PD-1 Antibody in EBV Positive Metastatic Gastric Cancer Patients.

EBV Clinical Trial

Official title:

Phase II Study of PD-1 Antibody SHR-1210 in EBV Positive Metastatic Gastric Cancer Patients.

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03755440
• Other study ID #: EBVaGC-SYSUCC
• Status: Completed
• Phase: Phase 2
• Start date: December 1, 2018
• Est. completion date: December 31, 2020

Study information

• Verified date: September 2022
• Source: Sun Yat-sen University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

EBV positive tumor accounts for 8-9% of all gastric cancer (GC) patients. PD-1 antibody has been proved as third line therapy for PD-L1 positive gastric cancer. Previous studies showed that EBV(+) tumors exhibit high response to PD-1 antibody. In this phase II study, we will investigate the efficacy and safety of PD-1 antibody in EBV positive metastatic GC patients.

Description:

EBV positive metastatic GC patients who failed to standard chemotherapy will receive therapy of single agent, PD-1 antibody, SHR-1210, 200mg, every 2 weeks. The primary endpoint is response rate. Secondary endpoint is progress free survival, overall survival, safety and quality of life. Using the Simon two-stage sample size calculation, the sample size is 19. We will collect tissue and blood sample for exploratory analysis, including PD-L1 stuatus, tumor mutation burden, et al.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 6
• Est. completion date: December 31, 2020
• Est. primary completion date: December 31, 2020
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

1. Histologically confirmed Recurrent/Metastatic gastric adenocarcinoma;

2. EBER positive;

3. Failed from first-line platinum and fluorouracil based chemotherapy and second-line chemotherapy; or could not tolerate systematic chemotherapy

4. ECOG performance status of 0 or 1;

5. Life expectancy = 12 weeks;

6. Subjects must have measurable disease by CT or MRI per RECIST 1.1 criteria;

7. Can provide either a newly obtained or archival tumor tissue sample;

8. Adequate laboratory parameters during the screening period as evidenced by the following:

Absolute neutrophil count = 1.5 × 10^9/L ; Platelets = 90 × 10^9/L; Hemoglobin = 9.0 g/dL; Serum albumin = 2.8g/dL; Total bilirubin (TBIL) = 1.5 × upper limit of normal (ULN), ALT and AST = 1.5×ULN Creatinine clearance=50 mL/min;

9. Female of child bearing potential, a negative urine or serum pregnancy test result within 72 h before study treatment. Participants of reproductive potential must be willing to use adequate contraception for the course of the study through 60 days after the last dose of SHR-1210. Male subjects must be willing to use adequate contraception for the course of the study through 120 days after the last dose of SHR-1210;

10. Subjects must be willing to participate in the research and sign an informed consent form (ICF);

Exclusion Criteria:

1. Subjects with any active autoimmune disease or history of autoimmune disease;

2. Subjects having clinical symptoms of metastases to central nervous system (such as cerebral edema, requiring steroids intervention, or brain metastasis progression);

3. Has a known additional malignancy within the last 5 years before study treatment with the exception of curatively treated basal cell and squamous cell carcinoma of the skin and/or curatively resected in-situ cervical cancers;

4. Uncontrolled clinically significant heart disease, including but not limited to the following: (1) > NYHA II congestive heart failure; (2) unstable angina, (3) myocardial infarction within the past 1 year; (4) clinically significant supraventricular arrhythmia or ventricular arrhythmia requirement for treatment or intervention;

5. Concurrent medical condition requiring the use of cortisol (>10mg/day Prednisone or equivalent dose) or other systematic immunosuppressive medications within 14 days before the study treatment. Except: inhalation or topical corticosteroids. Doses > 10 mg/day prednisone or equivalent for replacement therapy;

6. Has received prior anti-cancer monoclonal antibody (mAb), chemotherapy, targeted small molecule therapy within 4 weeks prior to first dosing or not recovered to =CTCAE 1 from adverse events (except for hair loss or neurotoxic sequelae from prior platinum therapy) due to a previously administered agent. 7. Palliative irradiation finished within 2 weeks;

8. Active infection or an unexplained fever > 38.5°C before two weeks of first dosing (subjects with tumor fever may be enrolled at the discretion of the investigator); 9. Known Human Immunodeficiency Virus (HIV) infection?active Hepatitis B or Hepatitis C; 10. Currently participating or has participated in a study within 4 weeks of the first dose of study medication; 11. Pregnancy or breast feeding; 12. Prior therapy with a PD-1, anti-PD-Ligand 1 (PD-L1) or CTLA-4 agent; 13. Subjects are known to have a history of psychiatric substance abuse, alcoholism, or drug addiction; 14. According to the investigator, other conditions that may lead to stop the research.

Related Conditions & MeSH terms

• EBV
• Gastric Cancer Stage IV
• Stomach Neoplasms

Intervention

Drug:
• PD-1 antibody (SHR-1210)
PD-1 antibody (SHR-1210), 200mg, ivdrip, every 2 weeks.

Locations

Country	Name	City	State
China	Cancer center of Sun Yat-sen University	Guangzhou	Guangdong

Sponsors (1)

Lead Sponsor	Collaborator
Sun Yat-sen University

Country where clinical trial is conducted

China, 

References & Publications (1)

Sun YT, Guan WL, Zhao Q, Wang DS, Lu SX, He CY, Chen SZ, Wang FH, Li YH, Zhou ZW, Xu RH, Qiu MZ. PD-1 antibody camrelizumab for Epstein-Barr virus-positive metastatic gastric cancer: a single-arm, open-label, phase 2 trial. Am J Cancer Res. 2021 Oct 15;11 — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Response rate	The percentage of patients whose cancer shrinks or disappears after treatment	From first patient first visit to 6 month after last patient first visit ] Based on Response Evaluation Criteria in Solid Tumors 1.1 (RECIST 1.1)
Secondary	Progression-Free Survival (PFS)	PFS as measured in accordance with the Response Evaluation Criteria In Solid Tumours (RECIST) version 1.1	up to approximately 1 year
Secondary	Overall Survival (OS)	The time from registration to death due to any cause, or censored at date last known alive.	up to approximately 2 year
Secondary	Disease Control Rate (DCR)	Based on Response Evaluation Criteria in Solid Tumors 1.1 (RECIST 1.1)	From first patient first visit to 6 month after last patient first visit