A Study of AK109 and AK104 in Advanced Gastric Adenocarcinoma or Gastroesophageal Junction Adenocarcinoma
Primary Purpose
Gastric Adenocarcinoma and Gastroesophageal Junction Adenocarcinoma
Status
Recruiting
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
AK104 and AK109
PTX
Sponsored by
About this trial
This is an interventional treatment trial for Gastric Adenocarcinoma and Gastroesophageal Junction Adenocarcinoma
Eligibility Criteria
Inclusion Criteria:
- Written and signed informed consent
- Age ≥ 18 years but ≤ 75 years
- ECOG of 0 or 1.
- Estimated life expectancy of ≥3 months.
- Histologically or cytologically documented advanced unresectable or metastatic gastric adenocarcinoma or gastroesophageal Junction (GEJ) adenocarcinoma.
- At least one measurable lesion per RECIST v1.1.
- Gastric adenocarcinoma or gastroesophageal junction (GEJ) adenocarcinoma with failure of first-line treatment
- Adequate organ function.
- Have agreed to take effective contraception from the date of signing the informed consent form until 120 days after the last administration.
Exclusion Criteria:
- Known HER2-positive
- Other invasive malignancies within 3 years, except for locally treatable (manifested as cured) malignancies, such as basal or skin squamous cell carcinoma, superficial bladder cancer, cervical or breast carcinoma in situ.
- Any previous systemic therapy targeting VEGF or anti-VEGFR signaling pathways.
- In addition to PD1 or PD-L1,Prior exposure to anti-CTLA-4 antibody, or any other antibody or drug therapy for T cell co-stimulatory or checkpoint pathways, such as ICOS or agonists (e.g. CD40, CD137, GITR and OX40 etc).
- Known history of primary immunodeficiency virus infection.
- Known history of allogeneic organ transplantation or allogeneic hematopoietic stem cell transplantation.
- Known history of interstitial lung disease.
- Known history of active tuberculosis (TB).
- Central nervous system (CNS) metastasis, meningeal metastasis, spinal cord compression, or leptomeningeal disease.
- Patients with untreated chronic hepatitis B or HBV DNA exceeding 500IU/mL or active hepatitis C should be excluded. Patients with HCV antibody positive are eligible to participate in the study if the results of HCV RNA test show negative.
- Known history of testing positive for human immunodeficiency virus (HIV).
- Uncontrolled pleural effusion, pericardial effusion, or ascites requiring repeated drainage.
- Subjects with active, known or suspected autoimmune disease, or a medical history of autoimmune disease, with the exceptions of the following: vitiligo, alopecia, Grave disease, psoriasis or eczema not requiring systemic treatment within the last 2 years, hypothyroidism (caused by autoimmune thyroiditis) only requiring steady doses of hormone replacement therapy and type I diabetes only requiring steady doses of insulin replacement therapy, or completely relieved childhood asthma that requires no intervention in adulthood, or primary diseases that will not relapse unless triggered by external factors.
- Pregnant or lactating women.
Sites / Locations
- Beijing Cancer HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Experimental
Arm Label
AK104 and AK109
AK104 and AK109 combined with chemotherapy
Arm Description
AK104 IV every 2 weeks (q4w) AK109 IV every 2 weeks (q4w)
AK104 IV every 2 weeks (q4w) AK109 IV every 2 weeks (q4w) PTX iV 85mg/m2 day1 day8 day15(q4w)
Outcomes
Primary Outcome Measures
Number of subjects experiencing dose-limiting toxicities (DLTs)
DLTs will be assessed during the first 28 days of treatment and are defined as toxicities that meet pre-defined severity criteria, and assessed as having a suspected relationship to study drug, and unrelated to disease, disease progression, inter-current illness, or concomitant medications .
Adverse events (AEs)
An AE is defined as any untoward medical occurrence in a participant administered a pharmaceutical product temporally associated with the use of study treatment, whether or not considered related to the study treatment.
Objective response rate (ORR)
The ORR is defined as the proportion of subjects with CR or PR, based on RECIST Version 1.1.
Secondary Outcome Measures
Progression-free survival (PFS)
PFS is defined as the time from the date of first dosing till the first documentation of disease progression (per RECIST v1.1) or death from any cause (whichever occurs first)
Disease control rate (DCR)
DCR is defined as the proportion of subjects with CR, PR, or SD, based on RECIST v1.1
Duration of response (DoR)
Duration of response is defined as the duration from the first documentation of objective response to the first documented disease progression or death due to any cause, whichever occurs first.
Overall survival (OS)
OS defined as the time from the first dose to death from any cause. Subjects who do not die at the end of the extended follow-up period, or were lost to follow-up during the study, were censored at the last date they were known to be alive.
Observed pharmacokinetics (PK) exposure of AK109 and AK104
The endpoints for assessment of PK of AK109 and AK104 include serum concentrations of AK109 and AK104 at different timepoints after AK109 and AK104 administration.
Number of subjects who develop detectable anti-drug antibodies (ADAs)
The immunogenicity of AK104 and AK109 will be assessed by summarizing the number of subjects who develop detectable anti-drug antibodies (ADAs)
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT04982276
Brief Title
A Study of AK109 and AK104 in Advanced Gastric Adenocarcinoma or Gastroesophageal Junction Adenocarcinoma
Official Title
An Open Label, Multicentre, Phase Ib/II Clinical Study of AK109 and AK104 With or Without Chemotherapy in Second-line Treatment of Advanced Gastric Adenocarcinoma or Gastroesophageal Junction Adenocarcinoma
Study Type
Interventional
2. Study Status
Record Verification Date
October 2022
Overall Recruitment Status
Recruiting
Study Start Date
July 13, 2021 (Actual)
Primary Completion Date
July 30, 2023 (Anticipated)
Study Completion Date
January 30, 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Akeso
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 is an open label, multicentre, Phase Ib/II Clinical Study of AK109 and AK104 With or Without Chemotherapy in Second-line Treatment of Advanced Gastric Adenocarcinoma or Gastroesophageal Junction Adenocarcinoma .
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Gastric Adenocarcinoma and Gastroesophageal Junction Adenocarcinoma
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
87 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
AK104 and AK109
Arm Type
Experimental
Arm Description
AK104 IV every 2 weeks (q4w) AK109 IV every 2 weeks (q4w)
Arm Title
AK104 and AK109 combined with chemotherapy
Arm Type
Experimental
Arm Description
AK104 IV every 2 weeks (q4w) AK109 IV every 2 weeks (q4w) PTX iV 85mg/m2 day1 day8 day15(q4w)
Intervention Type
Biological
Intervention Name(s)
AK104 and AK109
Intervention Description
Subjects will receive AK104 and AK109 by intravenous administration.
Intervention Type
Drug
Intervention Name(s)
PTX
Intervention Description
Subjects will receive AK104 and AK109 in combination with PTX.
Primary Outcome Measure Information:
Title
Number of subjects experiencing dose-limiting toxicities (DLTs)
Description
DLTs will be assessed during the first 28 days of treatment and are defined as toxicities that meet pre-defined severity criteria, and assessed as having a suspected relationship to study drug, and unrelated to disease, disease progression, inter-current illness, or concomitant medications .
Time Frame
During the first 4 weeks
Title
Adverse events (AEs)
Description
An AE is defined as any untoward medical occurrence in a participant administered a pharmaceutical product temporally associated with the use of study treatment, whether or not considered related to the study treatment.
Time Frame
up to 2 years
Title
Objective response rate (ORR)
Description
The ORR is defined as the proportion of subjects with CR or PR, based on RECIST Version 1.1.
Time Frame
up to 2 years
Secondary Outcome Measure Information:
Title
Progression-free survival (PFS)
Description
PFS is defined as the time from the date of first dosing till the first documentation of disease progression (per RECIST v1.1) or death from any cause (whichever occurs first)
Time Frame
Up to 2 years
Title
Disease control rate (DCR)
Description
DCR is defined as the proportion of subjects with CR, PR, or SD, based on RECIST v1.1
Time Frame
Up to 2 years
Title
Duration of response (DoR)
Description
Duration of response is defined as the duration from the first documentation of objective response to the first documented disease progression or death due to any cause, whichever occurs first.
Time Frame
Up to 2 years
Title
Overall survival (OS)
Description
OS defined as the time from the first dose to death from any cause. Subjects who do not die at the end of the extended follow-up period, or were lost to follow-up during the study, were censored at the last date they were known to be alive.
Time Frame
up to 2 years
Title
Observed pharmacokinetics (PK) exposure of AK109 and AK104
Description
The endpoints for assessment of PK of AK109 and AK104 include serum concentrations of AK109 and AK104 at different timepoints after AK109 and AK104 administration.
Time Frame
From first dose of AK109 and AK104 through 90 days after last dose of AK109 and AK104
Title
Number of subjects who develop detectable anti-drug antibodies (ADAs)
Description
The immunogenicity of AK104 and AK109 will be assessed by summarizing the number of subjects who develop detectable anti-drug antibodies (ADAs)
Time Frame
From first dose of AK109 and AK104 through 90 days after last dose of AK109 and AK104
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:
Written and signed informed consent
Age ≥ 18 years but ≤ 75 years
ECOG of 0 or 1.
Estimated life expectancy of ≥3 months.
Histologically or cytologically documented advanced unresectable or metastatic gastric adenocarcinoma or gastroesophageal Junction (GEJ) adenocarcinoma.
At least one measurable lesion per RECIST v1.1.
Gastric adenocarcinoma or gastroesophageal junction (GEJ) adenocarcinoma with failure of first-line treatment
Adequate organ function.
Have agreed to take effective contraception from the date of signing the informed consent form until 120 days after the last administration.
Exclusion Criteria:
Known HER2-positive
Other invasive malignancies within 3 years, except for locally treatable (manifested as cured) malignancies, such as basal or skin squamous cell carcinoma, superficial bladder cancer, cervical or breast carcinoma in situ.
Any previous systemic therapy targeting VEGF or anti-VEGFR signaling pathways.
In addition to PD1 or PD-L1,Prior exposure to anti-CTLA-4 antibody, or any other antibody or drug therapy for T cell co-stimulatory or checkpoint pathways, such as ICOS or agonists (e.g. CD40, CD137, GITR and OX40 etc).
Known history of primary immunodeficiency virus infection.
Known history of allogeneic organ transplantation or allogeneic hematopoietic stem cell transplantation.
Known history of interstitial lung disease.
Known history of active tuberculosis (TB).
Central nervous system (CNS) metastasis, meningeal metastasis, spinal cord compression, or leptomeningeal disease.
Patients with untreated chronic hepatitis B or HBV DNA exceeding 500IU/mL or active hepatitis C should be excluded. Patients with HCV antibody positive are eligible to participate in the study if the results of HCV RNA test show negative.
Known history of testing positive for human immunodeficiency virus (HIV).
Uncontrolled pleural effusion, pericardial effusion, or ascites requiring repeated drainage.
Subjects with active, known or suspected autoimmune disease, or a medical history of autoimmune disease, with the exceptions of the following: vitiligo, alopecia, Grave disease, psoriasis or eczema not requiring systemic treatment within the last 2 years, hypothyroidism (caused by autoimmune thyroiditis) only requiring steady doses of hormone replacement therapy and type I diabetes only requiring steady doses of insulin replacement therapy, or completely relieved childhood asthma that requires no intervention in adulthood, or primary diseases that will not relapse unless triggered by external factors.
Pregnant or lactating women.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Ting Liu, MD
Phone
+86 (0760) 8987 3999
Email
clinicaltrials@akesobio.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Lin Shen, MD
Organizational Affiliation
Peking University Cancer Hospital & Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
Beijing Cancer Hospital
City
Beijing
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Lin Shen, MD
12. IPD Sharing Statement
Plan to Share IPD
No
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A Study of AK109 and AK104 in Advanced Gastric Adenocarcinoma or Gastroesophageal Junction Adenocarcinoma
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