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HER2 Positive Newly Diagnosed Metastatic Esophageal, Gastric, GEJ Cancer Patients With an ECOG Performance Status of 2Phase 2NCT07126561

Trastuzumab Deruxtecan to Treat HER2 + Newly Diagnosed Metastatic GI Cancers

A Phase 2 study testing Trastuzumab Deruxtecan in people with HER2 Positive Newly Diagnosed Metastatic Esophageal, Gastric, GEJ Cancer Patients With an ECOG Performance Status of 2, run by University of Chicago.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
Search all trials

Trial summary

Purpose: This clinical trial is designed to evaluate the safety and effectiveness of Trastuzumab Deruxtecan for patients with HER2 Positive Newly Diagnosed Metastatic Esophageal, Gastric, GEJ Cancer. The goal is to determine how well this treatment works and to identify any potential side effects. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Trastuzumab Deruxtecan
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
43 participants
Where
No sites listed yet
Study dates
1 Nov 2026to 1 Nov 2028
Phase
Phase 2
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 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • 1.1.1 Participants must agree to provide written informed consent and HIPAA authorization for release of personal health information prior to registration.
  • NOTE: HIPAA authorization may be included in the informed consent or obtained separately.
  • 1.1.2 Participants must be ≥ 18 years of age at the time of consent.
  • 1.1.3 Participants must have histologically confirmed locally advanced unresectable and/or metastatic esophageal, gastric or GEJ adenocarcinoma per AJCC, 8th edition.
  • 1.1.4 Participants must have measurable disease according to RECIST 1.1 within 42 days prior to registration.
  • 1.1.5 Participants must have an ECOG PS of Grade 2 within 28 days prior to registration.
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  • 1.1.6 Participants must NOT be candidates for combination therapy per treating provider judgement.
  • 1.1.7 Participants must have HER2 protein overexpression or HER2 gene amplification in tumor tissue (preferred on tumor tissue biopsy if available) or liquid biopsy. (Note: HER2 levels considered positive Score 3+ on IHC, Score of 2+ with positive results of FISH)
  • 1.1.8 Prior definitive chemoradiation therapy for localized disease, systemic therapy including immunotherapy in the adjuvant setting is allowed.
  • 1.1.9 Prior cancer treatment in the adjuvant setting must be completed at least 3 months prior to registration and the participant must have recovered from all reversible acute toxic effects of the regimen (other than alopecia) to Grade ≤ 1 or baseline.
  • 1.1.10 Participants must demonstrate adequate organ and bone marrow function within 28 days before registration as described in the table below. Organ and bone marrow function criteria must also be met when laboratory tests are repeated within 3 days before Cycle 1 Day 1.
  • 1.1.1 Females of childbearing potential must have a negative serum pregnancy test within 7 days prior to registration. A negative result for serum pregnancy test (test must have a sensitivity of at least 25 mIU/mL) must be available at the screening visit and urine beta-human chorionic gonadotropin (β-HCG) pregnancy test prior to each administration of IMP.
  • Women of childbearing potential are defined as those who are not surgically sterile (i.e. underwent bilateral salpingectomy, bilateral oophorectomy, or complete hysterectomy) or post-menopausal. Women will be considered post-menopausal if they have been amenorrheic for 12 months without an alternative medical cause.
  • 1.1.2 Females of childbearing potential who are sexually active with a male able to father a child must be willing to abstain from penile-vaginal intercourse or must use at least one highly effective method of contraception from the time of first exposure to study intervention until 7 months after the final dose. They must also refrain from breastfeeding or donating ova /retrieving ova for their own use for the same time period.
  • 1.1.3 Males able to father a child who are sexually active with female of childbearing potential must be willing to abstain from penile-vaginal intercourse or must use at least one highly effective method of contraception from the time of first exposure to study intervention until 4 months after the final dose. They must also refrain from freezing or donating sperm during the same time period.
  • 1.1.4 All participants must be able to understand and comply with study procedures for the entire length of the study, as determined by the enrolling physician or protocol designee.

Who cannot join

  • 1.1.1 Prior systemic therapy in the metastatic setting is not allowed, including no prior HER2-directed therapy. However, prior palliative radiation therapy is allowed.
  • 1.1.2 Participants who are eligible for combination therapy are excluded.
  • 1.1.3 Participants who are mismatch repair (MMR) deficient and/or MSI High as determined by institutional standards are not eligible for this study.
  • 1.1.4 Participants who have an LVEF <50% within 28 days before first exposure to study drug are not eligible for this study.
  • 1.1.5 Participants who have unresolved toxicities from previous anticancer therapy, defined as toxicities (other than alopecia) not yet resolved to Grade ≤1 or baseline are excluded.
  • NOTE: Participants may be enrolled with chronic, stable Grade 2 toxicities (defined as no worsening to >Grade 2 for at least 3 months prior to first exposure to study intervention and managed with standard of care treatment) that the investigator deems related to previous anticancer therapy, including:
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  • Chemotherapy-induced neuropathy
  • Fatigue
  • Residual toxicities from prior immuno-oncology treatment: Grade 1 or Grade 2 endocrinopathies which may include:
  • Hypothyroidism/hyperthyroidism
  • Type 1 diabetes
  • Hyperglycemia
  • Adrenal insufficiency
  • Adrenalitis
  • Skin hypopigmentation (vitiligo)
  • 1.1.6 Participants with an active primary immunodeficiency, known uncontrolled active human immunodeficiency virus (HIV) infection, or active hepatitis B (HBV) or C (HCV) virus infection are excluded. Note: Hepatitis B/C serology is required; HIV testing is not required unless required by local policy.
  • NOTE: Participants with past or resolved HBV infection are eligible only if they meet all of the following criteria:
  • HBsAg (-) (for > 6 months off anti-viral treatment);
  • Anti-HBc (+) (IgG or total Ig);
  • HBV DNA undetectable;
  • Liver architecture normal (absence of any liver pathology including absence of cirrhosis or fibrosis on prior imaging or biopsy;
  • Absence of HCV co-infection or history of HCV co-infection;
  • Access to a local Hepatitis B expert during and after the study;
  • Those participants must be closely monitored for HBV reactivation. Further instructions for monitoring and management of participants at risk of Hepatitis B reactivation (those with HBsAg (-), anti-HBc (+) (IgG or total Ig) serology) are provided in Appendix I.
  • NOTE: Participants positive for HCV antibody are eligible only if polymerase chain reaction is negative for HCV RNA.
  • 1.1.7 Participants with a medical history of myocardial infarction (MI) within 6 months before study registration or symptomatic congestive heart failure (New York Heart Association Class II to IV) are not eligible. Participants with troponin levels above ULN at screening, and without any myocardial related symptoms, should have a cardiologic consultation before enrollment to rule out MI.
  • 1.1.8 Participants with a history of (non-infectious) ILD/pneumonitis that required steroids, has current ILD/pneumonitis, or where suspected ILD/pneumonitis cannot be ruled out by imaging at screening.
  • 1.1.9 Participants with a history of any of the following lung criteria are excluded:
  • Lung-specific intercurrent clinically significant illnesses including, but not limited to, any underlying pulmonary disorder (e.g., pulmonary emboli within three months of registration, severe asthma, severe chronic obstructive pulmonary disorder, restrictive lung disease, pleural effusion, etc.)
  • Any autoimmune, connective tissue or inflammatory disorders, including Rheumatoid arthritis, Sjogren's, and sarcoidosis, where there is documented, or a suspicion of pulmonary involvement at the time of screening. Full details of the disorder should be recorded in the eCRF for participants who are included in the study.
  • Prior pneumonectomy (complete),
  • 1.1.10 Participants who have spinal cord compression or clinically active central nervous system metastases, defined as untreated and symptomatic, or requiring therapy with corticosteroids or anticonvulsants to control associated symptoms are not eligible. Participants with clinically inactive brain metastases may be included in the study. Participants with treated brain metastases that are no longer symptomatic and who require no treatment with corticosteroids or anticonvulsants may be included in the study if they have recovered from the acute toxic effect of radiotherapy. A minimum of 2 weeks must have elapsed between the end of whole brain radiotherapy and study registration.
  • 1.1.11 Participants with uncontrolled infection requiring IV antibiotics, antivirals, or antifungals.
  • 1.1.12 Participants with a prior or concurrent malignancy whose natural history or treatment has the potential to interfere with the safety or efficacy assessment of the investigational regimen, per treating physician discretion, are not eligible for this trial.
  • 1.1.13 Participants who have received treatment with any investigational anti-cancer drug within 2 weeks prior to registration are excluded.
  • Washout periods for other therapies are listed below:
  • Treatment Minimum Washout Chloroquine/Hydroxychloroquine ≥ 14 days Radiation Therapy including palliative stereotactic radiation therapy to chest ≥ 4 weeks Palliative stereotactic radiation therapy to other anatomic areas including whole brain radiation ≥ 2 weeks
  • 1.1.14 Participants who have received live, attenuated vaccine (mRNA and replication deficient adenoviral vaccines are not considered attenuated live vaccines) within 30 days prior to study registration are excluded. NOTE: Participants, if enrolled, should not receive live vaccine during the study and up to 30 days after the last dose of study intervention.
  • 1.1.15 Participant has substance abuse or any other medical conditions such as clinically significant cardiac or psychological conditions, that may, in the opinion of the investigator, interfere with the subject's participation in the clinical study or evaluation of the clinical study results.
  • 1.1.16 Participant has Corrected QT interval (QTcF) prolongation to > 470 msec (females) or >450 msec (males) based on average of the screening triplicate12-lead ECG.
  • 1.1.17 Participant has a known allergy or hypersensitivity to study treatment or any of the study drug excipients.
  • 1.1.18 Participant has a history of severe hypersensitivity reactions to other monoclonal antibodies.
  • 1.1.19 Participant has multiple primary malignancies within 3 years, with the exception of: adequately resected non-melanoma skin cancer, curatively treated in-situ disease. other solid tumors curatively treated
  • 1.1.20 Participant has a pleural effusion, ascites or pericardial effusion that requires drainage, peritoneal shunt, or Cell-free and Concentrated Ascites Reinfusion Therapy (CART).

Trial locations and contacts

No sites are listed yet. Contact the study team or a site near you to ask about taking part.

University of Chicago CTSO Quality Unit contact

1-855-702-8222

PhaseIICRA@medicine.bsd.uchicago.edu

About this study

Official title: Phase II Open Label Trial of Trastuzumab Deruxtecan (Enhertu, DS-8210) in HER2 Positive Newly Diagnosed Metastatic Esophageal, Gastric, GEJ Cancer Patients With an ECOG Performance Status of 2

Purpose: This clinical trial is designed to evaluate the safety and effectiveness of Trastuzumab Deruxtecan for patients with HER2 Positive Newly Diagnosed Metastatic Esophageal, Gastric, GEJ Cancer. The goal is to determine how well this treatment works and to identify any potential side effects.

Who Can Participate: We are looking for Participants with histologically confirmed HER2 positive locally advanced unresectable and/or metastatic esophageal, gastric or GEJ adenocarcinoma with an ECOG PS of 2 and measurable disease according to RECIST 1.1 within 42 days prior to registration. Participants will be carefully screened to ensure they meet the study requirements.

Read more

What to Expect: Participants will undergo 6.4mg/kg, IV infusion of Trastuzumab deruxtucan over the course of the study. They will receive detailed information about the study and will have the opportunity to ask questions before deciding to participate. Informed consent will be obtained to ensure that participants understand the study's purpose, procedures, risks, and benefits.

Safety Monitoring: The health and safety of participants are our top priority. An Independent Data and Safety Monitoring Committee (DSMC) will regularly review the study data to ensure participant safety and to monitor for any adverse events. Any serious side effects will be reported and addressed promptly.

Benefits and Risks: While the study aims to provide potential benefits, such as improved treatment options for HER2 Positive Newly Diagnosed Metastatic Esophageal, Gastric, GEJ Cancer there may also be risks involved. Participants will be informed of all possible risks before enrolling in the study.

Confidentiality: All personal information will be kept confidential, and data will be used only for research purposes.

Contact Information: For more information about this study, please contact PhaseIICRA@medicine.bsd.uchicago.edu

Being tested
Trastuzumab Deruxtecan
Keywords
HER2, TRASTUZUMAB, DERUXTECAN, METASTATIC, CANCER, ESOPHAGEAL, GASTRIC, GEJ
Medical subject headings
Neoplasm Metastasis, Neoplasms

What participants receive

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

  • Trastuzumab DeruxtecanDrug

    Do not substitute trastuzumab deruxtecan with trastuzumab or ado-trastuzumab emtansine. Do not administer as an intravenous push or bolus. Trastuzumab deruxtecan is not compatible with sodium chloride 0.9% solution for infusion. During treatment, patients should be observed for infusion-related reactions (IRRs). For additional information on the management of IRRs

Study groups in NCT07126561
Study groupRoleWhat they receive
multicenter single-arm phase II open label trial of Trastuzumab Deruxtecan (Enhertu, DS-8210).ExperimentalNot described
Receives: Drug: Trastuzumab Deruxtecan

What is being measured

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

  1. Objective Response Rate

    The overall response rate (ORR) of participants with an Eastern Cooperative Oncology Group performance status (PS) of 2 who receive single-agent trastuzumab deruxtecan as determined by the treating investigator using RECIST 1.1.

    Measured: 12 months

Secondary outcomes (5)
  1. Percentage of Study Participants with Toxic Side Effects in Response to Trastuzumab Deruxtecan

    Percentage of subjects with treatment-emergent grade 3-4 toxicities, defined by the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.

    Measured: 12 months

  2. Overall Survival

    Overall survival defined as the time from Day 1 of administering trastuzumab deruxtecan (Enhertu) to death from any cause.

    Measured: 12 months

  3. Progression Free Survival

    Progression free survival defined as the time from Day 1 of administering trastuzumab deruxtecan (Enhertu) until the criteria for disease progression is met as determined by the treating investigator using RECIST 1.1 or death as a result of any cause.

    Measured: 12 months

  4. Disease Control Rate

    Disease control rate defined as the proportion of participants with RECIST 1.1-based progressive disease, complete response and stable disease divided by the total number of evaluable participants.

    Measured: 12 months

  5. Duration of Response

    Duration of response defined as the time from disease response to progression or death. This will only calculated for the participants with response.

    Measured: 12 months

Timeline

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

  1. First posted17 Aug 2025
  2. Study start1 Nov 2026 (estimated)
  3. Primary completion1 Nov 2028 (estimated)
  4. Study completion1 Nov 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 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Sequential
Model description
Simon's two-stage optimal design
Masking
None (open label)
Enrolment
43 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07126561
Sponsor's protocol ID
IRB25-1217
Status last verified
Jul 2025
First submitted
11 Aug 2025
Last updated
8 Jan 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Loren AW, Mangu PB, Beck LN, Brennan L, Magdalinski AJ, Partridge AH, Quinn G, Wallace WH, Oktay K; American Society of Clinical Oncology. Fertility preservation for patients with cancer: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 2013 Jul 1;31(19):2500-10. doi: 10.1200/JCO.2013.49.2678. Epub 2013 May 28.

    PubMed 23715580
  • Garland SN, Pelletier G, Lawe A, Biagioni BJ, Easaw J, Eliasziw M, Cella D, Bathe OF. Prospective evaluation of the reliability, validity, and minimally important difference of the functional assessment of cancer therapy-gastric (FACT-Ga) quality-of-life instrument. Cancer. 2011 Mar 15;117(6):1302-12. doi: 10.1002/cncr.25556. Epub 2010 Oct 19.

    PubMed 20960518
  • Boku N, Yamamoto S, Fukuda H, Shirao K, Doi T, Sawaki A, Koizumi W, Saito H, Yamaguchi K, Takiuchi H, Nasu J, Ohtsu A; Gastrointestinal Oncology Study Group of the Japan Clinical Oncology Group. Fluorouracil versus combination of irinotecan plus cisplatin versus S-1 in metastatic gastric cancer: a randomised phase 3 study. Lancet Oncol. 2009 Nov;10(11):1063-9. doi: 10.1016/S1470-2045(09)70259-1. Epub 2009 Oct 7.

    PubMed 19818685
  • Enzinger PC, Kulke MH, Clark JW, Ryan DP, Kim H, Earle CC, Vincitore MM, Michelini AL, Mayer RJ, Fuchs CS. A phase II trial of irinotecan in patients with previously untreated advanced esophageal and gastric adenocarcinoma. Dig Dis Sci. 2005 Dec;50(12):2218-23. doi: 10.1007/s10620-005-3038-2.

    PubMed 16416165
  • Einzig AI, Neuberg D, Remick SC, Karp DD, O'Dwyer PJ, Stewart JA, Benson AB 3rd. Phase II trial of docetaxel (Taxotere) in patients with adenocarcinoma of the upper gastrointestinal tract previously untreated with cytotoxic chemotherapy: the Eastern Cooperative Oncology Group (ECOG) results of protocol E1293. Med Oncol. 1996 Jun;13(2):87-93. doi: 10.1007/BF02993858.

    PubMed 9013471
  • Ilson DH, Wadleigh RG, Leichman LP, Kelsen DP. Paclitaxel given by a weekly 1-h infusion in advanced esophageal cancer. Ann Oncol. 2007 May;18(5):898-902. doi: 10.1093/annonc/mdm004. Epub 2007 Mar 9.

    PubMed 17351256
  • Hall PS, Swinson D, Cairns DA, Waters JS, Petty R, Allmark C, Ruddock S, Falk S, Wadsley J, Roy R, Tillett T, Nicoll J, Cummins S, Mano J, Grumett S, Stokes Z, Kamposioras KV, Chatterjee A, Garcia A, Waddell T, Guptal K, Maisey N, Khan M, Dent J, Lord S, Crossley A, Katona E, Marshall H, Grabsch HI, Velikova G, Ow PL, Handforth C, Howard H, Seymour MT; GO2 Trial Investigators. Efficacy of Reduced-Intensity Chemotherapy With Oxaliplatin and Capecitabine on Quality of Life and Cancer Control Among Older and Frail Patients With Advanced Gastroesophageal Cancer: The GO2 Phase 3 Randomized Clinical Trial. JAMA Oncol. 2021 Jun 1;7(6):869-877. doi: 10.1001/jamaoncol.2021.0848.

    PubMed 33983395
  • Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET, Carbone PP. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol. 1982 Dec;5(6):649-55. No abstract available.

    PubMed 7165009
  • Bang YJ, Van Cutsem E, Feyereislova A, Chung HC, Shen L, Sawaki A, Lordick F, Ohtsu A, Omuro Y, Satoh T, Aprile G, Kulikov E, Hill J, Lehle M, Ruschoff J, Kang YK; ToGA Trial Investigators. Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): a phase 3, open-label, randomised controlled trial. Lancet. 2010 Aug 28;376(9742):687-97. doi: 10.1016/S0140-6736(10)61121-X. Epub 2010 Aug 19.

    PubMed 20728210
  • Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2022. CA Cancer J Clin. 2022 Jan;72(1):7-33. doi: 10.3322/caac.21708. Epub 2022 Jan 12.

    PubMed 35020204
  • Torre LA, Siegel RL, Ward EM, Jemal A. Global Cancer Incidence and Mortality Rates and Trends--An Update. Cancer Epidemiol Biomarkers Prev. 2016 Jan;25(1):16-27. doi: 10.1158/1055-9965.EPI-15-0578. Epub 2015 Dec 14.

    PubMed 26667886
  • Sitarz R, Skierucha M, Mielko J, Offerhaus GJA, Maciejewski R, Polkowski WP. Gastric cancer: epidemiology, prevention, classification, and treatment. Cancer Manag Res. 2018 Feb 7;10:239-248. doi: 10.2147/CMAR.S149619. eCollection 2018.

    PubMed 29445300

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Trastuzumab Deruxtecan in people with HER2 Positive Newly Diagnosed Metastatic Esophageal, Gastric, GEJ Cancer Patients With an ECOG Performance Status of 2, run by University of Chicago.

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 16 inclusion and 44 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: opening soon, as of the sponsor's last update on 8 Jan 2026. Status can change between updates, so confirm with the study contact before making plans.

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?

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 Manik Amin, MD ((773) 702-4400, PhaseIICRA@medicine.bsd.uchicago.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Objective Response Rate (time frame: 12 months). 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 NCT07126561, which also lists 12 linked publications.

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 Jan 2026.

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