A Study of Ramucirumab (LY3009806) in Combination With Capecitabine and Cisplatin in Participants With Stomach Cancer (RAINFALL)
Metastatic Gastric Adenocarcinoma, Gastroesophageal Junction Adenocarcinoma
About this trial
This is an interventional treatment trial for Metastatic Gastric Adenocarcinoma
Eligibility Criteria
Inclusion Criteria:
- Have a histopathologically confirmed diagnosis of metastatic gastric or gastroesophageal junction (GEJ) adenocarcinoma. All histologies of nonsquamous cell origin including undifferentiated gastric carcinoma are eligible.
- Have not received any prior first-line systemic therapy (prior adjuvant or neo-adjuvant therapy is permitted). Participants whose disease has progressed after >12 months following the last dose of systemic treatment in the adjuvant/neoadjuvant setting are eligible.
- Have measurable or nonmeasurable but evaluable disease determined using guidelines in Response Evaluation Criteria in Solid Tumors, Version 1.1 (RECIST v 1.1). Baseline tumor assessment should be performed using a high resolution computed tomography (CT) scan using IV and oral contrast unless clinically contra-indicated. Magnetic resonance imaging (MRI) is acceptable if a CT cannot be performed.
- Have a performance status of 0 or 1 on the Eastern Cooperative Oncology Group scale at baseline.
- Have adequate organ function.
- Have baseline clinical and laboratory parameters that are consistent with the requirements prescribed in respective labels and are suitable for consideration of treatment with capecitabine (or 5-FU) and cisplatin (for example, dihydropyrimidine dehydrogenase deficiency).
- Have an estimated life expectancy of ≥12 weeks in the judgment of the investigator.
Exclusion Criteria:
- Participants with adenocarcinoma of the esophagus are excluded.
- Participants with human epidermal growth factor receptor 2 (HER2)-positive status.
- Participants receiving chronic therapy with nonsteroidal anti-inflammatory agents.
- Have radiation therapy within 14 days prior to randomization.
- Have documented brain metastases, leptomeningeal disease or uncontrolled spinal cord compression.
- Have significant bleeding disorders, vasculitis, or had a significant bleeding episode from the gastrointestinal tract within 12 weeks prior to randomization.
- Have experienced any arterial thromboembolic event, including myocardial infarction, unstable angina, cerebrovascular accident, or transient ischemic attack, within 6 months prior to randomization.
- Have symptomatic congestive heart failure (New York Heart Association II-IV) or symptomatic or poorly controlled cardiac arrhythmia.
- Have uncontrolled hypertension prior to initiating study treatment, despite antihypertensive intervention.
- Have undergone major surgery within 28 days prior to randomization, or central venous access device placement within 7 days prior to first dose of study treatment, except if the procedure is minimally invasive (for example, introduction of peripherally inserted central catheter [PICC] line) and the investigator does not anticipate any significant bleeding.
- Have a history of gastrointestinal perforation and/or fistulae within 6 months prior to randomization.
- Have a history of inflammatory bowel disease or Crohn's disease requiring medical intervention (immunomodulatory or immunosuppressive medications or surgery) ≤12 months prior to randomization.
- Have an acute or subacute bowel obstruction or history of chronic diarrhea which is considered clinically significant in the opinion of the investigator.
The participant has:
- cirrhosis at a level of Child-Pugh B (or worse) or
- cirrhosis (any degree) and a history of hepatic encephalopathy or clinically meaningful ascites resulting from cirrhosis. Clinically meaningful ascites is defined as ascites resulting from cirrhosis and requiring ongoing treatment with diuretics and/or paracentesis.
- Have known allergy or hypersensitivity to any components of study treatment.
- Are pregnant or lactating.
Sites / Locations
- Highlands Oncology Group
- Comprehensive Blood and Cancer Center
- St Jude Medical Center
- SMO TRIO -Translational Research
- UCLA Medical Center
- Cancer Care Associates Medical Group
- Coastal Integrative Cancer Care
- Central Coast Medical Oncology Corporation
- University of Colorado School of Medicine
- Yale University School of Medicine
- Holy Cross Hospital Inc.
- Florida Cancer Specialists
- Florida Cancer Specialists and Research Institute
- Emory University
- Illinois CancerCare
- Dana Farber Cancer Institute
- Weill Cornell Medical College
- Memorial Sloan Kettering Cancer Center
- Oncology Hematology Care Inc
- Fox Chase Cancer Center
- Allegheny General Hospital
- SMO Sarah Cannon Research Inst.
- Tennessee Oncology PLLC
- UT Southwestern Med Ctr
- Baylor College of Medicine
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- Ad-Vance Medical Research
- Hospital Espanol Auxilio Mutuo
- VA Caribbean Healthcare System
- Hospital Municipal de San Juan
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- For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.
- For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.
- For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.
- For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.
- For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.
- For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Ramucirumab + Cisplatin + Capecitabine
Placebo + Cisplatin + Capecitabine
8 milligrams/kilogram (mg/kg) ramucirumab given intravenously (IV) on days 1 and 8 in combination with 80 mg/square meter (m^2) cisplatin given IV on day 1 of each 21-day cycle (for up to 6 cycles) and 1000 mg/m^2 capecitabine given orally twice a day on days 1 through 14. Participants that were unable to take capecitabine will be given 800 mg/m^2/day fluorouracil (5-FU) IV on days 1 to 5 of each 21-day cycle.
Placebo for blinding given IV on days 1 and 8 in combination with 80 mg/m^2 cisplatin given IV on day 1 of each 21-day cycle (for up to 6 cycles) and 1000 mg/m^2 capecitabine given orally twice a day on days 1 through 14. Participants that were unable to take capecitabine will be given 800 mg/m^2/day 5-FU IV on days 1 to 5 of each 21-day cycle.