Authorised Therapeutic confirmatory (Phase III) Claudin (CLDN)18.2-Positive, HER2-Negative, Locally Advanced Unresectable or Metastatic Gastric or Gastroesophageal Junction (GEJ) Adenocarcinoma

A Study of Zolbetuximab (IMAB362) plus CAPOX in Adults with Gastric Cancer.

EU CTIS ID: 2024-511648-16-00

What this study is testing

To evaluate the efficacy of zolbetuximab plus capecitabine and oxaliplatin (CAPOX) compared with placebo plus CAPOX (as first-line treatment) as measured by Progression Free Survival (PFS) in subjects with Claudin (CLDN) 18.2-positive, human epidermal growth factor receptor 2 (HER2)-negative locally advanced unresectable or metastatic gastric and gastroesophageal junction (GEJ) adenocarcinoma.

Therapeutic confirmatory (Phase III)

A plain-language read of the study's public EU CTIS listing. The study team confirms the details.

Who can take part

You may be able to join if

1.Institutional Review Board (IRB)/Independent Ethics Committee (IEC) approved written informed consent and privacy language as per national regulations must be obtained from the subject or legally authorized representative (if applicable) prior to any study-related procedures.
10. Subject has histologically confirmed diagnosis of Gastric or GEJ adenocarcinoma.
11. Subject has radiologically confirmed locally advanced unresectable or metastatic disease within 28 days prior to randomization.
12. Subject has radiologically evaluable disease (measurable and/or non-measurable) according to RECIST 1.1, per local assessment, ≤ 28 days prior to randomization. For subjects with only 1 evaluable lesion and prior radiotherapy ≤ 3 months before randomization, the lesion must either be outside the field of prior radiotherapy or have documented progression following radiation therapy.
13. Subject's tumor expresses CLDN18.2 in ≥ 75% of tumor cells demonstrating moderate to strong membranous staining as determined by central IHC testing.
14. Subject has a HER2-negative tumor as determined by local or central testing on a gastric or GEJ tumor specimen.

You likely can't join if

1. Subject has received prior systemic chemotherapy for locally advanced unresectable or metastatic gastric or GEJ adenocarcinoma. However, subject may have received either neo-adjuvant or adjuvant chemotherapy, immunotherapy or other systemic anticancer therapies as long as it was completed at least 6 months prior to randomization.
10. Subject has a complete gastric outlet syndrome or a partial gastric outlet syndrome with persistent/recurrent vomiting.
11. Per investigator judgment, subject has significant gastric bleeding and/or untreated gastric ulcers that exclude the subject from participation.
"12. Subject has a known history of a positive test for human immunodeficiency virus (HIV) infection or known active hepatitis B (positive HBs Ag) or C infection. NOTE: Screening for these infections should be conducted per local requirements. a. For subjects who are negative for HBs Ag, but HBc Ab positive, an HB DNA test will be performed, and if positive, the subject will be excluded. b. Subjects with positive hepatitis C virus (HCV) serology but negative HCV RNA test are eligible. c. Subjects treated for HCV with undetectable viral load results are eligible."
13. Subject has an active autoimmune disease that has required systemic treatment within the past 3 months prior to randomization.
14. Subject has active infection requiring systemic therapy that has not completely resolved within 7 days prior to randomization.

See the full eligibility criteria

Who can join

1.Institutional Review Board (IRB)/Independent Ethics Committee (IEC) approved written informed consent and privacy language as per national regulations must be obtained from the subject or legally authorized representative (if applicable) prior to any study-related procedures.
10. Subject has histologically confirmed diagnosis of Gastric or GEJ adenocarcinoma.
11. Subject has radiologically confirmed locally advanced unresectable or metastatic disease within 28 days prior to randomization.
12. Subject has radiologically evaluable disease (measurable and/or non-measurable) according to RECIST 1.1, per local assessment, ≤ 28 days prior to randomization. For subjects with only 1 evaluable lesion and prior radiotherapy ≤ 3 months before randomization, the lesion must either be outside the field of prior radiotherapy or have documented progression following radiation therapy.
13. Subject's tumor expresses CLDN18.2 in ≥ 75% of tumor cells demonstrating moderate to strong membranous staining as determined by central IHC testing.
14. Subject has a HER2-negative tumor as determined by local or central testing on a gastric or GEJ tumor specimen.
15. Subject has ECOG performance status 0 or 1.
16. Subject has predicted life expectancy ≥ 12 weeks in the opinion of the investigator.
"17. Subject must meet all of the following criteria based on the centrally or locally analyzed laboratory tests collected within 14 days prior to randomization. In the case of multiple sample collections within this period, the most recent sample collection with available results should be used to determine eligibility. a. Hemoglobin (Hgb) ≥ 9 g/dL. Subjects requiring transfusions are eligible if they have a post-transfusion Hgb ≥ 9 g/dL. b. Absolute Neutrophil Count (ANC) ≥ 1.5x109/L c. Platelets ≥ 100x109/L d. Albumin ≥ 2.5 g/dL e. Total bilirubin ≤ 1.5 x upper limit of normal (ULN) without liver metastases (or < 3.0 x ULN if liver metastases are present) f. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 2.5 x ULN without liver metastases (or ≤ 5 x ULN if liver metastases are present) g. Estimated creatinine clearance ≥ 30 mL/min h. Prothrombin time/international normalized ratio (PT/INR) and partial thromboplastin time (PTT) ≤ 1.5 x ULN (except for subjects receiving anticoagulation therapy)"
2. Subject is considered an adult (e.g., ≥ 18 years of age in the US) according to local regulation at the time of signing the informed consent
3. A female subject is eligible to participate if she is not pregnant (negative serum pregnancy test at screening; female subjects with elevated serum beta human chorionic gonadotropin (βhCG) and a demonstrated non-pregnant status through additional testing are eligible) and at least 1 of the following conditions applies: - Not a woman of childbearing potential (WOCBP) as defined in [Appendix 12.3 Contraception Requirements] OR - WOCBP who agrees to follow the contraceptive guidance as defined in [Appendix 12.3 Contraception Requirements] throughout the treatment period and for 9 months after the final administration of oxaliplatin and 6 months after the final administration of all other study drugs.
4. Female subject must agree not to breastfeed starting at screening and throughout the study period, and for 6 months after the final study treatment administration.
5. Female subject must not donate ova starting at screening and throughout the study period, and for 9 months after the final administration of oxaliplatin and 6 months after the final administration of all other study drugs
6. A male subject with female partner(s) of childbearing potential: - must agree to use contraception as detailed in [Appendix 12.3 Contraception Requirements] during the treatment period and for 6 months after the final study treatment administration.
7. A male subject must not donate sperm during the treatment period and for 6 months after the final study treatment administration.
8. Male subject with a pregnant or breastfeeding partner(s) must agree to remain abstinent or use a condom for the duration of the pregnancy or time partner is breastfeeding throughout the study period and for 6 months after the final study treatment administration.
9. Subject agrees not to participate in another interventional study while receiving study drug in present study.

What rules you out

1. Subject has received prior systemic chemotherapy for locally advanced unresectable or metastatic gastric or GEJ adenocarcinoma. However, subject may have received either neo-adjuvant or adjuvant chemotherapy, immunotherapy or other systemic anticancer therapies as long as it was completed at least 6 months prior to randomization.
10. Subject has a complete gastric outlet syndrome or a partial gastric outlet syndrome with persistent/recurrent vomiting.
11. Per investigator judgment, subject has significant gastric bleeding and/or untreated gastric ulcers that exclude the subject from participation.
"12. Subject has a known history of a positive test for human immunodeficiency virus (HIV) infection or known active hepatitis B (positive HBs Ag) or C infection. NOTE: Screening for these infections should be conducted per local requirements. a. For subjects who are negative for HBs Ag, but HBc Ab positive, an HB DNA test will be performed, and if positive, the subject will be excluded. b. Subjects with positive hepatitis C virus (HCV) serology but negative HCV RNA test are eligible. c. Subjects treated for HCV with undetectable viral load results are eligible."
13. Subject has an active autoimmune disease that has required systemic treatment within the past 3 months prior to randomization.
14. Subject has active infection requiring systemic therapy that has not completely resolved within 7 days prior to randomization.
15. Subject has significant cardiovascular disease, including any of the following: a. Congestive heart failure (defined as New York Heart Association [NYHA] Class III or IV), myocardial infarction, unstable angina, coronary angioplasty, coronary stenting, coronary artery bypass graft, cerebrovascular accident (CVA), or hypertensive crisis within 6 months prior to randomization; b. History of clinically significant ventricular arrhythmias (i.e., sustained ventricular tachycardia, ventricular fibrillation, or Torsades de Pointes); c. QTc interval > 450 msec for male subjects; QTc interval > 470 msec for female subjects; d. History or family history of congenital long QT syndrome e. Cardiac arrhythmias requiring anti-arrhythmic medications (Subjects with rate controlled atrial fibrillation for > 1 month prior to randomization are eligible.)
16. Subject has history of central nervous system (CNS) metastases and/or carcinomatous meningitis from gastric/GEJ cancer.
"17. Subject has known peripheral sensory neuropathy > grade 1 unless the absence of deep tendon reflexes is the sole neurological abnormality"
18. Subject has had a major surgical procedure ≤ 28 days prior to randomization. a. Subject without complete recovery from a major surgical procedure ≤ 14 days prior to randomization.
19. Subject has psychiatric illness or social situations that would preclude study compliance, per investigator judgment
2. Subject has received radiotherapy for locally advanced unresectable or metastatic gastric or GEJ adenocarcinoma ≤ 14 days prior to randomization and has not recovered from any related toxicity
20. Subject has another malignancy for which treatment is required per investigator's clinical judgment.
21. Subject has any concurrent disease, infection, or co-morbid condition that interferes with the ability of the subject to participate in the study, which places the subject at undue risk or complicates the interpretation of data in the opinion of the investigator.
3. Subject has received treatment with herbal medications or other treatments that have known antitumor activity within 28 days prior to randomization.
4. Subject has received systemic immunosuppressive therapy, including systemic corticosteroids within 14 days prior to randomization. Subject using a physiologic replacement dose of hydrocortisone or its equivalent (defined as up to 30 mg per day of hydrocortisone or up to 10 mg per day of prednisone), receiving a single dose of systemic corticosteroids, or receiving systemic corticosteroids as premedication for radiologic imaging contrast use is eligible.
5. Subject has received other investigational agents or devices within 28 days prior to randomization.
6. Subject has prior severe allergic reaction or intolerance to known ingredients of zolbetuximab or other monoclonal antibodies, including humanized or chimeric antibodies.
7. Subject has known immediate or delayed hypersensitivity, intolerance or contraindication to any component of study treatment. 8. Subject has prior severe allergic reaction or intolerance to any component of CAPOX.
8. Subject has prior severe allergic reaction or intolerance to any component of CAPOX.
9. Subject has known dihydropyrimidine dehydrogenase (DPD) deficiency. (NOTE: Screening for DPD deficiency should be conducted per local requirements.)

The study team makes the final eligibility decision.

Where it's taking place

United Kingdom
Malaysia
Argentina
Turkey
Thailand
United States
Canada
Taiwan
Korea, Republic of
Japan
China

Questions & answers

Do participants get paid in this trial?

This listing doesn't specify compensation. Many trials still reimburse travel or offer a stipend, so it's worth asking the study team when you connect.

Is it free to join, and do I need insurance?

Searching and applying through BridgeMD is free. In clinical trials the study-related treatment and visits are generally provided at no cost to you. You usually don't need insurance to take part - confirm specifics with the study team.

How long does this study last?

The listing doesn't state an exact length. The study team walks you through the schedule and number of visits before you decide to enroll.

Who can join this trial?

This study is enrolling all sexes, 18-64 years, 65+ years. The study team makes the final eligibility decision.

Where is this trial taking place?

Study sites include United Kingdom; Malaysia; Argentina; Turkey; Thailand; United States and 5 more location(s). Enter your location above to see the nearest site and check your eligibility.

Explore other conditions

Obesity Type 2 diabetes Type 1 diabetes Prediabetes Weight loss Metabolic syndrome High cholesterol High triglycerides High blood pressure PCOS Hypothyroidism Thyroid disease Gout Fatty liver disease (NAFLD/NASH)Heart failure Coronary artery disease

BridgeMD is an information and trial-matching tool - not medical advice, and not the study sponsor. Details come from EU CTIS; the study team decides eligibility.