Avelumab in First-Line Maintenance Gastric Cancer (JAVELIN Gastric 100)
Unresectable, Locally Advanced or Metastatic, Adenocarcinoma of the Stomach, or of the Gastro Esophageal Junction

About this trial
This is an interventional treatment trial for Unresectable, Locally Advanced or Metastatic, Adenocarcinoma of the Stomach, or of the Gastro Esophageal Junction focused on measuring Avelumab, Cancer, Unresectable, Locally advanced, Metastatic, Adenocarcinoma of the stomach, Gastro-esophageal junction
Eligibility Criteria
Inclusion Criteria:
- Male or female participants greater than or equal to (>=) 18 years
- Disease must be measurable by Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1)
- Participants with histologically confirmed unresectable locally advanced or metastatic adenocarcinoma of the stomach or gastro-esophageal junction (GEJ)
- Eastern Cooperative Oncology Group Performance Status (ECOG PS) of 0 to 1 at trial entry
- Estimated life expectancy of more than 12 weeks
- Adequate haematological, 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 participants 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 or immunosuppressive agents
- Prior chemotherapy for unresectable locally advanced or metastatic adenocarcinoma of the stomach or gastro-esophageal junction (GEJ)
- Tumor shown to be human epidermal growth factor 2 plus (HER2+)
- Major surgery for any reason, except diagnostic biopsy, within 4 weeks of enrolment and/or if the participant has not fully recovered from the surgery within 4 weeks of enrolment
- Participants receiving immunosuppressive agents (such as steroids) for any reason should be tapered off these drugs before initiation of the study treatment (with the exception of participants with adrenal insufficiency, who may continue corticosteroids at physiologic replacement dose, equivalent to <= 10 mg prednisone daily)
- All participants with brain metastases, except those meeting the following criteria: a. Brain metastases have been treated locally, have not been progressing at least 2 months after completion of therapy, and no steroid maintenance therapy is required, 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 related to prior therapy except alopecia
- Neuropathy Grade > 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 participant's tolerance of study treatment
- Any psychiatric condition that would prohibit the understanding or rendering of informed consent and that would limit compliance with study requirements
- Vaccination with live or live/attenuated viruses within 55 days of the first dose of avelumab and while on trial is prohibited except for administration of inactivated vaccines
- Legal incapacity or limited legal capacity
- Participants will be excluded from the Induction Phase and the Maintenance Phase if administration of their chemotherapy would be inconsistent with the current local labelling (SmPC) (e.g., in regard to contraindications, warnings/precautions or special provisions) for that chemotherapy. Investigators should check updated labelling via relevant websites at the time of entry into the Induction Phase and the Maintenance Phase
- Other protocol defined exclusion criteria could apply
Sites / Locations
- Comprehensive Blood & Cancer Center
- Virginia Crosson Cancer Center
- UCLA Medical Center
- Desert Hematology Oncology Medical Group, Inc.
- Sansum Clinic
- Trio - Central Coast Medical Oncology Corporation
- Norwalk Hospital
- UF Health Cancer Center Orlando
- Memorial West Cancer Institute
- University of South Florida - Parent
- Oncology Specialists, S.C.
- Franciscan St. Francis Health Cancer Center
- Cedar Rapids Oncology Project
- Cotton-O'Neil Clinical Research Center, Hematology and Oncology
- University of Kansas Medical Center Research Institute, Inc.
- Virginia Piper Cancer Institute
- Nevada Cancer Research Foundation
- Mount Sinai - PRIME
- Clinical Research Alliance, Inc
- University of Rochester
- UC Health Clinical Trials Office
- TriHealth Hatton Institute
- Mid Ohio Oncology Hematology, DBA The Mark H. Zangmeister Center
- Oregon Health & Science University
- St. Luke's Hospital
- Thomas Jefferson University Hospital
- Rhode Island Hospital
- Greenville Hospital System University Medical Center (ITOR)
- University of Texas Southwestern Medical Center
- Oncology Consultants, P.A.
- University of Texas Health Science Center at San Antonio
- Baylor Scott & White Health
- University of Washington - Seattle Cancer Care Alliance
- Northwest Medical Specialties, PLLC
- Wenatchee Valley Hospital & Clinics
- St George Hospital
- Royal North Shore Hospital
- Greenslopes Private Hospital
- Royal Brisbane and Women's Hospital
- Flinders Medical Centre
- Lyell McEwin Hospital
- Royal Hobart Hospital
- Ballarat Base Hospital
- Bendigo Hospital
- Monash Medical Centre Clayton
- Box Hill Hospital
- Royal Melbourne Hospital
- Border Medical Oncology
- Fiona Stanley Hospital
- NOB - Núcleo de Oncologia da Bahia
- Hospital São Lucas da PUCRS
- Hospital Bruno Born
- Oncosinos - Clínica de Oncologia - Hospital Regina
- Hospital de Clínicas de Porto Alegre
- Hospital São Lucas da PUCRS
- Hospital de Câncer de Barretos-Fundação Pio XII
- IMV - Instituto De Medicina Vascular Hospital Mae de Deus
- CEPHO - Centro de Estudos e Pesquisas em Hematologia e Oncologia
- Fundação Faculdade Regional de Medicina de São José do Rio Preto
- ICESP - Instituto do Câncer do Estado de São Paulo Octavio Frias de Oliveira
- Hospital Infanta Cristina
- Queen Elizabeth II Health Sciences Centre
- The Royal Victoria Hospital
- Humber River Hospital
- Mount Sinai Hospital
- Cité de la Santé de Laval
- McGill University - Dept. Oncology Clinical Research Program
- Centre Antoine Lacassagne
- Hôpital de la Timone
- Hôpital Morvan
- Centre Georges François Leclerc
- CHU Besancon - Hopital Jean Minjoz
- CHU Bordeaux
- CHU de Toulouse - Hôpital Rangueil
- CRLCC Eugene Marquis
- CHU Tours - Hôpital Trousseau
- ICO - Site René Gauducheau
- Hôpital Cochin
- Hôpital Européen Georges Pompidou
- CHU Clermont Ferrand
- Clinique Victor Hugo - Centre Jean Bernard
- Klinikum Esslingen GmbH
- SLK-Kliniken Heilbronn GmbH
- Klinikum Bogenhausen
- Leopoldina Krankenhaus Schweinfurt
- Krankenhaus Nordwest GmbH
- Universitaetsmedizin der Johannes Gutenberg-Universitaet Mainz
- Onkologische Schwerpunktpraxis Eppendorf
- Marienkrankenhaus Hamburg
- Pecsi Tudomanyegyetem
- Petz Aladar Megyei Oktato Korhaz
- Debreceni Egyetem Klinikai Kozpont
- Magyar Honvedseg Egeszsegugyi
- SzSzB Megyei Korhazak es Egyetemi Oktatokorhaz
- Tolna Megyei Balassa Janos Korhaz
- Jasz-Nagykun-Szolnok Megyei Hetenyi Geza Korhaz-Rendelointezet
- Zala Megyei Szent Rafael Korhaz
- Presidio Ospedaliero Garibaldi Nesima
- Azienda Socio Sanitaria Territoriale di Cremona (Istituti Ospitalieri di Cremona)
- Azienda Ospedaliera Universitaria Careggi
- Ospedale San Raffaele
- Fondazione IRCCS Istituto Nazionale dei Tumori
- IEO Istituto Europeo di Oncologia
- Istituto Nazionale Tumori Fondazione G. Pascale
- Seconda Università degli Studi di Napoli
- IOV - Istituto Oncologico Veneto IRCCS
- Ospedale degli Infermi
- Università Campus Bio-Medico di Roma
- Azienda Ospedaliera S. Maria Di Terni
- Azienda Ospedaliero-Universitaria Santa Maria della Misericordia
- Chiba Cancer Center
- Kagawa University Hospital
- Kanagawa Cancer Center
- Kumamoto University Hospital
- Tohoku University Hospital
- Niigata Cancer Center Hospital
- Oita University Hospital
- Kindai University Hospital
- Izumi Municipal Hospital
- Saitama Medical University International Medical Center
- Saitama Cancer Center
- Tochigi Cancer Center
- Nat Cancer Ctr Hosp
- Toranomon Hospital
- Kagoshima University Medical And Dental Hospital
- Chungbuk National University Hospital
- National Cancer Center
- Seoul National University Bundang Hospital
- Chonnam National University Hwasun Hospital
- Keimyung University Dongsan Hospital
- Inje University Haeundae Paik Hospital
- Kyungpook National University Medical Center
- Asan Medical Center
- The Catholic University of Korea, Seoul St. Mary's Hospital
- Korea University Anam Hospital
- Seoul National University Hospital
- Yonsei University Health System
- Institutul Oncologic "Prof. Dr. Ion Chiricuta" Cluj Napoca
- S.C Radiotherapy Center Cluj S.R.L
- S.C Centrul de Oncologie Sf. Nectarie S.R.L
- Spital Lotus SRL
- S.C Oncocenter Oncologie Clinica S.R.L
- S.C Oncomed S.R.L
- S.C Oncopremium Team S.R.L
- Institutul Clinic Fundeni
- Spitalul Clinic Coltea
- Hifu Terramed Conformal SRL
- Institutul Regional de Oncologie Iasi
- Pavlov First Saint Petersburg State Medical University
- FBI "Scientific Research Institute of Oncology n. a. N. N. Petrov"
- SBIH of Arkhangelsk region "Arkhangelsk Clinical Oncological Dispensary"
- LLC Evimed
- RBIH "Ivanovo Regional Oncological Dispensary"
- SBIH " Clinical Oncological Dispensary # 1"
- FSBSI "Russian Oncological Scientific Center n.a. N.N. Blokhin"
- BHI of Omsk region "Clinical Oncology Dispensary"
- SBIH of Stavropol territory "Pyatigorsk Oncological Dispensary"
- SPb SBIH "City Clinical Oncological Dispensary"
- Hospital General Universitario de Elche
- ICO l´Hospitalet - Hospital Duran i Reynals
- Corporacio Sanitaria Parc Tauli
- Hospital Universitari Vall d'Hebron
- Hospital Clinic i Provincial de Barcelona
- Hospital de la Santa Creu i Sant Pau
- Hospital General Universitario Gregorio Marañon
- Hospital Universitario 12 de Octubre
- Hospital Universitario La Paz
- Hospital Universitario HM Madrid Sanchinarro
- Hospital Universitario Virgen del Rocio
- Kaohsiung Chang Gung Memorial Hospital
- China Medical University Hospital
- Taichung Veterans General Hospital
- National Cheng Kung University Hospital
- National Taiwan University Hospital
- Mackay Memorial Hospital
- Taipei Veterans General Hospital
- Chang Gung Memorial Hospital, Linkou
- King Chulalongkorn Memorial Hospital
- Maharaj Nakorn Chiang Mai Hospital
- Siriraj Hospital
- Acibadem Adana Hospital
- Adana Numune Training and Research Hospital
- Hacettepe University Medical Faculty
- Akdeniz University Medical Faculty
- Dicle University, Medical faculty
- Istanbul University Cerrahpasa Medical Faculty
- Marmara University Pendik Research and Training Hospital
- Kocaeli University Medical Faculty
- Konya Necmettin Erbakan University Meram Medical Faculty
- Inonu Uni. Med. Fac.
- Mersin University Medical Faculty
- Derriford Hospital
- Barts Hospital
- University College London Hospitals
- The Christie
- The Clatterbridge Cancer Centre
- Mount Vernon Hospital
- Royal Surrey County Hospital
- Ninewells Hospital
- St James's University Hospital
Arms of the Study
Arm 1
Arm 2
Experimental
Experimental
Chemotherapy + Best Supportive Care (BSC)
Avelumab
In Maintenance Phase, participants continued the same regimen of oxaliplatin-fluoropyrimidine doublet chemotherapy (oxaliplatin + 5FU/LV or oxaliplatin + capecitabine) as they received during the Induction Phase until disease progression, significant clinical deterioration, unacceptable toxicity, or discontinuation. Participants who were not deemed eligible to receive chemotherapy at the dose and schedule specified above received BSC alone once every 3 weeks. BSC was defined as treatment administered with the intent to maximize quality of life without a specific antineoplastic regimen and was based on Investigator's discretion.
In Maintenance phase, participants received avelumab as a 1-hour intravenous (IV) infusion at 10 milligrams per kilogram (mg/kg) once every 2-week treatment cycle until progressive disease or unacceptable toxicity or discontinuation.