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Phase 2 Study of AMG 386 (20060439) in Combination With Cisplatin & Capecitabine in Subjects With Metastatic Gastric, Gastroesophageal Junction, or Distal Esophageal Adenocarcinoma

Primary Purpose

Gastrointestinal Cancer

Status
Completed
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
AMG 386 placebo
AMG 386 10mg/kg
AMG 386 3mg/kg
Cisplatin
Capecitabine
Cisplatin
Capecitabine
Cisplatin
Capecitabine
Sponsored by
Amgen
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Gastrointestinal Cancer focused on measuring Gastric Cancer, Metastatic Gastric, Gastroesophageal Junction, or Distal Esophageal Adenocarcinoma, AMG 386, Cisplatin, Capecitabine

Eligibility Criteria

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

Inclusion Criteria:

  • Disease Related

    • Histologically or cytologically confirmed adenocarcinoma of the stomach, gastroesophageal junction or distal esophagus with metastatic disease
    • Measurable or non-measurable disease per RECIST Guidelines
    • Prior gastrectomy (total or partial) may be allowed as long as subjects can take oral medications and meet all other inclusion/exclusion criteria. Subjects may not take crushed or dissolved capecitabine via a feeding/gastrostomy tube
    • Palliative radiotherapy for metastatic esophageal or gastric cancer prior to study entry may be allowed as long as all toxicities from radiotherapy have resolved and the radiotherapy was not to the only site of known metastatic disease
  • Demographic

    •18 years of age or older at the time the written informed consent is obtained

  • General

    • Able to swallow oral medication
    • ECOG performance status of 0 or 1
  • Laboratory

    • Adequate organ and hematological function as evidenced by laboratory studies prior to randomization

Exclusion Criteria:

  • Disease Related

    • Prior chemotherapy for metastatic disease (1st line)
    • Less than 12 months have elapsed from completion of previous adjuvant or neoadjuvant chemotherapy or chemoradiotherapy
    • Subjects with persistent gastric outlet obstruction, complete dysphagia or feeding jejunostomy
    • Radiotherapy ≤ 14 days prior to randomization. Subjects must have recovered from all radiotherapy-related toxicities
    • Current or prior history of central nervous system metastases
    • History of arterial or deep venous thromboembolism within 12 months prior to randomization
    • History of bleeding diathesis or clinically significant bleeding within 6 months prior to randomization
    • Major surgical procedure within 28 days prior to randomization
    • Minor surgical procedure, placement of central venous access device or fine needle aspiration within 3 days prior to randomization
    • Prior malignancy except: malignancy treated with curative intent and without evidence of active disease for ≥ 3 years prior to randomization and felt to be at low risk for recurrence by treating physician, adequately treated non-melanomatous skin cancer or lentigo maligna without evidence of disease, adequately treated cervical carcinoma in situ without evidence of disease, prostatic intraepithelial neoplasia without evidence of prostate cancer
    • Prior malignancy (other than in situ cervical cancer, or basal cell cancer of the skin) unless treated with curative intent and without evidence of disease for ≥ 3 years prior to randomization
    • Clinically significant cardiovascular diseases within 12 months prior to randomization
    • Presence of clinically significant non-healing wound, ulcer (including gastrointestinal) or fracture as judged by the investigator
    • Ongoing or clinically significant active infection as judged by the investigator
    • Known hypersensitivity to bacterial proteins, or any of the drugs required in this study
    • Known peripheral neuropathy ≥Grade 1
    • Known dihydropyrimidine dehydrogenase deficiency
    • Known hypersensitivity to 5-FU/capecitabine
    • Known positive test for human immunodeficiency virus (HIV), hepatitis C, or hepatitis B surface antigen
    • Known active or chronic hepatitis
  • Medications

    • Currently or previously treated with angiopoietin inhibitors, or inhibitors of TIE-1 or TIE-2
    • Treatment with immune modulators such as cyclosporine or tacrolimus within 30 days prior to randomization
    • Treatment with sorivudine or its chemically related analogues
    • Anticoagulants (other than aspirin and anti-platelet agents) within 7 days prior to randomization. The concurrent use of low molecular weight heparin or heparanoids or low dose warfarin (i.e, ≤ 1 mg daily) for prophylaxis against thrombosis is acceptable while on study
  • General

    • Not yet completed at least 30 days since ending other investigational device/drug trial(s), or subject is receiving other investigational treatments
    • Pregnant or is breast feeding

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm Type

    Experimental

    Experimental

    Active Comparator

    Arm Label

    B

    A

    C

    Arm Description

    Outcomes

    Primary Outcome Measures

    Progression Free Survival (PFS)

    Secondary Outcome Measures

    Safety and Tolerability
    Objective Response Rate (ORR)
    Duration of Response (DOR)
    Overall Survival (OS)
    Time to Progression (TTP)
    Time to Response
    Pharmacokinetics
    Patient Reported Outcomes

    Full Information

    First Posted
    December 20, 2007
    Last Updated
    April 21, 2014
    Sponsor
    Amgen
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    1. Study Identification

    Unique Protocol Identification Number
    NCT00583674
    Brief Title
    Phase 2 Study of AMG 386 (20060439) in Combination With Cisplatin & Capecitabine in Subjects With Metastatic Gastric, Gastroesophageal Junction, or Distal Esophageal Adenocarcinoma
    Official Title
    A Randomized, Double Blind, Multi-Center, Phase 2 Study to Estimate the Efficacy and Evaluate the Safety and Tolerability of Cisplatin & Capecitabine (CX) in Combination With AMG 386 or Placebo in Subjects With Metastatic Gastric, Gastroesophageal Junction, or Distal Esophageal Adenocarcinoma
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    April 2014
    Overall Recruitment Status
    Completed
    Study Start Date
    December 2007 (undefined)
    Primary Completion Date
    March 2010 (Actual)
    Study Completion Date
    June 2012 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Amgen

    4. Oversight

    5. Study Description

    Brief Summary
    This is a phase 2, randomized, double blind, placebo controlled, multi-center study to estimate the improvement in progression free survival (compared to control subjects) and evaluate the safety and tolerability of AMG 386 in combination with Cisplatin & Capecitabine in the treatment of subjects with Metastatic Gastric, Gastroesophageal Junction, or Distal Esophageal Adenocarcinoma. AMG 386 is a man-made medication that is designed to stop the development of blood vessels in cancer tissues. Cancer tissues rely on the development of new blood vessels, a process called angiogenesis, to obtain a supply of oxygen and nutrients to grow.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Gastrointestinal Cancer
    Keywords
    Gastric Cancer, Metastatic Gastric, Gastroesophageal Junction, or Distal Esophageal Adenocarcinoma, AMG 386, Cisplatin, Capecitabine

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 2
    Interventional Study Model
    Parallel Assignment
    Masking
    ParticipantCare ProviderInvestigatorOutcomes Assessor
    Allocation
    Randomized
    Enrollment
    171 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    B
    Arm Type
    Experimental
    Arm Title
    A
    Arm Type
    Experimental
    Arm Title
    C
    Arm Type
    Active Comparator
    Intervention Type
    Drug
    Intervention Name(s)
    AMG 386 placebo
    Intervention Description
    AMG 386 placebo IV QW until radiographic disease progression, clinical progression, unacceptable toxicity, subject withdrawal of consent, or death
    Intervention Type
    Drug
    Intervention Name(s)
    AMG 386 10mg/kg
    Intervention Description
    AMG 386 10 mg/kg IV QW until radiographic disease progression, clinical progression, unacceptable toxicity, subject withdrawal of consent, or death
    Intervention Type
    Drug
    Intervention Name(s)
    AMG 386 3mg/kg
    Intervention Description
    AMG 386 3 mg/kg IV QW until radiographic disease progression, clinical progression, unacceptable toxicity, subject withdrawal of consent, or death
    Intervention Type
    Drug
    Intervention Name(s)
    Cisplatin
    Intervention Description
    Cisplatin 80 mg/m2 IV Q3W until radiographic disease progression, clinical progression, unacceptable toxicity, subject withdrawal of consent, or death
    Intervention Type
    Drug
    Intervention Name(s)
    Capecitabine
    Intervention Description
    Capecitabine1000 mg/m2 PO BID x 14 days Q3W until radiographic disease progression, clinical progression, unacceptable toxicity, subject withdrawal of consent, or death
    Intervention Type
    Drug
    Intervention Name(s)
    Cisplatin
    Intervention Description
    Cisplatin 80 mg/m2 IV Q3W until radiographic disease progression, clinical progression, unacceptable toxicity, subject withdrawal of consent, or death
    Intervention Type
    Drug
    Intervention Name(s)
    Capecitabine
    Intervention Description
    Capecitabine 1000 mg/m2 PO BID x 14 days Q3W until radiographic disease progression, clinical progression, unacceptable toxicity, subject withdrawal of consent, or death
    Intervention Type
    Drug
    Intervention Name(s)
    Cisplatin
    Intervention Description
    Cisplatin 80 mg/m2 IV Q3W until radiographic disease progression, clinical progression, unacceptable toxicity, subject withdrawal of consent, or death
    Intervention Type
    Drug
    Intervention Name(s)
    Capecitabine
    Intervention Description
    Capecitabine 1000 mg/m2 PO BID x 14 days Q3W until radiographic disease progression, clinical progression, unacceptable toxicity, subject withdrawal of consent, or death
    Primary Outcome Measure Information:
    Title
    Progression Free Survival (PFS)
    Time Frame
    22 months
    Secondary Outcome Measure Information:
    Title
    Safety and Tolerability
    Time Frame
    22 months
    Title
    Objective Response Rate (ORR)
    Time Frame
    22 months
    Title
    Duration of Response (DOR)
    Time Frame
    22 months
    Title
    Overall Survival (OS)
    Time Frame
    22 months
    Title
    Time to Progression (TTP)
    Time Frame
    22 months
    Title
    Time to Response
    Time Frame
    22 months
    Title
    Pharmacokinetics
    Time Frame
    22 months
    Title
    Patient Reported Outcomes
    Time Frame
    22 months

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Disease Related Histologically or cytologically confirmed adenocarcinoma of the stomach, gastroesophageal junction or distal esophagus with metastatic disease Measurable or non-measurable disease per RECIST Guidelines Prior gastrectomy (total or partial) may be allowed as long as subjects can take oral medications and meet all other inclusion/exclusion criteria. Subjects may not take crushed or dissolved capecitabine via a feeding/gastrostomy tube Palliative radiotherapy for metastatic esophageal or gastric cancer prior to study entry may be allowed as long as all toxicities from radiotherapy have resolved and the radiotherapy was not to the only site of known metastatic disease Demographic •18 years of age or older at the time the written informed consent is obtained General Able to swallow oral medication ECOG performance status of 0 or 1 Laboratory Adequate organ and hematological function as evidenced by laboratory studies prior to randomization Exclusion Criteria: Disease Related Prior chemotherapy for metastatic disease (1st line) Less than 12 months have elapsed from completion of previous adjuvant or neoadjuvant chemotherapy or chemoradiotherapy Subjects with persistent gastric outlet obstruction, complete dysphagia or feeding jejunostomy Radiotherapy ≤ 14 days prior to randomization. Subjects must have recovered from all radiotherapy-related toxicities Current or prior history of central nervous system metastases History of arterial or deep venous thromboembolism within 12 months prior to randomization History of bleeding diathesis or clinically significant bleeding within 6 months prior to randomization Major surgical procedure within 28 days prior to randomization Minor surgical procedure, placement of central venous access device or fine needle aspiration within 3 days prior to randomization Prior malignancy except: malignancy treated with curative intent and without evidence of active disease for ≥ 3 years prior to randomization and felt to be at low risk for recurrence by treating physician, adequately treated non-melanomatous skin cancer or lentigo maligna without evidence of disease, adequately treated cervical carcinoma in situ without evidence of disease, prostatic intraepithelial neoplasia without evidence of prostate cancer Prior malignancy (other than in situ cervical cancer, or basal cell cancer of the skin) unless treated with curative intent and without evidence of disease for ≥ 3 years prior to randomization Clinically significant cardiovascular diseases within 12 months prior to randomization Presence of clinically significant non-healing wound, ulcer (including gastrointestinal) or fracture as judged by the investigator Ongoing or clinically significant active infection as judged by the investigator Known hypersensitivity to bacterial proteins, or any of the drugs required in this study Known peripheral neuropathy ≥Grade 1 Known dihydropyrimidine dehydrogenase deficiency Known hypersensitivity to 5-FU/capecitabine Known positive test for human immunodeficiency virus (HIV), hepatitis C, or hepatitis B surface antigen Known active or chronic hepatitis Medications Currently or previously treated with angiopoietin inhibitors, or inhibitors of TIE-1 or TIE-2 Treatment with immune modulators such as cyclosporine or tacrolimus within 30 days prior to randomization Treatment with sorivudine or its chemically related analogues Anticoagulants (other than aspirin and anti-platelet agents) within 7 days prior to randomization. The concurrent use of low molecular weight heparin or heparanoids or low dose warfarin (i.e, ≤ 1 mg daily) for prophylaxis against thrombosis is acceptable while on study General Not yet completed at least 30 days since ending other investigational device/drug trial(s), or subject is receiving other investigational treatments Pregnant or is breast feeding
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    MD
    Organizational Affiliation
    Amgen
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Citations:
    PubMed Identifier
    23108953
    Citation
    Eatock MM, Tebbutt NC, Bampton CL, Strickland AH, Valladares-Ayerbes M, Swieboda-Sadlej A, Van Cutsem E, Nanayakkara N, Sun YN, Zhong ZD, Bass MB, Adewoye AH, Bodoky G. Phase II randomized, double-blind, placebo-controlled study of AMG 386 (trebananib) in combination with cisplatin and capecitabine in patients with metastatic gastro-oesophageal cancer. Ann Oncol. 2013 Mar;24(3):710-8. doi: 10.1093/annonc/mds502. Epub 2012 Oct 28.
    Results Reference
    background
    Links:
    URL
    http://www.amgentrials.com
    Description
    AmgenTrials clinical trials website

    Learn more about this trial

    Phase 2 Study of AMG 386 (20060439) in Combination With Cisplatin & Capecitabine in Subjects With Metastatic Gastric, Gastroesophageal Junction, or Distal Esophageal Adenocarcinoma

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