 days) thereafter, approximately 88.1 weeks
Disease Control Rate (DCR)
The DCR was defined as the percentage of participants who achieved confirmed CR, confirmed PR or stable disease (SD) as per RECIST v1.1. The SD was defined as neither sufficient shrinkage from the baseline study to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study.
Time frame: Tumor assessments performed at Baseline (Day 1), then every 6 weeks (±7 days) thereafter, approximately 88.1 weeks
Individual Observed Predose Concentrations (Ctrough) of Tusamitamab Ravtansine
Blood samples were collected for the measurement of Ctrough of tusamitamab ravtansine.
Time frame: Pre-infusion on Cycle 2 Day 1
Individual Observed Predose Concentrations (Ctrough) of Ramucirumab
Blood samples were collected for the measurement of Ctrough of concentrations of ramucirumab.
Time frame: Pre-infusion on Cycle 2 Day 1
Number of Participants With Antitherapeutic Antibodies (ATAs) Against Tusamitamab Ravtansine
Blood samples were collected to assess the presence of ATA against tusamitamab ravtansine in plasma from all participants. ATA incidence was defined as the number of participants found to have seroconverted (treatment-induced ATAs) or boosted their pre-existing ATA response (treatment-boosted ATAs) at any time after first study drug administration.
Time frame: Upto 92.1 weeks
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