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Pembrolizumab, Trastuzumab, HER2 Positive Gastric Cancer

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ClinicalTrials.gov Identifier: NCT02901301
Recruitment Status : Active, not recruiting
First Posted : September 15, 2016
Last Update Posted : April 6, 2021
Information provided by (Responsible Party):
Hyun Cheol Chung, Yonsei University

Brief Summary:

Gastric cancer is one of the major health problems worldwide, and one of the leading cause of death especially in Asia. Though the cytotoxic chemotherapy is the main treatment option, newer and molecularly targeted agents are recently incorporated to improve the survival outcome. Human epidermal growth factor receptor 2 (HER2, ErbB2) is a transmembrane tyrosine kinase receptor and is overexpressed or amplified in 10-20% of gastric cancer. Recently, Trastuzumab for Gastric Cancer (ToGA) study reported the clinical benefit of trastuzumab for HER2 positive gastric cancer patients. However, because the majority of patients develop intrinsic or acquired resistance within 1 year, elucidating the molecular mechanisms for trastuzumab resistance is warranted to improve the survival outcome of HER2 positive gastric cancer patients.

A growing body of preclinical and clinical evidence shows that the immune system contributes substantially to the therapeutic effects of "monoclonal antibody, trastuzumab" in solid tumors. Pembrolizumab is a potent and highly selective humanized monoclonal antibody designed to directly block the interaction between PD-1 and its ligands, PD-L1 and PD-L2.

Based on strong rationale in exploring the impact of combining trastuzumab with anti-PD-1 inhibitor in HER2 positive cancer, we suggest multicenter phase IB/II study to determine antitumor activity and safety of pembrolizumab in combination with standard treatment (trastuzumab, capecitabine, and cisplatin) in patients with HER2 positive gastric cancer.

Condition or disease Intervention/treatment Phase
Gastric Cancer Drug: Pembrolizumab Drug: Trastuzumab Drug: Capecitabine Drug: Cisplatin Phase 1 Phase 2

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 41 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase Ib/II Study of First Line Pembrolizumab in Combination With Trastuzumab, Capecitabine, and Cisplatin in HER2 Positive Gastric Cancer
Actual Study Start Date : February 6, 2017
Actual Primary Completion Date : October 31, 2020
Estimated Study Completion Date : October 2021

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Stomach Cancer

Arm Intervention/treatment
Experimental: 4 combination
pembrolizumab 200mg, IV, q3weeks, Day 1 trastuzumab 6mg/kg (8mg loading dose), IV, q3weeks, Day 1 capecitabine 1000mg/m2, PO, BID, Day 1-14 cisplatin 80mg/m2 (level 1), IV, q3weeks, Day 1
Drug: Pembrolizumab
200mg, IV, q3weeks, Day 1

Drug: Trastuzumab
6mg/kg (8mg loading dose), IV, q3weeks, Day 1

Drug: Capecitabine
1000mg/m2, PO, BID, Day 1-14

Drug: Cisplatin
80mg/m2 (level 1), IV, q3weeks, Day 1

Primary Outcome Measures :
  1. The recommended dose of phase II [ Time Frame: 4 weeks ]
  2. The overall response rate using RECIST 1.1 [ Time Frame: 6 weeks ]

Secondary Outcome Measures :
  1. Duration of response [ Time Frame: 1 year ]
  2. Time to response [ Time Frame: 6 weeks ]

Information from the National Library of Medicine

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Ages Eligible for Study:   19 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  1. HER2 positive advanced gastric cancer
  2. Be willing and able to provide written informed consent/assent for the trial.
  3. Be 19 years of age on day of signing informed consent.
  4. Have measurable disease based on RECIST 1.1.
  5. performance status of 0 or 1 on the Eastern Cooperative Oncology Group Performance Scale.
  6. Demonstrate adequate organ function
  7. Female subject of childbearing potential should have a negative urine or serum pregnancy or be willing to use birth control.

Exclusion Criteria:

  1. Is currently participating and receiving study therapy or has participated in a study of an investigational agent and received study therapy or used an investigational device within 4 weeks of the first dose of treatment.
  2. Has a diagnosis of immunodeficiency or is receiving systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior to the first dose of trial treatment.
  3. Has a known history of active Bacillus Tuberculosis
  4. Hypersensitivity to pembrolizumab or any of its excipients.
  5. Has had a prior anti-cancer monoclonal antibody within 4 weeks prior to study Day 1 or who has not recovered from adverse events due to agents administered more than 4 weeks earlier.
  6. Has had prior chemotherapy, targeted small molecule therapy, or radiation therapy within 2 weeks prior to study Day 1 or who has not recovered from adverse events due to a previously administered agent.
  7. Has a known additional malignancy that is progressing or requires active treatment within 3 years.
  8. Has known active central nervous system metastases and/or carcinomatous meningitis.
  9. Has active autoimmune disease that has required systemic treatment in the past 2 years
  10. Has known history of, or any evidence of active, non-infectious pneumonitis.
  11. Has received prior therapy with an anti-PD-1, anti-PD-L1, or anti-PD-L2 agent.
  12. Has known active Hepatitis B or Hepatitis C
  13. Has received a live vaccine within 30 days of planned start of study therapy.

Information from the National Library of Medicine

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): NCT02901301

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Korea, Republic of
Severance Hospital, Yonsei University Health System
Seoul, Korea, Republic of, 03722
Sponsors and Collaborators
Yonsei University
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Responsible Party: Hyun Cheol Chung, Professor, Yonsei University
ClinicalTrials.gov Identifier: NCT02901301    
Other Study ID Numbers: 4-2016-0190
First Posted: September 15, 2016    Key Record Dates
Last Update Posted: April 6, 2021
Last Verified: April 2021
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Undecided

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
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Stomach Neoplasms
Gastrointestinal Neoplasms
Digestive System Neoplasms
Neoplasms by Site
Digestive System Diseases
Gastrointestinal Diseases
Stomach Diseases
Antineoplastic Agents
Antineoplastic Agents, Immunological
Antimetabolites, Antineoplastic
Molecular Mechanisms of Pharmacological Action