This study is designed to assess the efficacy and safety of ifinatamab deruxtecan (I-DXd) in patients with unresectable advanced or metastatic esophageal squamous cell carcinoma (ESCC) who have experienced disease progression following treatment with a platinum-based systemic therapy and an immune checkpoint inhibitor (ICI) compared with investigator's choice of chemotherapy (ICC).
Eligibility
Sex
ALL
Min age
18 Years
Max age
—
Healthy volunteers
No
Inclusion Criteria:
Participants must meet all of the following criteria to be eligible for randomization into the study:
1. Participants aged ≥18 years (follow local regulatory requirements if the legal age of consent for study participation is \>18 years old).
2. Has histologically or cytologically documented unresectable locally advanced or metastatic ESCC according to American Joint Committee on Cancer 8th edition staging system on ESCC.
3. Has disease progression post a platinum-based chemotherapy and an ICI treatment per global or local guidelines, with a maximum of 1 prior line of systemic therapy for unresectable advanced or metastatic ESCC.
4. The participant must provide adequate baseline tumor samples with sufficient quantity and quality of tumor tissue content as defined in the Laboratory Manual.
5. Has at least 1 measurable lesion on computed tomography (CT)/magnetic resonance imaging (MRI) according to RECIST v1.1 as assessed by the investigator. Measurable lesions should not be from a previously irradiated site. If the lesion at a previously irradiated site is the only selectable target lesion, a radiological assessment showing significant progression of the irradiated lesion should be provided by the investigator.
6. Has an ECOG PS of 0 or 1 within 7 days prior to Cycle 1 Day 1.
Exclusion Criteria:
Participants who meet any of the following criteria will be disqualified from entering the study:
1. Has received prior treatment with orlotamab, enoblituzumab, or other B7-H3 targeted agents, including I-DXd.
2. Has received any topoisomerase inhibitor.
3. Has histologically or cytologically confirmed adenosquamous carcinoma subtype.
4. Is ineligible to all the chemotherapies in the comparator arm due to prior progression or intolerance.
5. Has tumor invasion into organs located adjacent to the esophageal disease site (eg, aorta or respiratory tract) at an increased risk of bleeding or fistula as assessed by the investigator.
6. Clinically active brain metastases, spinal cord compression, or leptomeningeal carcinomatosis, defined as untreated or symptomatic, or requiring therapy with steroids or anticonvulsants to control associated symptoms. Subjects with clinically inactive or treated brain metastases who are asymptomatic (ie, without neurologic signs or symptoms and not requiring treatment with corticosteroids or anticonvulsants) may be included in the study. Subjects must have a stable neurologic status and discontinue corticosteroid usage for at least 2 weeks prior to Screening.
7. Has any of the following within the past 6 months: cerebrovascular accident, transient ischemic attack, other arterial thromboembolic event, or pulmonary embolism.
8. Has a clinically significant corneal disease.
9. Has a history of (non-infectious) interstitial lung disease (ILD)/pneumonitis that required corticosteroids, current ILD/pneumonitis, or suspected ILD/pneumonitis that cannot be ruled out by imaging at Screening.
10. Has clinically severe pulmonary compromise resulting from intercurrent pulmonary illnesses, including, but not limited to, any underlying pulmonary disorder (ie, pulmonary emboli within 3 months of the study randomization, severe asthma, chronic obstructive pulmonary disease \[COPD\], restrictive lung disease, pleural effusion, etc), and potential pulmonary involvement caused by any autoimmune, connective tissue, or inflammatory disorders (eg, rheumatoid arthritis, Sjögren's syndrome, sarcoidosis, etc), prior pneumonectomy, or requirement for supplemental oxygen.
11. Is on chronic steroid treatment (dose of 10 mg daily or more prednisone equivalent), except for low-dose inhaled steroids (for asthma/COPD), topical steroids (for mild skin conditions), or intra-articular steroid injections.
Primary outcome measure(s)
Overall Survival (OS) — From the date of randomization to the date of death due to any cause, up to approximately 54 months Overall Survival (OS) is defined as the time interval from the date of randomization to the date of death due to any cause.
Trial sites (132)
Facility
City
Region
Status
Mayo Clinic Hospital
Phoenix
Arizona
Recruiting
Providence Medical Foundation
Fullerton
California
Recruiting
Univ of California Irvine College of Medicine
Orange
California
Recruiting
Henry Ford Health System
Detroit
Michigan
Recruiting
Mayo Clinic Rochester
Rochester
Minnesota
Recruiting
MidAmerica Cancer Care - American Oncology Partners
Kansas City
Missouri
Recruiting
Morristown Medical Center
Morristown
New Jersey
Recruiting
Maimonides Cancer Center
Brooklyn
New York
Recruiting
Penn State University Milton S. Hershey Medical Center
Hershey
Pennsylvania
Recruiting
Baptist Cancer Center
Memphis
Tennessee
Recruiting
SCRI Oncology Partners
Nashville
Tennessee
Recruiting
John Peter Smith Hospital
Fort Worth
Texas
Recruiting
Virginia Cancer Specialists
Fairfax
Virginia
Recruiting
Institut Jules Bordet
Brussels
Belgium
Recruiting
Cliniques Universitaires Saint-Luc
Brussels
Belgium
Recruiting
Antwerp University Hospital
Edegem
Belgium
Recruiting
UZ Leuven
Leuven
Belgium
Recruiting
Chu de Liege
Liège
Belgium
Recruiting
Anyang Cancer Hospital
Anyang
China
Recruiting
Beijing Cancer Hospital
Beijing
China
Recruiting
Jilin Cancer Hospital
Changchun
China
Recruiting
Changzhou Cancer Hospital
Changzhou
China
Recruiting
Sichuan cancer hospital
Chengdu
China
Recruiting
West China Hospital Sichuan University
Chengdu
China
Recruiting
Fujian Cancer Hospital
Fuzhou
China
Recruiting
Harbin Medical University Cancer Hospital
Harbin
China
Recruiting
The First Affiliated Hospital of Fujian Medical University
Hefei
China
Recruiting
Jinan Central Hospital
Jinan
China
Recruiting
Shandong Cancer Hospital
Jinan
China
Recruiting
Affiliated Hospital of Jining Medical University
Jining
China
Recruiting
Guangxi Medical University Affiliated Tumor Hospital
Nanning
China
Recruiting
Liaoning Cancer Hospital and Institute
Shenyang
China
Recruiting
Tianjin Medical University Cancer Institute and Hospital
Tianjin
China
Recruiting
The First Affiliated Hospital of Xinxiang Medical University
Weihui
China
Recruiting
Hubei Cancer Hospital
Wuhan
China
Recruiting
Union Hospital Tongji Medical College Huazhong University of Science and Technology
Wuhan
China
Recruiting
Zhongshan Hospital Xiamen University
Xiamen
China
Recruiting
Subei Peoples Hospital
Yangzhou
China
Recruiting
Aarhus University Hospital
Arhus N
Denmark
Recruiting
Rigshospitalet
Copenhagen
Denmark
Recruiting
+ 92 more sites — see the full list on the official registry below.
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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