Gastric CancerPhase 2/3NCT05002127
A Study of Evorpacept (ALX148) in Patients With Advanced HER2+ Gastric Cancer (ASPEN-06)
A Phase 2/3 study testing Evorpacept (ALX148), Trastuzumab and Ramucirumab in people with Gastric Cancer and Gastroesophageal Junction Adenocarcinoma, run by ALX Oncology Inc. at 83 sites in 12 countries.
Trial summary
A Phase 2/3 Study of Evorpacept (ALX148) in Combination With Trastuzumab, Ramucirumab, and Paclitaxel in Patients With Advanced HER2-overexpressing gastric/GEJ adenocarcinoma. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Gastric Cancer, Gastroesophageal Junction Adenocarcinoma, Gastric Adenocarcinoma
- What is being tested?
- Evorpacept (ALX148), Trastuzumab and Ramucirumab
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 127 participants
- Where
- 83 sitesin 12 countries
- Study dates
- 15 Jan 2022to 30 Jun 2026
- Phase
- Phase 2/3
- Are there results?
- None posted in the registry
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
- HER2-overexpressing advanced or metastatic gastric or gastroesophageal junction (GEJ) adenocarcinoma that has progressed on or after a prior HER2-directed agent and fluoropyrimidine- or platinum-containing chemotherapy (2nd-line or 3rd-line)
- Adequate Bone Marrow Function.
- Adequate Renal \& Liver Function.
- Adequate Performance Status
Who cannot join
- Patients with known symptomatic central nervous system (CNS) metastases or leptomeningeal disease requiring steroids.
- Prior treatment with any anti-CD47 or anti-SIRPα agent.
- Prior treatment with ramucirumab.
Trial locations and contacts
83 sites in 12 countries.
83 sites in 12 countries
South Korea19 sites
Inje University Haeundae Paik Hospital
Busan, 48108
Dong-A University Hospital
Busan, 49201
Pusan National University Hospital
Busan, 49241
Yeungnam University Medical Center
Daegu, 42415
Chungnam National University Hospital
Daejeon, 35015
Hallym University Sacred Heart Hospital
Dongan, 14068
National Cancer Center - Korea
Goyang-si, 10408
Jeonbuk National University Hospital
Jeonju, 561-712
Seoul National University Bundang Hospital
Seongnam, 13620
Korea University Anam Hospital
Seoul, 02708
Seoul National University Hospital
Seoul, 03080
Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine
Seoul, 03181
Asan Medical Center
Seoul, 05505
Gangnam Severance Hospital
Seoul, 06273
Severance Hospital
Seoul, 06273
Samsung Medical Center
Seoul, 06351
Boramae Medical Center
Seoul, 07061
Korea University Guro Hospital
Seoul, 10408
The Catholic University of Korea Saint Vincent's Hospital
Suwon, 16247
Japan15 sites
National Cancer Center Hospital East
Chiba, 277-8577
Kyushu Cancer Center
Fukuoka, 811-1395
Gifu University Hospital
Gifu, 501-1194
Japanese Red Cross Kumamoto Hospital
Kumamoto, 861-8520
University Hospital Kyoto Prefectural University of Medicine
Kyoto, 602-8566
Nagasaki University Hospital
Nagasaki, 852-8501
Oita University Hospital - Hasama Campus
Ōita, 879-5593
Osaka Prefectural Hospital Organization - Osaka International Cancer Institute
Osaka, 541-8567
Kindai University Hospital
Osaka, 589-8511
Saitama Cancer Center
Saitama, 362-0806
Tohoku University Hospital
Sendai, 980-8574
Shizuoka Cancer Center
Shizuoka, 411-8777
National Cancer Center Hospital
Tokyo, 104-0045
Cancer Institute Hospital of JFCR
Tokyo, 135-8550
Kanagawa Cancer Center
Yokohama, 241-8515
Spain10 sites
Hospital General Universitario de Elche
Alicante, 03203
Hospital Germans Trias i Pujol
Badalona, 08916
Hospital Quirónsalud Barcelona
Barcelona, 08035
Hospital Universitari Vall d'Hebrón
Barcelona, 08035
Hospital Clinic de Barcelona
Barcelona, 08036
Hospital Universitario Reina Sofía
Córdoba, 14004
Hospital Universitario Lucus Augusti
Lugo, 27003
Hospital Universitario Ramón y Cajal
Madrid, 28034
Hospital Universitario Marqués de Valdecilla
Santander, 39008
Hospital Universitario Miguel Servet
Zaragoza, 50009
France9 sites
Centre Hospitalier Régional et Universitaire de Besançon - Hôpital Jean-Minjoz
Besançon, 25030
Centre Hospitalier Universitaire de Bordeaux
Bordeaux, 33000
Hôpital Morvan
Brest, 29200
Centre Léon Bérard
Lyon, 69008
Hôpital Privé Jean Mermoz
Lyon, 69008
Institut Paoli-Calmettes
Marseille, 13009
Hôpital Saint-Antoine
Paris, 75012
Hôpital Trousseau
Paris, 75012
Hôpital Rangueil
Toulouse, 31059
Taiwan7 sites
Koo Foundation Sun Yat-Sen Cancer Center
Beitou, 112
Kaohsiung Medical University Chung-Ho Memorial Hospital
Kaohsiung City, 807
China Medical University Hospital
Taichung, 40447
National Cheng Kung University Hospital
Tainan, 704
Chi Mei Hospital - Liouying
Tainan, 73657
National Taiwan University Hospital
Taipei, 10048
Taipei Veterans General Hospital
Taipei, 112
United States5 sites
The Oncology Institute of Hope & Innovation
Anaheim, California, 92801
NEXT Virginia
Fairfax, Virginia, 22031
University of California Los Angeles
Los Angeles, California, 90095
Vanderbilt University Medical Center
Nashville, Tennessee, 37232
Fred Hutchinson Cancer Center
Seattle, Washington, 98109
Italy5 sites
Azienda Ospedaliera di Rilievo Nazionale e di Alta Specializzazione Garibaldi
Catania, 95123
Azienda Ospedaliero - Universitaria Careggi
Florence, 50134
Fondazione IRCCS - Istituto Nazionale dei Tumori
Milan, 20133
Policlinico Universitario Campus Bio-Medico
Roma, 00128
Azienda Sanitaria Universitaria Friuli Centrale - P.O. Santa Maria della Misericordia
Udine, 33100
Belgium3 sites
Universitair Ziekenhuis Antwerpen
Antwerp, 2650
Universitair Ziekenhuis Leuven - Campus Gasthuisberg
Leuven, 3000
Centre Hospitalier Universitaire de Liège
Liège, 4000
Czechia3 sites
Fakultní Nemocnice Hradec Králové
Hradec Králové, 500 05
Fakultní Nemocnice Olomouc
Olomouc, 779 00
Vseobecna Fakultni Nemocnice v Praze
Prague, 12800
United Kingdom3 sites
Royal Free Hospital
London, NW3 2QG
Guy's and Saint Thomas' NHS Foundation Trust
London, SE1 9RT
The Royal Marsden Hospital
London, SW3 6JJ
Australia2 sites
Monash Medical Centre
Clayton, Victoria, 3168
Icon Cancer Centre Southport
Southport, Queensland, 4215
Singapore2 sites
National Cancer Centre Singapore
Singapore, 168583
Icon Cancer Centre Farrer Park
Singapore, 217562
About this study
Official title: A Phase 2/3 Study of Evorpacept (ALX148) in Patients With Advanced HER2-Overexpressing Gastric/Gastroesophageal Junction Adenocarcinoma (ASPEN-06)
A Phase 2/3 Study of Evorpacept (ALX148) in Combination With Trastuzumab, Ramucirumab, and Paclitaxel in Patients With Advanced HER2-overexpressing gastric/GEJ adenocarcinoma.
Read the detailed description
This is a randomized phase 2 (open-label) / 3 (blinded), international, multi-center study of patients with metastatic HER2-overexpressing gastric/GEJ adenocarcinoma that has progressed on or after prior HER2-directed therapy and fluoropyrimidine- or platinum-containing chemotherapy and are suitable for chemotherapy (2nd-line or 3rd-line). Approximately 450 adult patients are expected to be enrolled in the study across both phases.
The Sponsor has decided not to proceed with the Phase 3 portion of the study due to strategic considerations.
- Being tested
- Evorpacept (ALX148), Trastuzumab, Ramucirumab, Paclitaxel
- Keywords
- ALX148, CD47, SIRPα, Gastric, Gastroesophageal, GEJ, HER2 positive, Ramucirumab, Evorpacept
- Medical subject headings
- Stomach Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Evorpacept (ALX148)Drug
IV Q2W
TrastuzumabDrug
Also called Herceptin
IV Q2W
RamucirumabDrug
Also called Cyramza
IV Q2W
PaclitaxelDrug
Also called Taxol
IV Days 1, 8, and 15 of a 28-day cycle
| Study group | Role | What they receive |
|---|---|---|
| Phase 2 - Arm A | Experimental | Evorpacept (ALX148) 30 mg/kg every two weeks (Q2W) intravenous (IV), trastuzumab (initial dose of 6 mg/kg followed by 4 mg/kg) Q2W IV, ramucirumab 8 mg/kg Q2W IV, and paclitaxel 80 mg/m2 IV Days 1, 8, and 15 of a 28-day cycle. Receives: Drug: Evorpacept (ALX148); Drug: Trastuzumab; Drug: Ramucirumab; Drug: Paclitaxel |
| Phase 2 - Arm B | Active comparator | Trastuzumab (initial dose of 6 mg/kg followed by 4 mg/kg) Q2W IV, ramucirumab 8 mg/kg Q2W IV, and paclitaxel 80 mg/m2 IV Days 1, 8, and 15 of a 28-day cycle. Receives: Drug: Trastuzumab; Drug: Ramucirumab; Drug: Paclitaxel |
| Phase 3 - Arm A | Experimental | Evorpacept (ALX148) 30 mg/kg Q2W IV, trastuzumab (initial dose of 6 mg/kg followed by 4 mg/kg) Q2W IV, ramucirumab 8 mg/kg Q2W IV, and paclitaxel 80 mg/m2 IV Days 1, 8, and 15 of a 28-day cycle. Receives: Drug: Evorpacept (ALX148); Drug: Trastuzumab; Drug: Ramucirumab; Drug: Paclitaxel |
| Phase 3 - Arm B | Active comparator | Ramucirumab 8 mg/kg Q2W IV and paclitaxel 80 mg/m2 IV Days 1, 8, and 15 of a 28-day cycle. Receives: Drug: Ramucirumab; Drug: Paclitaxel |
What is being measured
The primary outcome is the main question the study is designed to answer.
Phase 2
Percentage of patients with objective response per RECIST 1.1
Measured: Last randomized patient on study at least 16 weeks
Phase 3
Overall Survival
Measured: From the date of randomization to the date of death (due to any cause), up to 36 months postdose
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted12 Aug 2021
- Study start15 Jan 2022
- Primary completion24 May 2024
- Study completion30 Jun 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Gastric CancerStudies of the same condition, open and under way.
- 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 2/3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 127 participants (actual)
Sponsor and investigators
- Lead sponsor
- ALX Oncology Inc.
- Sponsor type
- Industry (pharma, biotech, devices)
- Collaborators
- Eli Lilly and Company
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05002127
- Sponsor's protocol ID
- AT148006
- Status last verified
- Nov 2026
- First submitted
- 27 Jul 2021
- Last updated
- 5 Nov 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Shitara K, Wainberg Z, Tabernero J, Van Cutsem E, Coutzac C, De La Fouchardiere C, Lee J, Rha SY, Kang YK, Fanning P, Forgie A, Mao C, Brickman D, Pons J, Tsiatis AC, Randolph S, Lee KW. Evorpacept plus trastuzumab, ramucirumab and paclitaxel in HER2-positive gastric cancer: a randomized phase 2 trial. Nat Med. 2026 Sep 24. doi: 10.1038/s41591-026-04700-3. Online ahead of print.
PubMed 42786305
Study at a glance
From the registry record, last updated by the sponsor on 5 Nov 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase 2/3 Study of Evorpacept (ALX148) in Patients With Advanced HER2-Overexpressing Gastric/Gastroesophageal Junction Adenocarcinoma (ASPEN-06)
- ClinicalTrials.gov ID
- NCT05002127
- Acronym / sponsor ID
- AT148006
- Keywords
- ALX148, CD47, SIRPα, Gastric, Gastroesophageal, GEJ, HER2 positive, Ramucirumab
- Phase
- Phase 2/3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 127 participants (actual)
- Lead sponsor
- ALX Oncology Inc.Industry (pharma, biotech, devices)
- Collaborators
- Eli Lilly and Company
- Study start
- 15 Jan 2022 (actual)
- Primary completion
- 24 May 2024 (actual)
- Study completion
- 30 Jun 2026 (actual)
- First posted
- 12 Aug 2021 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
A Phase 2/3 Study of Evorpacept (ALX148) in Combination With Trastuzumab, Ramucirumab, and Paclitaxel in Patients With Advanced HER2-overexpressing gastric/GEJ adenocarcinoma.
Detailed description
This is a randomized phase 2 (open-label) / 3 (blinded), international, multi-center study of patients with metastatic HER2-overexpressing gastric/GEJ adenocarcinoma that has progressed on or after prior HER2-directed therapy and fluoropyrimidine- or platinum-containing chemotherapy and are suitable for chemotherapy (2nd-line or 3rd-line). Approximately 450 adult patients are expected to be enrolled in the study across both phases.
The Sponsor has decided not to proceed with the Phase 3 portion of the study due to strategic considerations.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 4
| Arm | Type | Receives |
|---|---|---|
| Phase 2 - Arm A | Experimental | Drug: Evorpacept (ALX148), Drug: Trastuzumab, Drug: Ramucirumab, Drug: PaclitaxelEvorpacept (ALX148) 30 mg/kg every two weeks (Q2W) intravenous (IV), trastuzumab (initial dose of 6 mg/kg followed by 4 mg/kg) Q2W IV, ramucirumab 8 mg/kg Q2W IV, and paclitaxel 80 mg/m2 IV Days 1, 8, and 15 of a 28-day cycle. |
| Phase 2 - Arm B | Active comparator | Drug: Trastuzumab, Drug: Ramucirumab, Drug: PaclitaxelTrastuzumab (initial dose of 6 mg/kg followed by 4 mg/kg) Q2W IV, ramucirumab 8 mg/kg Q2W IV, and paclitaxel 80 mg/m2 IV Days 1, 8, and 15 of a 28-day cycle. |
| Phase 3 - Arm A | Experimental | Drug: Evorpacept (ALX148), Drug: Trastuzumab, Drug: Ramucirumab, Drug: PaclitaxelEvorpacept (ALX148) 30 mg/kg Q2W IV, trastuzumab (initial dose of 6 mg/kg followed by 4 mg/kg) Q2W IV, ramucirumab 8 mg/kg Q2W IV, and paclitaxel 80 mg/m2 IV Days 1, 8, and 15 of a 28-day cycle. |
| Phase 3 - Arm B | Active comparator | Drug: Ramucirumab, Drug: PaclitaxelRamucirumab 8 mg/kg Q2W IV and paclitaxel 80 mg/m2 IV Days 1, 8, and 15 of a 28-day cycle. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- HER2-overexpressing advanced or metastatic gastric or gastroesophageal junction (GEJ) adenocarcinoma that has progressed on or after a prior HER2-directed agent and fluoropyrimidine- or platinum-containing chemotherapy (2nd-line or 3rd-line)
- Adequate Bone Marrow Function.
- Adequate Renal \& Liver Function.
- Adequate Performance Status
Key exclusion criteria (3 listed)
- Patients with known symptomatic central nervous system (CNS) metastases or leptomeningeal disease requiring steroids.
- Prior treatment with any anti-CD47 or anti-SIRPα agent.
- Prior treatment with ramucirumab.
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 |
|---|---|---|
| Evorpacept (ALX148)IV Q2W | Drug | Phase 2 - Arm A, Phase 3 - Arm A |
| TrastuzumabAlso: HerceptinIV Q2W | Drug | Phase 2 - Arm A, Phase 2 - Arm B, Phase 3 - Arm A |
| RamucirumabAlso: CyramzaIV Q2W | Drug | Phase 2 - Arm A, Phase 2 - Arm B, Phase 3 - Arm A, Phase 3 - Arm B |
| PaclitaxelAlso: TaxolIV Days 1, 8, and 15 of a 28-day cycle | Drug | Phase 2 - Arm A, Phase 2 - Arm B, Phase 3 - Arm A, Phase 3 - Arm B |
Primary outcome
Phase 2
Time frame: Last randomized patient on study at least 16 weeks
Percentage of patients with objective response per RECIST 1.1
Phase 3
Time frame: From the date of randomization to the date of death (due to any cause), up to 36 months postdose
Overall Survival
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 5 Nov 2026.
- Derived from this study: PubMed 42786305Shitara K, Wainberg Z, Tabernero J, Van Cutsem E, Coutzac C, De La Fouchardiere C, Lee J, Rha SY, Kang YK, Fanning P, Forgie A, Mao C, Brickman D, Pons J, Tsiatis AC, Randolph S, Lee KW. Evorpacept plus trastuzumab, ramucirumab and paclitaxel in HER2-positive gastric cancer: a randomized phase 2 trial. Nat Med. 2026 Sep 24. doi: 10.1038/s41591-026-04700-3. Online ahead of print.
- Individual participant dataSharing planned: No
Related trials for Gastric Cancer
RecruitingPhase 1/2
Study of INBRX-106 and INBRX-106 in Combination With Pembrolizumab (Keytruda®) in Subjects With Locally Advanced or Metastatic Solid Tumors (Hexavalent OX40 Agonist)
Solid Tumor, Non-Small Cell Lung Cancer
RecruitingPhase 2/3
Multicenter Validation Trial of [18F]AlF-FAPI-74 for PET Imaging of Cancer-associated Fibroblasts Through Fibroblast Activation Protein Inhibitors (FAPI) in Different Tumor Types
Oesophageal Cancer, Gastric Cancer
Not yet recruitingPhase 1
GK01 Cell Therapy in Gastric Cancer With Peritoneal Metastasis
Gastric Cancer (GC)
RecruitingPhase 3
A Study of Neoadjuvant-adjuvant Durvalumab and FLOT Chemotherapy Followed by Adjuvant Durvalumab in Chinese Patients With Resectable GC/GEJC.
Gastric, Esophagogastric Junction
Active, not recruitingEarly Phase 1
Iomab-ACT: A Pilot Study of 131-I Apamistamab Followed by CD19-Targeted CAR T-Cell Therapy for Patients With Relapsed or Refractory B-Cell Acute Lymphoblastic Leukemia or Diffuse Large B-Cell Lymphoma
B-ALL, DLBCL
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.
The record lists no contact. Use the official record to reach the sponsor.
83 sites in 12 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2/3 study testing Evorpacept (ALX148), Trastuzumab and Ramucirumab in people with Gastric Cancer and Gastroesophageal Junction Adenocarcinoma, run by ALX Oncology Inc. at 83 sites in 12 countries.
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 4 inclusion and 3 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 5 Nov 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 83 sites in South Korea, Japan, Spain, France, Taiwan and 7 more countries. 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 combined 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.
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
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?
Phase 2 (time frame: Last randomized patient on study at least 16 weeks). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT05002127, which also lists 1 linked publication.
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 5 Nov 2026.