Sonesitatug Vedotin in Combination With Capecitabine With or Without Rilvegostomig in Participants With Advanced or Metastatic Gastric, Gastroesophageal Junction, or Esophageal Adenocarcinoma Expressing Claudin18.2

Georgia's Online Cancer Information Center

Find A Clinical Trial

Sonesitatug Vedotin in Combination With Capecitabine With or Without Rilvegostomig in Participants With Advanced or Metastatic Gastric, Gastroesophageal Junction, or Esophageal Adenocarcinoma Expressing Claudin18.2

Status
Approved-not yet active
Cancer Type
Esophogeal Cancer
Stomach/ Gastric Cancer
Trial Phase
Phase III
Eligibility
18 Years and older, Male and Female
Study Type
Treatment
NCT ID
NCT07431281
Protocol IDs
D9803C00001 (primary)
2024-519787-40-00
Study Sponsor
AstraZeneca
NCI Full Details

Summary

The purpose of this study is to evaluate the efficacy and safety of sonesitatug vedotin in combination with capecitabine with or without rilvegostomig in first-line (1L) Claudin18.2 (CLDN18.2)-positive, human epidermal growth factor receptor 2 (HER2)-negative, gastric, gastroesophageal junction (GEJ), and esophageal adenocarcinoma.

Objectives

The purpose of this Phase III study is to evaluate the efficacy and safety of sonesitatug vedotin in combination with capecitabine with or without rilvegostomig in 1L CLDN18.2-positive, HER2-negative gastric, GEJ, and esophageal adenocarcinoma, and the clinical performance of the investigation in vitro diagnostics (IVDs). The study will include 2 cohorts to provide a treatment option for all participants that are HER2-negative and CLDN18.2-positive. Cohort 1 will evaluate sonesitatug vedotin in combination with rilvegostomig with capecitabine in participants who are CLDN18.2-positive and programmed death-ligand 1 (PD-L1) positive. Cohort 2 will evaluate sonesitatug vedotin in combination with capecitabine in participants who are CLDN18.2-positive and PD-L1 negative or immune checkpoint inhibitor (ICI) ineligible.

Eligibility

Inclusion Criteria:

  • Capable of giving signed informed consent
  • Participant must be 18 years or the legal age of consent in the jurisdiction in which the study is taking place, at the time of signing the informed consent.
  • Previously untreated histologically documented unresectable, locally advanced, or metastatic gastric, GEJ, or distal esophagus (distal third of the esophagus) adenocarcinoma
  • Positive CLDN18.2 expression, as determined prospectively by central IHC testing
  • Confirmed PD-L1 CPS status by central IHC testing and ICI eligibility per investigator judgement is required to determine cohort eligibility as described below:

    1. Cohort 1: PD-L1 positive as determined by central IHC testing and the participant is deemed ICI eligible per investigator judgement.
    2. Cohort 2: PD-L1 negative as determined by central IHC testing OR the participant is ICI ineligible
  • ECOG performance status of 0 or 1 with no deterioration to > 1 over the previous 2 weeks prior to baseline at screening and prior to randomisation.
  • Minimum life expectancy of ≥ 12 weeks.
  • At least one lesion (measurable and/or non-measurable) that can be accurately assessed by the investigator based on RECIST 1.1.
  • Adequate organ and bone marrow function as specified in the protocol
  • Body weight ≥ 35 kg.
  • Sex and contraceptive requirements

Exclusion Criteria:

  • Known HER2-positive status
  • Significant or unstable gastric bleeding and/or untreated gastric ulcers.
  • Active or history of autoimmune or inflammatory disorders requiring systemic treatment with steroids or other immunosuppressive treatment or assessed by investigator as not appropriate to participate due to undue risk are excluded.
  • CNS pathology
  • Clinically significant pleural effusions or ascites and/or pleural effusions or ascites that require drainage, peritoneal shunt, or indwelling catheter/drain.
  • Require parenteral nutrition support due to gastric or gastrointestinal obstruction.
  • Peripheral neuropathy, sensory or motor, ≥ CTCAE Grade 2 at screening.
  • Persistent toxicities caused by previous anticancer therapy excluding alopecia, not yet improved to Grade ≤ 1 or baseline.
  • Cardiac abnormalities as outlined in the protocol
  • Uncontrolled diabetes or diabetic neuropathy within 3 months prior to randomisation.
  • Infectious disease including active hepatitis A infection; uncontrolled hepatitis B and/or chronic or active hepatitis B with HBV DNA ≥ 100 IU/mL; Known chronic, active, or uncontrolled hepatitis C; HIV infection that is not well controlled
  • Known partial or total DPD enzyme deficiency

Treatment Sites in Georgia

Central Georgia Cancer Care


114 Sutherlin Dr.
Suite C-1
Warner Robins, GA 31088
www.centralGeorgiaradiation.com/

Doctors:

Bradley T. Sumrall MD

Piedmont Physicians Medical Oncology


1800 Howell Mill Road
Suite 300
Atlanta, GA 30318
www.piedmont.org

Doctors:

Eyal Meiri MD

Winship Cancer Institute of Emory University


1365 Clifton Road NE
Building C
Atlanta, GA 30322
winshipcancer.emory.edu

Doctors:

Lindsay Hannan MD
**Clinical trials are research studies that involve people. These studies test new ways to prevent, detect, diagnose, or treat diseases. People who take part in cancer clinical trials have an opportunity to contribute to scientists’ knowledge about cancer and to help in the development of improved cancer treatments. They also receive state-of-the-art care from cancer experts... Click here to learn more about clinical trials.