Advanced or Metastatic Gastric Cancer, Advanced or Metastatic Gastroesophageal Junction Carcinoma
Conditions
Keywords
MRG003, Antibody Drug Conjugate (ADC), Gastric Cancer, EGFR-positive, HER2-negative
Brief summary
The objective of this study is to assess the safety, efficacy, pharmacokinetics, and immunogenicity of MRG003 in patients with EGFR-positive, HER2-negative, inoperable locally advanced or metastatic gastric cancer.
Detailed description
Approximately 6054 patients will be enrolled to evaluate the safety and preliminarily efficacy of MRG003. Patients will receive 2.0 mg/kg dose of MRG003 intravenously every 3 weeks (Q3W) and may receive up to 24 months of MRG003 if there is evidence of clinical benefit to the patients.
Interventions
Administered intravenously
Sponsors
Study design
Eligibility
Inclusion criteria
* \- Willing to sign the ICF and follow the requirements specified in the protocol. * Age: 18-75 years (including 18 and 75), both genders. * Expected survival time≥3 months. * Patients with histologically confirmed inoperable locally advanced or metastatic gastric adenocarcinoma. * Tumor tissue must be EGFR positive and HER2 negative. * Patients must have measurable lesions according to the Response Evaluation Criteria in Solid Tumors (RECIST v1.1). * ECOG performance score 0 or 1. * Organ functions and coagulation function must meet the basic requirements. * No severe cardiac dysfunction with left ventricular ejection fraction (LVEF) ≥ 50%. * Serum or urine pregnancy test negative within 7 days before the first dose of investigational drug. * Patients with childbearing potential must use effective contraception during the treatment and for 6 months after the last dose of treatment.
Exclusion criteria
* \- Squamous cell carcinoma, carcinoid, neuroendocrine carcinoma, undifferentiated carcinoma, or other gastric cancers,or adenocarcinoma with other pathological components that cannot be classified, or adenocarcin oma accompanied by other pathological components. * History of hypersensitivity to any component of the study drug or to other EGFR-targeting agents. * Antitumor biological therapy or immunotherapy, targeted small molecule therapy and have history of systemic chemotherapy within 4 weeks before the first administration of the investigational drug, or major surgery. Traditional Chinese medicine, Chinese patent medicine or traditional Chinese medicine formula with anti-tumor effect should not be used within 2 weeks before the first administration. * Potent CYP3A4 inhibitors or inducers are in use and cannot be discontinued. * Known active CNS metastasis. * Uncontrolled pleural effusion, pericardial effusion or recurrent ascites. * Patients with intestinal obstruction requiring treatment were excluded. * Residual toxicity reactions caused by previous anti-tumor treatment or abnormal values of laboratory tests higher than grade 1 (CTCAE v5.0). Peripheral neuropathy ≥ Grade 2 (NCICTCAE version 5.0). * Uncontrolled or poorly controlled hypertension. * Uncontrolled or poorly controlled heart disease. * Known active hepatitis B or C. * Active bacterial, viral, fungal, rickettsia, or parasitic infections that require systemic anti-infective treatment. * Known history of malignancy. * History of ophthalmologic abnormalities * History of severe skin disease * Moderate to severe dyspnea at rest caused by advanced cancer or its complications, or severe primary lung disease, oxygen saturation \< 93% in non-oxygen state, or history of any interstitial lung disease or interstitial lung disease (ILD) requiring oral or intravenous glucocorticoids or non-infectious pneumonia. * Patients with a history of active bleeding, coagulopathy, or receiving coumarin anticoagulation therapy. * History of pulmonary embolism or deep vein thrombosis within 6 months before the first administration of the investigational drug. * Patients with a history of active bleeding, coagulopathy, or receiving coumarin anticoagulation therapy. Decompensated cirrhosis of Child-Pugh class B, C * Complicated with severe, uncontrolled infection or known human immunodeficiency virus (HIV) infection, or diagnosed as acquired immunodeficiency syndrome (AIDS); or uncontrolled autoimmune disease; or history of allogeneic tissue/organ transplantation, stem cell or bone marrow transplantation, or solid organ transplantation. * Vaccination of live virus vaccine within 30 days before the first administration of the study drug. Inactivated seasonal influenza vaccine or approved COVID-19 vaccine is allowed. * Uncontrolled intercurrent illness * Patients requiring parenteral nutrition within 4 weeks * Women who are lactating or pregnant. * Other conditions that in the clinical judgement of the investigator make the patient not suitable for participation in this study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Objective Response Rate (ORR) by Independent Review Committee (IRC) | Baseline to study completion (up to 24 months) | ORR is defined as the proportions of patients with a complete response (CR) and partial response (PR). ORR will be assessed by Independent Review Committee (IRC) according to RECIST v1.1. |
| Adverse Events (AEs) | Baseline to 30(for AE) and 45(for SAE) days after the last dose of study treatment | Any reaction, side effect, or untoward event that occurs during the course of the clinical trial whether or not the event is considered related to the study drug. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Duration of Response (DoR) | Baseline to study completion (up to 24 months) | DOR is defined as the duration from the initial recording of objective disease response to the first onset of tumor progression, or death of any cause. |
| Disease Control Rate (DCR) | Baseline to study completion (up to 24 months) | DCR is defined as the proportions of patients achieving CR, PR, and stable disease (SD) after treatment. |
| Overall Survival (OS) | Baseline to study completion (up to 24 months) | OS is defined as the duration from the start of treatment to death of any cause. |
| PK parameter for MRG003: (Cmax) | Baseline to 30 days after the last dose of study treatment | Maximum observed plasma concentration. |
| PK parameter for MRG003: (AUClast) | Baseline to 30 days after the last dose of study treatment | Area under the curve up to the last validated measurable plasma concentration |
| Objective Response Rate (ORR) by Investigator | Baseline to study completion (up to 24 months) | ORR is defined as the proportions of patients with a complete response (CR) and partial response (PR). ORR will be assessed by investigator according to RECIST v1.1. |
| PK parameter for TAb: AUClast | Baseline to 30 days after the last dose of study treatment | Area under the curve up to the last validated measurable plasma concentration |
| PK parameter for Monomethyl Auristatin E (MMAE): Cmax | Baseline to 30 days after the last dose of study treatment | Maximum observed plasma concentration. |
| PK parameter for MMAE: AUClast | Baseline to 30 days after the last dose of study treatment | Area under the curve up to the last validated measurable plasma concentration |
| The proportion of patients with positive of anti-drug antibody (ADA) | Baseline to 30 days after the last dose of study treatment | The proportion of patients with positive ADA immunogenicity results. |
| PK parameter for total antibody (TAb): Cmax | Baseline to 30 days after the last dose of study treatment | Maximum observed plasma concentration. |
| Progression Free Survival (PFS) | Baseline to study completion (up to 24 months) | PFS is defined as the duration from the start of treatment to the onset of tumor progression or death of any cause. |
Countries
China