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RECRUITING
NCT06901531
PHASE3

A Study of Zolbetuximab Together With Pembrolizumab and Chemotherapy in Adults With Gastric Cancer

Sponsor: Astellas Pharma Global Development, Inc.

View on ClinicalTrials.gov

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

Interventions

DRUG

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.

DRUG

Pembrolizumab

Participants will receive an IV infusion of pembrolizumab every 3 weeks or every 6 weeks.

DRUG

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.

DRUG

Oxaliplatin

Participants receiving CAPOX or mFOLFOX6 regimen of chemotherapy will receive an IV infusion of oxaliplatin once every 2 or 3 weeks.

DRUG

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.

DRUG

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.

DRUG

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