Met or EGFR Inhibition in Gastroesophageal Adenocarcinoma (MEGA): FOLFOX alone or in combination with AMG 102 or panitumumab as first-line treatment in patients with advanced gastroesophageal adenocarcinoma: FNCLCC-FFCD-AGEO-GERCOR PRODIGE 17-ACCORD 20 randomized phase II trial.

Authors

null

D. Malka

Institut Gustave Roussy, Villejuif, France

D. Malka , S. Gourgou-Bourgade , J. Emile , P. Laurent-Puig , J. Taïeb

Organizations

Institut Gustave Roussy, Villejuif, France, Centre Val d'Aurelle, Montpellier, France, Department of Pathology, Ambroise Paré Hospital, Boulogne, France, APHP, Hôpital Européen Georges Pompidou, Paris, France, Hôpital European Georges Pompidou, Paris, France

Research Funding

Pharmaceutical/Biotech Company

Background: Advanced gastroesophageal cancers (AGEC) harbour a dismal prognosis (overall survival [OS] < 1 year). EGFR inhibitors showed promising activity in patients (pts) with AGEC. Dysregulation of the HGF/c-Met pathway is a rational therapeutic target in AGEC. This randomised phase II study aims to assess the efficacy and safety of fluorouracil (FU), folinic acid (FA) and oxaliplatin-based chemotherapy (modified FOLFOX6 regimen) alone or combined to either panitumumab, an anti-EGFR monoclonal antibody, or to AMG 102, an anti-HGF monoclonal antibody, as first-line treatment for pts with AGEC. Methods: This multicentre, open-label, randomised phase II trial is ongoing in 30 centres in France. Main eligibility criteria include: histologically proven adenocarcinoma of the stomach, esophagus or gastroesophageal junction; locally advanced or metastatic disease; measurable disease (RECIST 1.1); no known HER2 overexpression; no prior palliative chemotherapy; age > 18 years; ECOG performance status 0 or 1; adequate bone marrow, liver and renal function. Patients are randomised to modified FOLFOX6 (oxaliplatin 85 mg/m², FA 400 mg/m², FU 400 mg/m² bolus then 2400 mg/m² over 46 hr) alone or combined to either panitumumab (6 mg/kg) or AMG 102 (10 mg/kg) every two weeks until unacceptable toxicity or disease progression. Judgment criteria include 4-month progression-free survival rate (primary endpoint), OS, objective response rate, and safety. Ancillary studies aim to identify candidate predictive and prognostic biomarkers among functional of molecular alterations of the EGFR/RAS/RAF and HGF/c-Met pathways, and to monitor circulating tumour cells and circulating immune cells (myeloid derived suppressor cells, NK cells) in sequential blood samples taken at baseline and through the study treatment. A total of 165 pts will be enrolled (Fleming’s one-step design). The first patient enrolled in January 2011.

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Abstract Details

Meeting

2011 ASCO Annual Meeting

Session Type

Trials in Progress Poster Session

Session Title

Trials in Progress Poster Session

Track

Special Sessions,Clinical Trials

Sub Track

Esophageal, Gastric, or Small Bowel

Clinical Trial Registration Number

2009-012797-12

Citation

J Clin Oncol 29: 2011 (suppl; abstr TPS178)

Abstract #

TPS178

Poster Bd #

45H

Abstract Disclosures