AdenocarcinomaPhase 2NCT02213289
PANGEA-IMBBP: Personalized Antibodies for Gastro-Esophageal Adenocarcinoma - A 1st Pilot Metastatic Trial of Biologics Beyond Progression
A Phase 2 study testing Trastuzumab, ABT-806 and Bemarituzumab in people with Adenocarcinoma, run by University of Chicago at 1 site in United States.
Trial summary
The purpose of this study is to determine if doctors can use the results of special tests of subjects tumor tissue, that will look for specific abnormalities in the tumor, to choose a specific drug that is targeted to work against that abnormality (called molecular profiling) and to see what effects (good and/or bad)… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Adenocarcinoma
- What is being tested?
- Trastuzumab, ABT-806 and Bemarituzumab
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 80 participants
- Where
- 1 siteUnited States
- Study dates
- 20 Jan 2015to 20 Aug 2020
- Phase
- Phase 2
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Histologically confirmed metastatic gastric or esophagogastric junction (type I,II,III Siewert) adenocarcinoma
- Newly-diagnosed chemo-naïve or recurrent after curative-intent surgery
- >6 months after completion of adjuvant therapy (including chemotherapy and/or radiotherapy)
- No prior treatment with any targeted agent
- Patients who have started first line mFOLFOX6 therapy (+/-trastuzumab for HER2 amplified tumors) may be considered for trial participation if they have received no more than 4 doses of therapy at the time of consent and screening.
- Measurable metastatic disease by RECIST criteria,
Show all 27Show fewer
- Must be amenable to ultrasound or CT-guided biopsy of one metastatic lesion
- Peritoneal disease as the sole site of occult metastasis or presenting as malignant ascites is acceptable if a cell block of tumor cells can be obtained showing >20% viable tumor cells.
- ECOG PS 0,1
- Age > 18 years
- Patients must have normal organ and marrow function as defined below:
- granulocytes >1,2500/mcL
- platelets >100,000/mcL
- total bilirubin < 1.5 x ULN, <1.8 x ULN with liver metastases
- AST(SGOT)/ALT(SGPT) <2.5 X ULN without liver metastases; <5 X ULN with liver metastases
- creatinine within normal institutional limits (<1.5) OR
- creatinine clearance >50 mL/min/1.73m2, (for creatinine level above normal)
- INR: < 1.5 (patients on warfarin need to be converted to LMWH during study participation to be eligible)
- Consent to baseline metastatic and progressive disease biopsy (of metastatic/progressing lesion) for enabling biomarker assessment and treatment assignment (at each time point - baseline, PD1, PD2, PD3) as well as for correlative studies.
- Consent to baseline and serial blood draws for plasma/serum/whole blood banking for correlative studies
- Ability to understand and the willingness to sign a written informed consent document and consent to the serial nature of the proposed PANGEA treatment with first, second and third line therapy as tolerated.
- Ability to comply with requirements of the protocol, as assessed by the investigator by the patient signing the consent form.
- If history of exposure to anthracyclines during perioperative treatment, the following cumulative doses of anthracyclines must be less than:
- Epirubicin < 720 mg/m2 Doxorubicin or liposomal doxorubicin < 360 mg/m2 Mitoxantrone > 120 mg/m2 and idarubicin > 90 mg/m2 If more than one anthracycline has been used, then the cumulative dose must not exceed the equivalent of 360 mg/m2 of doxorubicin.
- Cardiac Ejection Fraction >50% (for HER2+ patients) as assessed by echocardiogram, MUGA scan, or cardiac MRI
- Willingness to use effective and reliable methods of contraception (For appropriate methods of contraception considered acceptable see Appendix B).
- Both men and women and members of all races and ethnic groups are eligible for this trial.
Who cannot join
- No CVA within 6 months, no recent MI within 6 months
- No currently active second malignancy
- No uncontrolled intercurrent illness or infection
- No peripheral edema > grade 2 at baseline.
- No peripheral neuropathy > grade 2 at baseline.
- No diarrhea > grade 2 at baseline.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: PANGEA: Personalized Antibodies for Gastro-Esophageal Adenocarcinoma
The purpose of this study is to determine if doctors can use the results of special tests of subjects tumor tissue, that will look for specific abnormalities in the tumor, to choose a specific drug that is targeted to work against that abnormality (called molecular profiling) and to see what effects (good and/or bad) that targeted drug has on subjects cancer when it is given with standard chemotherapy.
- Conditions
- Adenocarcinoma
- Being tested
- Trastuzumab, ABT-806, Bemarituzumab, Ramucirumab, Nivolumab
- Keywords
- Gastric, Esophagogastric
- Medical subject headings
- Adenocarcinoma
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
TrastuzumabDrug
Also called Herceptin®
Trastuzumab
ABT-806Drug
ABT-806
BemarituzumabDrug
Bemarituzumab
RamucirumabDrug
Also called Cyramza
Ramucirumab
NivolumabDrug
Also called Opdivo
Nivolumab
Standard cytotherapyDrug
FOLFOX (First Line) +FOLFIRI (Second Line) +FOLTAX (Third Line)
| Study group | Role | What they receive |
|---|---|---|
| ITT-PTS: Personalized Treatment Strategy (Immuno-oncology) | Experimental | For patients with monclonal antibiodies available, initial therapy was tailored based on biomarker profile as follows:
Immuno-oncology included PD-L1 IHC combined positivity score >10, high microsatellite instability, tumor mutation burden >15 mutations per megabase, and/or Epstein-Barr virus positive. These patients received standard cytotherapy plus Nivolumab. Receives: Drug: Nivolumab; Drug: Standard cytotherapy |
| ITT-PTS: Personalized Treatment Strategy (HER2 amplified) | Experimental | HER2 amplified. These patients received standard cytotherapy plus Trastuzumab. Receives: Drug: Trastuzumab; Drug: Standard cytotherapy |
| ITT-PTS: Personalized Treatment Strategy (EFGR amplified) | Experimental | EGFR amplified. These patients received ABT-806. Receives: Drug: ABT-806; Drug: Standard cytotherapy |
| ITT-PTS: Personalized Treatment Strategy (FGFR2 amplified) | Experimental | FGFR2 amplified. These patients received standard cytotherapy plus Bemarituzumab. Receives: Drug: Bemarituzumab; Drug: Standard cytotherapy |
| ITT-PTS: Personalized Treatment Strategy (MAPK/PIK3CA aberrant) | Experimental | MAPK/PIK3CA aberrant. These patients received standard cytotherapy plus Ramucirumab. Receives: Drug: Ramucirumab; Drug: Standard cytotherapy |
| ITT-PTS: Personalized Treatment Strategy (EGFR expressing) | Experimental | EGFR expressing. These patients received standard cytotherapy plus ABT 806. Receives: Drug: ABT-806; Drug: Standard cytotherapy |
| ITT-PTS: Personalized Treatment Strategy (All negative) | Experimental | All negative. These patients received standard cytotherapy plus Ramucirumab. Receives: Drug: Ramucirumab; Drug: Standard cytotherapy |
| Non-ITT: Standard Therapy | Other | Patients without monoclonal antibodies available received standard cytotherapy. Receives: Drug: Standard cytotherapy |
What is being measured
The primary outcome is the main question the study is designed to answer.
Overall Survival
Time from enrollment to death from any cause.
Measured: Up to 60 months
Secondary outcomes (6)
Number of Biopsies Leading to an Adverse Event
Number of biopsies leading to an adverse event of the total undergoing baseline biopsies of a primary and metastatic disease site (liver, lung, lymph node, peritoneum/carcinomatosis).
Measured: 1 Month
Completion of Biopsy and Successful, Molecularly-based Treatment Assignment
Completion of biopsies with successful assignment per the treatment algorithm. Biomarker profile assays included next generation sequencing (NGS). EGFR expression was performed by selected-reaction-monitoring mass spectrometry (SRM-MS).
Measured: Up to 1 month
Adverse Event From Serial Biopsy for Second-line Treatment
Number of participants with adverse events from serial biopsies of progressing metastatic disease sites (liver, lung, lymph node, peritoneum/carcinomatosis)
Measured: Up to 60 Months
Completion of Serial Biopsy for Second Line Therapy and Successful, Molecularly-based Treatment Assignment
Completion of biopsy with successful treatment assignment per the treatment algorithm. Biomarker profile assays included next generation sequencing (NGS). EGFR expression was performed by selected-reaction-monitoring mass spectrometry (SRM-MS).
Measured: Up to 60 months
Adverse Event From Serial Biopsy for Third-line Treatment
Number of participants with adverse events from serial biopsies of progressing metastatic disease sites (liver, lung, lymph node, peritoneum/carcinomatosis)
Measured: Up to 60 months
Completion of Serial Biopsy for Third Line Therapy and Successful, Molecularly-based Treatment Assignment
Completion of biopsy with successful treatment assignment per the treatment algorithm. Biomarker profile assays included next generation sequencing (NGS). EGFR expression was performed by selected-reaction-monitoring mass spectrometry (SRM-MS).
Measured: Up to 60 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted11 Aug 2014 (estimated)
- Study start20 Jan 2015
- Primary completion1 Feb 2020
- Study completion20 Aug 2020
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for AdenocarcinomaStudies of the same condition, open and under way.
- More trials run by University of ChicagoThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 80 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Chicago
- Sponsor type
- University, hospital or other
- Collaborators
- AbbVie
- Responsible party
- Sponsor
- Investigators
- Daniel Catenacci, MD, Principal investigator, University of Chicago
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02213289
- Sponsor's protocol ID
- IRB14-0141
- Status last verified
- Mar 2021
- First submitted
- 1 Aug 2014
- Last updated
- 8 Apr 2021
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
Study at a glance
From the registry record, last updated by the sponsor on 8 Apr 2021. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- PANGEA: Personalized Antibodies for Gastro-Esophageal Adenocarcinoma
- ClinicalTrials.gov ID
- NCT02213289
- Acronym / sponsor ID
- IRB14-0141
- Conditions
- Adenocarcinoma
- Keywords
- Gastric, Esophagogastric
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 80 participants (actual)
- Lead sponsor
- University of ChicagoUniversity, hospital or other
- Collaborators
- AbbVie
- Study start
- 20 Jan 2015 (actual)
- Primary completion
- 1 Feb 2020 (actual)
- Study completion
- 20 Aug 2020 (actual)
- First posted
- 11 Aug 2014 (estimated)
- Results
- Posted 8 Apr 2021
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this study is to determine if doctors can use the results of special tests of subjects tumor tissue, that will look for specific abnormalities in the tumor, to choose a specific drug that is targeted to work against that abnormality (called molecular profiling) and to see what effects (good and/or bad) that targeted drug has on subjects cancer when it is given with standard chemotherapy.
Study design
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 8
| Arm | Type | Receives |
|---|---|---|
| ITT-PTS: Personalized Treatment Strategy (Immuno-oncology) | Experimental | Drug: Nivolumab, Drug: Standard cytotherapyFor patients with monclonal antibiodies available, initial therapy was tailored based on biomarker profile as follows: Immuno-oncology included PD-L1 IHC combined positivity score >10, high microsatellite instability, tumor mutation burden >15 mutations per megabase, and/or Epstein-Barr virus positive. These patients received standard cytotherapy plus Nivolumab. |
| ITT-PTS: Personalized Treatment Strategy (HER2 amplified) | Experimental | Drug: Trastuzumab, Drug: Standard cytotherapyHER2 amplified. These patients received standard cytotherapy plus Trastuzumab. |
| ITT-PTS: Personalized Treatment Strategy (EFGR amplified) | Experimental | Drug: ABT-806, Drug: Standard cytotherapyEGFR amplified. These patients received ABT-806. |
| ITT-PTS: Personalized Treatment Strategy (FGFR2 amplified) | Experimental | Drug: Bemarituzumab, Drug: Standard cytotherapyFGFR2 amplified. These patients received standard cytotherapy plus Bemarituzumab. |
| ITT-PTS: Personalized Treatment Strategy (MAPK/PIK3CA aberrant) | Experimental | Drug: Ramucirumab, Drug: Standard cytotherapyMAPK/PIK3CA aberrant. These patients received standard cytotherapy plus Ramucirumab. |
| ITT-PTS: Personalized Treatment Strategy (EGFR expressing) | Experimental | Drug: ABT-806, Drug: Standard cytotherapyEGFR expressing. These patients received standard cytotherapy plus ABT 806. |
| ITT-PTS: Personalized Treatment Strategy (All negative) | Experimental | Drug: Ramucirumab, Drug: Standard cytotherapyAll negative. These patients received standard cytotherapy plus Ramucirumab. |
| Non-ITT: Standard Therapy | Other | Drug: Standard cytotherapyPatients without monoclonal antibodies available received standard cytotherapy. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (27 listed)
- Histologically confirmed metastatic gastric or esophagogastric junction (type I,II,III Siewert) adenocarcinoma
- Newly-diagnosed chemo-naïve or recurrent after curative-intent surgery
- Measurable metastatic disease by RECIST criteria,
- ECOG PS 0,1
- Age > 18 years
Key exclusion criteria (6 listed)
- No CVA within 6 months, no recent MI within 6 months
- No currently active second malignancy
- No uncontrolled intercurrent illness or infection
- No peripheral edema > grade 2 at baseline.
- No peripheral neuropathy > grade 2 at baseline.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| TrastuzumabAlso: Herceptin®Trastuzumab | Drug | ITT-PTS: Personalized Treatment Strategy (HER2 amplified) |
| ABT-806ABT-806 | Drug | ITT-PTS: Personalized Treatment Strategy (EFGR amplified), ITT-PTS: Personalized Treatment Strategy (EGFR expressing) |
| BemarituzumabBemarituzumab | Drug | ITT-PTS: Personalized Treatment Strategy (FGFR2 amplified) |
| RamucirumabAlso: CyramzaRamucirumab | Drug | ITT-PTS: Personalized Treatment Strategy (All negative), ITT-PTS: Personalized Treatment Strategy (MAPK/PIK3CA aberrant) |
| NivolumabAlso: OpdivoNivolumab | Drug | ITT-PTS: Personalized Treatment Strategy (Immuno-oncology) |
| Standard cytotherapyFOLFOX (First Line) +FOLFIRI (Second Line) +FOLTAX (Third Line) | Drug | ITT-PTS: Personalized Treatment Strategy (All negative), ITT-PTS: Personalized Treatment Strategy (EFGR amplified), ITT-PTS: Personalized Treatment Strategy (EGFR expressing), ITT-PTS: Personalized Treatment Strategy (FGFR2 amplified), ITT-PTS: Personalized Treatment Strategy (HER2 amplified), ITT-PTS: Personalized Treatment Strategy (Immuno-oncology), ITT-PTS: Personalized Treatment Strategy (MAPK/PIK3CA aberrant), Non-ITT: Standard Therapy |
Primary outcome
Overall Survival
Time frame: Up to 60 months
Time from enrollment to death from any cause.
6 secondary outcomes
Number of Biopsies Leading to an Adverse Event
Time frame: 1 Month
Completion of Biopsy and Successful, Molecularly-based Treatment Assignment
Time frame: Up to 1 month
Adverse Event From Serial Biopsy for Second-line Treatment
Time frame: Up to 60 Months
Completion of Serial Biopsy for Second Line Therapy and Successful, Molecularly-based Treatment Assignment
Time frame: Up to 60 months
Adverse Event From Serial Biopsy for Third-line Treatment
Time frame: Up to 60 months
Completion of Serial Biopsy for Third Line Therapy and Successful, Molecularly-based Treatment Assignment
Time frame: Up to 60 months
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 8 Apr 2021.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Daniel Catenacci, MD principal investigator
University of Chicago
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Trastuzumab, ABT-806 and Bemarituzumab in people with Adenocarcinoma, run by University of Chicago at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 27 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 8 Apr 2021. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 8 Apr 2021). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Overall Survival (time frame: Up to 60 months). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Apr 2021.