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DV Combined With PD-1 and Platinum-based First-line Treatment in Patients With HER2 IHC2+/3+ ESCC

Primary Purpose

Esophageal Squamous Carcinoma, HER-2 Protein Overexpression

Status
Not yet recruiting
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
RC48+PD-1+platinum-based
Sponsored by
Changhai Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Esophageal Squamous Carcinoma

Eligibility Criteria

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

Inclusion Criteria: ≥18 years old, male or female; Patients with locally advanced unresectable, recurrent, or metastatic esophageal cancer were confirmed by imaging examination, and esophageal squamous cell carcinoma was confirmed by histopathology. For those who have received radical therapy and (new) adjuvant therapy, the time of first recurrence or disease progression is greater than 6 months after the end of the last treatment; The HER2 immunohistochemical test was 2+ or 3+; According to the solid tumor Efficacy Evaluation Criteria (RECIST), there should be at least one target lesion that has not received local treatment such as radiotherapy (target lesion located in the previous radiotherapy area can also be selected as a target lesion if it is confirmed to have progressed and meets the RECIST criteria); ECOG score: 0~1; Expected survival≥12 weeks; The function of vital organs met the following requirements (no blood components and cell growth factors were used in the first 2 weeks of enrollment): Absolute neutrophil count ≥1.5×109/L Platelet ≥100 × 109/L Hemoglobin ≥90g/L Serum albumin ≥28g/L Bilirubin≤ 1.5 × ULN In the absence of liver metastasis, ALT and AST≤2.5 × ULN; in the presence of liver metastasis, ALT and AST≤5 × ULN Creatinine clearance ≥50ml/min(Cockcroft-Gault); Left ventricular ejection fraction (LVEF) was ≥50% by echocardiography; Fertile female subjects should undergo a urine or serum pregnancy test that proves negative within 72 hours prior to receiving the initial study drug administration and be willing to use an effective method of contraception during the trial period until 3 months after the last dose. For male subjects whose partner is a woman of childbearing age, effective contraception should be used during the trial and within 3 months after the last dose; The subjects voluntarily joined the study, signed informed consent, had good compliance, and cooperated with follow-up. Exclusion Criteria: Other malignancies have been diagnosed within 3 years prior to the first dose, except for effectively treated basal cell carcinoma of the skin, clinical cell carcinoma of the skin, and/or effectively resected cervical and/or breast cancer in situ; There is central nervous system metastasis treatment within one month after stabilization; Have any active autoimmune disease or a history of autoimmune disease (such as interstitial pneumonia, uveitis, enteritis, hepatitis, hypophysitis, vasculitis, myocarditis, nephritis, hyperthyroidism, hypothyroidism (can be included after normal hormone replacement therapy); Patients with vitiligo or who had complete remission of asthma in childhood and did not require any intervention as adults could be included, but patients with asthma requiring medical intervention with bronchodilators could not be included; suffering from uncontrolled cardiac clinical symptoms or diseases, such as NYHA class II or above heart failure; Unstable angina pectoris; Myocardial infarction within 1 year; Patients with clinically significant supraventricular or ventricular arrhythmias requiring clinical intervention; Active infection or unexplained fever >38.5℃ occurred during screening or before the first administration of the drug (as determined by the investigator, the subject's fever due to the tumor could be enrolled); Known history or evidence of interstitial lung disease or active non-infectious pneumonia; congenital or acquired immune deficiency (such as HIV infection), active hepatitis B (HBV-DNA≥104/L copy number /ml) or hepatitis C (hepatitis C antibody positive and HCV-RNA higher than the lower detection limit of analytical methods); Known allergic reactions, hypersensitivities or contraindications to macromolecular protein preparations, or to platinum or any component used in preparations there of; Subjects requiring systemic therapy with corticosteroids (>10mg/ day efficacy dose of prednisone) or other immunosuppressants within 14 days prior to initial drug use. In the absence of active autoimmune disease, inhaled or topical steroid and adrenocortical hormone replacement at a therapeutic dose of >10mg/ day of prednisone are permitted; Participate in other clinical studies; Have received live vaccine within 4 weeks prior to the first administration of the drug, and are allowed to receive inactivated virus vaccine for seasonal influenza injection, but are not allowed to receive live attenuated influenza vaccine for nasal administration; Pregnant or lactating women; In the investigator's judgment, the subject has other factors that may lead to the forced termination of the study, such as other serious medical conditions (including mental illness) requiring co-treatment, serious abnormalities in laboratory test values, or family or social factors that may affect the subject's safety or the circumstances of the trial data collection.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    RC48+PD-1+platinum-based

    Arm Description

    Dose 1: RC48 2.5mg/kg intravenous infusion, d1 once every 3 weeks; Camrelizumab dose: 200mg, intravenous infusion 30-60min, d1 once every 3 weeks; Platinum (cisplatin or nedaplatin) : Cisplatin 75mg/m2, added into 500ml 0.9% sodium chloride injection for infusion, hydration and alkalization of -1d, d1, d2, once every 3 weeks; Nedaplatin 75mg/m2 was added to 500ml 0.9% sodium chloride injection, once every 3 weeks. Dose 2: rc48 2.0mg/kg, d1, once every 3 weeks; Camrelizumab 200mg, d1 once every 3 weeks; Platinum: Cisplatin 75mg/m2(or nedaplatin 75mg/m2), d1, once every 3 weeks

    Outcomes

    Primary Outcome Measures

    Phase II recommended dose (RP2D)
    Defined as maximum tolerated dose or maximum administration dose.
    Progression-Free Survival (PFS)
    The time between the start of treatment and the onset of disease progression or death

    Secondary Outcome Measures

    objective response rate (ORR)
    The percentage of patients whose tumors have shrunk to a certain amount and remain there for a certain amount of time, including complete response (CR) and partial response (PR) cases

    Full Information

    First Posted
    August 30, 2023
    Last Updated
    September 24, 2023
    Sponsor
    Changhai Hospital
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    1. Study Identification

    Unique Protocol Identification Number
    NCT06055153
    Brief Title
    DV Combined With PD-1 and Platinum-based First-line Treatment in Patients With HER2 IHC2+/3+ ESCC
    Official Title
    DV Combined With PD-1 and Platinum-based First-line Treatment in Patients With Locally Advanced or Metastatic HER2 IHC2+/3+ Esophageal Squamous Cell Carcinoma
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    August 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    September 30, 2023 (Anticipated)
    Primary Completion Date
    February 28, 2025 (Anticipated)
    Study Completion Date
    April 30, 2025 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Changhai Hospital

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    No
    Studies a U.S. FDA-regulated Device Product
    No
    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    This is a single-arm, exploratory clinical study.
    Detailed Description
    This is a single-arm, exploratory clinical study. Aim to explore the safety and efficacy of Vedicetuzumab combined with an immune checkpoint inhibitor (carrellizumab) and platinum-based first-line treatment for locally advanced/metastatic HER2 overexpression (IHC 2+/3+) esophageal squamous cell carcinoma.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Esophageal Squamous Carcinoma, HER-2 Protein Overexpression

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 1, Phase 2
    Interventional Study Model
    Single Group Assignment
    Masking
    None (Open Label)
    Allocation
    N/A
    Enrollment
    20 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    RC48+PD-1+platinum-based
    Arm Type
    Experimental
    Arm Description
    Dose 1: RC48 2.5mg/kg intravenous infusion, d1 once every 3 weeks; Camrelizumab dose: 200mg, intravenous infusion 30-60min, d1 once every 3 weeks; Platinum (cisplatin or nedaplatin) : Cisplatin 75mg/m2, added into 500ml 0.9% sodium chloride injection for infusion, hydration and alkalization of -1d, d1, d2, once every 3 weeks; Nedaplatin 75mg/m2 was added to 500ml 0.9% sodium chloride injection, once every 3 weeks. Dose 2: rc48 2.0mg/kg, d1, once every 3 weeks; Camrelizumab 200mg, d1 once every 3 weeks; Platinum: Cisplatin 75mg/m2(or nedaplatin 75mg/m2), d1, once every 3 weeks
    Intervention Type
    Drug
    Intervention Name(s)
    RC48+PD-1+platinum-based
    Other Intervention Name(s)
    Disitamab Vedotin+PD-1+platinum-based
    Intervention Description
    Phase I: Three subjects with HER2 overexpression (IHC 2+/3+) were initially enrolled. If dose-limiting toxicity (DLT) was observed in two of the three subjects, the study was continued from dose 1 to dose 2. If ≤1 DLT is observed in 3 subjects, continue to enroll 3 patients, and if ≤2 DLT is observed in 6 subjects, proceed to the second phase. If > 2 cases of DLT are observed in 6 subjects, adjust to dose 2 for phase 2. Dose 1: RC48 2.5mg/kg, d1, once every 3 weeks; Camrelizumab 200mg, d1 once every 3 weeks; Platinum: Cisplatin 75mg/m2(or nedaplatin 75mg/m2), d1, once every 3 weeks Dose 2: RC48 2.0mg/kg, d1, once every 3 weeks; Camrelizumab 200mg, d1 once every 3 weeks; Platinum: Cisplatin 75mg/m2(or nedaplatin 75mg/m2), d1, once every 3 weeks The second stage: sample size expansion stage. RP2D obtained at stage 1 continues to be enrolled in up to 20 patients until disease progression or intolerable toxicity occurs.
    Primary Outcome Measure Information:
    Title
    Phase II recommended dose (RP2D)
    Description
    Defined as maximum tolerated dose or maximum administration dose.
    Time Frame
    Up to 28 days
    Title
    Progression-Free Survival (PFS)
    Description
    The time between the start of treatment and the onset of disease progression or death
    Time Frame
    Up to 2 years
    Secondary Outcome Measure Information:
    Title
    objective response rate (ORR)
    Description
    The percentage of patients whose tumors have shrunk to a certain amount and remain there for a certain amount of time, including complete response (CR) and partial response (PR) cases
    Time Frame
    Up to 2 years

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: ≥18 years old, male or female; Patients with locally advanced unresectable, recurrent, or metastatic esophageal cancer were confirmed by imaging examination, and esophageal squamous cell carcinoma was confirmed by histopathology. For those who have received radical therapy and (new) adjuvant therapy, the time of first recurrence or disease progression is greater than 6 months after the end of the last treatment; The HER2 immunohistochemical test was 2+ or 3+; According to the solid tumor Efficacy Evaluation Criteria (RECIST), there should be at least one target lesion that has not received local treatment such as radiotherapy (target lesion located in the previous radiotherapy area can also be selected as a target lesion if it is confirmed to have progressed and meets the RECIST criteria); ECOG score: 0~1; Expected survival≥12 weeks; The function of vital organs met the following requirements (no blood components and cell growth factors were used in the first 2 weeks of enrollment): Absolute neutrophil count ≥1.5×109/L Platelet ≥100 × 109/L Hemoglobin ≥90g/L Serum albumin ≥28g/L Bilirubin≤ 1.5 × ULN In the absence of liver metastasis, ALT and AST≤2.5 × ULN; in the presence of liver metastasis, ALT and AST≤5 × ULN Creatinine clearance ≥50ml/min(Cockcroft-Gault); Left ventricular ejection fraction (LVEF) was ≥50% by echocardiography; Fertile female subjects should undergo a urine or serum pregnancy test that proves negative within 72 hours prior to receiving the initial study drug administration and be willing to use an effective method of contraception during the trial period until 3 months after the last dose. For male subjects whose partner is a woman of childbearing age, effective contraception should be used during the trial and within 3 months after the last dose; The subjects voluntarily joined the study, signed informed consent, had good compliance, and cooperated with follow-up. Exclusion Criteria: Other malignancies have been diagnosed within 3 years prior to the first dose, except for effectively treated basal cell carcinoma of the skin, clinical cell carcinoma of the skin, and/or effectively resected cervical and/or breast cancer in situ; There is central nervous system metastasis treatment within one month after stabilization; Have any active autoimmune disease or a history of autoimmune disease (such as interstitial pneumonia, uveitis, enteritis, hepatitis, hypophysitis, vasculitis, myocarditis, nephritis, hyperthyroidism, hypothyroidism (can be included after normal hormone replacement therapy); Patients with vitiligo or who had complete remission of asthma in childhood and did not require any intervention as adults could be included, but patients with asthma requiring medical intervention with bronchodilators could not be included; suffering from uncontrolled cardiac clinical symptoms or diseases, such as NYHA class II or above heart failure; Unstable angina pectoris; Myocardial infarction within 1 year; Patients with clinically significant supraventricular or ventricular arrhythmias requiring clinical intervention; Active infection or unexplained fever >38.5℃ occurred during screening or before the first administration of the drug (as determined by the investigator, the subject's fever due to the tumor could be enrolled); Known history or evidence of interstitial lung disease or active non-infectious pneumonia; congenital or acquired immune deficiency (such as HIV infection), active hepatitis B (HBV-DNA≥104/L copy number /ml) or hepatitis C (hepatitis C antibody positive and HCV-RNA higher than the lower detection limit of analytical methods); Known allergic reactions, hypersensitivities or contraindications to macromolecular protein preparations, or to platinum or any component used in preparations there of; Subjects requiring systemic therapy with corticosteroids (>10mg/ day efficacy dose of prednisone) or other immunosuppressants within 14 days prior to initial drug use. In the absence of active autoimmune disease, inhaled or topical steroid and adrenocortical hormone replacement at a therapeutic dose of >10mg/ day of prednisone are permitted; Participate in other clinical studies; Have received live vaccine within 4 weeks prior to the first administration of the drug, and are allowed to receive inactivated virus vaccine for seasonal influenza injection, but are not allowed to receive live attenuated influenza vaccine for nasal administration; Pregnant or lactating women; In the investigator's judgment, the subject has other factors that may lead to the forced termination of the study, such as other serious medical conditions (including mental illness) requiring co-treatment, serious abnormalities in laboratory test values, or family or social factors that may affect the subject's safety or the circumstances of the trial data collection.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Xianbao Zhan, Doctor
    Phone
    862131162338
    Email
    zhanxianbao@126.com

    12. IPD Sharing Statement

    Plan to Share IPD
    No

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    DV Combined With PD-1 and Platinum-based First-line Treatment in Patients With HER2 IHC2+/3+ ESCC

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