Combining Envafolimab with chemotherapy for advanced gastric cancer

A Prospective, Single-arm Clinical Trial of Envafolimab Combined With Chemotherapy in Metastatic or Recurrent Gastric Adenocarcinoma

This study is testing if adding a new drug called Envafolimab to chemotherapy can help adults with advanced gastric cancer feel better and improve their treatment results.

Quick facts

• Phase: PHASE2
• Study type: Interventional
• Enrollment: 38 (estimated)
• Ages: 18 Years to 75 Years
• Sex: All
• Sponsor: Jiangsu Cancer Institute & Hospital (other)
• Drugs / interventions: chemotherapy, Envafolimab
• Locations: 1 site (Nanjing, Jiangsu)
• Trial ID: NCT05237349 on ClinicalTrials.gov

What this trial studies

This study investigates the efficacy and safety of Envafolimab, a subcutaneous PD-L1 monoclonal antibody, in combination with chemotherapy for patients with metastatic or recurrent gastric adenocarcinoma. The trial focuses on adult patients who have advanced solid tumors with specific genetic markers, such as microsatellite instability-high (MSI-H) or mismatch repair gene defects (dMMR). Participants will receive Envafolimab alongside standard chemotherapy agents like Oxaliplatin and S1, with the aim of improving treatment outcomes for this challenging cancer type.

Who should consider this trial

Good fit: Ideal candidates are adults aged 18-75 with advanced gastric adenocarcinoma that has not responded to previous treatments and meets specific genetic criteria.

Not a fit: Patients who have received systemic chemotherapy recently or those with HER2 gene expression may not benefit from this study.

Why it matters

Potential benefit: If successful, this treatment could provide a new therapeutic option for patients with advanced gastric adenocarcinoma, potentially improving survival rates and quality of life.

How similar studies have performed: Other studies have shown promise with similar immunotherapy approaches, indicating potential for success in this novel combination.

Eligibility criteria

Inclusion Criteria:

* 18-75 years；
* ECOG 0-1；
* life expectancy of at least 3 months；
* Negative for HER2 gene expression by central laboratory ；
* The tumor expresses PD-L1 as detected by the central laboratory, and the tumor proportion score (CPS) ≥ 1；
* At least one measurable objective tumor lesion by spiral CT examination, the maximum diameter ≥ 1cm（according to RECIST 1.1）；
* Diagnosed by histology and/or cytology, and assessed by imaging (refer to RECIST 1.1) as advanced metastatic gastric adenocarcinoma or gastric adenocarcinoma that has recurred after previous gastric cancer surgery;
* Not received systemic chemotherapy in the past. Patients who have previously received fluorouracil monotherapy or fluorouracil-based adjuvant therapy or neoadjuvant therapy, and patients who have completed adjuvant therapy or neoadjuvant therapy before the start of the chemotherapy regimen in this trial 6 months ago can be included in this trial. In cases of metastatic disease requiring local remission, remission therapy with radiosensitizing doses of fluorouracil or capecitabine alone is permitted only ；
* satisfactory main organ function，laboratory test must meet the following criteria: hemoglobin (HGB) ≥90g/L, neutrophil count（ANC） ≥1.5×109/L, platelet count（PLT） ≥80×109/L, Serum creatinine（CR）≤1.5 upper normal limitation (UNL)，total bilirubin (TBil) ≤1.5 upper normal limitation (UNL), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤2.5 UNL (For patients with liver metastasis, the AST/ALT must be ≤5.0 UNL), Activated partial thromboplastin time (APTT), international normalized ratio (INR), prothrombin time (PT) ≤ 1.5×ULN; left ventricular ejection fraction (LVEF) ≥ 50%; thyroid stimulating hormone (TSH) within the normal range Within: if the baseline TSH exceeds the normal range, subjects with total T3 (or FT3) and FT4 within the normal range can also be enrolled;
* Subjects of childbearing potential must use an appropriate method of contraception during the study period and within 120 days after the end of the study, have a negative serum pregnancy test within 7 days prior to study enrollment, and must be non-lactating subjects ；

Exclusion Criteria:

* Suffered from other malignant tumors within 5 years before the start of treatment in this study;
* Pathologically suggested patients with abnormally increased AFP OR MSI-H ；
* Grade ≥1 unresolved toxicities (according to the most recent version of the National Cancer Institute \[NCI\] Common Terminology Criteria for Adverse Events \[CTCAE\]) due to any prior therapy, excluding alopecia and fatigue; neurotoxicity was Recovery to ≤ grade 1 or baseline before the group;
* Subjects with any severe and/or uncontrolled disease ；
* Poorly controlled diabetes (fasting blood glucose \[FBG\] \> 10 mmol/L) ；
* Received major surgical treatment, incisional biopsy, or significant traumatic injury within 28 days prior to the start of study treatment; or had a long-term unhealed wound or fracture；
* Serious arterial/venous thrombotic event within 6 months prior to initiation of study treatment ；
* Previously received drug therapy against PD-1, PD-L1 and other related immune checkpoints ；
* Participating in or participating in other clinical investigators within 4 weeks prior to the start of the study ；
* Allergic to the active ingredients or excipients of the study drug ；
* Unsuitable for the study or other chemotherapy determined by investigator.

Where this trial is running

Nanjing, Jiangsu

• Jiangsu Cancer Institute & Hospital — Nanjing, Jiangsu, China (RECRUITING)

Study contacts

• Study coordinator: Liangjun Zhu

Conditions: Metastatic or Recurrent Gastric Adenocarcinoma