Bemarituzumab Plus Chemotherapy and Nivolumab Versus Chemotherapy and Nivolumab for FGFR2b Overexpressed Untreated Advanced Gastric and Gastroesophageal Junction Cancer (FORTITUDE-102)
Gastric Cancer, Gastroesophageal Junction Adenocarcinoma
About this trial
This is an interventional treatment trial for Gastric Cancer focused on measuring Bemarituzumab, AMG 552, 5-Fluorouracil, Leucovorin, and Oxaliplatin (mFOLFOX6), Nivolumab, Gastric Cancer, Gastroesophageal Junction Adenocarcinoma, FGFR2b Overexpression, Capecitabine and Oxaliplatin (CAPOX)
Eligibility Criteria
Inclusion Criteria Part 1 and Part 2:
- Adult with unresectable, locally advanced or metastatic (not amenable to curative therapy) histologically documented gastric or gastroesophageal junction adenocarcinoma
- Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1
- Measurable disease or non-measurable, but evaluable disease, according to Response Evaluation Criteria in Solid Tumours version 1.1 (RECIST v1.1)
- Participant has no contraindications to mFOLFOX6 chemotherapy or nivolumab
Adequate organ function as follows:
- Absolute neutrophil count ≥ 1.5 x 10^9/L
- Platelet count ≥ 100 x 10^9/L
- Hemoglobin ≥ 9 g/dL without red blood cell (RBC) transfusion within 7 days prior to the first dose of study treatment
- Aspartate aminotransaminase (AST) and Alanine aminotransaminase (ALT) <3 x upper limit of normal (ULN) (or < 5 x ULN if liver involvement)
- Total bilirubin <1.5 x ULN (or < 2 x ULN if liver involvement or Gilbert's disease)
- Calculated or measured creatinine clearance (CrCl) of ≥ 50 mL/minute calculated using the formula of Cockcroft and Gault
- International Normalized Ratio (INR) or prothrombin time (PT) < 1.5 × ULN except for participants receiving anticoagulation, who must be on a stable dose of anticoagulant therapy for 6 weeks prior to enrollment
Additional Inclusion Criteria Part 2:
- No prior treatment for metastatic or unresectable disease except for a maximum of 1 dose of mFOLFOX6 with or without nivolumab. Prior adjuvant, neo-adjuvant, and peri-operative therapy is allowed, provided it has been completed more than 6 months prior to the first dose of study treatment
- Fibroblast growth factor receptor 2b (FGFR2b) overexpression positive as determined by centrally performed immunohistochemistry (IHC) testing based on tumor sample either archival (obtained within 6 months/180 days prior to signing pre-screening informed consent) or a fresh biopsy.
Exclusion Criteria:
- Prior treatment with any selective inhibitor of the fibroblast growth factor (FGF)-FGFR pathway
- Known positive human epidermal growth factor receptor 2 (HER2) status
- Untreated or symptomatic central nervous system disease metastases and leptomeningeal disease
- Peripheral sensory neuropathy grade 2 or higher
- Clinically significant cardiac disease
- Other malignancy within the last 2 years (exceptions for definitively treated disease)
- Chronic or systemic ophthalmologic disorders
- Major surgery or other investigational study within 28 days prior to randomization
- Palliative radiotherapy within 14 days prior to randomization
- Abnormalities of the cornea that may pose an increased risk of developing a corneal ulcer
- Active autoimmune disease that has required systemic treatment (except replacement therapy) within the past 2 years or any other diseases requiring immunosuppressive therapy while on study
Sites / Locations
- Mayo Clinic - ArizonaRecruiting
- The Oncology Institute Clinical ResearchRecruiting
- Cancer and Blood Specialty ClinicRecruiting
- City of Hope National Medical CenterRecruiting
- University of California Los AngelesRecruiting
- University of California IrvineRecruiting
- Torrance Memorial Physician NetworkRecruiting
- Translational Research in Oncology - US IncRecruiting
- Translational Research in Oncology US Inc, Trio Central PharmacyRecruiting
- Olive View-University of California in Los Angeles Medical CenterRecruiting
- Presbyterian Intercommunity Hospital Health Whitter HospitalRecruiting
- Florida Cancer Specialists - Fort MyersRecruiting
- Mayo Clinic FloridaRecruiting
- Adventist Health System/Sunbelt, Inc d/b/a AdventHealth OrlandoRecruiting
- Orlando Health Cancer InstituteRecruiting
- Greater Baltimore Medical CenterRecruiting
- Henry Ford Health SystemRecruiting
- Mayo Clinic RochesterRecruiting
- Summit Medical GroupRecruiting
- Memorial Sloan Kettering Cancer CenterRecruiting
- Stony Brook University Medical CenterRecruiting
- FirstHealth Cancer CenterRecruiting
- Gabrail Cancer Center, LLCRecruiting
- Providence Portland Medical CenterRecruiting
- Saint Lukes University Health NetworkRecruiting
- Medical University of South Carolina, Hollings Cancer CenterRecruiting
- The West Clinic, PLLCRecruiting
- Sarah Cannon Research InstituteRecruiting
- Texas Oncology - Austin MidtownRecruiting
- University of Texas MD Anderson Cancer CenterRecruiting
- United States Oncology Regulatory Affairs Corporate OfficeRecruiting
- US Oncology Research Investigational Products CenterRecruiting
- Virginia Oncology AssociatesRecruiting
- Northwest Cancer Specialists - VancouverRecruiting
- Aurora Health Care Metro IncRecruiting
- CemicRecruiting
- Hospital Italiano de La PlataRecruiting
- Centro Medico AustralRecruiting
- Fundacion Ars MedicaRecruiting
- Clinica ViedmaRecruiting
- Fundacion RespirarRecruiting
- Hospital ItalianoRecruiting
- Sanatorio AllendeRecruiting
- Centro Oncologico Riojano IntegralRecruiting
- GenesisCare -North Shore OncologyRecruiting
- The Queen Elizabeth HospitalRecruiting
- Ballarat Health ServicesRecruiting
- Austin Health, Austin HospitalRecruiting
- Medizinische Universitaet GrazRecruiting
- Medizinische Universitaet InnsbruckRecruiting
- Landeskrankenhaus FeldkirchRecruiting
- Landeskrankenhaus SalzburgRecruiting
- Krankenhaus Wiener NeustadtRecruiting
- Universitaetsklinikum Allgemeines Krankenhaus WienRecruiting
- Universite Catholique de Louvain Cliniques Universitaires Saint LucRecruiting
- Grand Hopital de CharleroiRecruiting
- Universitair Ziekenhuis AntwerpenRecruiting
- Universitair Ziekenhuis GentRecruiting
- Universitair Ziekenhuis BrusselRecruiting
- Universitair Ziekenhuis Leuven - Campus GasthuisbergRecruiting
- Centre Hospitalier de l ArdenneRecruiting
- Centre Hospitalier Universitaire de Liege - Sart TilmanRecruiting
- Hospital Haroldo Juacaba - Instituto do Cancer do CearaRecruiting
- Hospital Sirio LibanesRecruiting
- Personal Oncologia de Precisao e PersonalizadaRecruiting
- Liga Norte-Riograndense Contra O CancerRecruiting
- Hospital de Clinicas de Porto AlegreRecruiting
- Centro Gaucho Integrado de Oncologia, Hematologia, Ensino e Pesquisa - Hospital Mae de DeusRecruiting
- Fundacao Pio 12 Hospital de Amor de BarretosRecruiting
- Instituto do Cancer Arnaldo Vieira de CarvalhoRecruiting
- Sociedade Beneficente de Senhoras Hospital Sirio LibanesRecruiting
- AC Camargo Cancer CenterRecruiting
- Fundacao Faculdade Regional de Medicina de Sao Jose do Rio PretoRecruiting
- Instituto CoiRecruiting
- Instituto do Cancer do Estado de Sao Paulo Octavio Frias de Oliveira IcespRecruiting
- Complex Oncology Center - BurgasRecruiting
- Multiprofile Hospital for Active Treatment - Uni Hospital OODRecruiting
- Multiprofile Hospital for Active Treatment Central Onco Hospital OODRecruiting
- Military Medical Academy Multiprofile Hospital for Active Treatment - SofiaRecruiting
- London Health Sciences CentreRecruiting
- Princess Margaret Cancer CentreRecruiting
- Centre Hospitalier de L Universite de MontrealRecruiting
- CHU de Quebec Hopital de l Enfant JesusRecruiting
- Centro De Estudios Clínicos Suecia SpARecruiting
- Oncocentro ApysRecruiting
- IC La Serena ResearchRecruiting
- OncovidaRecruiting
- IcegclinicRecruiting
- Fakultni nemocnice Hradec KraloveRecruiting
- Fakultni nemocnice OlomoucRecruiting
- Fakultni nemocnice Kralovske VinohradyRecruiting
- Vseobecna fakultni nemocnice v PrazeRecruiting
- Fakultni Thomayerova nemocniceRecruiting
- Centre Hospitalier Universitaire Amiens Picardie - Hopital SudRecruiting
- Centre Hospitalier Regional Universitaire de Besancon - Hopital Jean MinjozRecruiting
- Institut BergonieRecruiting
- Centre Hospitalier Universitaire de BrestRecruiting
- Centre Hospitalier Universitaire de Clermont Ferrand, Hôpital EstaingRecruiting
- Centre Hospitalier Régional Universitaire de Lille - Hôpital Claude HuriezRecruiting
- Centre Hospitalier Universitaire de Limoges - Hopital DupuytrenRecruiting
- Centre Leon BerardRecruiting
- Centre Antoine LacassagneRecruiting
- Hôpital Saint LouisRecruiting
- Hôpital Européen Georges PompidouRecruiting
- Centre Hospitalier Universitaire de RouenRecruiting
- Centre Rene Gauducheau - Institut de Cancerologie de l OuestRecruiting
- Centre Hospitalier Universitaire Nord de Saint Etienne - Hôpital NordRecruiting
- Institut de cancerologie Strasbourg EuropeRecruiting
- Centre Hospitalier Universitaire de Toulouse - Hopital RangueilRecruiting
- Institut Gustave RoussyRecruiting
- Charite - Universitaetsmedizin Berlin, Campus VirchowRecruiting
- Universitaetsklinikum DresdenRecruiting
- Krankenhaus Nordwest GmbHRecruiting
- Medizinische Hochschule HannoverRecruiting
- Universitaetsklinikum Schleswig-HolsteinRecruiting
- Universitaetsklinikum LeipzigRecruiting
- Regional Kliniken Holding Klinikum LudwigsburgRecruiting
- Johannes Gutenberg Universitaet MainzRecruiting
- Universitaetsmedizin MannheimRecruiting
- Klinikum der LMU MuenchenRecruiting
- Klinikum rechts der Isar der TUMRecruiting
- Universitaetsklinikum der Eberhard Karls Universitaet TuebingenRecruiting
- Universitaetsklinikum UlmRecruiting
- Klinikum der Stadt WolfsburgRecruiting
- Prince of Wales HospitalRecruiting
- Semmelweis EgyetemRecruiting
- Del-pesti Centrumkorhaz - Orszagos Hematologiai es Infektologiai IntezetRecruiting
- Orszagos Onkologiai IntezetRecruiting
- Debreceni Egyetem Klinikai KozpontRecruiting
- Jasz-Nagykun-Szolnok Varmegyei Hetenyi Geza Korhaz-RendelointezetRecruiting
- Komarom-Esztergom Varmegyei Szent Borbala KorhazRecruiting
- Rambam Health Care CampusRecruiting
- Shaare Zedek Medical CenterRecruiting
- Hadassah Ein-Kerem Medical CenterRecruiting
- Sheba Medical CenterRecruiting
- Tel-Aviv Sourasky Medical CenterRecruiting
- Azienda Ospedaliero Universitaria Ospedali Riuniti di AnconaRecruiting
- Azienda Socio Sanitaria Territoriale Papa Giovanni XXIIIRecruiting
- Ente Ospedaliero IRCCS Saverio De BellisRecruiting
- Azienda Socio Sanitaria Territoriale di CremonaRecruiting
- Azienda Ospedaliera Universitaria CareggiRecruiting
- Ospedale Policlinico San Martino IRCCSRecruiting
- IRCCS Ospedale San RaffaeleRecruiting
- Fondazione IRCCS Istituto Nazionale dei TumoriRecruiting
- Azienda Ospedaliero Universitaria Luigi VanvitelliRecruiting
- Istituto Oncologico Veneto IRCCSRecruiting
- Azienda Ospedaliera Universitaria Pisana Ospedale Santa ChiaraRecruiting
- Nagoya University HospitalRecruiting
- Chiba Cancer CenterRecruiting
- National Cancer Center Hospital EastRecruiting
- National Hospital Organization Shikoku Cancer CenterRecruiting
- National Hospital Organization Kyushu Cancer CenterRecruiting
- Gifu University HospitalRecruiting
- Hokkaido University HospitalRecruiting
- Hyogo Cancer CenterRecruiting
- Kobe City Medical Center General HospitalRecruiting
- Yokohama City University Medical CenterRecruiting
- Kanagawa Prefectural Hospital Organization Kanagawa Cancer CenterRecruiting
- Niigata Cancer Center HospitalRecruiting
- Kansai Medical University HospitalRecruiting
- Osaka International Cancer InstituteRecruiting
- Kindai University HospitalRecruiting
- Osaka University HospitalRecruiting
- Saitama Cancer CenterRecruiting
- Shizuoka Cancer CenterRecruiting
- National Cancer Center HospitalRecruiting
- The Cancer Institute Hospital of Japanese Foundation for Cancer ResearchRecruiting
- Kyungpook National University Chilgok HospitalRecruiting
- Chungnam National University HospitalRecruiting
- Jeonbuk National University HospitalRecruiting
- Seoul National University Bundang HospitalRecruiting
- Korea University Anam HospitalRecruiting
- Seoul National University HospitalRecruiting
- Kangbuk Samsung HospitalRecruiting
- Severance Hospital Yonsei University Health SystemRecruiting
- Asan Medical CenterRecruiting
- Samsung Medical CenterRecruiting
- The Catholic University of Korea Seoul St Marys HospitalRecruiting
- Korea University Guro HospitalRecruiting
- Narodowy Instytut Onkologii im M Sklodowskiej-Curie Panstwowy Instytut Badawczy Oddzial w GliwicachRecruiting
- Przychodnia Lekarska Komed Roman KaraszewskiRecruiting
- Samodzielny Publiczny Szpital Kliniczny Nr 1Recruiting
- Mazowiecki Szpital Wojewodzki im Sw Jana Pawla II w Siedlcach spzooRecruiting
- Samodzielny Publiczny Szpital Kliniczny Nr 1 Pomorskiego Uniwersytetu Medycznego w SzczecinieRecruiting
- Lux med onkologia sp zoo szpital szamockaRecruiting
- Uniwersytecki Szpital Kliniczny im Jana Mikulicza-Radeckiego we WroclawiuRecruiting
- Hospital de Braga, EPERecruiting
- Hospital da Luz, SARecruiting
- Centro Hospitalar Universitario de Lisboa Norte, EPE - Hospital de Santa MariaRecruiting
- Unidade Local de Saude de Matosinhos, EPE - Hospital Pedro HispanoRecruiting
- Centro Hospitalar Universitario de Sao Joao, EPE - Hospital de Sao JoaoRecruiting
- Institutul Clinic FundeniRecruiting
- Institutul Oncologic Prof Dr Ion Chiricuta Cluj-NapocaRecruiting
- Institutul Regional de Gastroenterologie si Hepatologie " Prof Dr Octavian Fodor"Recruiting
- Centrul de Oncologie Sf Nectarie SRLRecruiting
- Institutul Regional de Oncologie IasiRecruiting
- SC Oncomed SRLRecruiting
- National University HospitalRecruiting
- National Cancer Centre SingaporeRecruiting
- Hospital Universitario Virgen del RocioRecruiting
- Hospital Universitario Central de AsturiasRecruiting
- Hospital Universitario Marques de ValdecillaRecruiting
- Hospital del MarRecruiting
- Hospital Universitari Vall d HebronRecruiting
- Institut Catala d Oncologia Hospitalet Hospital Duran i ReynalsRecruiting
- Hospital General Universitario de ElcheRecruiting
- Hospital Clinico Universitario de ValenciaRecruiting
- Complexo Hospitalario Universitario A Coruña Hospital Teresa HerreraRecruiting
- Hospital Universitario de NavarraRecruiting
- Hospital Universitario Ramon y CajalRecruiting
- Hospital Clinico San CarlosRecruiting
- Hospital Universitario 12 de OctubreRecruiting
- Kaohsiung Medical University Chung-Ho Memorial HospitalRecruiting
- China Medical University HospitalRecruiting
- National Cheng Kung University HospitalRecruiting
- Taipei Veterans General HospitalRecruiting
- Tri-Service General HospitalRecruiting
- Chulabhorn HospitalRecruiting
- Maharaj Nakorn Chiang Mai HospitalRecruiting
- Chiangrai Prachanukroh HospitalRecruiting
- Prince of Songkla HospitalRecruiting
- Addenbrookes HospitalRecruiting
- University Hospital CoventryRecruiting
- Ninewells Hospital and Medical SchoolRecruiting
- Guys HospitalRecruiting
- Christie HospitalRecruiting
- Mount Vernon Cancer CentreRecruiting
- Torbay HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Experimental
Placebo Comparator
Part 1 Safety Lead-in: Bemarituzumab with mFOLFOX6 and Nivolumab
Part 2: Bemarituzumab with chemotherapy (mFOLFOX6 or CAPOX) and Nivolumab
Part 2: Placebo with chemotherapy (mFOLFOX6 or CAPOX) and Nivolumab
Participants will be administered bemarituzumab at different doses with mFOLFOX6 and nivolumab to determine the recommended phase 3 dose (RP3D) based on occurrence of dose-limiting toxicities (DLTs), and on an evaluation of the overall safety, tolerability, and pharmacokinetics (PK).
Participants will be administered bemarituzumab at the RP3D determined from Part 1 in combination with mFOLFOX6 and nivolumab on a 14-day cycle. Or participants will be administered bemarituzumab in combination with CAPOX and nivolumab on a 21-day cycle.
Participants will be administered placebo comparator in combination with mFOLFOX6 and nivolumab on a 14-day cycle. Or participants will be administered placebo comparator in combination with CAPOX and nivolumab on a 21-day cycle.