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Clinical Study of SHR-1701 Plus Chemotherapy as Perioperative Treatment in Subjects With Gastric Cancer

Primary Purpose

Perioperative Treatment in Subjects With Locally Advanced Resectable Gastric Cancer or Gastroesophageal Junction Cancer

Status
Enrolling by invitation
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
SHR-1701 injection
Placebo
Sponsored by
Suzhou Suncadia Biopharmaceuticals Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Perioperative Treatment in Subjects With Locally Advanced Resectable Gastric Cancer or Gastroesophageal Junction Cancer

Eligibility Criteria

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

Inclusion Criteria:

  1. Pathologically diagnosed with GC or GEJC, histologically confirmed to be adenocarcinoma, and have no previous anti-tumor treatments for GC or GEJC.
  2. Aged 18 or above, male or female.
  3. Be suitable for (investigator's assessment) and planning to undergo neoadjuvant therapy + radical surgery with curative intent before entering into the study.
  4. locally advanced Gastric Cancer or Gastroesophageal Junction Cancer confirmed by investigator.
  5. Be able to provide tumor tissue blocks.
  6. Eastern Cooperative Oncology Group (ECOG) performance status score of 0-1.
  7. Life expectancy of ≥ 6 months.
  8. Have adequate organ and bone marrow functions.
  9. Women without childbearing potential refer to post-menopausal women, or women who underwent bilateral oophorectomy with medical records. Male subjects and female subjects of childbearing potential must agree to take a medically approved contraceptive measure (refer to Appendix 4) during the study, within 3 months after the last dose of investigational product (SHR-1701), and within 9 months after the last dose of chemotherapy agents (S-1 and oxaliplatin); have a negative serum pregnancy test result within 3 days prior to the start of study treatment and not be breastfeeding.
  10. Subjects must agree and have signed the informed consent form, be willing and able to follow the scheduled visits, study treatment, laboratory tests, and other study procedures.

Exclusion Criteria:

  1. Have known squamous cell carcinoma, undifferentiated carcinoma, or other histological types of gastric cancer, or adenocarcinoma mixed with gastric cancer of other histological types.
  2. Have unresectable factors, including unresectable tumors or contraindications to surgery or refusal of surgery.
  3. Have more than 20% weight loss within 2 months prior to enrollment or randomization.
  4. Have previously received some treatments or medications including anti-tumor treatments.
  5. Diagnosed with other malignant tumors within 5 years prior to enrollment.
  6. Have any active, known, or suspected autoimmune disease.
  7. Have clinically significant bleeding symptoms or clear bleeding tendency within 3 months prior to enrollment or randomization; have gastrointestinal perforation and/or gastrointestinal fistula within 6 months prior to enrollment or randomization; have arterial/venous thrombotic events within 6 months prior to enrollment or randomization.
  8. Have major vascular disease within 6 months prior to enrollment or randomization.
  9. Have severe, unhealed, or dehisced wounds and active ulcers or untreated fractures.
  10. Have intestinal obstruction and/or clinical signs or symptoms of gastrointestinal obstruction within 6 months prior to enrollment or randomization.
  11. Have interstitial lung disease, non-infectious pneumonitis, or uncontrolled systemic disease.
  12. Have known allergies to the study drug or their excipients; have severe allergic reactions to other monoclonal antibodies.
  13. Have HIV infection or known AIDS, active untreated hepatitis or co-infection with hepatitis B and C.
  14. Have uncontrolled cardiac symptoms or disease:
  15. Have received systemic antibiotics for ≥ 7 days within 4 weeks prior to enrollment or randomization, or have unexplained fever > 38.5 °C during screening or before the first dose.
  16. Have known history of allogeneic organ transplantation or allogeneic hematopoietic stem cell transplantation.
  17. Have been screened for other clinical studies but failed the screening because PD-L1 expression did not meet the inclusion criteria or met the exclusion criteria; have participated in clinical studies of any other drugs, less than 4 weeks or 5 half-lives of the drug between the last dose of these study treatments and enrollment/randomization for this study (whichever is longer).
  18. Have a known history of psychotropic substance abuse or drug abuse.
  19. Have other severe physical or psychiatric disorders or laboratory abnormalities, which may increase the risk of participation in this study or interfere with the study results, or deemed unsuitable by the investigator.

Sites / Locations

  • The First Affiliated Hospital of Bengbu Medical College
  • The Second Affiliated Hospital Of Anhui Medical University
  • Beijing Cancer Hospital
  • Fujian Medical University Union Hospital
  • Southern Medical University NanFang Hospital
  • The First Affiliated Hospital, Sun Yat-sen University
  • The Fourth Hospital of Hebei Medical University
  • Xingtai People's Hospital
  • Anyang Cancer Hospital
  • The First Affiliated Hospital of Henan University of Science & Technology
  • Henan Cancer Hospital
  • The First Affiliated Hospital of Zhengzhou University
  • Hubei Cancer Hospital
  • Subei people's Hospital of Jiangsu Province
  • Liaoning Cancer Hospital&Institute
  • Zhongshan Hospital, Fudan University
  • The Second Affiliated Hospital of Air Force Military University Tangdu Hospital
  • The First Affiliated Hospital of Xi'an Jiaotong University
  • Sichuan Cancer Hospital & Institute
  • Tianjin Medical University Cancer Institute and Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

SHR-1701 + Tegafur Gimeracil Oteracil Potassium and Oxaliplatin

Placebo + Tegafur Gimeracil Oteracil Potassium and Oxaliplatin

Arm Description

Outcomes

Primary Outcome Measures

Phase II : Pathological Complete Response pCR rate.
pCR rate is defined as the proportion of subjects whose specimens (including primary lesion and lymph nodes) obtained during GC or GEJC radical surgery are pathologically assessed to be free of residual live tumor cells after neoadjuvant therapy.
Phase III : Event-free Survival (EFS)
EFS is defined as time from randomization to PD or death (whichever occurs first), detailed that tumor progression/recurrence or new lesion confirmed by RECIST v1.1 criteria or death due to any cause.

Secondary Outcome Measures

Disease-free Survival (DFS).
DFS is defined as time from R0 resection to PD or death (whichever occurs first), detailed that tumor recurrence or new lesion confirmed by RECIST v1.1 criteria or death due to any cause.
Preoperative Objective Response Rate (ORR).
Preoperative ORR is defined as proportion of enrolled or randomized subjects with a best overall response (BOR) of complete response (CR) or partial response (PR) according to RECIST v1.1 criteria during neoadjuvant therapy period.
Major pathological response (MPR) rates.
MPR rate is defined as proportion of subjects whose primary lesion specimens obtained during GC or GEJC radical surgery are pathologically assessed to have < 10% residual live tumor cells relative to the primary tumor tissue (Becker grade 1a or 1b) after neoadjuvant therapy.
R0 resection rate
R0 resection rate is defined as proportion of subjects without gross or microscopic residual tumor (negative margin) after neoadjuvant therapy and GC or GEJC radical surgery.
Overall Survival (OS).
OS is defined as time from randomization to death of any cause.
Percentage of Participants Who Experience One or More Adverse Events (AEs).
An AE is defined as any untoward medical occurrence in a participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment. The percentage of participants who experience at least one AE will be presented.
30-day postoperative mortality.
30-day postoperative mortality is defined as proportion of subjects who died due to any reason within 30 days after radical surgery for GC.

Full Information

First Posted
November 9, 2021
Last Updated
February 8, 2022
Sponsor
Suzhou Suncadia Biopharmaceuticals Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT05149807
Brief Title
Clinical Study of SHR-1701 Plus Chemotherapy as Perioperative Treatment in Subjects With Gastric Cancer
Official Title
A Randomized, Double-Blind, Multi-Center Phase II/III Clinical Study of PD-L1 Antibody/TGF-βRII (SHR-1701) Plus Tegafur Gimeracil Oteracil Potassium and Oxaliplatin Versus Placebo Plus Tegafur Gimeracil Oteracil Potassium and Oxaliplatin as Perioperative Treatment in Subjects With Resectable Gastric Cancer or Gastroesophageal Junction Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
November 2021
Overall Recruitment Status
Enrolling by invitation
Study Start Date
January 26, 2022 (Actual)
Primary Completion Date
July 31, 2027 (Anticipated)
Study Completion Date
December 31, 2027 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Suzhou Suncadia Biopharmaceuticals Co., Ltd.

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 a multi-center phase II/III clinical study consisting of two stages: Stage I is a single-arm open-label phase II study to preliminarily explore the efficacy and safety of SHR-1701 plus S-1 and oxaliplatin mainly by the endpoint of pCR rate. Stage II is a randomized, double-blind, multi-center phase III study of SHR-1701 plus S-1 and oxaliplatin versus placebo plus S-1 and oxaliplatin as perioperative treatment in subjects with resectable GC or GEJC. A total of 846 treatment naïve subjects will be enrolled, and primary endpoint of this stage is Independent Review Committee (IRC)-assessed EFS.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Perioperative Treatment in Subjects With Locally Advanced Resectable Gastric Cancer or Gastroesophageal Junction Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2, Phase 3
Interventional Study Model
Parallel Assignment
Model Description
This is a multi-center phase II/III clinical study consisting of two stages: Stage I is a single-arm open-label phase II study to preliminarily explore the efficacy and safety of SHR-1701 plus S-1 and oxaliplatin; Stage II is a randomized, double-blind, multi-center phase III study of SHR-1701 plus S-1 and oxaliplatin versus placebo plus S-1 and oxaliplatin as perioperative treatment in subjects with resectable GC or GEJC.
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
896 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
SHR-1701 + Tegafur Gimeracil Oteracil Potassium and Oxaliplatin
Arm Type
Experimental
Arm Title
Placebo + Tegafur Gimeracil Oteracil Potassium and Oxaliplatin
Arm Type
Placebo Comparator
Intervention Type
Drug
Intervention Name(s)
SHR-1701 injection
Intervention Description
SHR-1701 injection Tegafur Gimeracil Oteracil Potassium Oxaliplatin
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo Tegafur Gimeracil Oteracil Potassium Oxaliplatin
Primary Outcome Measure Information:
Title
Phase II : Pathological Complete Response pCR rate.
Description
pCR rate is defined as the proportion of subjects whose specimens (including primary lesion and lymph nodes) obtained during GC or GEJC radical surgery are pathologically assessed to be free of residual live tumor cells after neoadjuvant therapy.
Time Frame
Up to approximately 23 months
Title
Phase III : Event-free Survival (EFS)
Description
EFS is defined as time from randomization to PD or death (whichever occurs first), detailed that tumor progression/recurrence or new lesion confirmed by RECIST v1.1 criteria or death due to any cause.
Time Frame
Up to approximately 57 months
Secondary Outcome Measure Information:
Title
Disease-free Survival (DFS).
Description
DFS is defined as time from R0 resection to PD or death (whichever occurs first), detailed that tumor recurrence or new lesion confirmed by RECIST v1.1 criteria or death due to any cause.
Time Frame
Up to approximately 57 months
Title
Preoperative Objective Response Rate (ORR).
Description
Preoperative ORR is defined as proportion of enrolled or randomized subjects with a best overall response (BOR) of complete response (CR) or partial response (PR) according to RECIST v1.1 criteria during neoadjuvant therapy period.
Time Frame
Up to approximately 57 months
Title
Major pathological response (MPR) rates.
Description
MPR rate is defined as proportion of subjects whose primary lesion specimens obtained during GC or GEJC radical surgery are pathologically assessed to have < 10% residual live tumor cells relative to the primary tumor tissue (Becker grade 1a or 1b) after neoadjuvant therapy.
Time Frame
Up to approximately 23 months
Title
R0 resection rate
Description
R0 resection rate is defined as proportion of subjects without gross or microscopic residual tumor (negative margin) after neoadjuvant therapy and GC or GEJC radical surgery.
Time Frame
Up to approximately 23 months
Title
Overall Survival (OS).
Description
OS is defined as time from randomization to death of any cause.
Time Frame
Up to approximately 57 months
Title
Percentage of Participants Who Experience One or More Adverse Events (AEs).
Description
An AE is defined as any untoward medical occurrence in a participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment. The percentage of participants who experience at least one AE will be presented.
Time Frame
Up to approximately 57 months
Title
30-day postoperative mortality.
Description
30-day postoperative mortality is defined as proportion of subjects who died due to any reason within 30 days after radical surgery for GC.
Time Frame
Up to approximately 24 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Pathologically diagnosed with GC or GEJC, histologically confirmed to be adenocarcinoma, and have no previous anti-tumor treatments for GC or GEJC. Aged 18 or above, male or female. Be suitable for (investigator's assessment) and planning to undergo neoadjuvant therapy + radical surgery with curative intent before entering into the study. locally advanced Gastric Cancer or Gastroesophageal Junction Cancer confirmed by investigator. Be able to provide tumor tissue blocks. Eastern Cooperative Oncology Group (ECOG) performance status score of 0-1. Life expectancy of ≥ 6 months. Have adequate organ and bone marrow functions. Women without childbearing potential refer to post-menopausal women, or women who underwent bilateral oophorectomy with medical records. Male subjects and female subjects of childbearing potential must agree to take a medically approved contraceptive measure (refer to Appendix 4) during the study, within 3 months after the last dose of investigational product (SHR-1701), and within 9 months after the last dose of chemotherapy agents (S-1 and oxaliplatin); have a negative serum pregnancy test result within 3 days prior to the start of study treatment and not be breastfeeding. Subjects must agree and have signed the informed consent form, be willing and able to follow the scheduled visits, study treatment, laboratory tests, and other study procedures. Exclusion Criteria: Have known squamous cell carcinoma, undifferentiated carcinoma, or other histological types of gastric cancer, or adenocarcinoma mixed with gastric cancer of other histological types. Have unresectable factors, including unresectable tumors or contraindications to surgery or refusal of surgery. Have more than 20% weight loss within 2 months prior to enrollment or randomization. Have previously received some treatments or medications including anti-tumor treatments. Diagnosed with other malignant tumors within 5 years prior to enrollment. Have any active, known, or suspected autoimmune disease. Have clinically significant bleeding symptoms or clear bleeding tendency within 3 months prior to enrollment or randomization; have gastrointestinal perforation and/or gastrointestinal fistula within 6 months prior to enrollment or randomization; have arterial/venous thrombotic events within 6 months prior to enrollment or randomization. Have major vascular disease within 6 months prior to enrollment or randomization. Have severe, unhealed, or dehisced wounds and active ulcers or untreated fractures. Have intestinal obstruction and/or clinical signs or symptoms of gastrointestinal obstruction within 6 months prior to enrollment or randomization. Have interstitial lung disease, non-infectious pneumonitis, or uncontrolled systemic disease. Have known allergies to the study drug or their excipients; have severe allergic reactions to other monoclonal antibodies. Have HIV infection or known AIDS, active untreated hepatitis or co-infection with hepatitis B and C. Have uncontrolled cardiac symptoms or disease: Have received systemic antibiotics for ≥ 7 days within 4 weeks prior to enrollment or randomization, or have unexplained fever > 38.5 °C during screening or before the first dose. Have known history of allogeneic organ transplantation or allogeneic hematopoietic stem cell transplantation. Have been screened for other clinical studies but failed the screening because PD-L1 expression did not meet the inclusion criteria or met the exclusion criteria; have participated in clinical studies of any other drugs, less than 4 weeks or 5 half-lives of the drug between the last dose of these study treatments and enrollment/randomization for this study (whichever is longer). Have a known history of psychotropic substance abuse or drug abuse. Have other severe physical or psychiatric disorders or laboratory abnormalities, which may increase the risk of participation in this study or interfere with the study results, or deemed unsuitable by the investigator.
Facility Information:
Facility Name
The First Affiliated Hospital of Bengbu Medical College
City
Bengbu
State/Province
Anhui
ZIP/Postal Code
233004
Country
China
Facility Name
The Second Affiliated Hospital Of Anhui Medical University
City
Hefei
State/Province
Anhui
ZIP/Postal Code
230601
Country
China
Facility Name
Beijing Cancer Hospital
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100142
Country
China
Facility Name
Fujian Medical University Union Hospital
City
Fuzhou
State/Province
Fujian
ZIP/Postal Code
350000
Country
China
Facility Name
Southern Medical University NanFang Hospital
City
Guangzhou
State/Province
Guangdong
ZIP/Postal Code
510000
Country
China
Facility Name
The First Affiliated Hospital, Sun Yat-sen University
City
Guangzhou
State/Province
Guangdong
ZIP/Postal Code
510000
Country
China
Facility Name
The Fourth Hospital of Hebei Medical University
City
Shijiazhuang
State/Province
Hebei
ZIP/Postal Code
050000
Country
China
Facility Name
Xingtai People's Hospital
City
Xingtai
State/Province
Hebei
ZIP/Postal Code
054031
Country
China
Facility Name
Anyang Cancer Hospital
City
Anyang
State/Province
Henan
ZIP/Postal Code
455000
Country
China
Facility Name
The First Affiliated Hospital of Henan University of Science & Technology
City
Luoyang
State/Province
Henan
ZIP/Postal Code
471003
Country
China
Facility Name
Henan Cancer Hospital
City
Zhengzhou
State/Province
Henan
ZIP/Postal Code
450000
Country
China
Facility Name
The First Affiliated Hospital of Zhengzhou University
City
Zhengzhou
State/Province
Henan
ZIP/Postal Code
450000
Country
China
Facility Name
Hubei Cancer Hospital
City
Wuhan
State/Province
Hubei
ZIP/Postal Code
430079
Country
China
Facility Name
Subei people's Hospital of Jiangsu Province
City
Yangzhou
State/Province
Jiangsu
ZIP/Postal Code
225001
Country
China
Facility Name
Liaoning Cancer Hospital&Institute
City
Shenyang
State/Province
Liaoning
ZIP/Postal Code
110801
Country
China
Facility Name
Zhongshan Hospital, Fudan University
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200000
Country
China
Facility Name
The Second Affiliated Hospital of Air Force Military University Tangdu Hospital
City
Xi'an
State/Province
Shanxi
ZIP/Postal Code
7100038
Country
China
Facility Name
The First Affiliated Hospital of Xi'an Jiaotong University
City
Xi'an
State/Province
Shanxi
ZIP/Postal Code
710061
Country
China
Facility Name
Sichuan Cancer Hospital & Institute
City
Chengdu
State/Province
Sichuan
ZIP/Postal Code
610042
Country
China
Facility Name
Tianjin Medical University Cancer Institute and Hospital
City
Tianjin
State/Province
Tianjin
ZIP/Postal Code
300060
Country
China

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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Clinical Study of SHR-1701 Plus Chemotherapy as Perioperative Treatment in Subjects With Gastric Cancer

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