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Fruquintinib Combined With Sintilimab as Second-line Therapy for Gastric or Gastro-esophageal Junction Adenocarcinoma

Primary Purpose

Stomach Neoplasms

Status
Not yet recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Fruquintinib
Sintilimab
Sponsored by
Wuhan Union Hospital, China
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Stomach Neoplasms

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Signed the Informed Consent Form Ages: 18-75 Years (concluding 18 and 75 Years) Pathologically confirmed unresectable advanced gastric/gastroesophageal junction adenocarcinoma Failure to 1st line therapy, completed at least 28 days before enrollment HER2-negative Eastern Cooperative Oncology Group (ECOG) performance status 0-2 Life expectancy greater than 3 months At least one measurable lesion (larger than 10 mm in diameter by spiral CT scan, larger than 20 mm in diameter by conventional CT scan) according to RECIST1.1 Sufficient organ functions as follows (any blood transfusion or cell growth factor use within 14 days before enrollment is not allowed): Absolute Neutrophil Count (ANC) ≥1.5×109/L Platelet Count of ≥175×109/L; Hemoglobin≥90g/L; Total Bilirubin (TBIL) ≤1.5 x ULN; ALT and /or AST<1.5 x ULN; If there is liver metastasis, then ALT and/or AST<3.0 x ULN; Serum Creatinine (SCr) ≤1.5×ULN; Endogenous creatinine clearance rate ≥50ml / min; Man and woman who childbearing potential agrees to use adequate contraception Willingness to provide enough tumor tissues for PD-L1 expression test Exclusion Criteria: Patients could not obey the study protocol. Previous therapy with VEGFR Inhibitor. Other malignancy within 5 years prior to study enrolment, except for cervical carcinoma in situ, basal or squamous cell skin cancer. Known brain or CNS metastases. Patients with any active autoimmune disease or a documented history of autoimmune disease within 4 weeks prior to enrollment. Prior allogeneic bone marrow transplantation or prior solid organ transplantation. Uncontrolled malignant ascites. Clinically significant cardiovascular diseases, including but not limited to acute myocardial infarction, severe / unstable angina pectoris or coronary artery bypass grafting within 6 months before enrollment; Congestive heart failure, New York Heart Association (NYHA) grade > 2; ventricular arrhythmia requiring drug treatment; LVEF (left ventricular ejection fraction) < 50%. Known allergy or hypersensitivity to any of the study drugs or any of the study drug excipients. Participation in another clinical trial with any experimental drug within 4 weeks prior to enrollment. Clinically significant electrolyte abnormalities judged by researchers. Systolic blood pressure > 140mmHg or diastolic blood pressure > 90mmHg regardless of any antihypertensive drugs. Poorly controlled diabetes before enrollment. Any factors that influence the usage of oral administration and patients cannot take fruquintinib orally. Active gastric and duodenal ulcer, ulcerative colitis or uncontrolled hemorrhage in GI, or other conditions that may cause GI bleeding and perforation as determined by the investigator. Patients with obvious evidence of bleeding tendency or medical history within 3 months before enrollment, hemoptysis or thromboembolism within 12 months. Active infection or serious infection that is uncontrolled by drug (NCI CTCAE v. 5.0 Grade ≥ 2). History of clinically significant hepatic disease, including hepatitis B virus (HBV) infection with HBV DNA positive (copies ≥1×104/ml or >2000IU/ml); known hepatitis C virus infection with HCV RNA positive (copies ≥1×103/ml). Persisting toxicity related to prior therapy (NCI CTCAE v. 5.0 Grade > 1). Pregnant or breastfeeding female patient. Receive blood transfusion, blood products and hematopoietic factors such as albumin and granulocyte colony stimulating factor (G-CSF) within 14 days prior to enrollment. Other severe acute or chronic medical conditions including metabolic disorder, physical examination or laboratory abnormalities that may increase the risk associated with study participation or study treatment administration or may interfere with the interpretation of study results and, in the judgment of the investigator, would make the patient inappropriate for entry into this study. Urinary protein ≥ ++, and the 24-hour urine protein quantification is greater than 1.0 g. Use of immunosuppressive medication, or systemic/local immunosuppressive corticosteroids for complication. Patients considered unsuitable for inclusion in this study by the investigator.

Sites / Locations

  • Wuhan Union Hospital, China

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Fruquintinib plus Sintilimab

Arm Description

Fruquintinib combined with sintilimab. Fruquintinib: 4 mg/d, qd, po, d1-14, q3w; Sintilimab: 200 mg/d, ivgtt, d1, q3w.

Outcomes

Primary Outcome Measures

Objective Response Rate (ORR)
ORR is defined as percentage of participants achieving assessed complete response (CR) and partial response (PR) by the investigator according to the RECIST 1.1.

Secondary Outcome Measures

Progression-Free Survival (PFS)
PFS is defined as the time from randomization to the first documented disease progression or death due to any cause, whichever occurs first. Responses are according to the Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1) as assessed by investigator.
Overall Survival (OS)
OS is defined as the time from randomization to death due to any cause.
Disease Control Rate (DCR)
DCR is defined as the percentage of participants who have a confirmed complete response(CR) or partial response(PR) or stable disease(SD) per RECIST 1.1 as assessed by investigator
Duration of Response (DoR)
DoR is defined as the time how long response lasts
Adverse Event (AEs)
Safety will be evaluated by incidence, severity and outcomes of adverse events (AEs) and categorized by severity in accordance with the NCI CTC AE Version 5.0.

Full Information

First Posted
November 9, 2022
Last Updated
November 22, 2022
Sponsor
Wuhan Union Hospital, China
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1. Study Identification

Unique Protocol Identification Number
NCT05625737
Brief Title
Fruquintinib Combined With Sintilimab as Second-line Therapy for Gastric or Gastro-esophageal Junction Adenocarcinoma
Official Title
A Single-center, Single-arm, Open-label, Exploratory Study Evaluating Fruquintinib Combined With Sintilimab in Second-line Treatment of Patients With Advanced Gastric or Gastro-esophageal Junction Adenocarcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
November 2022
Overall Recruitment Status
Not yet recruiting
Study Start Date
November 2022 (Anticipated)
Primary Completion Date
December 2023 (Anticipated)
Study Completion Date
September 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Wuhan Union Hospital, China

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 was a single-arm, prospective study to investigate the efficacy and safety of fruquintinib combined with sintilimab in the second-line treatment of Chinese patients with advanced gastric/GEJ adenocarcinoma.
Detailed Description
Patients with adenocarcinoma of the gastro-esophageal junction or the stomach who have documented progression after being treated with a 1st line chemotherapy can be included. All patients will receive a second line therapy with fruquintinib and sintilimab, a checkpoint inhibitor. Clinical and radiographic assessment will be performed regularly. Patients will be treated until disease progression, untolerable toxicity or withdrawal of consent.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Stomach Neoplasms

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
29 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Fruquintinib plus Sintilimab
Arm Type
Experimental
Arm Description
Fruquintinib combined with sintilimab. Fruquintinib: 4 mg/d, qd, po, d1-14, q3w; Sintilimab: 200 mg/d, ivgtt, d1, q3w.
Intervention Type
Drug
Intervention Name(s)
Fruquintinib
Intervention Description
Fruquintinib will be administrated as 4mg orally, once daily for 2 weeks on/1 week off.
Intervention Type
Drug
Intervention Name(s)
Sintilimab
Intervention Description
Sintilimab will be administrated as 200mg once every 3 weeks.
Primary Outcome Measure Information:
Title
Objective Response Rate (ORR)
Description
ORR is defined as percentage of participants achieving assessed complete response (CR) and partial response (PR) by the investigator according to the RECIST 1.1.
Time Frame
from date of randomization until the date of progressive disease or EOT due to any cause, assessed up to 1 year
Secondary Outcome Measure Information:
Title
Progression-Free Survival (PFS)
Description
PFS is defined as the time from randomization to the first documented disease progression or death due to any cause, whichever occurs first. Responses are according to the Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1) as assessed by investigator.
Time Frame
From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 1 year
Title
Overall Survival (OS)
Description
OS is defined as the time from randomization to death due to any cause.
Time Frame
from date of randomization until the date of death due to any cause, assessed up to 2 years
Title
Disease Control Rate (DCR)
Description
DCR is defined as the percentage of participants who have a confirmed complete response(CR) or partial response(PR) or stable disease(SD) per RECIST 1.1 as assessed by investigator
Time Frame
from date of randomization until the date of progressive disease or EOT due to any cause, assessed up to 1 year
Title
Duration of Response (DoR)
Description
DoR is defined as the time how long response lasts
Time Frame
from date of the first documentation of response to the date of the first documentation of objective tumor progression or death due to any cause, whichever came first, assessed up to 1 year
Title
Adverse Event (AEs)
Description
Safety will be evaluated by incidence, severity and outcomes of adverse events (AEs) and categorized by severity in accordance with the NCI CTC AE Version 5.0.
Time Frame
from the date of first dose to the 30 days post the last dose
Other Pre-specified Outcome Measures:
Title
Exploratory endpoint
Description
To identify the correlation between PD-L1 expression and inflammatory factor score with clinical outcomes
Time Frame
from date of randomization until the date of progressive disease or EOT due to any cause, assessed up to 1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Signed the Informed Consent Form Ages: 18-75 Years (concluding 18 and 75 Years) Pathologically confirmed unresectable advanced gastric/gastroesophageal junction adenocarcinoma Failure to 1st line therapy, completed at least 28 days before enrollment HER2-negative Eastern Cooperative Oncology Group (ECOG) performance status 0-2 Life expectancy greater than 3 months At least one measurable lesion (larger than 10 mm in diameter by spiral CT scan, larger than 20 mm in diameter by conventional CT scan) according to RECIST1.1 Sufficient organ functions as follows (any blood transfusion or cell growth factor use within 14 days before enrollment is not allowed): Absolute Neutrophil Count (ANC) ≥1.5×109/L Platelet Count of ≥175×109/L; Hemoglobin≥90g/L; Total Bilirubin (TBIL) ≤1.5 x ULN; ALT and /or AST<1.5 x ULN; If there is liver metastasis, then ALT and/or AST<3.0 x ULN; Serum Creatinine (SCr) ≤1.5×ULN; Endogenous creatinine clearance rate ≥50ml / min; Man and woman who childbearing potential agrees to use adequate contraception Willingness to provide enough tumor tissues for PD-L1 expression test Exclusion Criteria: Patients could not obey the study protocol. Previous therapy with VEGFR Inhibitor. Other malignancy within 5 years prior to study enrolment, except for cervical carcinoma in situ, basal or squamous cell skin cancer. Known brain or CNS metastases. Patients with any active autoimmune disease or a documented history of autoimmune disease within 4 weeks prior to enrollment. Prior allogeneic bone marrow transplantation or prior solid organ transplantation. Uncontrolled malignant ascites. Clinically significant cardiovascular diseases, including but not limited to acute myocardial infarction, severe / unstable angina pectoris or coronary artery bypass grafting within 6 months before enrollment; Congestive heart failure, New York Heart Association (NYHA) grade > 2; ventricular arrhythmia requiring drug treatment; LVEF (left ventricular ejection fraction) < 50%. Known allergy or hypersensitivity to any of the study drugs or any of the study drug excipients. Participation in another clinical trial with any experimental drug within 4 weeks prior to enrollment. Clinically significant electrolyte abnormalities judged by researchers. Systolic blood pressure > 140mmHg or diastolic blood pressure > 90mmHg regardless of any antihypertensive drugs. Poorly controlled diabetes before enrollment. Any factors that influence the usage of oral administration and patients cannot take fruquintinib orally. Active gastric and duodenal ulcer, ulcerative colitis or uncontrolled hemorrhage in GI, or other conditions that may cause GI bleeding and perforation as determined by the investigator. Patients with obvious evidence of bleeding tendency or medical history within 3 months before enrollment, hemoptysis or thromboembolism within 12 months. Active infection or serious infection that is uncontrolled by drug (NCI CTCAE v. 5.0 Grade ≥ 2). History of clinically significant hepatic disease, including hepatitis B virus (HBV) infection with HBV DNA positive (copies ≥1×104/ml or >2000IU/ml); known hepatitis C virus infection with HCV RNA positive (copies ≥1×103/ml). Persisting toxicity related to prior therapy (NCI CTCAE v. 5.0 Grade > 1). Pregnant or breastfeeding female patient. Receive blood transfusion, blood products and hematopoietic factors such as albumin and granulocyte colony stimulating factor (G-CSF) within 14 days prior to enrollment. Other severe acute or chronic medical conditions including metabolic disorder, physical examination or laboratory abnormalities that may increase the risk associated with study participation or study treatment administration or may interfere with the interpretation of study results and, in the judgment of the investigator, would make the patient inappropriate for entry into this study. Urinary protein ≥ ++, and the 24-hour urine protein quantification is greater than 1.0 g. Use of immunosuppressive medication, or systemic/local immunosuppressive corticosteroids for complication. Patients considered unsuitable for inclusion in this study by the investigator.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Hongli Liu, PhD
Phone
+86-027-85871962
Email
hongli_liu@hust.edu.cn
First Name & Middle Initial & Last Name or Official Title & Degree
Jieying Zhang, MD
Phone
+86-027-85871962
Email
whxhzjy@hust.edu.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Hongli Liu, PhD
Organizational Affiliation
Wuhan Union Hospital, China
Official's Role
Principal Investigator
Facility Information:
Facility Name
Wuhan Union Hospital, China
City
Wuhan
State/Province
Hubei
ZIP/Postal Code
430030
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jieying Zhang, MD
Phone
+8613554281983
Email
whxhzjy@hust.edu.cn

12. IPD Sharing Statement

Learn more about this trial

Fruquintinib Combined With Sintilimab as Second-line Therapy for Gastric or Gastro-esophageal Junction Adenocarcinoma

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