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A Study of Zolbetuximab Together With Pembrolizumab and Chemotherapy in Adults With Gastric Cancer
Sponsor: Astellas Pharma Global Development, Inc.
Summary
Zolbetuximab is being studied in people with cancer in and around the stomach or where the food pipe (esophagus) joins the stomach, called gastroesophageal junction (GEJ) cancer. Zolbetuximab with chemotherapy may be used to treat stomach and GEJ cancer when the cancer cells do not have a protein called HER2 (human epidermal growth factor receptor 2) on their surface (HER2-negative) but do have a protein called Claudin 18.2 (Claudin 18.2-positive). Zolbetuximab is thought to work by attaching to the Claudin 18.2 protein in their tumor, which switches on the body's immune system to attack the tumor. Certain stomach and GEJ cancers may be treated with immunotherapy, which helps the body's immune system fight cancer. This study will give more information about how well zolbetuximab works when given with an immunotherapy medicine called pembrolizumab and chemotherapy. In this study, adults with stomach cancer or GEJ cancer will either be given zolbetuximab with pembrolizumab and chemotherapy or a placebo with pembrolizumab and chemotherapy. A placebo looks like zolbetuximab but doesn't have any medicine in it. The main aim of the study is to check how long people with stomach cancer and GEJ cancer live after treatment with zolbetuximab with pembrolizumab and chemotherapy compared to placebo with pembrolizumab and chemotherapy. Adults with locally advanced unresectable or metastatic stomach cancer or GEJ cancer can take part. Locally advanced means the cancer has spread to nearby tissue. Unresectable means the cancer cannot be removed by surgery. Metastatic means the cancer has spread to other parts of the body. A tumor sample (biopsy) of their cancer will have the Claudin 18.2 protein, PD-L1 protein, and be HER2-negative. They may have been previously treated with certain standard therapies. People cannot take part if they need to take medicines to suppress their immune system, have blockages or bleeding in their gut, have specific uncontrollable cancers such as symptomatic or untreated cancers in the nervous system, or have a specific heart condition, or infections. The study treatments are either zolbetuximab with pembrolizumab and chemotherapy, or placebo with pembrolizumab and chemotherapy. People who take part will receive just 1 of the study treatments by chance. The people in the study and the study doctors will not know who takes which of the study treatments. Study treatment will be given in 6-week (42-day) cycles. The study treatment is mainly given to people slowly through a tube into a vein. This is called an infusion. People will receive study treatment as follows: Zolbetuximab or placebo: 1 infusion every 2 or 3 weeks (2 or 3 infusions in a cycle) together with: Chemotherapy (1 of the following types of chemotherapy): 1. CAPOX (capecitabine and oxaliplatin): 1 infusion of oxaliplatin every 3 weeks (2 infusions in a cycle). People will also take 1 tablet of capecitabine twice a day for 2 weeks (14 days) at the start of each cycle (Day 1) and again in the middle of each cycle (Day 22). After 8 study treatments people will receive capecitabine only. 2. Modified FOLFOX6 or mFOLFOX6 (5-fluorouracil, folinic acid and oxaliplatin): 1 infusion every 2 weeks (3 infusions in a cycle). After 12 study treatments people will receive folinic acid and fluorouracil only, instead of mFOLFOX6. Pembrolizumab: 1 infusion every 3 or 6 weeks (1 or 2 infusions in a cycle). People can be in the study and will receive study treatment until their cancer worsens, they cannot tolerate the study treatment, or they need to start another cancer treatment. People may receive pembrolizumab for up to 2 years. People will visit the clinic on certain days to receive their study treatment and have health checks. The study doctors will check if people had any medical problems from taking zolbetuximab or the other study treatments. On some visits they will have scans to check for any changes in their cancer. People will have the option of giving a tumor sample if they stop treatment because their cancer has worsened. People will visit the clinic after they stop their study treatment. People will be asked about any medical problems and will have a health check. People will continue to have scans every 9 or 12 weeks to check for any changes in their cancer. They will have telephone health checks every 3 months. The number of visits and checks done at each visit will depend on the health of each person and whether they completed their study treatment or not.
Official title: A Phase 3, Double-blind, Randomized Study of Zolbetuximab in Combination With Pembrolizumab and Chemotherapy (CAPOX or mFOLFOX6) in First-line Treatment of Locally Advanced Unresectable or Metastatic Gastric or Gastroesophageal Junction Adenocarcinoma in Participants Whose Tumors Are HER2-negative, Claudin (CLDN) 18.2-positive and Programmed Death-ligand 1 (PD-L1)-Positive
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
500
Start Date
2025-05-22
Completion Date
2028-09-30
Last Updated
2026-05-28
Healthy Volunteers
No
Conditions
Interventions
zolbetuximab
Participants will receive an IV infusion of zolbetuximab on Cycle 1 Day 1 (C1D1) followed by subsequent IV infusion every 2 weeks or every 3 weeks.
Pembrolizumab
Participants will receive an IV infusion of pembrolizumab every 3 weeks or every 6 weeks.
Capecitabine
Participants receiving CAPOX regimen of chemotherapy will receive capecitabine Tablet twice daily orally on days 1 through 14 and days 22 through 35 of each cycle.
Oxaliplatin
Participants receiving CAPOX or mFOLFOX6 regimen of chemotherapy will receive an IV infusion of oxaliplatin once every 2 or 3 weeks.
Folinic acid (leucovorin or local equivalent)
Participants receiving mFOLFOX6 regimen of chemotherapy will receive an IV infusion of Folinic acid (leucovorin or local equivalent) once every 2 weeks.
5-fluorouracil (5-FU)
Participants receiving mFOLFOX6 regimen of chemotherapy will receive an IV infusion, or IV bolus of 5-FU once every 2 weeks.
Placebo
Participants will receive an IV infusion of placebo (0.9% of sodium chloride) on C1D1 followed by subsequent IV infusion every 2 weeks or every 3 weeks.
Locations (238)
UAB Medicine - UAB Hospital
Birmingham, Alabama, United States
CBCC Global Research - Comprehensive Blood & Cancer Center
Bakersfield, California, United States
TOI Clinical Research
Cerritos, California, United States
The Angeles Clinic and Research Institute, West Los Angeles Office
Los Angeles, California, United States
Hartford HealthCare - Hartford Hospital
Hartford, Connecticut, United States
Yale University School of Medicine
New Haven, Connecticut, United States
Piedmont Physician Medical Oncology Atlanta
Atlanta, Georgia, United States
Northwestern Memorial Hospital
Chicago, Illinois, United States
Franciscan Health Oncology and Hematology Specialists
Indianapolis, Indiana, United States
Holden Comprehensive Cancer Center
Iowa City, Iowa, United States
University of Kansas Cancer Center
Westwood, Kansas, United States
Saint Elizabeth Medical Center Edgewood
Edgewood, Kentucky, United States
University of Maryland Medical System - University of Maryland Medical Center
Baltimore, Maryland, United States
Dana Farber/Harvard Cancer Center
Boston, Massachusetts, United States
University of Massachusetts - UMass Chan Medical School
Worcester, Massachusetts, United States
University of Michigan Health System
Ann Arbor, Michigan, United States
Barbara Ann Karmanos Cancer Center
Detroit, Michigan, United States
Henry Ford Cancer Institute-Henry Ford Hospital
Detroit, Michigan, United States
Metro Minnesota Community Oncology Research Consortium (MMCORC)
Saint Louis Park, Minnesota, United States
University of Nebraska Medical Center
Omaha, Nebraska, United States
Oncology Hematology West PC dba Nebraska Cancer Specialists
Omaha, Nebraska, United States
Capital Health - Hematology Oncology Specialists
Pennington, New Jersey, United States
NYU Langone Medical Center
New York, New York, United States
Montefiore Medical Center
The Bronx, New York, United States
University of North Carolina at Chapel Hill
Chapel Hill, North Carolina, United States
Duke University Medical Center - Duke Cancer Centre
Durham, North Carolina, United States
Allegheny General Hospital (AGH)-Allegheny Singer Research Institute
Pittsburgh, Pennsylvania, United States
Rhode Island Hospital
Providence, Rhode Island, United States
The University of Tennessee Medical Center
Knoxville, Tennessee, United States
Vanderbilt University Medical Center
Nashville, Tennessee, United States
Texas Oncology-Baylor Charles A Sammons Cancer Center
Dallas, Texas, United States
The Center For Cancer And Blood Disorders (Texas Cancer Care)
Fort Worth, Texas, United States
Houston Methodist Cancer Center
Houston, Texas, United States
Utah Cancer Specialists Cancer Center - Medical Oncology
Salt Lake City, Utah, United States
Site AU61002
Kogarah, New South Wales, Australia
Site AU61004
Brisbane, Queensland, Australia
Site AU61003
Clayton, Victoria, Australia
Site AU61001
Fitzroy, Australia
Site BE32002
Bonheiden, Belgium
Site BE32001
Brussels, Belgium
Site BE32006
Edegem, Belgium
Site BE32003
Ghent, Belgium
Site BE32005
Leuven, Belgium
Site BE32004
Liège, Belgium
Site BR55014
Belo Horizonte, Brazil
Site BR55008
Jaú, Brazil
Site BR55004
Lages, Brazil
Site BR55003
Porto Alegre, Brazil
Site BR55006
São Caetano do Sul, Brazil
Site BR55001
São José do Rio Preto, Brazil
Site BR55007
São Paulo, Brazil
Anhui Provincial Cancer Hospital
Hefei, Anhui, China
Fujian Provincial Hospital - Department of Medical Oncology
Fuzhou, Fujian, China
Sun Yat-sen University - Cancer Center
Guangzhou, Guangdong, China
Sun Yat-sen University - Cancer Center
Guangzhou, Guangdong, China
Harbin Medical University Cancer Hospital - Oncology
Harbin, Heilongjiang, China
Henan Cancer Hospital - Oncology
Zhenngzhou, Henan, China
Hubei Cancer Hospital - Oncology
Wuhan, Hubei, China
Qinghai University Affiliated Hospital
Xining, Qinghai, China
Renji Hospital Shanghai Jiaotong Univ School of Medicine
Shanghai, Shanghai Municipality, China
Ruijin Hospital of Shanghai Jiaotong University School of Medicine
Shanghai, Shanghai Municipality, China
Sichuan Cancer Hospital
Chengdu, Sichuan, China
Tianjin Medical University General Hospital
Tianjin, Tianjin Municipality, China
The First Affiliated Hospital of Zhejiang University
Hangzhou, Zhejiang, China
Affiliated Hospital of Hebei University
Baoding, China
Peking Union Medical College Hospital - Dongdan Campus
Beijing, China
Site CZ42006
Brno, Czechia
Site CZ42005
Olomouc, Czechia
Site CZ42002
Prague, Czechia
Site CZ42003
Prague, Czechia
Site CZ42004
Prague, Czechia
Site FR33016
Bordeaux, France
Site FR33008
Brest, France
Site FR33012
Caen, France
Site FR33009
Carassonne, France
Site FR33005
Dijon, France
Site FR33002
Lille, France
Site FR33007
Lille, France
Site FR33014
Lyon, France
Site FR33017
Lyon, France
Site FR33020
Montpellier, France
Site FR33018
Nice, France
Site FR33003
Paris, France
Site FR33010
Paris, France
Site FR33013
Paris, France
Site FR33015
Plérin, France
Site FR33004
Poitiers, France
Site FR33006
Rouen, France
Site FR33019
Saint Herbian Cedex, France
Site FR33011
Strasbourg, France
Site DE49013
Berlin, Germany
Site DE49010
Essen, Germany
Site DE49007
Hanover, Germany
Site DE49004
Leipzig, Germany
Site DE49001
Mainz, Germany
Site DE49002
Saarbrücken, Germany
Site DE49011
Schweinfurt, Germany
Site DE49016
Wolfsburg, Germany
Site IT39019
Bergamo, Italy
Site IT39017
Bologna, Italy
Site IT39009
Brescia, Italy
Site IT39014
Candiolo, Italy
Site IT39006
Cremona, Italy
Site IT39011
Florence, Italy
Site IT39007
Meldola, Italy
Site IT39012
Milan, Italy
Site IT39018
Milan, Italy
Site IT39020
Milan, Italy
Site IT39021
Naples, Italy
Site IT39015
Pisa, Italy
Site IT39004
Reggio Emilia, Italy
Site IT39016
Roma, Italy
Site IT39001
Rome, Italy
Site IT39003
Torrette Di Ancona, Italy
Site IT39022
Udine, Italy
Site IT39002
Verona, Italy
Chiba Cancer Center
Chiba, Chiba, Japan
National Cancer Center Hospital East
Kashiwa, Chiba, Japan
National Hospital Organization Shikoku Cancer Center
Matsuyama, Ehime, Japan
Kyushu University Hospital (Hematology, Oncology & Cardiovascular medicine)
Fukuoka, Fukuoka, Japan
Kyushu University Hospital(Gastrointestinal Surgery)
Fukuoka, Fukuoka, Japan
National Hospital Organization Kyushu Cancer Center
Fukuoka, Fukuoka, Japan
Gunma University Hospital
Maebashi, Gunma, Japan
Hokkaido University Hospital
Sapporo, Hokkaido, Japan
Hyogo Cancer Center
Akashi-shi, Hyōgo, Japan
Kobe City Medical Center General Hospital
Kobe, Hyōgo, Japan
Kagawa University Hospital
Kida-gun, Kagawa-ken, Japan
St. Marianna University Hospital
Kawasaki-shi, Kanagawa, Japan
Kanagawa Cancer Ctr Hospital
Yokohama, Kanagawa, Japan
Tohoku University Hospital
Sendai, Miyagi, Japan
Osaka General Medical Center
Osaka, Osaka, Japan
Osaka International Cancer Institute
Osaka, Osaka, Japan
Osaka University Hospital
Suita-shi, Osaka, Japan
Saitama Medical University International Medical Center
Hidaka-shi, Saitama, Japan
Saitama Cancer Center
Kitaadachi-gun Ina-machi, Saitama, Japan
Shizuoka Cancer Center
Sunto-gun, Shizuoka, Japan
National Cancer Center Hospital
Chuo-ku, Tokyo, Japan
The Cancer Institute Hospital of JFCR
Koto-ku, Tokyo, Japan
Site LT37001
Kaunas, Lithuania
Site LT37002
Vilnius, Lithuania
Site MX52003
Mexico City, Mexico
Site MX52001
Oaxaca City, Mexico
Site NL31002
Leeuwarden, Netherlands
Site NL31001
Nijmegen, Netherlands
Site PL48005
Lubin, Lubusz Voivodeship, Poland
Site PL48004
Warsaw, Masovian Voivodeship, Poland
Site PL48001
Brzozów, Woj Podkarpackie, Poland
Site PL48006
Gliwice, Poland
Site PL48008
Olsztyn, Poland
Site PL48002
Przemyśl, Poland
Site PL48009
Swidnica, Poland
Site PL48007
Warsaw, Poland
Site PT35106
Almada, Portugal
Site PT35103
Braga, Portugal
Site PT35104
Guimarães, Portugal
Site PT35102
Lisbon, Portugal
Site PT35107
Lisbon, Portugal
Site PT35105
Porto, Portugal
Site PT35108
Porto, Portugal
Site PT35109
Porto, Portugal
Site RO40008
Bucharest, Romania
Site RO40001
Cluj-Napoca, Romania
Site RO40005
Cluj-Napoca, Romania
Site RO40006
Cluj-Napoca, Romania
Site RO40003
Craiova, Romania
Site RO40002
Floreşti, Romania
Site RO40007
Iași, Romania
Site RO40004
Timișoara, Romania
Site KR82011
Goyang-si, Gyeonggi-do, South Korea
Site KR82007
Seongnam-si, Gyeonggi-do, South Korea
Site KR82013
Suwon, Gyeonggi-do, South Korea
Site KR82015
Suwon, Gyeonggi-do, South Korea
Site KR82014
Hwasungun, Joellanamdo, South Korea
Site KR82009
Cheongju-si, North Chungcheong, South Korea
Site KR82003
Seocho-gu, Seoul, South Korea
Site KR82004
Daegu, South Korea
Site KR82005
Incheon, South Korea
Site KR82001
Seoul, South Korea
Site KR82002
Seoul, South Korea
Site KR82006
Seoul, South Korea
Site KR82008
Seoul, South Korea
Site KR82010
Seoul, South Korea
Site KR82012
Seoul, South Korea
Site ES34022
Elche, Alicante, Spain
Site ES34023
San Cugat Del Valles Barcelona, Cataluyna, Spain
Site ES34019
Madrid, Madrid, Spain
Site ES34027
Madrid, Madrid, Spain
Site ES34002
Navarra, Pamplona, Spain
Site ES34005
A Coruña, Spain
Site ES34006
Barcelona, Spain
Site ES34009
Barcelona, Spain
Site ES34010
Barcelona, Spain
Site ES34011
Barcelona, Spain
Site ES34024
Barcelona, Spain
Site ES34026
Barcelona, Spain
Site ES34028
Barcelona, Spain
Site ES34021
El Palmar, Spain
Site ES34014
Lleida, Spain
Site ES34003
Madrid, Spain
Site ES34008
Madrid, Spain
Site ES34016
Madrid, Spain
Site ES34017
Madrid, Spain
Site ES34031
Madrid, Spain
Site ES34030
Murcia, Spain
Site ES34013
Pozuelo de Alarcón, Spain
Site ES34029
Santiago de Compostela, Spain
Site ES34012
Seville, Spain
Site ES34025
Seville, Spain
Site ES34004
Valencia, Spain
Site ES34007
Valencia, Spain
Site ES34015
Zaragoza, Spain
Site ES34018
Zaragoza, Spain
Site TW88603
Dawan, Taiwan, Taiwan
Site TW88604
Kaohsiung City, Taiwan
Site TW88601
Taichung, Taiwan
Site TW88606
Tainan, Taiwan
Site TW88605
Taipei, Taiwan
Site TR90011
Adana, Turkey (Türkiye)
Site TR90001
Ankara, Turkey (Türkiye)
Site TR90004
Ankara, Turkey (Türkiye)
Site TR90006
Ankara, Turkey (Türkiye)
Site TR90014
Bursa, Turkey (Türkiye)
Site TR90013
Konya, Turkey (Türkiye)
Site TR90009
Samsun, Turkey (Türkiye)
Site TR90015
Van, Turkey (Türkiye)
Site GB44010
Cottingham, East Riding Of Yorkshire, United Kingdom
Site UK44001
Bristol, United Kingdom
Site GB44003
Cardiff, United Kingdom
Site GB44002
Coventry, United Kingdom
Site UK44006
Dundee, United Kingdom
Site GB44004
Glasgow, United Kingdom
Site GB44005
London, United Kingdom
Site UK44011
London, United Kingdom
Site UK44014
London, United Kingdom
Site UK44015
London, United Kingdom
Site UK44016
London, United Kingdom
Site UK44009
Manchester, United Kingdom
Site GB44008
Sheffield, United Kingdom