Phase 2 Study of AMG 386 (20060439) in Combination With Cisplatin & Capecitabine in Subjects With Metastatic Gastric, Gastroesophageal Junction, or Distal Esophageal Adenocarcinoma
Primary Purpose
Gastrointestinal Cancer
Status
Completed
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
AMG 386 placebo
AMG 386 10mg/kg
AMG 386 3mg/kg
Cisplatin
Capecitabine
Cisplatin
Capecitabine
Cisplatin
Capecitabine
Sponsored by
About this trial
This is an interventional treatment trial for Gastrointestinal Cancer focused on measuring Gastric Cancer, Metastatic Gastric, Gastroesophageal Junction, or Distal Esophageal Adenocarcinoma, AMG 386, Cisplatin, Capecitabine
Eligibility Criteria
Inclusion Criteria:
Disease Related
- Histologically or cytologically confirmed adenocarcinoma of the stomach, gastroesophageal junction or distal esophagus with metastatic disease
- Measurable or non-measurable disease per RECIST Guidelines
- Prior gastrectomy (total or partial) may be allowed as long as subjects can take oral medications and meet all other inclusion/exclusion criteria. Subjects may not take crushed or dissolved capecitabine via a feeding/gastrostomy tube
- Palliative radiotherapy for metastatic esophageal or gastric cancer prior to study entry may be allowed as long as all toxicities from radiotherapy have resolved and the radiotherapy was not to the only site of known metastatic disease
Demographic
•18 years of age or older at the time the written informed consent is obtained
General
- Able to swallow oral medication
- ECOG performance status of 0 or 1
Laboratory
- Adequate organ and hematological function as evidenced by laboratory studies prior to randomization
Exclusion Criteria:
Disease Related
- Prior chemotherapy for metastatic disease (1st line)
- Less than 12 months have elapsed from completion of previous adjuvant or neoadjuvant chemotherapy or chemoradiotherapy
- Subjects with persistent gastric outlet obstruction, complete dysphagia or feeding jejunostomy
- Radiotherapy ≤ 14 days prior to randomization. Subjects must have recovered from all radiotherapy-related toxicities
- Current or prior history of central nervous system metastases
- History of arterial or deep venous thromboembolism within 12 months prior to randomization
- History of bleeding diathesis or clinically significant bleeding within 6 months prior to randomization
- Major surgical procedure within 28 days prior to randomization
- Minor surgical procedure, placement of central venous access device or fine needle aspiration within 3 days prior to randomization
- Prior malignancy except: malignancy treated with curative intent and without evidence of active disease for ≥ 3 years prior to randomization and felt to be at low risk for recurrence by treating physician, adequately treated non-melanomatous skin cancer or lentigo maligna without evidence of disease, adequately treated cervical carcinoma in situ without evidence of disease, prostatic intraepithelial neoplasia without evidence of prostate cancer
- Prior malignancy (other than in situ cervical cancer, or basal cell cancer of the skin) unless treated with curative intent and without evidence of disease for ≥ 3 years prior to randomization
- Clinically significant cardiovascular diseases within 12 months prior to randomization
- Presence of clinically significant non-healing wound, ulcer (including gastrointestinal) or fracture as judged by the investigator
- Ongoing or clinically significant active infection as judged by the investigator
- Known hypersensitivity to bacterial proteins, or any of the drugs required in this study
- Known peripheral neuropathy ≥Grade 1
- Known dihydropyrimidine dehydrogenase deficiency
- Known hypersensitivity to 5-FU/capecitabine
- Known positive test for human immunodeficiency virus (HIV), hepatitis C, or hepatitis B surface antigen
- Known active or chronic hepatitis
Medications
- Currently or previously treated with angiopoietin inhibitors, or inhibitors of TIE-1 or TIE-2
- Treatment with immune modulators such as cyclosporine or tacrolimus within 30 days prior to randomization
- Treatment with sorivudine or its chemically related analogues
- Anticoagulants (other than aspirin and anti-platelet agents) within 7 days prior to randomization. The concurrent use of low molecular weight heparin or heparanoids or low dose warfarin (i.e, ≤ 1 mg daily) for prophylaxis against thrombosis is acceptable while on study
General
- Not yet completed at least 30 days since ending other investigational device/drug trial(s), or subject is receiving other investigational treatments
- Pregnant or is breast feeding
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm Type
Experimental
Experimental
Active Comparator
Arm Label
B
A
C
Arm Description
Outcomes
Primary Outcome Measures
Progression Free Survival (PFS)
Secondary Outcome Measures
Safety and Tolerability
Objective Response Rate (ORR)
Duration of Response (DOR)
Overall Survival (OS)
Time to Progression (TTP)
Time to Response
Pharmacokinetics
Patient Reported Outcomes
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT00583674
Brief Title
Phase 2 Study of AMG 386 (20060439) in Combination With Cisplatin & Capecitabine in Subjects With Metastatic Gastric, Gastroesophageal Junction, or Distal Esophageal Adenocarcinoma
Official Title
A Randomized, Double Blind, Multi-Center, Phase 2 Study to Estimate the Efficacy and Evaluate the Safety and Tolerability of Cisplatin & Capecitabine (CX) in Combination With AMG 386 or Placebo in Subjects With Metastatic Gastric, Gastroesophageal Junction, or Distal Esophageal Adenocarcinoma
Study Type
Interventional
2. Study Status
Record Verification Date
April 2014
Overall Recruitment Status
Completed
Study Start Date
December 2007 (undefined)
Primary Completion Date
March 2010 (Actual)
Study Completion Date
June 2012 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Amgen
4. Oversight
5. Study Description
Brief Summary
This is a phase 2, randomized, double blind, placebo controlled, multi-center study to estimate the improvement in progression free survival (compared to control subjects) and evaluate the safety and tolerability of AMG 386 in combination with Cisplatin & Capecitabine in the treatment of subjects with Metastatic Gastric, Gastroesophageal Junction, or Distal Esophageal Adenocarcinoma. AMG 386 is a man-made medication that is designed to stop the development of blood vessels in cancer tissues. Cancer tissues rely on the development of new blood vessels, a process called angiogenesis, to obtain a supply of oxygen and nutrients to grow.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Gastrointestinal Cancer
Keywords
Gastric Cancer, Metastatic Gastric, Gastroesophageal Junction, or Distal Esophageal Adenocarcinoma, AMG 386, Cisplatin, Capecitabine
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
171 (Actual)
8. Arms, Groups, and Interventions
Arm Title
B
Arm Type
Experimental
Arm Title
A
Arm Type
Experimental
Arm Title
C
Arm Type
Active Comparator
Intervention Type
Drug
Intervention Name(s)
AMG 386 placebo
Intervention Description
AMG 386 placebo IV QW until radiographic disease progression, clinical progression, unacceptable toxicity, subject withdrawal of consent, or death
Intervention Type
Drug
Intervention Name(s)
AMG 386 10mg/kg
Intervention Description
AMG 386 10 mg/kg IV QW until radiographic disease progression, clinical progression, unacceptable toxicity, subject withdrawal of consent, or death
Intervention Type
Drug
Intervention Name(s)
AMG 386 3mg/kg
Intervention Description
AMG 386 3 mg/kg IV QW until radiographic disease progression, clinical progression, unacceptable toxicity, subject withdrawal of consent, or death
Intervention Type
Drug
Intervention Name(s)
Cisplatin
Intervention Description
Cisplatin 80 mg/m2 IV Q3W until radiographic disease progression, clinical progression, unacceptable toxicity, subject withdrawal of consent, or death
Intervention Type
Drug
Intervention Name(s)
Capecitabine
Intervention Description
Capecitabine1000 mg/m2 PO BID x 14 days Q3W until radiographic disease progression, clinical progression, unacceptable toxicity, subject withdrawal of consent, or death
Intervention Type
Drug
Intervention Name(s)
Cisplatin
Intervention Description
Cisplatin 80 mg/m2 IV Q3W until radiographic disease progression, clinical progression, unacceptable toxicity, subject withdrawal of consent, or death
Intervention Type
Drug
Intervention Name(s)
Capecitabine
Intervention Description
Capecitabine 1000 mg/m2 PO BID x 14 days Q3W until radiographic disease progression, clinical progression, unacceptable toxicity, subject withdrawal of consent, or death
Intervention Type
Drug
Intervention Name(s)
Cisplatin
Intervention Description
Cisplatin 80 mg/m2 IV Q3W until radiographic disease progression, clinical progression, unacceptable toxicity, subject withdrawal of consent, or death
Intervention Type
Drug
Intervention Name(s)
Capecitabine
Intervention Description
Capecitabine 1000 mg/m2 PO BID x 14 days Q3W until radiographic disease progression, clinical progression, unacceptable toxicity, subject withdrawal of consent, or death
Primary Outcome Measure Information:
Title
Progression Free Survival (PFS)
Time Frame
22 months
Secondary Outcome Measure Information:
Title
Safety and Tolerability
Time Frame
22 months
Title
Objective Response Rate (ORR)
Time Frame
22 months
Title
Duration of Response (DOR)
Time Frame
22 months
Title
Overall Survival (OS)
Time Frame
22 months
Title
Time to Progression (TTP)
Time Frame
22 months
Title
Time to Response
Time Frame
22 months
Title
Pharmacokinetics
Time Frame
22 months
Title
Patient Reported Outcomes
Time Frame
22 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Disease Related
Histologically or cytologically confirmed adenocarcinoma of the stomach, gastroesophageal junction or distal esophagus with metastatic disease
Measurable or non-measurable disease per RECIST Guidelines
Prior gastrectomy (total or partial) may be allowed as long as subjects can take oral medications and meet all other inclusion/exclusion criteria. Subjects may not take crushed or dissolved capecitabine via a feeding/gastrostomy tube
Palliative radiotherapy for metastatic esophageal or gastric cancer prior to study entry may be allowed as long as all toxicities from radiotherapy have resolved and the radiotherapy was not to the only site of known metastatic disease
Demographic
•18 years of age or older at the time the written informed consent is obtained
General
Able to swallow oral medication
ECOG performance status of 0 or 1
Laboratory
Adequate organ and hematological function as evidenced by laboratory studies prior to randomization
Exclusion Criteria:
Disease Related
Prior chemotherapy for metastatic disease (1st line)
Less than 12 months have elapsed from completion of previous adjuvant or neoadjuvant chemotherapy or chemoradiotherapy
Subjects with persistent gastric outlet obstruction, complete dysphagia or feeding jejunostomy
Radiotherapy ≤ 14 days prior to randomization. Subjects must have recovered from all radiotherapy-related toxicities
Current or prior history of central nervous system metastases
History of arterial or deep venous thromboembolism within 12 months prior to randomization
History of bleeding diathesis or clinically significant bleeding within 6 months prior to randomization
Major surgical procedure within 28 days prior to randomization
Minor surgical procedure, placement of central venous access device or fine needle aspiration within 3 days prior to randomization
Prior malignancy except: malignancy treated with curative intent and without evidence of active disease for ≥ 3 years prior to randomization and felt to be at low risk for recurrence by treating physician, adequately treated non-melanomatous skin cancer or lentigo maligna without evidence of disease, adequately treated cervical carcinoma in situ without evidence of disease, prostatic intraepithelial neoplasia without evidence of prostate cancer
Prior malignancy (other than in situ cervical cancer, or basal cell cancer of the skin) unless treated with curative intent and without evidence of disease for ≥ 3 years prior to randomization
Clinically significant cardiovascular diseases within 12 months prior to randomization
Presence of clinically significant non-healing wound, ulcer (including gastrointestinal) or fracture as judged by the investigator
Ongoing or clinically significant active infection as judged by the investigator
Known hypersensitivity to bacterial proteins, or any of the drugs required in this study
Known peripheral neuropathy ≥Grade 1
Known dihydropyrimidine dehydrogenase deficiency
Known hypersensitivity to 5-FU/capecitabine
Known positive test for human immunodeficiency virus (HIV), hepatitis C, or hepatitis B surface antigen
Known active or chronic hepatitis
Medications
Currently or previously treated with angiopoietin inhibitors, or inhibitors of TIE-1 or TIE-2
Treatment with immune modulators such as cyclosporine or tacrolimus within 30 days prior to randomization
Treatment with sorivudine or its chemically related analogues
Anticoagulants (other than aspirin and anti-platelet agents) within 7 days prior to randomization. The concurrent use of low molecular weight heparin or heparanoids or low dose warfarin (i.e, ≤ 1 mg daily) for prophylaxis against thrombosis is acceptable while on study
General
Not yet completed at least 30 days since ending other investigational device/drug trial(s), or subject is receiving other investigational treatments
Pregnant or is breast feeding
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
MD
Organizational Affiliation
Amgen
Official's Role
Study Director
12. IPD Sharing Statement
Citations:
PubMed Identifier
23108953
Citation
Eatock MM, Tebbutt NC, Bampton CL, Strickland AH, Valladares-Ayerbes M, Swieboda-Sadlej A, Van Cutsem E, Nanayakkara N, Sun YN, Zhong ZD, Bass MB, Adewoye AH, Bodoky G. Phase II randomized, double-blind, placebo-controlled study of AMG 386 (trebananib) in combination with cisplatin and capecitabine in patients with metastatic gastro-oesophageal cancer. Ann Oncol. 2013 Mar;24(3):710-8. doi: 10.1093/annonc/mds502. Epub 2012 Oct 28.
Results Reference
background
Links:
URL
http://www.amgentrials.com
Description
AmgenTrials clinical trials website
Learn more about this trial
Phase 2 Study of AMG 386 (20060439) in Combination With Cisplatin & Capecitabine in Subjects With Metastatic Gastric, Gastroesophageal Junction, or Distal Esophageal Adenocarcinoma
We'll reach out to this number within 24 hrs