A Study of Atezolizumab With or Without Bevacizumab in Combination With Cisplatin Plus Gemcitabine in Patients With Untreated, Advanced Biliary Tract Cancer
Biliary Tract Cancer
About this trial
This is an interventional treatment trial for Biliary Tract Cancer
Eligibility Criteria
Inclusion Criteria:
- Considered to be eligible to receive platinum-based chemotherapy, in the investigator's judgment
- Documentation of recurrent/metastatic or locally advanced unresectable disease based on computed tomography (CT) or magnetic resonance imaging (MRI) scans
- Histologically or cytologically confirmed diagnosis of iCCA, eCCA, or GBC
- No prior systemic therapy for advanced BTC
- At least one measurable untreated lesion (per RECIST v1.1)
- Adequate biliary drainage with no evidence of ongoing infection
- Eastern Cooperative Oncology Group Performance Status of 0 or 1
- Life expectancy of > 3 months
- Adequate hematologic and end-organ function
- For women of childbearing potential: agreement to remain abstinent (refrain from heterosexual intercourse) or use contraceptive methods, and agreement to refrain from donating eggs
- For men: agreement to remain abstinent (refrain from heterosexual intercourse) or use a condom, and agreement to refrain from donating sperm
Exclusion Criteria:
- Recurrent disease <=6 months after curative surgery or <= 6 months after the completion of adjuvant therapy
- Prior local regional therapy such as radioembolization
- Combined or mixed hepatocellular/cholangiocarcinoma
- Clinically significant hepatic encephalopathy within the 12 months prior to Day 1 of Cycle 1
- National Cancer Institute Common Terminoogy Criteria for Adverse Events Grade >= 2 peripheral neuropathy
- Prior bleeding event due to untreated or incompletely treated esophageal and/or gastric varices within 6 months prior to Day 1 of Cycle 1
- Pregnant or breastfeeding, or intending to become pregnant during the study or within 5 months after the final dose of atezolizumab or within 6 months after the final dose of bevacizumab, cisplatin or gemcitabine
- Active or history of autoimmune disease or immune deficiency
- History of idiopathic pulmonary fibrosis, organizing pneumonia, drug-induced pneumonitis, or idiopathic pneumonitis, or evidence of active pneumonitis on screening chest computed tomography scan
- History of malignancy other than BTC within 5 years prior to screening, with the exception of malignancies with a negligible risk of metastasis or death
- Symptomatic, untreated, or actively progressing CNS metastases
- For patients with lung metastases, if one of the following criteria applies: Large, centrally located pulmonary metastases; Clear tumor infiltration into the thoracic great vessels seen on imaging; Clear cavitation of pulmonary lesions seen on imaging
- Active tuberculosis
- Co-infection with HBV and HCV
- Treatment with systemic immunostimulatory agents or immunosuppressive medication
- Inadequately controlled arterial hypertension
- History of hypertensive crisis or hypertensive encephalopathy
- Significant vascular disease
- Evidence of bleeding diathesis or significant coagulopathy
- Serious, non-healing or dehiscing wound, active ulcer, or untreated bone fracture
- Chronic daily treatment with a non-steroidal anti-inflammatory drug (NSAID)
- Preexisting renal impairment, myelosuppression, or hearing impairment
Sites / Locations
- City of Hope Cancer Center
- Massachusetts General Hospital
- Duke Cancer Center
- SCRI-Tennessee Oncology
- University of Virginia
- Nanfang Hospital, Southern Medical University
- Sir Run Run Shaw Hospital Zhejiang University
- Zhongshan Hospital Fudan University
- Queen Mary Hospital; Dept. Of Haematology & Oncology
- Prince of Wales Hosp; Dept. Of Clinical Onc
- Fondazione Pascale; U.O. Sperimentazioni Cliniche
- Azienda Ospedaliero Universitaria di Bologna; Istituto di Ematologia "Lorenzo e Ariosto Seragnoli"
- Istituto Clinico Humanitas - Humanitas Cancer Center
- IOV - Istituto Oncologico Veneto - IRCCS; Oncologia Medica II
- CHA Bundang Medical Center
- Seoul National University Bundang Hospital
- Seoul National University Hospital
- Asan Medical Center
- Samsung Medical Center
- SP ZOZ Wojewódzki Szpital Specjalistyczny nr 4; Oddzial Onkologii Klinicznej
- Uniwersyteckie Centrum Kliniczne; Klinika Onkologii i Radioterapii
- Szpital Wojewódzki im. Miko?aja Kopernika; Oddzia? Dzienny Chemioterapii
- NIO im Marii Sklodowskiej-Curie; Klinika Onkologii i Radioterapii
- Dolno?l?skie Centrum Onkologii; Oddzia? Onkologii Klinicznej i Chemioterapii
- FSBI "National Medical Research Center of Oncology N.N. Blokhin?
- First Moscow State Medical University n.a. I.M. Sechenov
- SBIH "Moscow Clinical Scientific and Practical Center named after A.S. Loginov of DHM"
- GBUZ Saint Petersburg Clinical Research Center of Specialized Types of Care (Oncology)
- Complejo Hospitalario de Navarra; Servicio de Oncologia
- Hospital Universitari Vall d'Hebron; Oncology
- Hospital Ramon y Cajal; Servicio de Oncologia
- Complejo Hospitalario de Orense; Servicio de Oncologia
- Hospital Universitario Miguel Servet; Servicio Oncologia
- Taipei Veterans General Hospital; Department of Oncology
- National Taiwan Uni Hospital; Dept of Oncology
- Maharaj Nakorn Chiang Mai Hosp; Oncology Unit
- Srinagarind Hospital; Medical Oncology Unit
- Sunpasitthiprasong Hospital; Oncology and/or Hematology
- Adana Ac?badem Hospital Oncology Department
- Memorial Ankara Hastanesi
- Inonu University Medical Faculty Turgut Ozal Medical Center Medical Oncology Department
- Koc Universitesi Hastanesi; T?bbi Onkoloji
- SI Institute of general&urgent surgery n/a Zaytseva V.T NAMSU
- ?Kharkov Regional Oncology Center
- SI "Shalimov National Institute of Surgery and Transplantation" of Nat.Acad of Med.Sci of Ukraine
- Beatson West of Scotland Cancer Centre
- Royal Free Hospital
- Churchill Hospital
- Royal Marsden Hospital (Sutton)
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Arm A: Atezo+Bev+CisGem, followed by Atezo+Bev
Arm B: Atezo+PBO+CisGem, followed by Atezo+PBO
Participants will receive atezolizumab intravenously on Day 1 of each 21-day cycle until unacceptable toxicity or loss of clinical benefit as determined by the investigator after an integrated assessment of radiographic and biochemical data, and clinical status. Participants will receive bevacizumab intravenously on Day 1 of each 21-day cycle. Participants will receive cisplatin intravenously followed by gemcitabine on Days 1 and 8 of each 21-day cycle for Cycles 1-8.
Participants will receive atezolizumab intravenously on Day 1 of each 21-day cycle until unacceptable toxicity or loss of clinical benefit as determined by the investigator after an integrated assessment of radiographic and biochemical data, and clinical status. Participants will receive placebo matching bevacizumab intravenously on Day 1 of each 21-day cycle. Participants will receive cisplatin intravenously followed by gemcitabine on Days 1 and 8 of each 21-day cycle for Cycles 1-8.