Fluorouracil (5-FU): 5-FU: administered as an IV infusion
Capecitabine: Capecitabine: administered orally
Durvalumab: Durvalumab: administered as an IV infusion
Oxaliplatin: Oxaliplatin: administered as an IV infusion
Trastuzumab: Trastuzumab: administered as an IV infusion
Trastuzumab deruxtecan: T-DXd: administered as an IV infusion
Cisplatin: Cisplatin: administered as an IV infusion
Pembrolizumab: Pembrolizumab: administered as an IV infusion
Volrustomig: Volrustomig: administered as an IV infusion
Rilvegostomig: Rilvegostomig: administered as an IV infusion
Study summary
DESTINY-Gastric03 will investigate the safety, tolerability, pharmacokinetics, immunogenicity, and preliminary antitumor activity of trastuzumab deruxtecan (T-DXd) alone or in combination with chemotherapy and/or immunotherapy in HER2-expressing advanced/metastatic gastric/gastroesophageal junction (GEJ) and esophageal adenocarcinoma patients.
Study hypotheses: Combination of T-DXd with cytotoxic chemotherapy and/or immunotherapy administered to subjects at the recommended phase 2 dose will show manageable safety and tolerability and preliminary anti-tumor efficacy so as to permit further clinical testing. T-DXd in combination with cytotoxic chemotherapy or immune checkpoint inhibitor administered to HER2-expressing gastric, GEJ and esophageal cancer patients who have not received prior treatment for advanced/metastatic disease will show preliminary evidence of anti-tumour activity and the potential to become a therapeutic option for this patient population.
Eligibility
Sex
ALL
Min age
18 Years
Max age
130 Years
Healthy volunteers
No
Inclusion criteria:
1. Male and female participants must be at least 18 years of age. Other age restrictions may apply as per local regulations
2. Disease Characteristics:
1. Locally advanced, unresectable, or metastatic disease based on most recent imaging
2. For Part 1, 2, 3a, 4a pathologically documented adenocarcinoma of the stomach/GEJ/esophagus, HER2-positive (IHC 3+ or IHC 2+/ISH+) based on local tissue testing results
3. For Part 3b,4b and Part 5, pathologically documented adenocarcinoma of the stomach/GEJ/esophagus, HER2-low (IHC 2+/ISH-negative or IHC 1+) based on local tissue testing results
3. For Part 1, progression on or after at least one prior trastuzumabcontaining regimen For Part 2, Part 3, Part 4 and Part 5, previously untreated for unresectable or metastatic adenocarcinoma of the stomach/GEJ/ esophagus with with HER2-positive (Part 2 and Part 3 \[Arm 3A\] and Part 4 \[Arm 4A\]) or HER2-low (Part 3 \[Arm 3B\], Part 4 \[Arm 4B\] and Part 5)) status
4. Has measurable target disease assessed by the Investigator based on RECIST version 1.1
5. Has protocol defined adequate bone marrow and organ function including cardiac, renal and hepatic function
6. If of reproductive potential, agrees to use a highly effective form of contraception or avoid intercourse during and upon completion of the study.
Exclusion criteria:
1. Part 1 to 4: History of active primary immunodeficiency, known HIV, active chronic, or past hepatitis B infection, or hepatitis C infection. Part 5: evidence of active, uncontroled HIV, HBV or HCV infection.
2. Uncontrolled intercurrent illness.
3. History of non-infectious pneumonitis/ILD, current ILD, or where suspected ILD that cannot be ruled out by imaging at screening.
4. Lung-specific intercurrent clinically significant severe illnesses.
5. Uncontrolled infection requiring intravenous (IV) antibiotics, antivirals, or antifungals.
6. Pleural effusion, ascites or pericardial effusion that requires drainage, peritoneal shunt, or Cell-free and Concentrated Ascites Reinfusion Therapy (CART).
7. Has spinal cord compression or clinically active central nervous system metastases.
Primary outcome measure(s)
Part 1: Occurrence of adverse events (AEs) and serious adverse events (SAEs), graded according to NCI CTCAE v5.0 — Safety will be assessed up to the follow-up period, approximately 24 months. Occurrence of AEs and SAEs graded according to NCI CTCAE v5.0
Part 1: Ocurrence of dose-limiting toxicities (DLTs) — Safety will be assessed up to the follow-up period, approximately 24 months. Occurrence of dose limiting toxicities
Part 1: Changes from baseline in laboratory parameters — Safety will be assessed up to the follow-up period, approximately 24 months. Changes in laboratory parameters (every in appropriate units) compared to baseline results.
Part 1: Changes from baseline in vital signs — Safety will be assessed up to the follow-up period, approximately 24 months. Changes in vital signs results compared to baseline results.
Part 1: Changes from baseline in electrocardiogram (ECG) results — Safety will be assessed up to the follow-up period, approximately 24 months. Changes in ECG results compared to baseline results.
Part 2, Part 3, Part 4 and Part 5: Endpoint assessed by Investigator per RECIST v1.1: Confirmed Objective Response Rate (ORR) — (Endpoint: ORR) Efficacy will be assessed at an average of approximately 12 months Confirmed ORR per RECIST 1.1 is the percentage of patients with Complete Response or Partial Response that is subsequently confirmed.
Trial sites (71)
Facility
City
Region
Status
Research Site
Baltimore
Maryland
Research Site
Boston
Massachusetts
Research Site
New York
New York
Research Site
Houston
Texas
Research Site
Londrina
Brazil
Research Site
Ribeirão Preto
Brazil
Research Site
Santa Maria
Brazil
Research Site
São Jose Do Rio Preto
Brazil
Research Site
São Paulo
Brazil
Research Site
Toronto
Ontario
Research Site
Montreal
Quebec
Research Site
Québec
Quebec
Research Site
Chengdu
China
Research Site
Guangzhou
China
Research Site
Hefei
China
Research Site
Shanghai
China
Research Site
Shenyang
China
Research Site
Wuhan
China
Research Site
Zhengzhou
China
Research Site
Frankfurt
Germany
Research Site
Frankfurt
Germany
Research Site
Hamburg
Germany
Research Site
Leipzig
Germany
Research Site
Mannheim
Germany
Research Site
München
Germany
Research Site
Milan
Italy
Research Site
Milan
Italy
Research Site
Naples
Italy
Research Site
Padova
Italy
Research Site
Roma
Italy
Research Site
Verona
Italy
Research Site
Chūōku
Japan
Research Site
Kashiwa
Japan
Research Site
Amsterdam
Netherlands
Research Site
Amsterdam
Netherlands
Research Site
Utrecht
Netherlands
Research Site
Gdansk
Poland
Research Site
Konin
Poland
Research Site
Koszalin
Poland
Research Site
Krakow
Poland
+ 31 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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