Combination Margetuximab, Retifanlimab, Tebotelimab, and Chemotherapy Phase 2/3 Trial in HER2+ Gastric/GEJ Cancer (MAHOGANY)
Gastric Cancer, Gastroesophageal Junction Cancer, HER2-positive Gastric Cancer
About this trial
This is an interventional treatment trial for Gastric Cancer
Eligibility Criteria
Key Inclusion Criteria:
Histologically confirmed diagnosis of previously untreated locally advanced unresectable or metastatic HER2+ GC or GEJ adenocarcinoma
- Prior systemic perioperative treatment is allowed; however the patient must have had a disease-free interval of at least 6 months from end of chemo/surgery
- Patients receiving perioperative anti-HER2 therapy require testing of HER2 status for eligibility
- Cohort A: HER2-positive (by IHC 3+) and PD-L1-positive (by IHC with 22C3 CPS ≥ 1%) per central review
- Cohort B: HER2-positive (by IHC 3+ or IHC 2+ in combination with FISH+) by local review. PD -L1 status is not required for enrollment.
- Availability of formalin-fixed, paraffin-embedded tumor specimen, unstained slides or contemporaneous biopsy for tumor target testing
- Eastern Cooperative Oncology Group performance status of 0 or 1, verified within 3 days of Day 1
- Life expectancy ≥ 6 months
- At least one radiographically measurable target lesion
- Acceptable laboratory parameters and adequate organ function
Key Exclusion Criteria:
Other malignancy that is progressing or required treatment within the past 5 years, with certain exceptions
- Patients with known MSI-H status
- History of allogeneic stem cell or tissue/solid organ transplant
- Central nervous system metastases
Clinically significant cardiovascular disease, gastrointestinal disorders, pulmonary compromise
- Prior neoadjuvant or adjuvant treatment with immunotherapy
Sites / Locations
- Mayo Clinic - Scottsdale
- City of Hope Comprehensive Cancer Center - Duarte
- Norris Comprehensive Cancer Center (USC)
- Salinas Memorial
- UCLA School of Medicine
- Yale University
- Florida Cancer Specialists South
- Mayo Clinic - Jacksonville
- Ocala Oncology Center PL DBA Florida Cancer Affiliates - Ocala
- Florida Cancer Specialists North
- Kaiser Permanente
- University of Chicago
- Edward H. Kaplan MD & Associates
- Massachusetts General Hospital Cancer Center
- Henry Ford Health System
- Cancer & Hematology Centers of Western Michigan - Lemmen-Holton Cancer Pavilion
- Mayo Clinic - Rochester
- Washington University School of Medicine
- Nebraska Heme Onc
- Rutgers Cancer Institute of New Jersey
- The University of New Mexico Comprehensive Cancer Center
- Stephenson Cancer Center at OUHSC
- Sarah Cannon Research Institute
- Oncology Consultants
- Utah Cancer Specialists
- Virginia Cancer Specialists
- Swedish Cancer Institute
- University of Wisconsin
- Beijing Cancer Hospital
- Jilin Cancer Hospital (Second People's Hospital Of Jilin Province)
- Fujian Medical University - Fujian Provincial Cancer Hospital (Fujian Provincial Tumor Hospital)
- SIR RUN RUN SHAW Hospital, Zhejiang University school of medicine
- Zhejiang Cancer Hospital
- Affiliated Tumor Hospital of Harbin Medical University- the 3rd Affiliated Hospital of Harbin
- The First Affiliated Hospital of Anhui Medical University
- Anhui Provincial Cancer Hospital
- Jinan Center Hospital
- Nanjing University Medical School; Nanjing Drug Tower
- Zhongshan Hospital Fudan University
- Liaoning cancer hospital
- Hebei cancer hospital (The Fourth Affiliate)
- Wuhan Union Hospital
- Henan Cancer Hospital
- The First Affiliated Hospital of Zhengzhou University
- Institute of Clinical Cancer Research Krankenhaus Nordwest (IKF)
- Haematologisch-Onkologische Praxis Eppendorf
- Universitätsmedizin Mainz
- Kliniken Maria Hilf GmbH
- Ospedale San Raffaele
- Istituto Europeo Di Oncologia
- Azienda Ospedaliero-Universitaria Pisana
- Hallym University Sacred Heart Hospital
- CHA bundang
- Inje University Haeundae Paik Hospital
- Seoul National University Bundang Hospital
- Asan Medical Center
- Korea University Guro
- Korea University, Anam Hospital
- Samsung Medical Center
- Seoul National University Hospital
- Yonsei University College of Medicine (Severance Hospital)
- Catholic University of Korea St. Vincent Hospital
- SPSK nr 1 in Lublin
- Centrum Medyczne MrukMed
- National University Hospital (Cancer Institute) -Singapore
- National Cancer Center Singapore
- Taipei Medical University Hospital
- Kaohsiung Chang Gung MemorialHospital
- Chang Gung Memorial Hospital, Keelung
- Liuying Chi MeiMedical Hospital
- National Taiwan University
- Cambridge University Hospitals NHS Foundation Trust Addenbrooke's Hospital
- The Christie Hospital NHS Foundation Trust
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Experimental
Experimental
Experimental
Experimental
Active Comparator
Chemotherapy-free arm
Margetuximab, retifanlimab, and chemotherapy arm
Margetuximab, tebotelimab and chemotherapy arm
Margetuximab and chemotherapy arm
Trastuzumab and chemotherapy arm
margetuximab plus retifanlimab
margetuximab plus retifanlimab plus investigator choice of chemotherapy options. Chemotherapy options: capecitabine and oxaliplatin (XELOX) or modified 5-FU, leucovorin, and oxaliplatin regimen 6 (mFOLFOX-6)
margetuximab plus tebotelimab plus investigator choice of chemotherapy options. Chemotherapy options: capecitabine and oxaliplatin (XELOX) or modified 5-FU, leucovorin, and oxaliplatin regimen 6 (mFOLFOX-6)
margetuximab plus investigator choice of chemotherapy options. Chemotherapy options: capecitabine and oxaliplatin (XELOX) or modified 5-FU, leucovorin, and oxaliplatin regimen 6 (mFOLFOX-6)
Trastuzumab plus investigator choice of chemotherapy options. Chemotherapy options: capecitabine and oxaliplatin (XELOX) or modified 5-FU, leucovorin, and oxaliplatin regimen 6 (mFOLFOX-6)