This is an open-label, single-arm, single-center Phase Ib/II study to exploratorily evaluate the tolerability, safety, and efficacy of regorafenib and nivolumab plus chemotherapy in patients with unresectable advanced/recurrent gastric/ gastroesophageal junction/esophageal adenocarcinoma.
Phase Ib part: To evaluate safety and tolerability in combination of Regorafenib, Nivolumab and chemotherapy in patient with unresectable advanced/recurrent gastric/ gastroesophageal junction/esophageal adenocarcinoma and to determine recommended dose in phase II part. Phase II part: To evaluate safety and potential efficacy in combination of Regorafenib, Nivolumab and chemotherapy in patients in expanded arm. The protocol treatment in this study is regorafenib and nivolumab plus CapeOX (Cohort A) / FOLFOX (Cohort B). Regorafenib (the initial dose is 90 mg/dose) is orally administered daily for 21 days, followed by a 7-day washout period. Nivolumab is administered intravenously at a dose of 360 mg every 3 weeks (Cohort A) or 240 mg every 2 weeks (Cohort B). Cohort A:CapeOX * Capecitabine 1,000 mg/m\^2 administered orally, twice daily (Days 1 to 14 continuous dosing of CapeOX therapy) * Oxaliplatin 130 mg/m\^2 administered intravenously (Day 1 of CapeOX therapy) \*Repeat every 3 weeks as CapeOX therapy Cohort B:FOLFOX * Leucovorin 400 mg/m\^2 administered intravenously (Day 1 of FOLFOX therapy) * Fluorouracil 400 mg/m\^2 administered intravenously (Day 1 of FOLFOX therapy) and 1,200 mg/m2 administered intravenously (Days 1 to 2 of FOLFOX therapy) * Oxaliplatin 85 mg/m\^2 administered intravenously (Day 1 of FOLFOX therapy) \*Repeat every 2 weeks as FOLFOX therapy
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
30
90 mg administered orally, once daily for 21 consecutive days followed by 7 days off \*Repeat every 4 weeks as Regorafenib therapy
CohotA:360 mg administered intravenously, every 3 weeks \*Administered on the same day as CapeOX therapy Cohort B: 240 mg administered intravenously, every 2 weeks \*Administered on the same day as FOLFOX therapy
For Cohort A only * Capecitabine 1,000 mg/m\^2 administered orally, twice daily (Days 1 to 14 continuous dosing of CapeOX therapy) * Oxaliplatin 130 mg/m\^2 administered intravenously (Day 1 of CapeOX therapy) \*Repeat every 3 weeks as CapeOX therapy
National Cancer Center Hospital East
Kashiwa, Chiba, Japan
Incidence of DLTs in Phase Ib part
The incidence of DLTs in each cohort will be calculated for the DLT evaluable population.
Time frame: 4weeks
ORR in Phase II part
ORR is defined as the proportion of subjects whose best overall response based on the RECIST guideline version 1.1 is either CR or PR.
Time frame: 1 year
PFS
Progression-free survival is defined as the time from the enrollment date until the date when disease progression is determined or until the date of death from any cause, whichever comes earlier.
Time frame: 1 year
DoR
DoR is defined in responders as the period from the date of the first determination of overall response as CR or PR according to the RECIST guideline version 1.1 to the date of determination of progression (PD based on diagnostic imaging) or the date of death from any cause, whichever comes first.
Time frame: 1 year
DCR
DCR is defined as the proportion of patients in whom the best overall response was determined as CR or PR, or patients who maintained SD for 6 weeks or more according to the RECIST guideline version 1.1.
Time frame: 1 year
OS
The period will be from the day of enrollment, as the starting date of the computation, to the day of death of any cause.
Time frame: 2 years
Incidence of adverse events
The treatment-emergent AEs will be summarized by CTCAE v5.0
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
For Cohort B only * Leucovorin 400 mg/m\^2 administered intravenously (Day 1 of FOLFOX therapy) * Fluorouracil 400 mg/m\^2 administered intravenously (Day 1 of FOLFOX therapy) and 1,200 mg/m2 administered intravenously (Days 1 to 2 of FOLFOX therapy) * Oxaliplatin 85 mg/m\^2 administered intravenously (Day 1 of FOLFOX therapy) \*Repeat every 2 weeks as FOLFOX therapy
Time frame: up to 30 days after the last dose