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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT04604132
Registration number
NCT04604132
Ethics application status
Date submitted
21/10/2020
Date registered
27/10/2020
Titles & IDs
Public title
Derazantinib Alone or in Combination With Paclitaxel, Ramucirumab or Atezolizumab in Gastric Adenocarcinoma
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Scientific title
A Phase 1b/2 Study of Derazantinib as Monotherapy and Combination Therapy With Paclitaxel, Ramucirumab or Atezolizumab in Patients With HER2-negative Gastric Adenocarcinoma Expressing FGFR2 Genetic Aberrations
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Secondary ID [1]
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DZB-CS-202
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Universal Trial Number (UTN)
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Trial acronym
FIDES-03
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Gastric Adenocarcinoma
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Condition category
Condition code
Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Derazantinib
Treatment: Drugs - Derazantinib-paclitaxel-ramucirumab combination
Treatment: Drugs - Derazantinib-paclitaxel-ramucirumab combination
Treatment: Drugs - Derazantinib
Treatment: Drugs - Derazantinib
Experimental: Substudy 1: Cohort 1.1 Derazantinib 300 mg once daily - Patients with FGFR2 fusions or amplifications were treated with 300 mg Derazantinib monotherapy once daily
Experimental: Substudy 1: Cohort 1.2 Derazantinib 300 mg once daily - Patients with FGFR1-3 mutations were treated with 300 mg Derazantinib monotherapy once daily
Experimental: Substudy 1: Cohort 1.3 Derazantinib 200 mg twice daily - Patients with FGFR fusions, amplifications or mutations were treated with 200 mg Derazantinib monotherapy twice daily
Experimental: Substudy 2: Derazantinib 200 mg once daily +Paclitaxel+ Ramucirumab - Patients with FGFR fusions, amplifications or mutations were treated with 200 mg Derazantinib once daily in combination with Paclitaxel and Ramucirumab
Experimental: Substudy 2: Derazantinib 300 mg once daily+Paclitaxel+ Ramucirumab - Patients with FGFR fusions, amplifications or mutations were treated with 300 mg Derazantinib once daily combination with Paclitaxel and Ramucirumab
Treatment: Drugs: Derazantinib
Derazantinib was administered orally at a dose of 300 mg once daily as monotherapy in the Substudy 1 (Cohort 1.1).
Treatment: Drugs: Derazantinib-paclitaxel-ramucirumab combination
Derazantinib was administered orally at a dose of 200 mg once daily in combination with paclitaxel and ramucirumab.
Paclitaxel was administered intravenously at a dose of 80 mg/m² on days 1, 8, and 15 of a 28-day cycle in combination with ramucirumab.
Ramucirumab was administered intravenously at a dose of 8 mg/kg every 2 weeks in combination with paclitaxel.
Treatment: Drugs: Derazantinib-paclitaxel-ramucirumab combination
Derazantinib was administered orally at a dose of 300 mg once daily in combination with paclitaxel and ramucirumab.
Paclitaxel was administered intravenously at a dose of 80 mg/m² on days 1, 8, and 15 of a 28-day cycle in combination with ramucirumab.
Ramucirumab was administered intravenously at a dose of 8 mg/kg every 2 weeks in combination with paclitaxel.
Treatment: Drugs: Derazantinib
Derazantinib was administered orally at a dose of 200 mg twice daily as monotherapy in the Substudy 1 (Cohort 1.3).
Treatment: Drugs: Derazantinib
Derazantinib was administered orally at a dose of 300 mg once daily as monotherapy in the Substudy 1 (Cohort 1.2).
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Objective Response Rate (ORR) in Substudy 1 (in Cohorts 1.1 and 1.2)
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Assessment method [1]
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ORR was defined by the percentage of patients with confirmed complete response (CR, which means disappearance of all target lesions) or partial response (PR, which means \>=30% decrease in the sum of the longest diameter of target lesions) by blinded independent central review (BICR) using the internationally recognized criteria for the radiological assessment in tumor response of solid tumors (RECIST 1.1). Overall Response (OR) = CR + PR.
The patients in Cohort 1.1 had FGFR2 fusions or amplification gastric adenocarcinoma (GAC) and FGFR1-3 mutations GAC in Cohort 1.2.
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Timepoint [1]
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From first dose and up to 18 months
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Primary outcome [2]
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Progression-free Survival at 4 Months (PFS4) in Substudy 1 in Cohort 1.3
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Assessment method [2]
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PFS4 was defined by the percentage of patients alive and free of disease progression (defined as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions) by BICR per RECIST. 1.1. Patients in this Cohort had FGFR fusions, amplifications or mutations GAC
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Timepoint [2]
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From first dose and up to 4 months
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Primary outcome [3]
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Recommended Phase 2 Dose (RP2D) in Substudy 2 (Derazantinib-paclitaxel-ramucirumab in Combination)
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Assessment method [3]
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RP2D was determined from safety and tolerability according to the aggregate of dose-limiting toxicity criteria and adverse event (AE) data, and considering further pharmacokinetic and efficacy data of the derazantinib-paclitaxel-ramucirumab combination in patients with FGFR fusions, amplifications or mutations GAC.
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Timepoint [3]
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From first dose and up to 18 months
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Secondary outcome [1]
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ORR in Substudy 1 in Cohort 1.3
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Assessment method [1]
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ORR was defined by the percentage of patients with CR or PR by BICR according to RECIST Version 1.1.
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Timepoint [1]
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From first dose and up to 9 months
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Secondary outcome [2]
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Disease Control Rate (DCR) in Substudy 1: Cohort 1.1, 1.2 and 1.3 and Combined Cohorts
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Assessment method [2]
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Defined as the percentage of patients with confirmed CR, PR or stable disease (SD) by BICR per RECIST version 1.1.
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Timepoint [2]
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From first dose and up to 18 months
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Secondary outcome [3]
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PFS in Substudy 1 in Cohort 1.3
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Assessment method [3]
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PFS was calculated from patient enrollment to progressive disease (PD) date by BICR per RECIST version 1.1
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Timepoint [3]
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From first dose and up to 9 months
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Secondary outcome [4]
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Overall Survival (OS) in Substudy 1 in Cohort 1.3
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Assessment method [4]
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OS was measured from patient enrollment to time of death.
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Timepoint [4]
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From first dose and up to 9 months
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Secondary outcome [5]
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OS in Substudy 2
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Assessment method [5]
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OS was measured from patient enrollment to time of death
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Timepoint [5]
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From first dose and up to 15 months
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Secondary outcome [6]
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ORR in Substudy 2
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Assessment method [6]
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ORR was defined by the percentage of patients with CR or PR by BICR per RECIST version 1.1.
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Timepoint [6]
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From first dose and up to 15 months
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Secondary outcome [7]
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DCR in Substudy 2
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Assessment method [7]
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Defined as the percentage of patients with confirmed CR, PR or SD by BICR per RECIST version 1.1.
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Timepoint [7]
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From first dose and up to 15 months
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Secondary outcome [8]
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DOR in Substudy 2 (Separate and Combined Cohorts)
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Assessment method [8]
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DOR was calculated from the first date of documented tumor response to disease progression by BICR per RECIST version 1.1 (or death if no documentation of PD is obtained).
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Timepoint [8]
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From first dose and up to 15 months
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Secondary outcome [9]
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PFS in Substudy 2
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Assessment method [9]
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PFS was calculated from patient enrollment to progressive disease (PD) date by BICR per RECIST version 1.1.
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Timepoint [9]
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From first dose and up to 15 months
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Secondary outcome [10]
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Number of Patients With at Least Grade 3 Treatment-emergent Adverse Events (TEAEs)
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Assessment method [10]
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Number of patients experiencing TEAE of Grade 3 and above according to Common Terminology Criteria for Adverse Events (CTCAE). CTCAE are a set of criteria for the standardized classification of TEAEs of drugs used in cancer therapy. It uses a range of grades from 1 to 5 describing increasing levels of severity of the TEAEs.
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Timepoint [10]
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TEAEs defined as AEs which were assessed per patient from the patient's first dose and until 90 days after the last dose, which corresponded up to 19 months
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Eligibility
Key inclusion criteria
Main inclusion criteria
Patients meeting all of the inclusion criteria at screening were eligible for enrollment in the study, including:
1. Histologically-confirmed adenocarcinoma of the gastro-esophageal junction or stomach.
2. Negative HER2 status obtained from the most recent available tissue sample.
3. Inoperable recurrent, locally advanced adenocarcinoma or progressing stage IV adenocarcinoma of the gastro-esophageal junction or stomach, and prior anti-tumor treatment as specified for each Substudy. Patients were required to be staged as inoperable at the time of screening in order to avoid interference of any potentially planned surgery with RECIST requirements during the study:
Substudy 1: Patients with radiographically documented disease progression after either standard first- or second-line treatment, and no approved and/or tolerable treatment alternative.
Substudy 2: Patients with radiographically documented disease progression after standard first-line treatment, and per Investigator assessment considered suitable to tolerate the treatment regimen.
4. Eligible FGFRfus/amp/mt positive test result. For Substudy 1 Cohort 1.1, FGFR2fus/amp; for Cohort 1.2, FGFR1-3mt; for Cohort 1.3, FGFRfus/amp/mt. For Substudy 2, FGFRfus/amp/mt.
5. Measurable disease as defined by the Investigator using RECIST 1.1 criteria
6. Eastern Cooperative Oncology Group (ECOG) performance score of 0 or 1
7. Adequate organ functions as indicated by Screening visit laboratory values.
Main exclusion criteria
Patients meeting any of the following exclusion criteria at screening were not eligible to be enrolled in the study:
* Receipt of prior cancer treatment within specific interval periods.
* For patients enrolled in Substudy 1, prior treatment with FGFR inhibitors.
* For patients enrolled in Substudy 2, prior treatment with:
* Taxanes within 6 months prior to randomization
* FGFR inhibitors or pathway-targeting agents
* Anti-VEGF(R) therapeutic antibody or pathway-targeting agents
* Concurrent evidence of clinically significant corneal or retinal disorder likely to increase the risk of eye toxicity, including but not limited to bullous/band keratopathy, keratoconjunctivitis (unless keratoconjunctivitis sicca), corneal abrasion (unless related to trauma), inflammation/ulceration, confirmed by ophthalmological examination.
* History of clinically significant cardiac disorders, including myocardial infarction, or New York Heart Association Class II to IV congestive heart failure, within 6 months of the first dose of study drug, and/or any arterial thrombotic event, including myocardial infarction, unstable angina, cerebrovascular accident, or transient ischemic attack, within 6 months of the first dose of study drug, and/or concurrent and clinically significant abnormalities on ECG at Screening, including QTcF > 450 ms for males or > 460 ms for females (mean values from triplicate ECGs).
* Any unresolved (at the time of Screening) clinically significant CTCAE Grade = 2 toxicity (except for alopecia, Grade = 2 platinum-therapy related neuropathy, or Grade = 2 anemia from previous anti-tumor treatment and/or from medical/surgical procedures/interventions).
* Known central nervous system metastases.
* Severe bacterial, fungal, viral and/or parasitic infections on therapeutic oral or IV medication at the time of first dose of study drug administration.
* Significant gastrointestinal disorders that could interfere with the absorption, metabolism, or excretion of derazantinib.
* History of additional malignancy that was progressing or required active treatment.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 1
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Stopped early
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
6/10/2020
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
21/11/2022
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Sample size
Target
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Accrual to date
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Final
47
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Recruitment in Australia
Recruitment state(s)
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Recruitment hospital [1]
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Monash Medical Centre Clayton - Clayton
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Recruitment hospital [2]
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Peter MacCallum Cancer Centre - Melbourne
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Recruitment hospital [3]
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The Alfred Hospital - Prahran
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Recruitment postcode(s) [1]
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3168 - Clayton
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Recruitment postcode(s) [2]
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3000 - Melbourne
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Recruitment postcode(s) [3]
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3181 - Prahran
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Recruitment outside Australia
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United States of America
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Florida
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United States of America
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New York
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Argentina
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Ciudad Autonoma Buenos Aires
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Argentina
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Ciudad Autonoma de Buenos Aires
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Belgium
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Edegem
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Belgium
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Leuven
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Belgium
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Menen
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Brazil
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Rio Grande Do Norte
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Brazil
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Jaú
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Brazil
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Rio De Janeiro
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Brazil
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Santo André
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Brazil
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São José Do Rio Preto
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Chile
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Region Met
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Chile
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Santiago
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Chile
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Temuco
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France
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Avignon
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France
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Besancon
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France
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Dijon
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France
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Paris
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France
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Villejuif
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Germany
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Baden Wuerttemberg
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Germany
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Niedersachsen
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Germany
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Sachsen
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Germany
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Dresden
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Germany
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Frankfurt
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Germany
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Mainz
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Italy
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Bologna
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Italy
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Catanzaro
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Italy
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Milano
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Italy
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Padova
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Italy
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Rozzano
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Italy
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Siena
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Korea, Republic of
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Goyang-si
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Hwasun
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Seongnam
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Seoul
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Suwon
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Poland
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Skórzewo
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Poland
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Warszawa
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Poland
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Lódz
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Russian Federation
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Kazan
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Russian Federation
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Moscow
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Russian Federation
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Omsk
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Russian Federation
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Pesochnyy
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Russian Federation
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Saint Petersburg
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Russian Federation
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Tomsk
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Russian Federation
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Ufa
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Spain
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Barcelona
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Spain
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L'Hospitalet de Llobregat
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Spain
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Madrid
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Spain
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Pamplona
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Turkey
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Adana
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Turkey
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Ankara
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Turkey
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Antalya
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Turkey
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Istanbul
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Turkey
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Kocaeli
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United Kingdom
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Cambridge
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United Kingdom
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Dundee
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United Kingdom
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Glasgow
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United Kingdom
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London
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United Kingdom
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Manchester
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United Kingdom
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Sutton
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Basilea Pharmaceutica
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Address
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Ethics approval
Ethics application status
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Summary
Brief summary
The purpose of this study was to evaluate the efficacy of derazantinib monotherapy or derazantinib in combination with paclitaxel and ramucirumab in patients with gastric adenocarcinoma (GAC) i.e. with human epidermal growth factor receptor 2 (HER2)-negative adenocarcinoma of the stomach or gastro-esophageal junction harboring fibroblast growth factor receptor 2 (FGFR2) genetic aberrations (GA).
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Trial website
https://clinicaltrials.gov/study/NCT04604132
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Manuel Häckl, MD
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Address
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Basilea Pharmaceutica International Ltd, Allschwil
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Fax
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Contact person for public queries
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Type
Other Details
Attachment
Study protocol
https://cdn.clinicaltrials.gov/large-docs/32/NCT04604132/Prot_000.pdf
Statistical analysis plan
https://cdn.clinicaltrials.gov/large-docs/32/NCT04604132/SAP_001.pdf
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT04604132