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The safety and efficacy of this agent(s), or use in this setting, has not been established or is subject to confirmation. For an agent(s) whose safety and efficacy has not been established or confirmed, future regulatory approval or commercial availability is not guaranteed.

Clinical Trial Details

Geo Regions

Category

Gastrointestinal Cancer

Tucatinib

A Phase 1b/2 Dose Escalation and Expansion Study of Tucatinib in Combination With Trastuzumab and Oxaliplatin-based Chemotherapy or Pembrolizumab-containing Combinations for HER2+ Gastrointestinal Cancers

Phase 1 /2

NCT04430738

Active Not-enrolling

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Locations

United States, Japan

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Study design
Participant Group/Arm

EXPERIMENTAL: Cohort 1A

Tucatinib + trastuzumab + FOLFOX given in 14-day cycles

Intervention/Treatment

DRUG: tucatinib

For Cohort 1A, 150 mg will be administered twice daily by mouth (orally) from Cycle 1 Day 8 onwards. For all other cohorts, 300 mg (or intermediate dose) will be given orally twice daily starting on Cycle 1 Day 1.

DRUG: trastuzumab

Cohorts 1A and 1B: a 6 mg/kg loading dose will be given into the vein (IV; intravenously) on Cycle 1 Day 1, followed by a dose of 4 mg/kg IV every 2 weeks starting on Cycle 2 Day 1. Cohorts 1C, 1D, 1E, 1F, 1G, 2A, and 2B: an 8 mg/kg loading dose will be administered IV on Cycle 1 Day 1, followed by a dose of 6 mg/kg IV every 3 weeks thereafter.

DRUG: oxaliplatin

85 mg/m\^2 given IV every 2 weeks for cohorts using FOLFOX. For cohorts using CAPOX regimen, 130 mg/m\^2 given every 3 weeks.

DRUG: leucovorin

200 (mFOLFOX7) or 400 (mFOLFOX6) mg/m\^2 given IV every 2 weeks. Part of FOLFOX regimen.

DRUG: fluorouracil

400 mg/m\^2 (IV bolus after leucovorin) and/or 2400 mg/m\^2 (continuous infusion over 46 hours). Part of FOLFOX regimen.
Participant Group/Arm

EXPERIMENTAL: Cohort 1B

Tucatinib + trastuzumab + FOLFOX given in 14-day cycles

Intervention/Treatment

DRUG: tucatinib

For Cohort 1A, 150 mg will be administered twice daily by mouth (orally) from Cycle 1 Day 8 onwards. For all other cohorts, 300 mg (or intermediate dose) will be given orally twice daily starting on Cycle 1 Day 1.

DRUG: trastuzumab

Cohorts 1A and 1B: a 6 mg/kg loading dose will be given into the vein (IV; intravenously) on Cycle 1 Day 1, followed by a dose of 4 mg/kg IV every 2 weeks starting on Cycle 2 Day 1. Cohorts 1C, 1D, 1E, 1F, 1G, 2A, and 2B: an 8 mg/kg loading dose will be administered IV on Cycle 1 Day 1, followed by a dose of 6 mg/kg IV every 3 weeks thereafter.

DRUG: oxaliplatin

85 mg/m\^2 given IV every 2 weeks for cohorts using FOLFOX. For cohorts using CAPOX regimen, 130 mg/m\^2 given every 3 weeks.

DRUG: leucovorin

200 (mFOLFOX7) or 400 (mFOLFOX6) mg/m\^2 given IV every 2 weeks. Part of FOLFOX regimen.

DRUG: fluorouracil

400 mg/m\^2 (IV bolus after leucovorin) and/or 2400 mg/m\^2 (continuous infusion over 46 hours). Part of FOLFOX regimen.
Participant Group/Arm

EXPERIMENTAL: Cohort 1C

Tucatinib + trastuzumab + CAPOX given in 21-day cycles

Intervention/Treatment

DRUG: tucatinib

For Cohort 1A, 150 mg will be administered twice daily by mouth (orally) from Cycle 1 Day 8 onwards. For all other cohorts, 300 mg (or intermediate dose) will be given orally twice daily starting on Cycle 1 Day 1.

DRUG: trastuzumab

Cohorts 1A and 1B: a 6 mg/kg loading dose will be given into the vein (IV; intravenously) on Cycle 1 Day 1, followed by a dose of 4 mg/kg IV every 2 weeks starting on Cycle 2 Day 1. Cohorts 1C, 1D, 1E, 1F, 1G, 2A, and 2B: an 8 mg/kg loading dose will be administered IV on Cycle 1 Day 1, followed by a dose of 6 mg/kg IV every 3 weeks thereafter.

DRUG: oxaliplatin

85 mg/m\^2 given IV every 2 weeks for cohorts using FOLFOX. For cohorts using CAPOX regimen, 130 mg/m\^2 given every 3 weeks.

DRUG: capecitabine

1000 mg/m\^2 is taken twice per day orally on Days 1-14 of each 3 week cycle. Part of CAPOX regimen.
Participant Group/Arm

EXPERIMENTAL: Cohort 1D

Tucatinib + trastuzumab + FOLFOX. Tucatinib and FOLFOX given in 14-day cycles and trastuzumab given every 21 days

Intervention/Treatment

DRUG: tucatinib

For Cohort 1A, 150 mg will be administered twice daily by mouth (orally) from Cycle 1 Day 8 onwards. For all other cohorts, 300 mg (or intermediate dose) will be given orally twice daily starting on Cycle 1 Day 1.

DRUG: trastuzumab

Cohorts 1A and 1B: a 6 mg/kg loading dose will be given into the vein (IV; intravenously) on Cycle 1 Day 1, followed by a dose of 4 mg/kg IV every 2 weeks starting on Cycle 2 Day 1. Cohorts 1C, 1D, 1E, 1F, 1G, 2A, and 2B: an 8 mg/kg loading dose will be administered IV on Cycle 1 Day 1, followed by a dose of 6 mg/kg IV every 3 weeks thereafter.

DRUG: oxaliplatin

85 mg/m\^2 given IV every 2 weeks for cohorts using FOLFOX. For cohorts using CAPOX regimen, 130 mg/m\^2 given every 3 weeks.

DRUG: leucovorin

200 (mFOLFOX7) or 400 (mFOLFOX6) mg/m\^2 given IV every 2 weeks. Part of FOLFOX regimen.

DRUG: fluorouracil

400 mg/m\^2 (IV bolus after leucovorin) and/or 2400 mg/m\^2 (continuous infusion over 46 hours). Part of FOLFOX regimen.
Participant Group/Arm

EXPERIMENTAL: Cohort 1E

Tucatinib + trastuzumab + pembrolizumab + FOLFOX. Tucatinib and FOLFOX given in 14-day cycles, trastuzumab given in 21-day cycles, and pembrolizumab given in 42-day cycles

Intervention/Treatment

DRUG: tucatinib

For Cohort 1A, 150 mg will be administered twice daily by mouth (orally) from Cycle 1 Day 8 onwards. For all other cohorts, 300 mg (or intermediate dose) will be given orally twice daily starting on Cycle 1 Day 1.

DRUG: trastuzumab

Cohorts 1A and 1B: a 6 mg/kg loading dose will be given into the vein (IV; intravenously) on Cycle 1 Day 1, followed by a dose of 4 mg/kg IV every 2 weeks starting on Cycle 2 Day 1. Cohorts 1C, 1D, 1E, 1F, 1G, 2A, and 2B: an 8 mg/kg loading dose will be administered IV on Cycle 1 Day 1, followed by a dose of 6 mg/kg IV every 3 weeks thereafter.

DRUG: oxaliplatin

85 mg/m\^2 given IV every 2 weeks for cohorts using FOLFOX. For cohorts using CAPOX regimen, 130 mg/m\^2 given every 3 weeks.

DRUG: leucovorin

200 (mFOLFOX7) or 400 (mFOLFOX6) mg/m\^2 given IV every 2 weeks. Part of FOLFOX regimen.

DRUG: fluorouracil

400 mg/m\^2 (IV bolus after leucovorin) and/or 2400 mg/m\^2 (continuous infusion over 46 hours). Part of FOLFOX regimen.

DRUG: pembrolizumab

400 mg given by IV on day 1 of cycle 1, then every 6 weeks.
Participant Group/Arm

EXPERIMENTAL: Cohort 1F

Tucatinib + trastuzumab + pembrolizumab + CAPOX. Tucatinib, trastuzumab, and CAPOX given in 21-day cycles and pembrolizumab given in 42-day cycles.

Intervention/Treatment

DRUG: tucatinib

For Cohort 1A, 150 mg will be administered twice daily by mouth (orally) from Cycle 1 Day 8 onwards. For all other cohorts, 300 mg (or intermediate dose) will be given orally twice daily starting on Cycle 1 Day 1.

DRUG: trastuzumab

Cohorts 1A and 1B: a 6 mg/kg loading dose will be given into the vein (IV; intravenously) on Cycle 1 Day 1, followed by a dose of 4 mg/kg IV every 2 weeks starting on Cycle 2 Day 1. Cohorts 1C, 1D, 1E, 1F, 1G, 2A, and 2B: an 8 mg/kg loading dose will be administered IV on Cycle 1 Day 1, followed by a dose of 6 mg/kg IV every 3 weeks thereafter.

DRUG: oxaliplatin

85 mg/m\^2 given IV every 2 weeks for cohorts using FOLFOX. For cohorts using CAPOX regimen, 130 mg/m\^2 given every 3 weeks.

DRUG: capecitabine

1000 mg/m\^2 is taken twice per day orally on Days 1-14 of each 3 week cycle. Part of CAPOX regimen.

DRUG: pembrolizumab

400 mg given by IV on day 1 of cycle 1, then every 6 weeks.
Participant Group/Arm

EXPERIMENTAL: Cohort 1G

Tucatinib + trastuzumab + pembrolizumab. Tucatinib and trastuzumab given in 21-day cycles and pembrolizumab given in 42-day cycles.

Intervention/Treatment

DRUG: tucatinib

For Cohort 1A, 150 mg will be administered twice daily by mouth (orally) from Cycle 1 Day 8 onwards. For all other cohorts, 300 mg (or intermediate dose) will be given orally twice daily starting on Cycle 1 Day 1.

DRUG: trastuzumab

Cohorts 1A and 1B: a 6 mg/kg loading dose will be given into the vein (IV; intravenously) on Cycle 1 Day 1, followed by a dose of 4 mg/kg IV every 2 weeks starting on Cycle 2 Day 1. Cohorts 1C, 1D, 1E, 1F, 1G, 2A, and 2B: an 8 mg/kg loading dose will be administered IV on Cycle 1 Day 1, followed by a dose of 6 mg/kg IV every 3 weeks thereafter.

DRUG: pembrolizumab

400 mg given by IV on day 1 of cycle 1, then every 6 weeks.
Participant Group/Arm

EXPERIMENTAL: Cohort 2A

Tucatinib + trastuzumab + pembrolizumab + (FOLFOX or CAPOX). Either (1) tucatinib and FOLFOX given in 14-day cycles or (2) tucatinib and CAPOX given in 21-day cycles. Trastuzumab given in 21-day cycles and pembrolizumab given in 42-day cycles.

Intervention/Treatment

DRUG: tucatinib

For Cohort 1A, 150 mg will be administered twice daily by mouth (orally) from Cycle 1 Day 8 onwards. For all other cohorts, 300 mg (or intermediate dose) will be given orally twice daily starting on Cycle 1 Day 1.

DRUG: trastuzumab

Cohorts 1A and 1B: a 6 mg/kg loading dose will be given into the vein (IV; intravenously) on Cycle 1 Day 1, followed by a dose of 4 mg/kg IV every 2 weeks starting on Cycle 2 Day 1. Cohorts 1C, 1D, 1E, 1F, 1G, 2A, and 2B: an 8 mg/kg loading dose will be administered IV on Cycle 1 Day 1, followed by a dose of 6 mg/kg IV every 3 weeks thereafter.

DRUG: oxaliplatin

85 mg/m\^2 given IV every 2 weeks for cohorts using FOLFOX. For cohorts using CAPOX regimen, 130 mg/m\^2 given every 3 weeks.

DRUG: leucovorin

200 (mFOLFOX7) or 400 (mFOLFOX6) mg/m\^2 given IV every 2 weeks. Part of FOLFOX regimen.

DRUG: fluorouracil

400 mg/m\^2 (IV bolus after leucovorin) and/or 2400 mg/m\^2 (continuous infusion over 46 hours). Part of FOLFOX regimen.

DRUG: capecitabine

1000 mg/m\^2 is taken twice per day orally on Days 1-14 of each 3 week cycle. Part of CAPOX regimen.

DRUG: pembrolizumab

400 mg given by IV on day 1 of cycle 1, then every 6 weeks.
Participant Group/Arm

EXPERIMENTAL: Cohort 2B

Tucatinib + trastuzumab + FOLFOX given in 14-day cycles.

Intervention/Treatment

DRUG: tucatinib

For Cohort 1A, 150 mg will be administered twice daily by mouth (orally) from Cycle 1 Day 8 onwards. For all other cohorts, 300 mg (or intermediate dose) will be given orally twice daily starting on Cycle 1 Day 1.

DRUG: trastuzumab

Cohorts 1A and 1B: a 6 mg/kg loading dose will be given into the vein (IV; intravenously) on Cycle 1 Day 1, followed by a dose of 4 mg/kg IV every 2 weeks starting on Cycle 2 Day 1. Cohorts 1C, 1D, 1E, 1F, 1G, 2A, and 2B: an 8 mg/kg loading dose will be administered IV on Cycle 1 Day 1, followed by a dose of 6 mg/kg IV every 3 weeks thereafter.

DRUG: oxaliplatin

85 mg/m\^2 given IV every 2 weeks for cohorts using FOLFOX. For cohorts using CAPOX regimen, 130 mg/m\^2 given every 3 weeks.

DRUG: leucovorin

200 (mFOLFOX7) or 400 (mFOLFOX6) mg/m\^2 given IV every 2 weeks. Part of FOLFOX regimen.

DRUG: fluorouracil

400 mg/m\^2 (IV bolus after leucovorin) and/or 2400 mg/m\^2 (continuous infusion over 46 hours). Part of FOLFOX regimen.
Study design table for Clinical Trial
Key eligibility criteria
Inclusion criteria
* Participants must have an unresectable or metastatic solid malignancy that is histologically or cytologically confirmed to be one of the tumor types listed below: * Cohorts 1A, 1B, 1C, and 1D * CRC * Gastric adenocarcinoma * GEJ adenocarcinoma * Esophageal adenocarcinoma * Cholangiocarcinoma * Gallbladder carcinoma * Cohorts 1E, 1F, 1G, and 2A * Gastric adenocarcinoma * GEJ adenocarcinoma * Esophageal adenocarcinoma * Cohort 2B * CRC * Participants must be candidates to receive an oxaliplatin-based regimen as part of their standard-of-care treatment for all cohorts, except Cohort 1G. * HER2+ disease, as determined by historic or local laboratory testing * Phase 1b cohorts: measurable or non-measurable disease according to RECIST v1.1 as determined by the investigator * Phase 2 cohorts: measurable disease according to RECIST v1.1 as determined by the investigator * Eastern Cooperative Oncology Group Performance Status score of 0 or 1.
Exclusion criteria
* History of known hypersensitivity to planned study treatment * Known to be positive for Hepatitis B or C * For Cohorts 2A and 2B: prior anti-HER2 therapies * For Cohorts 1E, 1F, 1G, 2A: Prior therapy with an anti-PD-1, anti-PD-L1, or anti PD L2 agent or with an agent directed to another stimulatory or co-inhibitory T-cell receptor (eg, CTLA-4, OX 40, CD137), and was discontinued from that treatment due to a Grade 3 or higher immune-related adverse event (irAE) There are additional inclusion criteria. The study center will determine if criteria for participations are met.
Key dates
Study start date
  • September 2020
Estimated Study Completion Date
  • October 2025
Key endpoints
Primary Outcome Measures
Outcome Measure

Incidence of renal dose-limiting toxicities (DLTs) (Cohorts 1A and 1B)

Measure Description

Time Frame

Up to one month; 2 cycles after receiving all study treatment (each cycle is 14 days)

Outcome Measure

Incidence of adverse events (AEs) (Cohorts 1C, 1D, 1E, 1F, 1G, 2A, and 2B)

Measure Description

An AE is defined as any untoward medical occurrence in a clinical investigational participant administered a medicinal product and which does not necessarily have a causal relationship with this treatment.

Time Frame

Up to approximately 12 months

Outcome Measure

Incidence of laboratory abnormalities (Cohorts 1C, 1D, 1E, 1F, 1G, 2A, and 2B)

Measure Description

Time Frame

Up to approximately 12 months

Outcome Measure

Incidence of DLTs (Cohorts 1C, 1D, 1E, 1F, and 1G)

Measure Description

Time Frame

Up to approximately 12 months

Outcome Measure

Incidence of dose alterations (Cohort 1D)

Measure Description

Time Frame

Up to approximately 12 months

Primary Outcome Measures table for Clinical Trial
Secondary Outcome Measures:
Outcome Measure

Incidence of AEs (Cohorts 1A and 1B)

Measure Description

An AE is defined as any untoward medical occurrence in a clinical investigational participant administered a medicinal product and which does not necessarily have a causal relationship with this treatment.

Time Frame

Up to approximately 12 months

Outcome Measure

Incidence of laboratory abnormalities (Cohorts 1A and 1B)

Measure Description

Time Frame

Up to approximately 12 months

Outcome Measure

Change in glomerular filtration rate (GFR) from baseline through 2 cycles of combination therapy (Cohorts 1A and 1B)

Measure Description

To be summarized using descriptive statistics

Time Frame

Up to approximately 6 weeks

Outcome Measure

Pharmacokinetic (PK) parameter of tucatinib - AUClast (Cohorts 1A and 1B)

Measure Description

To be summarized using descriptive statistics

Time Frame

Up to approximately 2.5 months; through predose of Cycle 2, Day 1 (each cycle is 14 days)

Outcome Measure

PK parameter of tucatinib - Cmax (Cohorts 1A and 1B)

Measure Description

To be summarized using descriptive statistics

Time Frame

Up to approximately 2.5 months; through predose of Cycle 2, Day 1 (each cycle is 14 days)

Outcome Measure

PK parameter of tucatinib - Ctrough (Cohorts 1A, 1B, 1C, 1E, 1F, and 1G)

Measure Description

To be summarized using descriptive statistics

Time Frame

Up to approximately 2.5 months; through predose of Cycle 6, Day 1

Outcome Measure

PK parameter of tucatinib - Tmax (Cohorts 1A and 1B)

Measure Description

To be summarized using descriptive statistics

Time Frame

Up to approximately 2.5 months; through predose of Cycle 2, Day 1 (each cycle is 14 days)

Outcome Measure

PK parameter of oxaliplatin - AUClast (Cohorts 1A and 1B)

Measure Description

To be summarized using descriptive statistics

Time Frame

Up to 15 days; through Cycle 2, Day 1 (each cycle is 14 days)

Outcome Measure

PK parameter of oxaliplatin - Cmax (Cohorts 1A and 1B)

Measure Description

To be summarized using descriptive statistics

Time Frame

Up to 15 days; through Cycle 2, Day 1 (each cycle is 14 days)

Outcome Measure

PK parameter of oxaliplatin - Tmax (Cohorts 1A and 1B)

Measure Description

To be summarized using descriptive statistics

Time Frame

Up to 15 days; through Cycle 2, Day 1 (each cycle is 14 days)

Outcome Measure

Confirmed objective response rate (cORR) according to Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 per investigator assessment (INV) (Cohort 2A)

Measure Description

cORR is defined as the proportion of participants with confirmed complete response (CR) or partial response (PR)

Time Frame

Up to approximately 2.5 years

Outcome Measure

Duration of response (DOR) according to RECIST v1.1 per INV (Cohorts 1C, 1E, 1F, 1G, and 2A)

Measure Description

DOR is defined as the time from first documentation of objective response of confirmed CR or confirmed PR to the first documentation of disease progression or death from any cause, whichever occurs first.

Time Frame

Up to approximately 2.5 years

Outcome Measure

Progression-free survival (PFS) according to RECIST v1.1 per INV (Cohorts 1C, 1E, 1F, 1G, and 2A)

Measure Description

PFS is defined as the time from the date of treatment initiation to the date of disease progression or death from any cause, which occurs first.

Time Frame

Up to approximately 2.5 years

Outcome Measure

Overall survival (OS) (Cohort 1C, 1E, 1F, 1G, and 2A)

Measure Description

OS is defined as the time from treatment initiation to death due to any cause

Time Frame

Up to approximately 2.5 years

Outcome Measure

Objective response rate (ORR) (Cohorts 1C, 1E, 1F, and 1G)

Measure Description

ORR is defined as the proportion of subjects with confirmed CR or PR, according to RECIST v1.1.

Time Frame

Up to approximately 2.5 years

Secondary Outcome Measures table for Clinical Trial
Number of participants

40

Collaborators and investigators

Sponsor: Seagen Inc.

Collaborator: None

This information is current as of October 15th 2024.

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When calling, please reference this study number:

More Information Close NCT# stands for National Clinical Trial number. This is a unique identification code given to each clinical trial registered on ClinicalTrials.gov. The format is "NCT" followed by an 8-digit number (for example, NCT00000419). Also called the ClinicalTrials.gov identifier. NCT04430738