Gastric Cancer Third Line Clinical Trial
Official title:
A Phase III Open-label, Multicenter Trial of Avelumab (MSB0010718C) as a Third-line Treatment of Unresectable, Recurrent, or Metastatic Gastric or Gastroesophageal Junction Adenocarcinoma
| Verified date | October 2020 |
| Source | EMD Serono |
| Contact | n/a |
| Is FDA regulated | No |
| Health authority | |
| Study type | Interventional |
The purpose of this study was to demonstrate superiority of treatment with avelumab plus best supportive care (BSC) versus physician's choice (chosen from a pre-specified list of therapeutic options) plus BSC.
| Status | Completed |
| Enrollment | 371 |
| Est. completion date | November 13, 2019 |
| Est. primary completion date | September 14, 2017 |
| Accepts healthy volunteers | No |
| Gender | All |
| Age group | 18 Years and older |
| Eligibility | Inclusion Criteria: - Male or female subjects aged greater than or equal to (>=) 18 years - Subjects with histologically confirmed recurrent unresectable, recurrent locally advanced or metastatic adenocarcinoma of the stomach or gastroesophageal junction (GEJ) - Availability of a formalin-fixed, paraffin-embedded (FFPE) block containing tumor tissue - Subjects must have received 2 prior courses of systemic treatment for unresectable, recurrent, locally advanced or metastatic gastric cancer, and must have progressed after the second line - Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0 to 1 at trial entry - Adequate hematological, hepatic and renal functions defined by the protocol - Negative blood pregnancy test at Screening for women of childbearing potential. - Highly effective contraception for both male and female subjects if the risk of conception exists Other protocol defined inclusion criteria could apply Exclusion Criteria: - Prior therapy with any antibody or drug targeting T-cell coregulatory proteins - Concurrent anticancer treatment - Major surgery - Subjects receiving immunosuppressive agents (such as steroids) for any reason should be tapered off these drugs before initiation of the trial treatment (with the exception of subjects with adrenal insufficiency, who may continue corticosteroids at physiologic replacement dose, equivalent to less than [<] 10 mg prednisone daily). - All subjects with brain metastases, except those meeting the following criteria: a. Brain metastases have been treated locally, and b. No ongoing neurological symptoms that are related to the brain localization of the disease (sequelae that are a consequence of the treatment of the brain metastases are acceptable) - Previous malignant disease (other than gastric cancer) within the last 5 years with the exception of basal or squamous cell carcinoma of the skin or carcinoma in situ (bladder,cervical, colorectal, breast) - Prior organ transplantation, including allogeneic stem-cell transplantation Significant acute or chronic infections - Active autoimmune disease that might deteriorate when receiving an immunostimulatory agent - Known severe hypersensitivity reactions to monoclonal antibodies, any history of anaphylaxis, or uncontrolled asthma (that is, 3 or more features of partially controlled asthma) - Persisting toxicity of grade >2 related to prior therapy except neuropathy and alopecia - Neuropathy Grade greater than or equal (>=) 3. - Pregnancy or lactation - Known alcohol or drug abuse - History of uncontrolled intercurrent illness including hypertension, active infection, diabetes - Clinically significant (i.e., active) cardiovascular disease - All other significant diseases might impair the subject's tolerance of trial treatment - Any psychiatric condition that would prohibit the understanding or rendering of informed consent and that would limit compliance with study requirements - Vaccination within 4 weeks of the first dose of avelumab and while on trial is prohibited except for administration of inactivated vaccines - Legal incapacity or limited legal capacity - Subjects will be excluded from the treatment with irinotecan or paclitaxel monotherapy if administration of their chemotherapy would be inconsistent with the current local labeling (for example, in regard to contraindications, warnings/precautions, or special provisions) for that chemotherapy. Investigators should check updated labeling via relevant websites before randomization - Subjects should start treatment administration within 28 days after signing the informed consent form (ICF). Treatment administration will start within 4 days after the randomization call |
| Country | Name | City | State |
|---|---|---|---|
| Australia | Flinders Medical Centre | Bedford Park | South Australia |
| Australia | Box Hill Hospital | Box Hill | Victoria |
| Australia | Royal Hobart Hospital | Hobart | Tasmania |
| Australia | Sunshine Hospital | St. Albans | Victoria |
| Australia | Fiona Stanley Hospital | Subiaco | Western Australia |
| Australia | Border Medical Oncology | Wodonga | Victoria |
| Australia | The Queen Elizabeth Hospital | Woodville South | South Australia |
| Australia | Princess Alexandra Hospital | Woolloongabba | Queensland |
| Belgium | OLV Ziekenhuis | Aalst | |
| Belgium | AZ Sint Lucas | Brugge | |
| Belgium | Cliniques Universitaires Saint-Luc | Bruxelles | |
| Belgium | ULB Hopital Erasme | Bruxelles | |
| Belgium | UZ Antwerpen | Edegem | |
| Belgium | CHC Clinique StJospeh | Liege | |
| Belgium | CHU Sart Tilman | Liège | |
| Belgium | AZ Turnhout - Campus Sint-Elisabeth | Turnhout | |
| Czechia | Nemocnice Rudolfa a Stefanie Benesov, a. s. | Benesov | |
| France | Service d'Oncologie Médicale | Brest Cedex | Finistere |
| France | Service d'Hépato-Gastro-Entérologie | La Roche S/ Yon Cedex 9 | Vendee |
| France | Centre Oscar Lambret | Lille | |
| Germany | Charite Universitaetsmedizin | Berlin | |
| Germany | Schwerpunktpraxis für Haematologie und OnkologieOnkologische Schwerpunktpraxis Eppendorf | Hamburg | |
| Germany | Universitaetsklinikum Koeln | Koeln | Nordrhein Westfalen |
| Germany | Schwerpunktpraxis für Haematologie und Onkologie | Magdeburg | Sachsen Anhalt |
| Germany | Leopoldina Krankenhaus | Schweinfurt | |
| Italy | Fondazione del Piemonte per l'Oncologia IRCC Candiolo | Candiolo | Torino |
| Italy | Ospedale San Raffaele | Milano | |
| Italy | A.O.U. Ospedali Riuniti Ancona- Clinica Oncologica | Torrette Di Ancona | Ancona |
| Korea, Republic of | Kyungpook National University Medical Center | Daegu | |
| Korea, Republic of | National Cancer Center | Goyang-Si | Gyeonggi-Do |
| Korea, Republic of | Chonnam National University Hwasun Hospital | Hwasun-Gun | Jeollanam-Do |
| Korea, Republic of | Seoul National University Bundang Hospital | Seongnam-Si | Gyeonggi-do |
| Korea, Republic of | Asan Medical Center | Seoul | |
| Korea, Republic of | Korea University Anam Hospital | Seoul | |
| Korea, Republic of | Samsung Medical Center | Seoul | |
| Korea, Republic of | Seoul National Univ Hospital | Seoul | |
| Korea, Republic of | Severance Hospital, Yonsei University Health System | Seoul | |
| Korea, Republic of | The Catholic University of Korea, Seoul St. Mary's Hospital | Seoul | |
| Poland | Centrum Onkologii-Instytut im. M. Sklodowskiej Curie | Warszawa | |
| Spain | Hospital del Mar | Barcelona | |
| Spain | Hospital Univ Vall dHebron | Barcelona | |
| Spain | Hospital Clinic de Barcelona | Barselona | |
| Spain | Clinico San Carlos Hospital | Madrid | |
| Spain | Hosp Univer Madrid Sanchinarro | Madrid | |
| Spain | Hospital General Universitario Gregorio Marañon | Madrid | |
| Spain | Hospital Universitario 12 de Octubre | Madrid | |
| Spain | Hospital Universitario la Paz - site 546 | Madrid | |
| United States | New York Oncology Hematology, P.C. 400 Patroon Creek Blvd, Suite 1 | Albany | New York |
| United States | Texas Oncology Bedford 1609 Hospital Parkway | Bedford | Texas |
| United States | Texas Oncology, P.A. 3410 Worth Street, Suites 300 & 400 | Dallas | Texas |
| United States | Texas Oncology, P.A. - Denton 3720 South I-35 East | Denton | Texas |
| United States | Rocky Mountain Cancer Centers 1800 Williams Street, Suite 100 | Denver | Colorado |
| United States | Henry Ford Health System 2799 West Grand Boulevard | Detroit | Michigan |
| United States | Sanford Roger Maris Cancer Center - Fargo 801 Broadway North Route 1058 | Fargo | North Dakota |
| United States | Hematology and Oncology Associates of SC, LLC 900 West Faris Rd, 3rd Floor | Greenville | South Carolina |
| United States | Ingalls Memorial Hospital One Ingalls Drive, W741 | Harvey | Illinois |
| United States | Penn State University Milton S. Hershey Medical Center 500 University Drive | Hershey | Pennsylvania |
| United States | Oncology Consultants, P.A. 2130 W. Holcombe Blvd. 10th Floor | Houston | Texas |
| United States | Southern Nevada Cancer Research Foundation 601 S Rancho Drive | Las Vegas | Nevada |
| United States | Texas Oncology, P.A. - McAllen 1901 South 2nd Street | McAllen | Texas |
| United States | Metairie Oncologist, LLC Office of Jayne Gurtler MD, Laura Brinz MD, Janet Burroff MD 3939 Houma Blvd, Suite 6 | Metairie | Louisiana |
| United States | Advanced Medical Specialties 8940 North Kendall Drive, Suite 300E | Miami | Florida |
| United States | Minnesota Oncology Hematology, P.A. 910 East 26th Street, Suites 100 and 200 | Minneapolis | Minnesota |
| United States | Tennessee Oncology 250 20th Ave North | Nashville | Tennessee |
| United States | Illinois Cancer Specialists 8915 W. Golf Rd. | Niles | Illinois |
| United States | Oncology Specialists, S.C. 1700 Luther Ln, Ste 2200, Park Ridge, IL 60068 7900 Milwaukee Ave, Ste 16 | Niles | Illinois |
| United States | Ocala Oncology Center, P.L. 433 S.W. 10th Street | Ocala | Florida |
| United States | Northwest Cancer Specialists, P.C. 265 N Broadway | Portland | Oregon |
| United States | Rocky Mountain Cancer Centers, LLP 3676 Parker Blvd #350 | Pueblo | Colorado |
| United States | Florida Cancer Specialists 560 Jackson Street, Suite 220 | Saint Petersburg | Florida |
| United States | Scott and White Memorial Hospital and Clinic 2401 South 31st Street | Temple | Texas |
| United States | Cotton-O'Neil Clinical Research Center, Hematology and Oncology and Stormont Vail Cancer Center 1414 SW 8th St | Topeka | Kansas |
| United States | Texas Oncology, P.A. - Tyler 910 E. Houston St, Suite 100 | Tyler | Texas |
| United States | Carle Cancer Center 509 W. University Avenue | Urbana | Illinois |
| United States | Texas Oncology - Waco 1700 W. Hwy. 6 | Waco | Texas |
| Lead Sponsor | Collaborator |
|---|---|
| EMD Serono Research & Development Institute, Inc. | Merck KGaA, Darmstadt, Germany |
United States, Australia, Belgium, Czechia, France, Germany, Italy, Korea, Republic of, Poland, Spain,
Bang YJ, Ruiz EY, Van Cutsem E, Lee KW, Wyrwicz L, Schenker M, Alsina M, Ryu MH, Chung HC, Evesque L, Al-Batran SE, Park SH, Lichinitser M, Boku N, Moehler MH, Hong J, Xiong H, Hallwachs R, Conti I, Taieb J. Phase III, randomised trial of avelumab versus — View Citation
| Type | Measure | Description | Time frame | Safety issue |
|---|---|---|---|---|
| Primary | Overall Survival (OS) | OS was defined as the time from randomization to the date of death due to any cause. For participants who were still alive at the time of data analysis or who were lost to follow-up, OS time was censored at the date of last contact. OS was measured using Kaplan-Meier (KM) estimates. | From randomization up to 627 days | |
| Secondary | Progression Free Survival (PFS) | The PFS time was defined as the time from date of randomization until date of the first documentation of progressive disease (PD) or death due to any cause (whichever occurs first). PFS was assessed as per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1). PD was defined as at least a 20 percent (%) increase in the sum of longest diameter (SLD), taking as reference the smallest SLD recorded from baseline or the appearance of 1 or more new lesions. PFS was measured using Kaplan-Meier (KM) estimates. | From randomization up to 627 days | |
| Secondary | Best Overall Response (BOR) | BOR was determined by RECIST v1.1 and defined as best-confirmed response of any of following: complete response (CR), partial response (PR), stable disease (SD) and PD recorded from date of randomization until disease progression or recurrence. CR: Disappearance of all evidence of target and non-target lesions. PR: At least 30% reduction from baseline in SLD of all lesions. SD: Neither sufficient increase to qualify for PD nor sufficient shrinkage to qualify for PR. PD is defined as at least a 20% increase in the SLD, taking as reference the smallest SLD recorded from baseline or appearance of 1 or more new lesions. PR or CR confirmed at a subsequent tumor assessment, not sooner than 5 weeks after initial documentation or at an assessment later than the next assessment after the initial documentation of PR or CR. SD confirmed at least 6 weeks after randomization. Confirmed PD equal to progression <=2 weeks after date of randomization (and not qualifying for CR, PR or SD). | From randomization up to 627 days | |
| Secondary | Objective Response Rate (ORR) | The ORR defined as the percentage of all randomized participants with a confirmed best overall response (BOR) of partial response (PR),or complete response (CR) according to RECIST v1.1 and as adjudicated by the Independent Review Committee (IRC). CR: Disappearance of all evidence of target and non-target lesions. PR: At least 30 percent (%) reduction from baseline in sum of longest diameter (SLD) of all lesions. | From randomization up to 627 days | |
| Secondary | Change From Baseline in European Quality of Life 5-dimensions (EQ-5D-5L) Health Outcome Questionnaire Through Composite Index Score at End of Treatment (EOT) | EQ-5D-5L is comprised of the following 5 participant-reported dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems, and extreme problems. The responses are used to derive overall composite health state index score, with scores ranging from -0.594 to 1. A higher score indicates better health state. | Baseline, EOT (up to Week 66) | |
| Secondary | Change From Baseline in European Quality of Life 5-dimensions (EQ-5D-5L) Health Outcome Questionnaire Through Visual Analogue Scale (VAS) at End of Treatment (EOT) | EQ-5D-5L is comprised of the following 5 participant-reported dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems, and extreme problems. The responses are used to derive overall score using a visual analog scale (VAS) that ranged from 0 to 100 millimeter (mm), where 0 is the worst health you can imagine and 100 is the best health you can imagine. | Baseline, EOT (up to Week 66) | |
| Secondary | Change From Baseline in European Organization for the Research and Treatment of Cancer Quality of Life (EORTC QLQ-C30) Global Health Status Scale Score at End of Treatment (EOT) | EORTC QLQ-C30 is a 30-question tool used to assess the overall quality of life (QoL) in cancer participants. It consisted of 15 domains: 1 global health status (GHS) scale, 5 functional scales (Physical, role, cognitive, emotional, social), and 9 symptom scales/items (Fatigue, nausea and vomiting, pain, dyspnoea, sleep disturbance, appetite loss, constipation, diarrhea, financial impact. The EORTC QLQ-C30 GHS/QoL score ranges from 0 to 100; High score indicates better GHS/QoL. Score 0 represents: very poor physical condition and QoL. Score 100 represents: excellent overall physical condition and QoL. | Baseline, EOT (up to Week 66) | |
| Secondary | Change From Baseline in European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire-Stomach Cancer Specific (EORTC QLQ-STO22) Questionnaire Scores at End of Treatment (EOT) | The EORTC QLQ-STO22 supplements the EORTC QLQ-C30 to assess symptoms and treatment-related side effects commonly reported in participants. There are 22 questions which comprise 5 scales (dysphagia, pain, reflux symptom, dietary restrictions, and anxiety) and 4 single items (dry mouth, hair loss, taste, body image). Most questions use 4-point scale (1 'Not at all' to 4 'Very much'; 1 question was a yes or no answer). A linear transformation was used to standardize all scores and single-items to a scale of 0 to 100; higher score=better level of functioning or greater degree of symptoms. | Baseline, EOT (up to Week 66) |