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Nab-paclitaxel Plus PD-1 Inhibitor Versus Nab-paclitaxel as Second-line Treatment in Advanced Gastric Cancer

Primary Purpose

Gastric Cancer, GastroEsophageal Cancer

Status
Active
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Albumin-bound Paclitaxel Plus SHR-1210 (PD-1 inhibitor)
Albumin-bound Paclitaxel
Sponsored by
Huazhong University of Science and Technology
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Gastric Cancer focused on measuring Gastric cancer, GastroEsophageal Cancer, Albumin-bound Paclitaxel, PD-1 inhibitor

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Age of 18-70 years.
  2. Second line treatment for cytological or histological diagnosis of recurrent or metastatic gastric and esophagogastric adenocarcinoma. Disease progression after adjuvant therapy within 6 months is eligible.
  3. ECOG performance status of 0-2.
  4. Estimated life expectancy of at least 3 months.
  5. Bone marrow function: white blood cell count≥3.0×109 /L, absolute neutrophil count(ANC) ≥1.5×109 /L, platelet count(PLT) ≥90×109 /L, hemoglobin(HB) ≥90 g/L.
  6. Left ventricular ejection fraction (LVEF) ≥ 50%.
  7. Liver and kidney function: Creatinine(Cr)≤1.5 x upper limit of normal range(ULN); alanine glutamate transaminase (ALT) and glutamate transaminase (AST) ≤2.5 x upper limit of normal range (ULN), or ≤5 x upper limit of normal range (ULN)when with hepatic metastases,total bilirubin (TBIL)≤1.5 x upper limit of normal range (ULN), or≤2.5 x upper limit of normal range (ULN) when with Gilbert's syndrome.
  8. Any acute, clinically significant treatment-related toxicity caused by previous treatment must have been reduced to less than or equal to grade 1, except hair loss.
  9. Able and willing to comply with the study plans in this protocol and sign the informed consent.

Exclusion Criteria:

  1. uncontrollable infections or have received systematic antibiotic treatment within 72 hours before enrollment.
  2. Any abnormal bone marrow hyperplasia or other abnormal hematopoietic function.
  3. Have a second malignancy within 5 years prior to registration except for cured carcinoma in situ of cervix uteri, non-melanoma skin cancer.
  4. Patients with symptomatic brain metastases.
  5. Allergic to the chemotherapy drugs or the materials in this study.
  6. Suffering from mental or nervous system disorders and unable to cooperate.
  7. Pregnant or nursing female patients. Men and women of reproductive age are unwilling to take reliable contraceptive measures during the study.
  8. Active autoimmune disease, history of autoimmune disease, use of corticosteroids or immunosuppressants, or use of hormone replacement therapy, such as thyroxine, insulin, etc.
  9. Live vaccine was administered within 30 days before enrolment (injectable seasonal influenza vaccine is allowed as it is inactivated).
  10. Patients with other diseases not suitable for enrolment, such as active tuberculosis, hepatitis B (after treatment, hepatitis B virus titer HBV-DNA <500IU/ml, and liver function is normal, but cannot be combined with hepatitis C), hepatitis C, uncontrolled electrolyte disorders ,pericardial effusion, pleural effusion and abdominal effusion, etc.
  11. Have participated in other clinical trials within 30 days prior to this study.
  12. History of organ transplantation.
  13. Patients that researcher consider cannot sign informed consent or complete the study.

Sites / Locations

  • Tongji hospital of Tongji Medical College, Huazhong University of Science and Technology

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Nab-P/PD-1

Nab-P

Arm Description

Patients in this arm receive albumin-bound paclitaxel and SHR-1210 (PD-1 inhibitor) thepary.

Patients in this arm receive albumin-bound paclitaxel single-agent chemotherapy.

Outcomes

Primary Outcome Measures

objective response rate(ORR)
The rate of participants that achieve either a complete response (CR) or a partial response (PR).Higher rate of ORR indicates better treatment effect.

Secondary Outcome Measures

Progression-free Survival (PFS)
Time from the start of treatment to progression of disease or death.Higher rate of 9m PFS in statistic analysis means better outcome.
Overall survival (OS)
Time from the start of treatment until death due to any reason.Increased rate of 12m OS compared to the other arm indicates more benefit from the treatment regimen.
Safety as measured by number and grade of adverse events
Summary adverse events according to NCI-CTCAE 5.0
patient-reported outcomes (PROs)
Patient-reported outcomes according to EQ-5D questionnaires.

Full Information

First Posted
March 2, 2020
Last Updated
January 21, 2023
Sponsor
Huazhong University of Science and Technology
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1. Study Identification

Unique Protocol Identification Number
NCT04294784
Brief Title
Nab-paclitaxel Plus PD-1 Inhibitor Versus Nab-paclitaxel as Second-line Treatment in Advanced Gastric Cancer
Official Title
A Multi-center, Open-label, Randomized Controlled Clinical Study of Nab-paclitaxel Plus SHR-1210(PD-1 Inhibitor)Versus Nab-paclitaxel as Second-line Treatment in Advanced or Recurrent Gastric and Esophagogastric Adenocarcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
January 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
April 3, 2020 (Actual)
Primary Completion Date
March 31, 2023 (Anticipated)
Study Completion Date
June 30, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Huazhong University of Science and Technology

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
This is a Multi-center, Open-label, Randomized Controlled,phase 2 clinical trail of Albumin-bound Paclitaxel Plus SHR-1210 (PD-1 inhibitor)Versus Albumin-bound Paclitaxel as Second-line Treatment in Advanced or Recurrent Gastric Adenocarcinoma
Detailed Description
This is a Multi-center, Open-label, Randomized Controlled,phase 2 clinical trail of an immune checkpoint inhibitor in patients with advanced or recurrent gastric and esophagogastric junction adenocarcinoma, including two arms to compare the efficacy and safety of Albumin-bound Paclitaxel Plus SHR-1210 (PD-1 inhibitor)regimen and Albumin-bound Paclitaxel single-agent regimen in second-line treatment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Gastric Cancer, GastroEsophageal Cancer
Keywords
Gastric cancer, GastroEsophageal Cancer, Albumin-bound Paclitaxel, PD-1 inhibitor

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
80 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Nab-P/PD-1
Arm Type
Experimental
Arm Description
Patients in this arm receive albumin-bound paclitaxel and SHR-1210 (PD-1 inhibitor) thepary.
Arm Title
Nab-P
Arm Type
Active Comparator
Arm Description
Patients in this arm receive albumin-bound paclitaxel single-agent chemotherapy.
Intervention Type
Drug
Intervention Name(s)
Albumin-bound Paclitaxel Plus SHR-1210 (PD-1 inhibitor)
Intervention Description
Albumin-bound Paclitaxel 100 mg/m2,ivdrip,d1,d8,d15,Q28d,or Albumin-bound Paclitaxel 125-130 mg/m2,ivdrip,d1,d8,Q21d,or Albumin-bound Paclitaxel 260mg/m2,ivdrip,d1,Q21d;SHR-1210 200mg, ivdrip,d1,Q21d.
Intervention Type
Drug
Intervention Name(s)
Albumin-bound Paclitaxel
Intervention Description
Albumin-bound Paclitaxel 100 mg/m2,ivdrip,d1,d8,d15,Q28d,or Albumin-bound Paclitaxel 125-130 mg/m2,ivdrip,d1,d8,Q21d,or Albumin-bound Paclitaxel 260mg/m2,ivdrip,d1,Q21d;
Primary Outcome Measure Information:
Title
objective response rate(ORR)
Description
The rate of participants that achieve either a complete response (CR) or a partial response (PR).Higher rate of ORR indicates better treatment effect.
Time Frame
up to 12 months
Secondary Outcome Measure Information:
Title
Progression-free Survival (PFS)
Description
Time from the start of treatment to progression of disease or death.Higher rate of 9m PFS in statistic analysis means better outcome.
Time Frame
up to 9 months
Title
Overall survival (OS)
Description
Time from the start of treatment until death due to any reason.Increased rate of 12m OS compared to the other arm indicates more benefit from the treatment regimen.
Time Frame
up to 12 months
Title
Safety as measured by number and grade of adverse events
Description
Summary adverse events according to NCI-CTCAE 5.0
Time Frame
up to 12 months
Title
patient-reported outcomes (PROs)
Description
Patient-reported outcomes according to EQ-5D questionnaires.
Time Frame
up to 12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age of 18-70 years. Second line treatment for cytological or histological diagnosis of recurrent or metastatic gastric and esophagogastric adenocarcinoma. Disease progression after adjuvant therapy within 6 months is eligible. ECOG performance status of 0-2. Estimated life expectancy of at least 3 months. Bone marrow function: white blood cell count≥3.0×109 /L, absolute neutrophil count(ANC) ≥1.5×109 /L, platelet count(PLT) ≥90×109 /L, hemoglobin(HB) ≥90 g/L. Left ventricular ejection fraction (LVEF) ≥ 50%. Liver and kidney function: Creatinine(Cr)≤1.5 x upper limit of normal range(ULN); alanine glutamate transaminase (ALT) and glutamate transaminase (AST) ≤2.5 x upper limit of normal range (ULN), or ≤5 x upper limit of normal range (ULN)when with hepatic metastases,total bilirubin (TBIL)≤1.5 x upper limit of normal range (ULN), or≤2.5 x upper limit of normal range (ULN) when with Gilbert's syndrome. Any acute, clinically significant treatment-related toxicity caused by previous treatment must have been reduced to less than or equal to grade 1, except hair loss. Able and willing to comply with the study plans in this protocol and sign the informed consent. Exclusion Criteria: uncontrollable infections or have received systematic antibiotic treatment within 72 hours before enrollment. Any abnormal bone marrow hyperplasia or other abnormal hematopoietic function. Have a second malignancy within 5 years prior to registration except for cured carcinoma in situ of cervix uteri, non-melanoma skin cancer. Patients with symptomatic brain metastases. Allergic to the chemotherapy drugs or the materials in this study. Suffering from mental or nervous system disorders and unable to cooperate. Pregnant or nursing female patients. Men and women of reproductive age are unwilling to take reliable contraceptive measures during the study. Active autoimmune disease, history of autoimmune disease, use of corticosteroids or immunosuppressants, or use of hormone replacement therapy, such as thyroxine, insulin, etc. Live vaccine was administered within 30 days before enrolment (injectable seasonal influenza vaccine is allowed as it is inactivated). Patients with other diseases not suitable for enrolment, such as active tuberculosis, hepatitis B (after treatment, hepatitis B virus titer HBV-DNA <500IU/ml, and liver function is normal, but cannot be combined with hepatitis C), hepatitis C, uncontrolled electrolyte disorders ,pericardial effusion, pleural effusion and abdominal effusion, etc. Have participated in other clinical trials within 30 days prior to this study. History of organ transplantation. Patients that researcher consider cannot sign informed consent or complete the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Xianglin Yuan, MD,PhD
Organizational Affiliation
oncology center of Tongji Hospital,wuhan,China
Official's Role
Study Chair
Facility Information:
Facility Name
Tongji hospital of Tongji Medical College, Huazhong University of Science and Technology
City
Wuhan
State/Province
Hubei
ZIP/Postal Code
430030
Country
China

12. IPD Sharing Statement

Plan to Share IPD
No

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Nab-paclitaxel Plus PD-1 Inhibitor Versus Nab-paclitaxel as Second-line Treatment in Advanced Gastric Cancer

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