A phase Ib multicenter study of trifluridine/tipiracil (FTD/TPI) in combination with irinotecan (IRI) in patients with advanced recurrent or unresectable gastric and gastroesophageal adenocarcinoma (aGEC) after at least one line of treatment with a fluoropyrimidine and platinum containing regimen.

Authors

Farshid Dayyani

Farshid Dayyani

University of California Irvine, Division of Hematology/Oncology, Department of Medicine, Orange, CA

Farshid Dayyani , Kit Tam , Edward Kim , Parvin Keshtmand , Samuel Ejadi , Fa Chyi Lee , May Thet Cho

Organizations

University of California Irvine, Division of Hematology/Oncology, Department of Medicine, Orange, CA, UC Davis Health System, Sacramento, CA, Department of Medicine, Division of Hematology and Oncology, University of California at Davis, Sacramento, CA, Department of Medicine, Division of Hematology and Oncology, University of California at Irvine, Orange, CA, University of California Davis Comprehensive Cancer Center, Sacramento, CA

Research Funding

Pharmaceutical/Biotech Company
Taiho Pharmaceutical Co., Ltd

Background: In 2L+ aGEC, taxanes +/- ramucirumab or IRI are recommended treatment options. IRI has been tested in multiple single arm and randomized trials in second line (2L)+ aGEC, with reported objective response rates (ORR) in the 15-29% range and median progression-free survival (PFS) of <3 months (mo). Outcomes for aGEC remain poor with a median overall survival (OS) of 9.6 mo and PFS at 6 mo (PFS6) of only 36%. The TAGS trial in third line (3L)+ aGEC showed a significant improvement in OS from 3.6 mo to 5.7 mo with FTD/TPI over placebo. A 2L treatment with taxanes after 1L platinum containing regimens is currently associated with worsening peripheral neuropathy, which often leads to dose reductions, treatment delays, and a reduced quality of life for patients. The feasibility of FTD/TPI combined with IRI (+/- bevacizumab) in a modified 14-day schedule has been published for advanced colon cancer (PMID: 31924737) with no new safety signals while also encouraging activity in a cohort of heavily pretreated patients. Methods: Hypothesis:The combination of FTD/TPI with IRI in 2L+ aGEC is feasible, clinically active, and provides a treatment option which is not associated with development of peripheral neuropathy. Trial Design: 2-center, prospective, open label, non-randomized phase 1b trial. Eligibility: Diagnosis of aGEC, 1+ line of treatment including a fluoropyrimidine/platinum, ECOG 0-2, adequate organ function. Treatment:FTD/TPI 25mg/m2 on days 1-5 and IRI 180mg/m2 on day 1 every 14 days. G-CSF in allowed as needed. Primary objective: Feasibility of the regimen and estimate of efficacy. Primary endpoint: PFS6. Secondary objectives: OS, ORR, adverse events. Total number of pts to be enrolled N=20. Current enrollment (September 2020) N=14. Clinical trial information: NCT04074343

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Abstract Details

Meeting

2021 Gastrointestinal Cancers Symposium

Session Type

Trials in Progress Poster Session

Session Title

Trials in Progress Poster Session: Esophageal and Gastric Cancer

Track

Esophageal and Gastric Cancer

Sub Track

Therapeutics

Clinical Trial Registration Number

NCT04074343

Citation

J Clin Oncol 39, 2021 (suppl 3; abstr TPS251)

DOI

10.1200/JCO.2021.39.3_suppl.TPS251

Abstract #

TPS251

Poster Bd #

Online Only

Abstract Disclosures