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Gastric CancerPhase 3NCT05918094

Comparing Modified XELOX Plus Sintilimab With Standard XELOX Plus Sintilimab in First-line Treatment for HER2-negative Gastric/Gastroesophageal Junction Adenocarcinoma

A Phase 3 study testing Experimental dose: modified XELOX + sintilimab and Standard dose: standard XELOX + sintilimab in people with Gastric Cancer, run by Sun Yat-sen University at 10 sites in China.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

This is a randomized, controlled, multicenter phase Ⅲ study to evaluate the therapeutic efficacy of modified XELOX plus sintilimab versus standard XELOX plus sintilimab in subjects with advanced HER2-negative gastric or gastroesophageal adenocarcinoma in the first-line treatment. Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
Gastric Cancer
What is being tested?
Experimental dose: modified XELOX + sintilimab and Standard dose: standard XELOX + sintilimab
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
540 participants
Where
10 sitesChina
Study dates
30 Apr 2023to Dec 2028
Phase
Phase 3
Are there results?
Not yet: the study is under way

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 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Have a good understanding of the study, are willing to follow the requirements of the study, and voluntarily sign the informed consent form.
  • Aged ≥ 18 years old and ≤ 75 years old.
  • Locally advanced unresectable or metastatic gastric or gastroesophageal adenocarcinoma confirmed by pathological histology or cytology.
  • No previous systemic therapy. Note: Patients who have previously received neoadjuvant or adjuvant therapy may be enrolled if they have ended treatment without recurrence or disease progression for at least 6 months.
  • Agree to provide a previously stored tumor tissue sample or a biopsy to collect tumor tissue.
  • ECOG PS score is in the range of 0~1.
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  • Expected survival time ≥ 3 months.
  • Subjects having adequate organ and bone marrow functions with laboratory test values within 7 days prior to enrollment meeting the following requirements (no blood components, cell growth factors, albumin, and other corrective therapy drugs are allowed to be given within the first 14 days of obtaining laboratory tests), as follows:
  • Blood routine: absolute neutrophil count (ANC) ≥ 1.5×10^9/L; platelet count (PLT) ≥ 75×10^9/L; hemoglobin level (HGB) ≥ 7.5 g/dL.
  • Liver function: serum total bilirubin (TBIL) ≤ 1.5 × upper limit of normal (ULN); alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 2.5 × ULN in subjects without liver metastases, and ALT and AST ≤ 5.0 × ULN in subjects with liver metastases; serum albumin ≥ 25 g/L.
  • Renal function: serum creatinine (Cr) ≤ 1.5 x ULN, or creatinine clearance>50 mL/min.
  • Female subjects of childbearing age or male subjects whose sexual partners are at childbearing age are required to take effective contraception measures throughout the treatment period and for 6 months after the treatment

Who cannot join

  • Prior exposure to any immune checkpoint inhibitors (anti-PD-1 antibody, anti-PD-L1 antibody, CTLA-4 antibody).
  • Receiving antitumor cytotoxic drugs, biological drugs (such as monoclonal antibodies), immunotherapy (such as interleukin 2 or interferon), or other investigational treatments within 4 weeks prior to enrollment.
  • Receiving radiotherapy within 4 weeks prior to the first dose.
  • Have undergone major surgical surgery within 4 weeks prior to enrollment or have not fully recovered from previous surgery.
  • Known presence of symptomatic CNS metastases and/or carcinomatous meningitis. Subjects with prior treatment for brain metastases may participate in the study provided that the brain metastases have remained stable for at least 4 weeks prior to the first dose of study treatment; and that neurological symptoms have recovered to ≤ grade 1 by NCI CTCAE version 5.0.
  • A history of other primary malignancies, except: malignancies in complete response for at least 2 years prior to enrollment and requiring no other treatment during the study period; adequately treated non-melanoma skin cancer or malignant freckled nevus with no evidence of disease recurrence; adequately treated carcinoma in situ with no evidence of disease recurrence.
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  • Active autoimmune disease requiring systemic therapy (e.g., use of disease-relieving drugs, corticosteroids, or immunosuppressants) within 2 years prior to the first dose. Alternative therapies (e.g., thyroxine, insulin, or physiologic corticosteroids for adrenal or pituitary insufficiency) are allowed. A known history of primary immunodeficiency. For patients with only positive autoimmune antibodies, the presence of autoimmune diseases should be confirmed at the discretion of the investigator.
  • A history of gastrointestinal perforation and/or fistula in the previous 6 months.
  • Presence of intestinal obstruction (including incomplete intestinal obstruction requiring parenteral nutrition).
  • Confirmed as HER2-positive (i.e., IHC 3+ or IHC 2+ with ISH+) gastric or gastroesophageal adenocarcinoma.
  • Have heart symptoms or diseases that are not well controlled, such as:
  • Have had NYHA grade 3 or 4 cardiac insufficiency within 6 months prior to enrollment;
  • Unstable angina;
  • Have had acute myocardial infarction within 6 months prior to enrollment;
  • Have had clinically significant arrhythmias within 6 months prior to enrollment requiring treatment or intervention.
  • Infected with human immunodeficiency virus (HIV) (HIV 1/2 antibody or HIV RNA positive).
  • Known to have acute or chronic active hepatitis B (HBsAg positive and HBV DNA ≥ 1000 copies/mL) or acute or chronic active hepatitis C (HCV antibody positive and HCV RNA positive).
  • Severe infections that are in the active phase or poorly controlled in clinical practice. Serious infection, including but not limited to hospitalization for complications of infection, bacteremia or severe pneumonia, within 4 weeks prior to the first dose.
  • A known history of allogeneic organ transplantation and allogeneic hematopoietic stem cell transplantation.
  • A history of allergy or known intolerance to any drug in the study regimen.
  • Receiving live attenuated vaccine within 4 weeks prior to the first dose or planning to receive during the study period.
  • The toxicity of previous antitumor therapy has not returned to grade 0-1 according to CTCAE 5.0.

Trial locations and contacts

10 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Feng Wang, MD, PhD contact

+86 20 87343795

wangfeng@sysucc.org.cn

10 sites in 1 country

China10 sites, 10 recruiting
  • West China Hospital of Sichuan University

    Chengdu, Sichuan

    Hongfeng Gou

    Not yet recruiting
  • The Second Hospital of Dalian Medical University

    Dalian, Liaoning

    Jinghua Sun

    Lingling Xu

    Recruiting
  • Sun Yat-sen University Cancer Center

    Guangzhou, Guangdong, 510060

    Ruihua Xu, MD, +862087343795, xurh@susycc.org.cn

    Feng Wang, MD, PhD, +862087343795

    Recruiting
  • The Affliated Cancer Hospital of Guizhou Medical University

    Guiyang, Guizhou

    Weiwei Chen

    Recruiting
  • Harbin Medical University Cancer Hospital

    Harbin, Heilongjiang

    Yanqiao Zhang

    Dan Su

    Not yet recruiting
  • The Second Affiliated Hospital of Kunming Medical University

    Kunming, Yunnan

    Xuefen Lei

    Not yet recruiting
  • The First Affiliated Hospital of Nanchang University

    Nanchang, Jiangxi

    Xiaojun Xiang

    Not yet recruiting
  • Ruijin Hospital, Shanghai Jiaotong University School of Medicine

    Shanghai, Shanghai Municipality

    Jun Zhang

    Not yet recruiting
  • Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology

    Wuhan, Hubei, 430030

    Xianglin Yuan

    Not yet recruiting
  • Henan Cancer Hospital

    Zhengzhou, Henan

    Xiaobing Chen

    Not yet recruiting

Other trials in China

About this study

This is a randomized, controlled, multicenter phase Ⅲ study to evaluate the therapeutic efficacy of modified XELOX plus sintilimab versus standard XELOX plus sintilimab in subjects with advanced HER2-negative gastric or gastroesophageal adenocarcinoma in the first-line treatment. The primary outcome is the progression-free survival (PFS), with a planned enrollment of 540 subjects.

Read the detailed description

Subjects will be randomized in a 1:1 ratio into either the modified XELOX plus sintilimab group or the standard XELOX plus sintilimab group. The treatment option for the modified XELOX group (study group) is 200 mg of sintilimab IV Drip Q3W, 600 mg/m2 of capecitabine PO BID for day 1-14, and oxaliplatin 78 mg/m2 IV Drip Q3W. The treatment option for the standard XELOX group (control group) is 200 mg of sintilimab IV Drip Q3W, 1000 mg/m2 of capecitabine PO BID for day 1-14, and oxaliplatin 130 mg/m2 IV Drip Q3W. After 6 cycles of treatment, patients could choose capecitabine + sintilimab maintenance with a maximum treatment duration of 2 years.

The primary endpoint of this study is the progression-free survival (PFS), defined as the time from random assignment of the subject to disease progression or death from any cause.

All eligible patients will be randomly assigned to either the trial or control group in a 1:1 ratio based on the following stratification factors: Whether the PD-L1 CPS score >= 5; Whether the age >70 years old.

Conditions
Gastric Cancer
Being tested
Experimental dose: modified XELOX + sintilimab, Standard dose: standard XELOX + sintilimab
Keywords
gastric cancer, anti-PD-1, modified chemotherapy
Medical subject headings
Stomach Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Experimental dose: modified XELOX + sintilimabDrug

    The treatment option for the modified XELOX group (study group) is 200 mg of sintilimab IV Drip Q3W, 600 mg/m2 of capecitabine PO BID for day 1-14, and oxaliplatin 78 mg/m2 IV Drip Q3W.

  • Standard dose: standard XELOX + sintilimabDrug

    The treatment option for the standard XELOX group (control group) is 200 mg of sintilimab IV Drip Q3W, 1000 mg/m2 of capecitabine PO BID for day 1-14, and oxaliplatin 130 mg/m2 IV Drip Q3W.

Study groups in NCT05918094
Study groupRoleWhat they receive
Modified XELOX + sintilimabExperimentalThe treatment option for the modified XELOX group (study group) is 200 mg of sintilimab IV Drip Q3W, 600 mg/m2 of capecitabine PO BID for day 1-14, and oxaliplatin 78 mg/m2 IV Drip Q3W. After 6 cycles of treatment, patients could choose capecitabine + sintilimab maintenance with a maximum treatment duration of 2 years.
Receives: Drug: Experimental dose: modified XELOX + sintilimab
Standard XELOX + sintilimabActive comparatorThe treatment option for the standard XELOX group (control group) is 200 mg of sintilimab IV Drip Q3W, 1000 mg/m2 of capecitabine PO BID for day 1-14, and oxaliplatin 130 mg/m2 IV Drip Q3W. After 6 cycles of treatment, patients could choose capecitabine + sintilimab maintenance with a maximum treatment duration of 2 years.
Receives: Drug: Standard dose: standard XELOX + sintilimab

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Progression-Free Survival (PFS)

    Time from randomization to disease progression or death from any cause

    Measured: an average of 4 years

Secondary outcomes (6)
  1. Objective Response Rates (ORR)

    The percentage of subjects whose therapeutic effect evaluation is complete response (CR) or partial response (PR) according to RECIST 1.1.

    Measured: an average of 4 years

  2. Overall Survival (OS)

    Time from randomization to death from any cause

    Measured: an average of 4 years

  3. Disease Control Rate (DCR)

    The percentage of subjects whose therapeutic effect evaluation is complete response (CR), partial response (PR) or stable disease (SD) according to RECIST 1.1.

    Measured: an average of 4 years

  4. Duration of Response (DOR)

    Time from achievement of a response to disease progression.

    Measured: an average of 4 years

  5. Change From Baseline in European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30)

    Quality of life is assessed using the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ) C30. It will be evaluated at Screening, Tumor Assessment Visit and End of Treatment visit. The higher score means the worse quality of life.

    Measured: an average of 4 years

  6. Change From Baseline in European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-STO22 (EORTC QLQ- STO22)

    Quality of life in patients with colorectal cancer is assessed using the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ) STO22. It will be evaluated at Screening, Tumor Assessment Visit and End of Treatment visit. The higher score means the worse quality of life.

    Measured: an average of 4 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted26 Jun 2023
  2. Study start30 Apr 2023
  3. Primary completionDec 2026 (estimated)
  4. Study completionDec 2028 (estimated)

Resources

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 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
540 subjects will be randomized in a 1:1 ratio into either the modified XELOX plus sintilimab group or the standard XELOX plus sintilimab group.
Masking
None (open label)
Enrolment
540 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05918094
Sponsor's protocol ID
mXELOX SYSUCC
Status last verified
Jan 2024
First submitted
15 Jun 2023
Last updated
26 Jan 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Experimental dose: modified XELOX + sintilimab and Standard dose: standard XELOX + sintilimab in people with Gastric Cancer, run by Sun Yat-sen University at 10 sites in China.

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 12 inclusion and 22 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: looking for participants now, as of the sponsor's last update on 26 Jan 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 10 sites in China. 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 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?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Ruihua Xu, MD (+86 20 87343795, xurh@sysucc.org.cn), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Progression-Free Survival (PFS) (time frame: an average of 4 years). 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 26 Jan 2024.

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