Derazantinib Alone or in Combination With Paclitaxel, Ramucirumab or Atezolizumab in Gastric Adenocarcinoma (FIDES-03)
Gastric Adenocarcinoma

About this trial
This is an interventional treatment trial for Gastric Adenocarcinoma focused on measuring gastric cancer, gastro-esophageal adenocarcinoma, adenocarcinoma of the stomach or gastro-esophageal junction, fibroblast growth factor receptor, FGFR genetic aberration, targeted therapy, derazantinib, atezolizumab, Tecentriq, paclitaxel, ramucirumab, Cyramza, solid tumor
Eligibility Criteria
Key Inclusion Criteria:
- Histologically-confirmed adenocarcinoma of the gastro-esophageal junction or stomach
- Male or female aged ≥ 18 years
- Negative HER2 status obtained from the most recent available tissue sample
- Inoperable recurrent, locally advanced adenocarcinoma or progressing stage IV adenocarcinoma of the gastro-esophageal junction or stomach, and disease progression after either standard first- or second-line treatment (Substudy 1), or after standard first-line treatment (Substudies 2 and 3)
- Positive test for eligible FGFR aberrations (FGFR2 fusions / rearrangements / amplifications; FGFR1, FGFR2, or FGFR3 mutations / short variants)
- Measurable disease as defined by the Investigator using RECIST 1.1 criteria
- ECOG PS of 0 or 1
- Men and women of childbearing potential must agree to avoid impregnating a partner or becoming pregnant, respectively, during the study, and for at least 150 days after the last dose of either investigational drug
Key Exclusion Criteria:
Prior anticancer or investigational drug treatment within an interval shorter than the following, as applicable:
- One chemotherapy or biological (e.g., antibody) cycle interval
- Five half-lives of any small molecule investigational or licensed medicinal product
- Two weeks, for any investigational medicinal product with an unknown half-life
- Four weeks of curative radiotherapy
- Seven days of palliative radiotherapy
- Prior treatment with FGFR Inhibitors (all substudies), and prior treatment with taxanes within 6 months prior to randomization and/or anti-VEGF(R) therapeutic antibody or pathway-targeting agents (Substudies 2 and 3), and prior treatment with anti-programmed cell death receptor-1 (PD-1) or anti-programmed death ligand-1 (PD-L1) therapeutic antibody or pathway-targeting agents (Substudy 3)
- Concurrent evidence of clinically significant corneal or retinal disorder
- History of clinically significant cardiac disorders and/or a QT interval corrected by Fridericia's formula (QTcF) > 450 ms for males or > 460 ms for females
- Known CNS metastases
- Concurrent uncontrolled or active infection with human immunodeficiency virus (HIV; known HIV 1/2 antibodies positive); active or chronic hepatitis B without current antiviral therapy and an HBV DNA ≥ 100 IU/mL virus (HBV); active hepatitis C virus (HCV) co-infection; active tuberculosis (for Substudies 2 and 3)
- Child-Pugh B or C liver cirrhosis, or a history of hepatic encephalopathy, hepatorenal syndrome, or clinically-meaningful ascites related to cirrhosis (for Substudies 2 and 3)
- Administration of a live, attenuated vaccine within 30 days prior to randomization (for Substudy 3)
- Treatment with systemic corticosteroids (except for steroidal replacement therapy) or other systemic immunosuppressive medications within 2 weeks prior to first dose of study drug or anticipated requirement for systemic immunosuppressive medications during the study (for Substudy 3)
Sites / Locations
- AdventHealth Cancer Institute
- Memorial Sloan Kettering Cancer Center
- Hospital de Gastroenterologia Dr. Carlos Bonorino Udaondo
- Fundación Favaloro para la Docencia e Investigación Médica
- Monash Medical Centre Clayton
- Peter MacCallum Cancer Centre
- The Alfred Hospital
- UZA
- UZ Leuven
- AZ Delta
- Liga Norte-Rio-Grandense Contra o Câncer
- Fundação Doutor Amaral Carvalho
- Instituto Nacional de Câncer José Alencar Gomes da Silva
- CEPHO - Centro de Estudos e Pesquisas de Hematologia e Oncologia
- Fundação Faculdade Regional de Medicina de São José do Rio Preto
- CeCim Biocinetic
- Centro de Estudios Clínicos SAGA
- Instituto Clinico Oncologico
- Institut Sainte Catherine
- CHU Besançon - Hôpital Jean Minjoz
- Centre Georges François Leclerc
- Hôpital Saint-Louis
- Hôpital Saint-Antoine
- Institut Gustave Roussy
- Universitaetsklinikum Ulm
- Medizinische Hochschule Hannover
- Universitaetsklinikum Carl Gustav Carus TU Dresden
- Staedtisches Klinikum Dresden Standort Dresden-Friedrichstadt
- Krankenhaus Nordwest GmbH
- Uniklinik Mainz
- Azienda Ospedaliera Universitaria Policlinico Sant'Orsola Malpighi
- Azienda Ospedaliero Universitaria Mater Domini
- Fondazione IRCCS Istituto Nazionale dei Tumori
- IEO Istituto Europeo di Oncologia
- Azienda Socio Sanitaria Territoriale Niguarda (Grande Ospedale Metropolitano Niguarda)
- IOV - Istituto Oncologico Veneto IRCCS
- Istituto Clinico Humanitas
- A.O.U. Senese Policlinico Santa Maria alle Scotte
- National Cancer Center
- Chonnam National University Hwasun Hospital
- Seoul National University Bundang Hospital
- Seoul National University Hospital
- Asan Medical Center
- Samsung Medical Center
- The Catholic University of Korea, Seoul St. Mary's Hospital
- Ajou University Hospital
- Examen sp. z o.o.
- Centrum Zdrowia MDM
- Narodowy Instytut Onkologii im. Marii Skłodowskiej-Curie - Państwowy Instytut Badawczy
- Centrum Terapii Wspolczesnej J.M. Jasnorzewska sp. komandytowo-akcyjna
- SAIH "Republican Clinical Oncological Dispensary of the Ministry of Healthcare of Republic Tatarstan
- FSBSI "Russian Oncological Scientific Center n.a. N.N. Blokhin"
- "VitaMed" LLC
- BHI of Omsk region "Clinical Oncology Dispensary"
- FSBI "Clinical Research and Practical Center for specialized medical care (oncology)"
- Pavlov First Saint Petersburg State Medical University
- FBI "Scientific Research Institute of Oncology n. a. N. N. Petrov"
- Tomsk Research Instutite of Oncology
- SBIH Republican Clinical Oncological Dispensary of the MoH of Republic Bashkortostan
- Hospital del Mar
- Hospital Universitari Vall d'Hebron
- Hospital Clinic de Barcelona
- ICO l'Hospitalet - Hospital Duran i Reynals
- MD Anderson Cancer Centre
- Hospital Universitario Ramon y Cajal
- Centro Integral Oncologico Clara Campal
- Clinica Universidad de Navarra
- Baskent University Adana Application and Research Center
- Hacettepe University Medical Faculty
- Dr. Abdurrahman Yurtaslan Oncology Teaching and Research Hospital
- Ankara City Hospital
- Akdeniz University Medical Faculty
- Istanbul University Cerrahpasa - Cerrahpasa Medical Faculty
- Istanbul Medeniyet Uni Goztepe Training&Res Hosp
- Kocaeli Universitesi Tip Fakultesi
- Addenbrooke's Hospital
- Ninewells Hospital
- Beatson West of Scotland Cancer Centre
- University College London Hospitals
- The Christie
- Royal Marsden Hospital- Sutton
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Experimental
Experimental
Experimental
Active Comparator
Derazantinib
Derazantinib-paclitaxel-ramucirumab
Derazantinib-atezolizumab
Standard of care
In Substudies 1 and 3.1, patients with HER2-negative adenocarcinoma of the stomach or gastro-esophageal junction harboring FGFR genetic aberrations will receive derazantinib.
In Substudies 2 and 3.2, patients with HER2-negative adenocarcinoma of the stomach or gastro-esophageal junction harboring FGFR genetic aberrations will receive derazantinib-paclitaxel-ramucirumab in combination.
In Substudy 3.3, patients with HER2-negative adenocarcinoma of the stomach or gastro-esophageal junction harboring FGFR genetic aberrations will receive derazantinib-atezolizumab in combination.
In Substudy 3.4, patients with HER2-negative adenocarcinoma of the stomach or gastro-esophageal junction harboring FGFR genetic aberrations will receive the Standard of Care drugs paclitaxel-ramucirumab in combination.