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YF476 in Barrett's Esophagus

Primary Purpose

Barrett's Esophagus

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
YF476
YF476 placebo
Sponsored by
Trio Medicines Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Barrett's Esophagus focused on measuring acid reflux, intragastric pH, gastrin, hypergastrinemia

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Aged >18 years, with histologically confirmed diagnosis of Barrett's esophagus (BE) without dysplasia. A prior endoscopy with biopsies read as indefinite for dysplasia is permitted if biopsies from the most recent endoscopy prior to study entry demonstrated BE without dysplasia.
  • Minimum of 1 cm circumferential Barrett's mucosa on endoscopy or at least 2 cm maximal contiguous extent of Barrett's mucosa, as measured from the top of the gastric folds to the squamocolumnar junction (Prague criteria C>1, any M or any C, M>2).
  • Proton pump inhibitor use at least once daily, for at least 12 months prior to enrolment, and stable dose of PPI for the 3 months before enrolment. Any PPI, dose, and frequency allowable.
  • ECOG performance status <2 and Karnofsky >60%
  • Normal organ and marrow function, defined as white blood cells >3 x 10e9, absolute neutrophil count >1.5 x 10e9, platelets >100 x 10e9, creatinine <1.5 mg/dL, total bilirubin <1.5 mg/dL, AST <100 U/L, ALT <100 U/L.
  • Use of adequate contraception during the study, as follows;
  • Post-menopausal women must have had their last menstrual period at least 1 year ago.
  • Pre-menopausal women, who are sexually-active, must have had a hysterectomy or bilateral oophorectomy; or must use an intrauterine device (IUD), or spermicide with a diaphragm, cap or condom. Streroid contraceptives such as 'the pill' are not allowed unless in combination with one of the aforementioned barrier contraceptive methods.
  • Men must use a condom and spermicide.
  • Willingness to comply with all treatment and follow-up procedures.
  • Ability to understand and the willingness to sign a written informed consent document.
  • Up to date with all age-appropriate cancer screening tests, as per American Cancer Society guidelines, (Columbia University only), and no cancer screening tests planned for the next 21 weeks.

Exclusion Criteria:

  • Histologically confirmed BE with high-grade dysplasia.
  • Histologically confirmed diagnosis of invasive carcinoma of the esophagus.
  • Histologically confirmed BE with low-grade dysplasia that has been diagnosed by at least 2 expert gastrointestinal pathologists.
  • Prior endoscopic therapy for BE.
  • Any history of esophageal or gastric surgery.
  • History of atrophic gastritis, pernicious anemia, or Zollinger-Ellison syndrome.
  • Participation in a trial of an IMP within the previous 28 days.
  • Prolonged QTc interval >450 msec.
  • History of allergic reactions attributed to compounds of similar chemical composition of YF476.
  • History of baseline findings of:
  • diabetes mellitus requiring insulin therapy
  • pancreatitis (baseline amylase and/or lipase >2.0 x ULN)
  • hepatitis B, hepatitis C or HIV
  • malabsorption syndrome or inability to swallow or retain oral medicine
  • major surgery <28 days prior to enrolment
  • ECOG performance status >2
  • another cancer within 3 years except for basal carcinoma of the skin or cervical carcinoma in-situ
  • also, any clinically significant and uncontrolled major morbidity including but not limited to: serious cardiac disease (unstable angina, s/p myocardial infarction <1 month); respiratory disease (advanced COPD or pulmonary fibrosis); uncontrolled hypertension; active systemic infection; or psychiatric illness/social situations that would limit compliance with study requirements.
  • Certain medicines and herbal remedies taken during the 7 days before the start of the study drug.
  • A history of cancer >3 years from the time of enrolment, and the patient is not up to date with surveillance for that cancer (based on the American Cancer Society guidelines, Columbia University only), has evidence of cancer at the time of enrolment, or has surveillance tests planned within 21 weeks after enrolment.

Sites / Locations

  • Columbia University, Division of Digestive & Liver Diseases
  • MRC Cancer Unit, University of Cambridge

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Treatment

YF476 Placebo

Arm Description

Patients will take 25 mg YF476 once daily for 12 weeks

Patients will take matching placebo once daily for 12 weeks

Outcomes

Primary Outcome Measures

Change in Ki67 Biomarker Expression
Esophagogastroduodenoscopy (EGD) was performed to enable taking biopsies for assessment of Ki67 expression, a marker of cellular proliferation. Ki67 expression was assessed by immunohistochemistry and calculating the number of Ki67 positive cells per mm^2 of Barrett's epithelium.

Secondary Outcome Measures

Expression of Biomarkers Potentially Associated With Esophageal Adenocarcinoma (EAC)
Blood samples were taken for assay of biomarkers associated with esophageal adenocarcinoma. Changes in biomarker expression were derived from RNA-Sequencing and calculated as log-fold change comparing the treatment group to the placebo group. The nature of how results are derived by RNA-sequencing means summary statistics cannot be generated individually for each arm and a value has not been calculated for each individual participant. Therefore, results are reported as the relative change in biomarker expression in the treatment arm compared to the placebo arm.
Abundance of Biomarkers of Gastric Acid Suppression
Blood samples were taken to assess the effects of YF476 on fasting serum gastrin, a marker of gastric acid suppression
Abundance of Biomarkers of ECL Cell Hyperplasia
Blood samples were taken to assess the effects of YF476 on fasting plasma CgA, a marker of ECL cell hyperplasia

Full Information

First Posted
June 3, 2015
Last Updated
April 9, 2021
Sponsor
Trio Medicines Ltd.
Collaborators
Columbia University, University of Cambridge
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1. Study Identification

Unique Protocol Identification Number
NCT02597712
Brief Title
YF476 in Barrett's Esophagus
Official Title
Randomized, Placebo-controlled Trial of YF476, a Gastrin Receptor Antagonist, in Barrett's Esophagus
Study Type
Interventional

2. Study Status

Record Verification Date
April 2021
Overall Recruitment Status
Completed
Study Start Date
May 15, 2013 (Actual)
Primary Completion Date
November 28, 2017 (Actual)
Study Completion Date
December 27, 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Trio Medicines Ltd.
Collaborators
Columbia University, University of Cambridge

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
A phase 2, randomised, double-blind, out-patient trial to determine if YF476 is a safe and effective treatment in patients with Barrett's esophagus.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Barrett's Esophagus
Keywords
acid reflux, intragastric pH, gastrin, hypergastrinemia

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
27 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Treatment
Arm Type
Experimental
Arm Description
Patients will take 25 mg YF476 once daily for 12 weeks
Arm Title
YF476 Placebo
Arm Type
Placebo Comparator
Arm Description
Patients will take matching placebo once daily for 12 weeks
Intervention Type
Drug
Intervention Name(s)
YF476
Other Intervention Name(s)
netazepide
Intervention Description
gastrin receptor antagonist
Intervention Type
Drug
Intervention Name(s)
YF476 placebo
Other Intervention Name(s)
netazepide placebo
Intervention Description
placebo
Primary Outcome Measure Information:
Title
Change in Ki67 Biomarker Expression
Description
Esophagogastroduodenoscopy (EGD) was performed to enable taking biopsies for assessment of Ki67 expression, a marker of cellular proliferation. Ki67 expression was assessed by immunohistochemistry and calculating the number of Ki67 positive cells per mm^2 of Barrett's epithelium.
Time Frame
Baseline and Week 12
Secondary Outcome Measure Information:
Title
Expression of Biomarkers Potentially Associated With Esophageal Adenocarcinoma (EAC)
Description
Blood samples were taken for assay of biomarkers associated with esophageal adenocarcinoma. Changes in biomarker expression were derived from RNA-Sequencing and calculated as log-fold change comparing the treatment group to the placebo group. The nature of how results are derived by RNA-sequencing means summary statistics cannot be generated individually for each arm and a value has not been calculated for each individual participant. Therefore, results are reported as the relative change in biomarker expression in the treatment arm compared to the placebo arm.
Time Frame
Week 12
Title
Abundance of Biomarkers of Gastric Acid Suppression
Description
Blood samples were taken to assess the effects of YF476 on fasting serum gastrin, a marker of gastric acid suppression
Time Frame
Week 4, Week 6, Week 8, Week 12 and Follow-up (4 weeks after stopping YF476 treatment)
Title
Abundance of Biomarkers of ECL Cell Hyperplasia
Description
Blood samples were taken to assess the effects of YF476 on fasting plasma CgA, a marker of ECL cell hyperplasia
Time Frame
Week 4, Week 6, Week 8, Week 12 and Follow-up (4 weeks after stopping YF476 treatment)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Aged >18 years, with histologically confirmed diagnosis of Barrett's esophagus (BE) without dysplasia. A prior endoscopy with biopsies read as indefinite for dysplasia is permitted if biopsies from the most recent endoscopy prior to study entry demonstrated BE without dysplasia. Minimum of 1 cm circumferential Barrett's mucosa on endoscopy or at least 2 cm maximal contiguous extent of Barrett's mucosa, as measured from the top of the gastric folds to the squamocolumnar junction (Prague criteria C>1, any M or any C, M>2). Proton pump inhibitor use at least once daily, for at least 12 months prior to enrolment, and stable dose of PPI for the 3 months before enrolment. Any PPI, dose, and frequency allowable. ECOG performance status <2 and Karnofsky >60% Normal organ and marrow function, defined as white blood cells >3 x 10e9, absolute neutrophil count >1.5 x 10e9, platelets >100 x 10e9, creatinine <1.5 mg/dL, total bilirubin <1.5 mg/dL, AST <100 U/L, ALT <100 U/L. Use of adequate contraception during the study, as follows; Post-menopausal women must have had their last menstrual period at least 1 year ago. Pre-menopausal women, who are sexually-active, must have had a hysterectomy or bilateral oophorectomy; or must use an intrauterine device (IUD), or spermicide with a diaphragm, cap or condom. Streroid contraceptives such as 'the pill' are not allowed unless in combination with one of the aforementioned barrier contraceptive methods. Men must use a condom and spermicide. Willingness to comply with all treatment and follow-up procedures. Ability to understand and the willingness to sign a written informed consent document. Up to date with all age-appropriate cancer screening tests, as per American Cancer Society guidelines, (Columbia University only), and no cancer screening tests planned for the next 21 weeks. Exclusion Criteria: Histologically confirmed BE with high-grade dysplasia. Histologically confirmed diagnosis of invasive carcinoma of the esophagus. Histologically confirmed BE with low-grade dysplasia that has been diagnosed by at least 2 expert gastrointestinal pathologists. Prior endoscopic therapy for BE. Any history of esophageal or gastric surgery. History of atrophic gastritis, pernicious anemia, or Zollinger-Ellison syndrome. Participation in a trial of an IMP within the previous 28 days. Prolonged QTc interval >450 msec. History of allergic reactions attributed to compounds of similar chemical composition of YF476. History of baseline findings of: diabetes mellitus requiring insulin therapy pancreatitis (baseline amylase and/or lipase >2.0 x ULN) hepatitis B, hepatitis C or HIV malabsorption syndrome or inability to swallow or retain oral medicine major surgery <28 days prior to enrolment ECOG performance status >2 another cancer within 3 years except for basal carcinoma of the skin or cervical carcinoma in-situ also, any clinically significant and uncontrolled major morbidity including but not limited to: serious cardiac disease (unstable angina, s/p myocardial infarction <1 month); respiratory disease (advanced COPD or pulmonary fibrosis); uncontrolled hypertension; active systemic infection; or psychiatric illness/social situations that would limit compliance with study requirements. Certain medicines and herbal remedies taken during the 7 days before the start of the study drug. A history of cancer >3 years from the time of enrolment, and the patient is not up to date with surveillance for that cancer (based on the American Cancer Society guidelines, Columbia University only), has evidence of cancer at the time of enrolment, or has surveillance tests planned within 21 weeks after enrolment.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Julian A Abrams, MD MS
Organizational Affiliation
Columbia University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Columbia University, Division of Digestive & Liver Diseases
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Facility Name
MRC Cancer Unit, University of Cambridge
City
Cambridge
State/Province
Cambridgeshire
ZIP/Postal Code
CB2 0XZ
Country
United Kingdom

12. IPD Sharing Statement

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YF476 in Barrett's Esophagus

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