Tucatinib Plus Trastuzumab and Oxaliplatin-based Chemotherapy or Pembrolizumab-containing Combinations for HER2+ Gastrointestinal Cancers
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ClinicalTrials.gov Identifier: NCT04430738 |
Recruitment Status :
Recruiting
First Posted : June 12, 2020
Last Update Posted : March 7, 2023
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This trial studies tucatinib to find out if it is safe when given with trastuzumab and other anti-cancer drugs (pembrolizumab, FOLFOX, and CAPOX). It will look at what side effects happen when participants take this combination of drugs. A side effect is anything the drug does other than treating cancer. It will also look at whether tucatinib works with these drugs to treat certain types of cancer.
The participants in this trial have HER2-positive (HER2+) cancer in their gut, stomach, intestines, or gallbladder (gastrointestinal cancer).
Condition or disease | Intervention/treatment | Phase |
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Colorectal Carcinoma Gastric Adenocarcinoma GEJ Adenocarcinoma Esophageal Adenocarcinoma Cholangiocarcinoma Gallbladder Carcinoma | Drug: tucatinib Drug: trastuzumab Drug: oxaliplatin Drug: leucovorin Drug: fluorouracil Drug: capecitabine Drug: pembrolizumab | Phase 1 Phase 2 |
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 120 participants |
Allocation: | Non-Randomized |
Intervention Model: | Sequential Assignment |
Masking: | None (Open Label) |
Primary Purpose: | Treatment |
Official Title: | A Phase 1b/2 Dose Escalation and Expansion Study of Tucatinib in Combination With Trastuzumab and Oxaliplatin-based Chemotherapy or Pembrolizumab-containing Combinations for HER2+ Gastrointestinal Cancers |
Actual Study Start Date : | September 15, 2020 |
Estimated Primary Completion Date : | May 30, 2024 |
Estimated Study Completion Date : | October 31, 2025 |

Arm | Intervention/treatment |
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Experimental: Cohort 1A
Tucatinib + trastuzumab + FOLFOX given in 14-day cycles
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Drug: tucatinib
For Cohort 1A, 150 mg will be administered twice daily by mouth (orally) from Cycle 1 Day 8 onwards. For all other cohorts, 300 mg (or intermediate dose) will be given orally twice daily starting on Cycle 1 Day 1.
Other Name: TUKYSA Drug: trastuzumab Cohorts 1A and 1B: a 6 mg/kg loading dose will be given into the vein (IV; intravenously) on Cycle 1 Day 1, followed by a dose of 4 mg/kg IV every 2 weeks starting on Cycle 2 Day 1. Cohorts 1C, 1D, 1E, 1F, 1G, 2A, and 2B: an 8 mg/kg loading dose will be administered IV on Cycle 1 Day 1, followed by a dose of 6 mg/kg IV every 3 weeks thereafter. Drug: oxaliplatin 85 mg/m^2 given IV every 2 weeks for cohorts using FOLFOX. For cohorts using CAPOX regimen, 130 mg/m^2 given every 3 weeks. Drug: leucovorin 200 (mFOLFOX7) or 400 (mFOLFOX6) mg/m^2 given IV every 2 weeks. Part of FOLFOX regimen. Drug: fluorouracil 400 mg/m^2 (IV bolus after leucovorin) and/or 2400 mg/m^2 (continuous infusion over 46 hours). Part of FOLFOX regimen. |
Experimental: Cohort 1B
Tucatinib + trastuzumab + FOLFOX given in 14-day cycles
|
Drug: tucatinib
For Cohort 1A, 150 mg will be administered twice daily by mouth (orally) from Cycle 1 Day 8 onwards. For all other cohorts, 300 mg (or intermediate dose) will be given orally twice daily starting on Cycle 1 Day 1.
Other Name: TUKYSA Drug: trastuzumab Cohorts 1A and 1B: a 6 mg/kg loading dose will be given into the vein (IV; intravenously) on Cycle 1 Day 1, followed by a dose of 4 mg/kg IV every 2 weeks starting on Cycle 2 Day 1. Cohorts 1C, 1D, 1E, 1F, 1G, 2A, and 2B: an 8 mg/kg loading dose will be administered IV on Cycle 1 Day 1, followed by a dose of 6 mg/kg IV every 3 weeks thereafter. Drug: oxaliplatin 85 mg/m^2 given IV every 2 weeks for cohorts using FOLFOX. For cohorts using CAPOX regimen, 130 mg/m^2 given every 3 weeks. Drug: leucovorin 200 (mFOLFOX7) or 400 (mFOLFOX6) mg/m^2 given IV every 2 weeks. Part of FOLFOX regimen. Drug: fluorouracil 400 mg/m^2 (IV bolus after leucovorin) and/or 2400 mg/m^2 (continuous infusion over 46 hours). Part of FOLFOX regimen. |
Experimental: Cohort 1C
Tucatinib + trastuzumab + CAPOX given in 21-day cycles
|
Drug: tucatinib
For Cohort 1A, 150 mg will be administered twice daily by mouth (orally) from Cycle 1 Day 8 onwards. For all other cohorts, 300 mg (or intermediate dose) will be given orally twice daily starting on Cycle 1 Day 1.
Other Name: TUKYSA Drug: trastuzumab Cohorts 1A and 1B: a 6 mg/kg loading dose will be given into the vein (IV; intravenously) on Cycle 1 Day 1, followed by a dose of 4 mg/kg IV every 2 weeks starting on Cycle 2 Day 1. Cohorts 1C, 1D, 1E, 1F, 1G, 2A, and 2B: an 8 mg/kg loading dose will be administered IV on Cycle 1 Day 1, followed by a dose of 6 mg/kg IV every 3 weeks thereafter. Drug: oxaliplatin 85 mg/m^2 given IV every 2 weeks for cohorts using FOLFOX. For cohorts using CAPOX regimen, 130 mg/m^2 given every 3 weeks. Drug: capecitabine 1000 mg/m^2 is taken twice per day orally on Days 1-14 of each 3 week cycle. Part of CAPOX regimen. |
Experimental: Cohort 1D
Tucatinib + trastuzumab + FOLFOX. Tucatinib and FOLFOX given in 14-day cycles and trastuzumab given every 21 days
|
Drug: tucatinib
For Cohort 1A, 150 mg will be administered twice daily by mouth (orally) from Cycle 1 Day 8 onwards. For all other cohorts, 300 mg (or intermediate dose) will be given orally twice daily starting on Cycle 1 Day 1.
Other Name: TUKYSA Drug: trastuzumab Cohorts 1A and 1B: a 6 mg/kg loading dose will be given into the vein (IV; intravenously) on Cycle 1 Day 1, followed by a dose of 4 mg/kg IV every 2 weeks starting on Cycle 2 Day 1. Cohorts 1C, 1D, 1E, 1F, 1G, 2A, and 2B: an 8 mg/kg loading dose will be administered IV on Cycle 1 Day 1, followed by a dose of 6 mg/kg IV every 3 weeks thereafter. Drug: oxaliplatin 85 mg/m^2 given IV every 2 weeks for cohorts using FOLFOX. For cohorts using CAPOX regimen, 130 mg/m^2 given every 3 weeks. Drug: leucovorin 200 (mFOLFOX7) or 400 (mFOLFOX6) mg/m^2 given IV every 2 weeks. Part of FOLFOX regimen. Drug: fluorouracil 400 mg/m^2 (IV bolus after leucovorin) and/or 2400 mg/m^2 (continuous infusion over 46 hours). Part of FOLFOX regimen. |
Experimental: Cohort 1E
Tucatinib + trastuzumab + pembrolizumab + FOLFOX. Tucatinib and FOLFOX given in 14-day cycles, trastuzumab given in 21-day cycles, and pembrolizumab given in 42-day cycles
|
Drug: tucatinib
For Cohort 1A, 150 mg will be administered twice daily by mouth (orally) from Cycle 1 Day 8 onwards. For all other cohorts, 300 mg (or intermediate dose) will be given orally twice daily starting on Cycle 1 Day 1.
Other Name: TUKYSA Drug: trastuzumab Cohorts 1A and 1B: a 6 mg/kg loading dose will be given into the vein (IV; intravenously) on Cycle 1 Day 1, followed by a dose of 4 mg/kg IV every 2 weeks starting on Cycle 2 Day 1. Cohorts 1C, 1D, 1E, 1F, 1G, 2A, and 2B: an 8 mg/kg loading dose will be administered IV on Cycle 1 Day 1, followed by a dose of 6 mg/kg IV every 3 weeks thereafter. Drug: oxaliplatin 85 mg/m^2 given IV every 2 weeks for cohorts using FOLFOX. For cohorts using CAPOX regimen, 130 mg/m^2 given every 3 weeks. Drug: leucovorin 200 (mFOLFOX7) or 400 (mFOLFOX6) mg/m^2 given IV every 2 weeks. Part of FOLFOX regimen. Drug: fluorouracil 400 mg/m^2 (IV bolus after leucovorin) and/or 2400 mg/m^2 (continuous infusion over 46 hours). Part of FOLFOX regimen. Drug: pembrolizumab 400 mg given by IV on day 1 of cycle 1, then every 6 weeks.
Other Name: KEYTRUDA |
Experimental: Cohort 1F
Tucatinib + trastuzumab + pembrolizumab + CAPOX. Tucatinib, trastuzumab, and CAPOX given in 21-day cycles and pembrolizumab given in 42-day cycles.
|
Drug: tucatinib
For Cohort 1A, 150 mg will be administered twice daily by mouth (orally) from Cycle 1 Day 8 onwards. For all other cohorts, 300 mg (or intermediate dose) will be given orally twice daily starting on Cycle 1 Day 1.
Other Name: TUKYSA Drug: trastuzumab Cohorts 1A and 1B: a 6 mg/kg loading dose will be given into the vein (IV; intravenously) on Cycle 1 Day 1, followed by a dose of 4 mg/kg IV every 2 weeks starting on Cycle 2 Day 1. Cohorts 1C, 1D, 1E, 1F, 1G, 2A, and 2B: an 8 mg/kg loading dose will be administered IV on Cycle 1 Day 1, followed by a dose of 6 mg/kg IV every 3 weeks thereafter. Drug: oxaliplatin 85 mg/m^2 given IV every 2 weeks for cohorts using FOLFOX. For cohorts using CAPOX regimen, 130 mg/m^2 given every 3 weeks. Drug: capecitabine 1000 mg/m^2 is taken twice per day orally on Days 1-14 of each 3 week cycle. Part of CAPOX regimen. Drug: pembrolizumab 400 mg given by IV on day 1 of cycle 1, then every 6 weeks.
Other Name: KEYTRUDA |
Experimental: Cohort 1G
Tucatinib + trastuzumab + pembrolizumab. Tucatinib and trastuzumab given in 21-day cycles and pembrolizumab given in 42-day cycles.
|
Drug: tucatinib
For Cohort 1A, 150 mg will be administered twice daily by mouth (orally) from Cycle 1 Day 8 onwards. For all other cohorts, 300 mg (or intermediate dose) will be given orally twice daily starting on Cycle 1 Day 1.
Other Name: TUKYSA Drug: trastuzumab Cohorts 1A and 1B: a 6 mg/kg loading dose will be given into the vein (IV; intravenously) on Cycle 1 Day 1, followed by a dose of 4 mg/kg IV every 2 weeks starting on Cycle 2 Day 1. Cohorts 1C, 1D, 1E, 1F, 1G, 2A, and 2B: an 8 mg/kg loading dose will be administered IV on Cycle 1 Day 1, followed by a dose of 6 mg/kg IV every 3 weeks thereafter. Drug: pembrolizumab 400 mg given by IV on day 1 of cycle 1, then every 6 weeks.
Other Name: KEYTRUDA |
Experimental: Cohort 2A
Tucatinib + trastuzumab + pembrolizumab + (FOLFOX or CAPOX). Either (1) tucatinib and FOLFOX given in 14-day cycles or (2) tucatinib and CAPOX given in 21-day cycles. Trastuzumab given in 21-day cycles and pembrolizumab given in 42-day cycles.
|
Drug: tucatinib
For Cohort 1A, 150 mg will be administered twice daily by mouth (orally) from Cycle 1 Day 8 onwards. For all other cohorts, 300 mg (or intermediate dose) will be given orally twice daily starting on Cycle 1 Day 1.
Other Name: TUKYSA Drug: trastuzumab Cohorts 1A and 1B: a 6 mg/kg loading dose will be given into the vein (IV; intravenously) on Cycle 1 Day 1, followed by a dose of 4 mg/kg IV every 2 weeks starting on Cycle 2 Day 1. Cohorts 1C, 1D, 1E, 1F, 1G, 2A, and 2B: an 8 mg/kg loading dose will be administered IV on Cycle 1 Day 1, followed by a dose of 6 mg/kg IV every 3 weeks thereafter. Drug: oxaliplatin 85 mg/m^2 given IV every 2 weeks for cohorts using FOLFOX. For cohorts using CAPOX regimen, 130 mg/m^2 given every 3 weeks. Drug: leucovorin 200 (mFOLFOX7) or 400 (mFOLFOX6) mg/m^2 given IV every 2 weeks. Part of FOLFOX regimen. Drug: fluorouracil 400 mg/m^2 (IV bolus after leucovorin) and/or 2400 mg/m^2 (continuous infusion over 46 hours). Part of FOLFOX regimen. Drug: capecitabine 1000 mg/m^2 is taken twice per day orally on Days 1-14 of each 3 week cycle. Part of CAPOX regimen. Drug: pembrolizumab 400 mg given by IV on day 1 of cycle 1, then every 6 weeks.
Other Name: KEYTRUDA |
Experimental: Cohort 2B
Tucatinib + trastuzumab + FOLFOX given in 14-day cycles.
|
Drug: tucatinib
For Cohort 1A, 150 mg will be administered twice daily by mouth (orally) from Cycle 1 Day 8 onwards. For all other cohorts, 300 mg (or intermediate dose) will be given orally twice daily starting on Cycle 1 Day 1.
Other Name: TUKYSA Drug: trastuzumab Cohorts 1A and 1B: a 6 mg/kg loading dose will be given into the vein (IV; intravenously) on Cycle 1 Day 1, followed by a dose of 4 mg/kg IV every 2 weeks starting on Cycle 2 Day 1. Cohorts 1C, 1D, 1E, 1F, 1G, 2A, and 2B: an 8 mg/kg loading dose will be administered IV on Cycle 1 Day 1, followed by a dose of 6 mg/kg IV every 3 weeks thereafter. Drug: oxaliplatin 85 mg/m^2 given IV every 2 weeks for cohorts using FOLFOX. For cohorts using CAPOX regimen, 130 mg/m^2 given every 3 weeks. Drug: leucovorin 200 (mFOLFOX7) or 400 (mFOLFOX6) mg/m^2 given IV every 2 weeks. Part of FOLFOX regimen. Drug: fluorouracil 400 mg/m^2 (IV bolus after leucovorin) and/or 2400 mg/m^2 (continuous infusion over 46 hours). Part of FOLFOX regimen. |
- Incidence of renal dose-limiting toxicities (DLTs) (Cohorts 1A and 1B) [ Time Frame: Up to one month; 2 cycles after receiving all study treatment (each cycle is 14 days) ]
- Incidence of adverse events (AEs) (Cohorts 1C, 1D, 1E, 1F, 1G, 2A, and 2B) [ Time Frame: Up to approximately 12 months ]An AE is defined as any untoward medical occurrence in a clinical investigational participant administered a medicinal product and which does not necessarily have a causal relationship with this treatment.
- Incidence of laboratory abnormalities (Cohorts 1C, 1D, 1E, 1F, 1G, 2A, and 2B) [ Time Frame: Up to approximately 12 months ]
- Incidence of DLTs (Cohorts 1C, 1D, 1E, 1F, and 1G) [ Time Frame: Up to approximately 12 months ]
- Incidence of dose alterations (Cohort 1D) [ Time Frame: Up to approximately 12 months ]
- Incidence of AEs (Cohorts 1A and 1B) [ Time Frame: Up to approximately 12 months ]An AE is defined as any untoward medical occurrence in a clinical investigational participant administered a medicinal product and which does not necessarily have a causal relationship with this treatment.
- Incidence of laboratory abnormalities (Cohorts 1A and 1B) [ Time Frame: Up to approximately 12 months ]
- Change in glomerular filtration rate (GFR) from baseline through 2 cycles of combination therapy (Cohorts 1A and 1B) [ Time Frame: Up to approximately 6 weeks ]To be summarized using descriptive statistics
- Pharmacokinetic (PK) parameter of tucatinib - AUClast (Cohorts 1A and 1B) [ Time Frame: Up to approximately 2.5 months; through predose of Cycle 2, Day 1 (each cycle is 14 days) ]To be summarized using descriptive statistics
- PK parameter of tucatinib - Cmax (Cohorts 1A and 1B) [ Time Frame: Up to approximately 2.5 months; through predose of Cycle 2, Day 1 (each cycle is 14 days) ]To be summarized using descriptive statistics
- PK parameter of tucatinib - Ctrough (Cohorts 1A, 1B, 1C, 1E, 1F, and 1G) [ Time Frame: Up to approximately 2.5 months; through predose of Cycle 6, Day 1 ]To be summarized using descriptive statistics
- PK parameter of tucatinib - Tmax (Cohorts 1A and 1B) [ Time Frame: Up to approximately 2.5 months; through predose of Cycle 2, Day 1 (each cycle is 14 days) ]To be summarized using descriptive statistics
- PK parameter of oxaliplatin - AUClast (Cohorts 1A and 1B) [ Time Frame: Up to 15 days; through Cycle 2, Day 1 (each cycle is 14 days) ]To be summarized using descriptive statistics
- PK parameter of oxaliplatin - Cmax (Cohorts 1A and 1B) [ Time Frame: Up to 15 days; through Cycle 2, Day 1 (each cycle is 14 days) ]To be summarized using descriptive statistics
- PK parameter of oxaliplatin - Tmax (Cohorts 1A and 1B) [ Time Frame: Up to 15 days; through Cycle 2, Day 1 (each cycle is 14 days) ]To be summarized using descriptive statistics
- Confirmed objective response rate (cORR) according to Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 per investigator assessment (INV) (Cohort 2A) [ Time Frame: Up to approximately 2.5 years ]cORR is defined as the proportion of participants with confirmed complete response (CR) or partial response (PR)
- Duration of response (DOR) according to RECIST v1.1 per INV (Cohorts 1C, 1E, 1F, 1G, and 2A) [ Time Frame: Up to approximately 2.5 years ]DOR is defined as the time from first documentation of objective response of confirmed CR or confirmed PR to the first documentation of disease progression or death from any cause, whichever occurs first.
- Progression-free survival (PFS) according to RECIST v1.1 per INV (Cohorts 1C, 1E, 1F, 1G, and 2A) [ Time Frame: Up to approximately 2.5 years ]PFS is defined as the time from the date of treatment initiation to the date of disease progression or death from any cause, which occurs first.
- Overall survival (OS) (Cohort 1C, 1E, 1F, 1G, and 2A) [ Time Frame: Up to approximately 2.5 years ]OS is defined as the time from treatment initiation to death due to any cause
- Objective response rate (ORR) (Cohorts 1C, 1E, 1F, and 1G) [ Time Frame: Up to approximately 2.5 years ]ORR is defined as the proportion of subjects with confirmed CR or PR, according to RECIST v1.1.

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.
Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
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Participants must have an unresectable or metastatic solid malignancy that is histologically or cytologically confirmed to be one of the tumor types listed below:
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Cohorts 1A, 1B, 1C, and 1D
- CRC
- Gastric adenocarcinoma
- GEJ adenocarcinoma
- Esophageal adenocarcinoma
- Cholangiocarcinoma
- Gallbladder carcinoma
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Cohorts 1E, 1F, 1G, and 2A
- Gastric adenocarcinoma
- GEJ adenocarcinoma
- Esophageal adenocarcinoma
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Cohort 2B
- CRC
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- Participants must be candidates to receive an oxaliplatin-based regimen as part of their standard-of-care treatment for all cohorts, except Cohort 1G.
- HER2+ disease, as determined by historic or local laboratory testing
- Phase 1b cohorts: measurable or non-measurable disease according to RECIST v1.1 as determined by the investigator
- Phase 2 cohorts: measurable disease according to RECIST v1.1 as determined by the investigator
- Eastern Cooperative Oncology Group Performance Status score of 0 or 1.
Exclusion Criteria:
- History of known hypersensitivity to planned study treatment
- Known to be positive for Hepatitis B or C
- For Cohorts 2A and 2B: prior anti-HER2 therapies
- For Cohorts 1E, 1F, 1G, 2A: Prior therapy with an anti-PD-1, anti-PD-L1, or anti PD L2 agent or with an agent directed to another stimulatory or co-inhibitory T-cell receptor (eg, CTLA-4, OX 40, CD137), and was discontinued from that treatment due to a Grade 3 or higher immune-related adverse event (irAE)
There are additional inclusion criteria. The study center will determine if criteria for participations are met.

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04430738
Contact: Seagen Trial Information Support | 8663337436 | clinicaltrials@seagen.com |

Study Director: | JoAl Mayor, PharmD, BCOP | Seagen Inc. |
Responsible Party: | Seagen Inc. |
ClinicalTrials.gov Identifier: | NCT04430738 |
Other Study ID Numbers: |
SGNTUC-024 |
First Posted: | June 12, 2020 Key Record Dates |
Last Update Posted: | March 7, 2023 |
Last Verified: | March 2023 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | No |
Studies a U.S. FDA-regulated Drug Product: | Yes |
Studies a U.S. FDA-regulated Device Product: | No |
HER2+ HER2-positive CRC |
Gastric cancer Esophageal cancer Seattle Genetics |
Carcinoma Adenocarcinoma Cholangiocarcinoma Colorectal Neoplasms Gastrointestinal Neoplasms Neoplasms, Glandular and Epithelial Neoplasms by Histologic Type Neoplasms Intestinal Neoplasms Digestive System Neoplasms Neoplasms by Site Digestive System Diseases Gastrointestinal Diseases Colonic Diseases Intestinal Diseases |
Rectal Diseases Leucovorin Pembrolizumab Trastuzumab Fluorouracil Capecitabine Oxaliplatin Tucatinib Antineoplastic Agents, Immunological Antineoplastic Agents Antimetabolites Molecular Mechanisms of Pharmacological Action Antimetabolites, Antineoplastic Immunosuppressive Agents Immunologic Factors |