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RecruitingNCT06587425Updated Sep 19, 2024

The Efficacy and Safety of LM-302 in Combination With Candonilimab and Capecitabine for First-Line Treatment in Patients With Unresectable Advanced, Recurrent, or Metastatic CLDN18.2-Positive Gastric or Gastroesophageal Junction Adenocarcinoma

A Phase 2 interventional study of LM-302+Candonilimab+Capecitabine in Gastric or Gastroesophageal Junction Adenocarcinoma, sponsored by Shanghai Zhongshan Hospital. Recruiting at 1 site in China. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2024-09-19.

Sponsored by Shanghai Zhongshan Hospital · Phase 2, Interventional, and Treatment

From the registry’s dates

  • Primary completion was expected by Jul 2025, 1 year 2 months ago, but the record still lists the study as recruiting.
  • Started Jul 2024; still recruiting 2 years 2 months later.
Phase
Phase 2
Study type
Interventional
Enrollment
50
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

A Phase II Study Evaluating the Efficacy and Safety of LM-302 in Combination with Candonilimab and Capecitabine for First-Line Treatment in Patients with Unresectable Advanced, Recurrent, or Metastatic CLDN18.2-Positive Gastric or Gastroesophageal Junction Adenocarcinoma

Read the detailed description

The antibody-drug conjugate (ADC) targeting CLDN18.2 exerts its anti-tumor effects through multiple mechanisms, including direct cytotoxicity to CLDN18.2-positive tumor cells via the delivery of a potent small-molecule toxin, a bystander effect that induces cytotoxicity in adjacent CLDN18.2-negative tumor cells, and the activation of the immune system through antibody-dependent cellular cytotoxicity (ADCC). The combination of this ADC with immune checkpoint inhibitors holds potential for synergistic anti-tumor activity. LM-302, an ADC specifically targeting CLDN18.2 and comprising a monoclonal antibody conjugated to MMAE, has demonstrated favorable efficacy and safety profiles in both preclinical and clinical studies for CLDN18.2-expressing gastrointestinal malignancies, including gastric and gastroesophageal junction adenocarcinomas. The combination of LM-302 with immune checkpoint inhibitors may offer enhanced clinical benefits for patients with advanced gastric cancer.

This clinical study aims to evaluate the efficacy and safety of LM-302 (ADC targeting Claudin18.2) in combination with cadonilimab (a bispecific antibody targeting PD-1 and CTLA-4) and capecitabine as a first-line treatment in patients with unresectable, recurrent, or metastatic CLDN18.2-positive gastric or gastroesophageal junction adenocarcinoma.

02

Conditions studied

  • Gastric or Gastroesophageal Junction Adenocarcinoma

Keywords

  • CLDN18.2
  • ADC drug
  • cadonilimab
  • Immune Checkpoint Inhibitor
  • Targeted therapy
  • Immunotherapy
  • Chemotherapy
03

In context

Adenocarcinoma

2,004 studies on the registry are indexed under Adenocarcinoma; 375 are open to participants now.

This study's planned enrollment of 50 is above the median of 45 across 1,553 interventional studies indexed under Adenocarcinoma.

Browse Adenocarcinoma studies →

Lead sponsor

Shanghai Zhongshan Hospital is the lead sponsor of 636 studies on the registry; 283 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • The subjects fully understand the purpose, nature, methods, and potential adverse reactions of the trial, voluntarily participate as participants, and sign an informed consent form (ICF) before any procedures begin
  • The subject must have locally advanced or metastatic gastric cancer or gastroesophageal junction cancer that cannot be surgically removed, and the histopathological examination confirms it to be simple adenocarcinoma
  • Permissible Previous Treatment: Participants with gastric cancer or gastroesophageal junction cancer who have previously received adjuvant or neoadjuvant treatment and have experienced clinical disease progression at least 6 months after the last administration are eligible for inclusion. (Note: The treatment-related toxicity of oxaliplatin in previous adjuvant or neoadjuvant treatments must be restored to the National Cancer Institute [NCI] General Terminology Standard for Adverse Events [CTCAE] v5.0 Level 1 before enrollment)
  • CLDN18.2 positivity: Provide sufficient tissue markers for Claudin18.2 immunohistochemistry testing. Claudin18.2 immunohistochemistry expression ≥ 10% is confirmed as positive, and\<10% is recorded as negative
  • According to RECIST v1.1 standard, there should be at least one measurable lesion
  • ECOG physical state ≤ 1
  • Expected lifespan>3 months
  • Adequate renal function: creatinine (Cr) ≤ 1.5 x upper limit of normal (ULN) and glomerular filtration rate (GFR) ≥ 60mL/min/1.73 m2;
  • Sufficient liver function: Total bilirubin ≤ 1.5 × ULN, AST and ALT ≤ 2.5 × ULN (if there is liver metastasis, AST and ALT ≤ 5 × ULN, total bilirubin ≤ 2.5 × ULN);
  • Adequate bone marrow reserve: Platelet count (PLT) ≥ 100 × 109/L, absolute neutrophil count (ANC) ≥ 1.5 × 109/L, hemoglobin ≥ 9 g/dL (no adjuvant therapy such as EPO, G-CSF, or GM-CSF has been received within 14 days, and no blood transfusion including red blood cells and platelets has been received at least 7 days before the first administration); Prothrombin time/activated partial thromboplastin time (PT/PTT)\<1.5 x ULN;
  • Male or female aged ≥ 18 years old.

Exclusion criteria

Exclusion Criteria:

  • Known HER2 positive gastric cancer/adenocarcinoma of the gastroesophageal junction. HER2 positivity refers to HER2 amplification that requires confirmation from ISH if the HER2 immunohistochemistry test result is 3+and the immunohistochemistry test result is 2+
  • Has undergone major surgery or radiation therapy within 4 weeks prior to enrollment;
  • Active, known or suspected autoimmune diseases
  • Congestive heart failure or symptomatic coronary artery disease within 3 months prior to enrollment
  • A cerebrovascular accident occurred within the past 6 months
  • Clinically significant bleeding, bleeding events, or thromboembolic diseases occur within 6 months
  • History of intestinal perforation
  • Have a history of (non infectious) pneumonia requiring steroid treatment or currently suffer from pneumonia
  • Known history of human immunodeficiency virus (HIV) infection. Subjects with active hepatitis B or active hepatitis C. (Unless receiving antiviral therapy for at least 14 days prior to the first study drug administration and passing hepatitis B virus (HBV) DNA titer testing (not exceeding 500 IU/mL or 2500 copies [cps]/mL) and hepatitis C virus (HCV) RNA testing (not exceeding the lower limit of the assay), eligible for inclusion in the trial and willing to continue receiving effective antiviral therapy during the study period);
  • Severe impairment of lung function or history of interstitial lung disease
  • Diagnosed with concurrent malignant tumors within the past 2 years (except for fully treated non melanoma skin cancer, superficial bladder transitional cell carcinoma, and cervical carcinoma in situ [CIS]) or any currently active malignant tumor
  • Previous or current evidence suggests that there may be confusion with the research results, interference with the participant\'s participation in the entire study process, any conditions, treatments, or laboratory abnormalities, or the researcher believes that participating in this study is not in the best interest of the participant
  • Pregnancy test positive within 7 days before the first administration, or women of childbearing age who are in lactation period
  • Individuals with known mental illnesses or disorders that may affect trial compliance
  • Subjects who take systemic corticosteroids (>10 mg daily prednisone equivalent) or other systemic immunosuppressive drugs (including but not limited to prednisone, dexamethasone, cyclophosphamide, azathioprine, methotrexate, thalidomide, and anti-tumor necrosis factor drugs) within 2 weeks prior to the first medication are allowed to use local, ocular, intra-articular, intranasal, and inhaled corticosteroids
  • Subjects with a known history of autoimmune diseases, including but not limited to myasthenia gravis, myositis, autoimmune hepatitis, systemic lupus erythematosus, rheumatoid arthritis, Guillain Barre syndrome, multiple sclerosis, or glomerulonephritis, excluding autoimmune hypothyroidism treated with stable dose hormone replacement therapy
  • Individuals with a history of previous immunodeficiency, including those with other acquired or congenital immunodeficiency diseases, or those with a history of organ transplantation, allogeneic bone marrow transplantation, or autologous hematopoietic stem cell transplantation The researcher determined that there are other situations that are not suitable for participation in this study
  • The researcher determined that there are other situations that are not suitable for participation in this study
05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
50 participants (estimated)

Study arms

  • Experimental
    LM-302+Cadonilimab+Capecitabine

    LM-302: 1.8mg/kg ivgtt d1, q2w; Canonilimab: 6mg/kg ivgtt d1, q2w; Capecitabine: 1000mg/m\^2 po bid d1-10, q2w.

    Drug: LM-302+Candonilimab+Capecitabine

Interventions

  • DrugLM-302+Candonilimab+Capecitabine

    LM-302: 1.8mg/kg ivgtt d1, q2w; Canonilimab: 6mg/kg ivgtt d1, q2w; Capecitabine: 1000mg/m\^2 po bid d1-10, q2w.

    Also known as: ADC-Claudin18.2+AK104+Capecitabine

06

What researchers measure

Primary outcomes

  1. Dose limiting toxicity (DLT)

    DLT is defined as a toxicity (adverse event at least possibly related to LM302) occurring during the DLT observation period

    Time frame: Cycle 1 of each cohort. Duration of one cycle is 28 days

  2. Progression Free Survival (PFS)

    PFS was defined as the time from date of randomization until first objective radiographic tumor progression or death from any cause, based on Investigator assessment

    Time frame: From enrollment until 6 months after the last participant discontinues treatment, up to approximately 42 months

Secondary outcomes

  1. Overall Survival (OS)

    OS was defined defined as the time from date of randomization until death from any cause.

    Time frame: From enrollment until 6 months after the last participant discontinues treatment, up to approximately 42 months.

  2. Objective response rate (ORR)

    defined as the proportion of participants who achieve a best response of complete response (CR) or partial response (PR) using the Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1) criteria as assessed by Investigator.

    Time frame: From start of treatment to date of documented disease progression, up to approximately 42 months

  3. Duration of response (DoR)

    defined time from the initial response (CR or PR) until documented tumor progression or death from any cause and based on Investigator assessment.

    Time frame: From start of treatment to date of documented disease progression, up to approximately 42 months

  4. Disease control rate (DCR)

    defined as the proportion of participants who achieved CR, PR, or stable disease (SD) for a minimum of 6 weeks during study treatment, based on Investigator assessment.

    Time frame: From start of treatment to date of documented disease progression, up to approximately 42 months

  5. . AE and SAE

    Adverse events will be graded according to the National Cancer Institute-Common Terminology Criteria for Adverse Events Version 5.0

    Time frame: : From signing the ICF until 28 days after EOT or accept other anti-cancer therapy,up to 40 days after last study dose

07

Study locations

1 of 1 sites recruiting
  • Zhongshan Hospital Fudan University
    Shanghai, Shanghai 200032, China
    • Yiyi Yu, Doctor · Contact · yu.yiyi@zs-hospital.sh.cn · +86 21 6404 1990
    • Tianshu Liu, Doctor · Principal investigator
    • Yiyi Yu, Doctor · Sub investigator
    • Mengling Liu, Doctor · Sub investigator
    Recruiting
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 19, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT06587425
Lead sponsor
Shanghai Zhongshan Hospital
Responsible party
Tianshu Liu (Professor, Shanghai Zhongshan Hospital) — Principal investigator
First posted
Sep 19, 2024
Start date
Jul 31, 2024
Primary completion
Jul 31, 2025 (estimated)
Completion
Dec 31, 2026 (estimated)
Last update
Sep 19, 2024

Study contacts

Yiyi Yu, Doctor
Contact
yu.yiyi@zs-hospital.sh.cn
+86 138 1673 0912
Mengling Liu, Doctor
Contact
liu.mengling@zs-hospital.sh.cn
+86 153 1615 8393
Tianshu Liu, Doctor
principal investigator · Fudan University

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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