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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT04662710
Registration number
NCT04662710
Ethics application status
Date submitted
4/12/2020
Date registered
10/12/2020
Titles & IDs
Public title
Efficacy and Safety of Lenvatinib (E7080/MK-7902) Plus Pembrolizumab (MK-3475) Plus Chemotherapy in Participants With Advanced/Metastatic Gastroesophageal Adenocarcinoma (MK-7902-015/E7080-G000-321/LEAP-015)
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Scientific title
Phase 3, Randomized Study to Evaluate the Efficacy and Safety of Lenvatinib (E7080/MK-7902) Plus Pembrolizumab (MK-3475) Plus Chemotherapy Compared With Standard of Care Therapy as First-line Intervention in Participants With Advanced/Metastatic Gastroesophageal Adenocarcinoma (LEAP-015)
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Secondary ID [1]
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MK-7902-015
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Secondary ID [2]
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7902-015
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Universal Trial Number (UTN)
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Trial acronym
LEAP-015
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Advanced/Metastatic Gastroesophageal Adenocarcinoma
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Condition category
Condition code
Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Other - Pembrolizumab
Treatment: Other - Lenvatinib
Treatment: Drugs - Oxaliplatin
Treatment: Drugs - Capecitabine
Treatment: Drugs - Leucovorin (or Levoleucovorin)
Treatment: Drugs - 5-FU
Experimental: Lenvatinib + Pembrolizumab + Chemotherapy - Participants receive lenvatinib administered orally (PO) every day (QD) in combination with pembrolizumab intravenously (IV) every 6 weeks (Q6W) plus chemotherapy with either capecitabine and oxaliplatin (CAPOX) or chemotherapy with 5-FU, leucovorin, and oxaliplatin (mFOLFOX6). Induction with lenvatinib 8 mg QD plus pembrolizumab (400 mg Q6W) plus chemotherapy (CAPOX or mFOLFOX6) will be administered for 2 cycles (approximately 12 weeks), followed by consolidation with lenvatinib 20 mg QD plus pembrolizumab (400 mg Q6W) for 16 cycles. A cycle is 6 weeks (42 days).
Experimental: Chemotherapy - Participants receive chemotherapy with either CAPOX Q3W or mFOLFOX6 Q2W. A cycle is 6 weeks (42 days).
Treatment: Other: Pembrolizumab
400 mg Q6W by IV infusion
Treatment: Other: Lenvatinib
Administered PO QD, 8 mg induction/20 mg consolidation.
Treatment: Drugs: Oxaliplatin
130 mg/m\^2 administered by IV infusion on Day 1 of Weeks 1 and 4 of each Q6W cycle as part of CAPOX chemotherapy, or 85 mg/m\^2 administered by IV infusion on Day 1 and Week 1, 3 and 5 of each Q6W cycle as part of mFOLFOX6 chemotherapy.
Treatment: Drugs: Capecitabine
1000 mg/m\^2 administered PO twice daily (BID) on Days 1-14, 22-35 of each Q6W cycle as part of CAPOX chemotherapy.
Treatment: Drugs: Leucovorin (or Levoleucovorin)
Administered by IV infusion at 400 mg/m\^2 (leucovorin) or 200 mg/m\^2 (levoleucovorin) on Day 1, and Week 1, 3 and 5 of each Q6W cycle as part of mFOLFOX6 chemotherapy.
Treatment: Drugs: 5-FU
400 mg/m\^2 bolus IV infusion followed by 2400 mg/m\^2 continuous IV infusion administered on Day 1, and Week 1, 3, 5, of each Q2W cycle as part of mFOLFOX6 chemotherapy.
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Intervention code [1]
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Treatment: Other
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Intervention code [2]
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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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Part 1: Number of Participants with Dose Limiting Toxicities (DLTs)
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Assessment method [1]
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Hematologic DLTs were defined as Grade 4 neutropenia lasting for =7 days, Grade 3 or Grade 4 febrile neutropenia, Grade 3 thrombocytopenia with bleeding, Grade 4 thrombocytopenia, or Grade 4 anemia. Other nonhematologic toxicities considered a DLT included any other Grade 4 or Grade 5 toxicity, Grade 3 toxicities lasting \>3 days (excluding nausea, vomiting, and diarrhea controlled by medical intervention within 72 hours, and Grade 3 rash in the absence of desquamation with no mucosal involvement), Grade 3 hypertension not able to be controlled by medication, =Grade 3 gastrointestinal perforation, =Grade 3 wound dehiscence requiring medical or surgical intervention, or any grade thromboembolic event. The number of participants in Part 1 with DLTs will be reported by treatment arm.
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Timepoint [1]
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Up to ~21 days
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Primary outcome [2]
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Part 1: Number of Participants with Adverse Events (AEs)
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Assessment method [2]
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An AE is any untoward medical occurrence in a participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment. The number of participants in Part 1 with AEs will be reported by treatment arm.
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Timepoint [2]
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Up to ~28 months
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Primary outcome [3]
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Part 1: Number of Participants who Discontinued Study Treatment Due to an AE
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Assessment method [3]
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An AE is any untoward medical occurrence in a participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment. The number of participants in Part 1 that discontinued study due to an AE will be reported by treatment arm.
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Timepoint [3]
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Up to ~25 months
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Primary outcome [4]
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Part 2: Overall Survival (OS) in Participants with Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) =1
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Assessment method [4]
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OS is defined as the time from randomization to death due to any cause. OS will be reported by treatment arm for PD-L1 CPS =1 participants in Part 2.
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Timepoint [4]
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Up to ~41 months
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Primary outcome [5]
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Part 2: OS in All Participants
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Assessment method [5]
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OS is defined as the time from randomization to death due to any cause. OS will be reported by treatment arm for all participants in Part 2.
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Timepoint [5]
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Up to ~41 months
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Primary outcome [6]
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Part 2: Progression-Free Survival (PFS) Per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1) as Assessed by Blinded Independent Central Review (BICR) in Participants with PD-L1 CPS =1
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Assessment method [6]
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PFS is defined as the time from randomization to the first documented progressive disease (PD) per RECIST 1.1 by BICR or death from any cause, whichever occurs first. Per RECIST 1.1 modified to follow a maximum of 10 target lesions and a maximum of 5 target lesions per organ, PD is defined as at least a 20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. The appearance of one or more new lesions is also considered PD. PFS will be reported by treatment arm for PD-L1 CPS =1 participants in Part 2.
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Timepoint [6]
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Up to ~31 months
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Primary outcome [7]
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Part 2: PFS Per RECIST 1.1 as Assessed by BICR in All Participants
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Assessment method [7]
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PFS is defined as the time from randomization to the first documented PD per RECIST 1.1 by BICR or death from any cause, whichever occurs first. Per RECIST 1.1 modified to follow a maximum of 10 target lesions and a maximum of 5 target lesions per organ, PD is defined as at least a 20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. The appearance of one or more new lesions is also considered PD. PFS will be reported by treatment arm for all participants in Part 2.
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Timepoint [7]
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Up to ~31 months
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Secondary outcome [1]
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Part 2: Objective Response Rate (ORR) Per RECIST 1.1 as Assessed by BICR in Participants with PD-L1 CPS =1
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Assessment method [1]
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ORR is defined as the percentage of participants in the analysis population who have a Complete Response (CR: disappearance of all target lesions) or a Partial Response (PR: at least a 30% decrease in the sum of diameters of target lesions) per RECIST 1.1 modified to follow a maximum of 10 target lesions and a maximum of 5 target lesions per organ, and assessed by BICR. ORR will be reported by treatment arm for PD-L1 CPS =1 participants in Part 2.
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Timepoint [1]
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Up to ~31 months
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Secondary outcome [2]
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Part 2: ORR Per RECIST 1.1 as Assessed by BICR in All Participants
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Assessment method [2]
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ORR is defined as the percentage of participants in the analysis population who have a CR (disappearance of all target lesions) or a PR (at least a 30% decrease in the sum of diameters of target lesions) per RECIST 1.1 modified to follow a maximum of 10 target lesions and a maximum of 5 target lesions per organ, and assessed by BICR. ORR will be reported by treatment arm for all participants in Part 2.
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Timepoint [2]
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Up to ~31 months
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Secondary outcome [3]
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Part 2: Duration of Response (DOR) Per RECIST 1.1 as Assessed by BICR in Participants with PD-L1 CPS =1
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Assessment method [3]
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For participants who demonstrated confirmed CR or PR, DOR is defined as the time from the first CR (disappearance of all target lesions) or PR (at least a 30% decrease in the sum of diameters of target lesions) to subsequent PD or death due to any cause, whichever occurs first. Per RECIST 1.1 modified to follow a maximum of 10 target lesions and a maximum of 5 target lesions per organ, PD is defined as at least a 20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. The appearance of one or more new lesions is also considered PD. DOR will be reported by treatment arm for PD-L1 CPS =1 participants in Part 2.
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Timepoint [3]
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Up to ~31 months
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Secondary outcome [4]
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Part 2: DOR Per RECIST 1.1 as Assessed by BICR in All Participants
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Assessment method [4]
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For participants who demonstrated confirmed CR or PR, DOR is defined as the time from the first CR (disappearance of all target lesions) or PR (at least a 30% decrease in the sum of diameters of target lesions) to subsequent PD or death due to any cause, whichever occurs first. Per RECIST 1.1 modified to follow a maximum of 10 target lesions and a maximum of 5 target lesions per organ, PD is defined as at least a 20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. The appearance of one or more new lesions is also considered PD. DOR will be reported by treatment arm for all participants in Part 2.
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Timepoint [4]
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Up to ~31 months
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Secondary outcome [5]
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Part 2: Number of Participants with AEs
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Assessment method [5]
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An AE is any untoward medical occurrence in a participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment. The number of participants in Part 2 with AEs will be reported by treatment arm.
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Timepoint [5]
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0
Up to ~28 months
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Secondary outcome [6]
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Part 2: Number of Participants who Discontinued Study Treatment Due to an AE
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Assessment method [6]
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An AE is any untoward medical occurrence in a participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment. The number of participants in Part 2 that discontinued study due to an AE will be reported by treatment arm.
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Timepoint [6]
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Up to ~25 months
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Eligibility
Key inclusion criteria
* Has histologically and/or cytologically confirmed diagnosis of previously untreated, locally advanced unresectable or metastatic gastroesophageal adenocarcinoma
* Is not expected to require tumor resection during the treatment course
* Has gastroesophageal adenocarcinoma that is not HER-2/neu positive
* Has measurable disease as defined by RECIST 1.1 by scan with IV contrast as determined by the local site investigator
* Male participants agree to refrain from donating sperm and agree to either remain abstinent from heterosexual intercourse as their preferred and usual lifestyle OR agree to use contraception, during the intervention period and for =7 days after last dose of lenvatinib or 90 days after last dose of chemotherapy-whichever comes last
* Female participants not pregnant or breastfeeding are eligible to participate if not a women of childbearing potential (WOCBP), or if a WOCBP they either use a contraceptive method that is highly effective OR remain abstinent from heterosexual intercourse as their preferred and usual lifestyle, and do not donate eggs (ova, oocytes) to others or freeze/store for their own use, and abstain from breastfeeding during the intervention period through 120 days after last dose of pembrolizumab, 30 days after last dose of lenvatinib, or 180 days after last dose of chemotherapy-whichever occurs last
* Has a performance status of 0 or 1 on the Eastern Cooperative Oncology Group (ECOG) Performance Scale within 3 days prior to the first dose of study treatment
* Has adequately controlled blood pressure with or without antihypertensive medications
* Has adequate organ function
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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
* Has had previous therapy for locally advanced unresectable or metastatic gastric/gastroesophageal junction (GEJ) esophageal adenocarcinoma
* Has had major surgery within 28 days prior to first dose of study interventions
* Has had radiotherapy within 14 days of randomization
* Has a known additional malignancy that is progressing or has required active treatment within the past 5 years
* Has known CNS metastases and/or carcinomatous meningitis
* Has severe hypersensitivity (=Grade 3) to treatment with an monoclonal antibody (mAb) or known sensitivity or intolerance to any component of lenvatinib, pembrolizumab, study chemotherapy agents and/or to any excipients, murine proteins, or platinum containing products
* Has had an allogeneic tissue/solid organ transplant
* Has perforation risks or significant gastrointestinal (GI) bleeding
* Has GI obstruction, poor oral intake (CAPOX participants), or difficulty in taking oral medication (CAPOX participants)
* Has received prior therapy with an anti-PD-1, anti-PD-L1, or anti-PD-L2 agent or with an agent directed to another stimulatory or coinhibitory T-cell receptor
* Has received prior therapy with anti- vascular endothelial growth factor (VEGF) tyrosine kinase inhibitor or anti-VEGF mAb
* Has received a live or live-attenuated vaccine within 30 days before the first dose of study drug
* Has an active autoimmune disease that has required systemic treatment in past 2 years (i.e., with use of disease modifying agents, corticosteroids or immunosuppressive drugs)
* Has radiographic evidence of encasement or invasion of a major blood vessel, or of intratumoral cavitation
* Has inadequate cardiac function
* Has a history of (noninfectious) pneumonitis/interstitial lung disease that required steroids or has current pneumonitis/interstitial lung disease
* Has poorly controlled diarrhea
* Has accumulation of pleural, ascitic, or pericardial fluid requiring drainage or diuretic drugs within 2 weeks prior to enrollment.
* Has peripheral neuropathy =Grade 2
* Has a known history of human immunodeficiency virus (HIV) or HIV 1/2 antibodies
* Has a known history of hepatitis B (defined as HBsAg reactive) or known active hepatitis C virus (defined as HCV RNA [qualitative] is detected) infection
* Has weight loss of >20% within the last 3 months
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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 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Active, not recruiting
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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
30/12/2020
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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
2/02/2026
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Actual
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Sample size
Target
890
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW,QLD,WA
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Recruitment hospital [1]
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Nepean Hospital ( Site 2305) - Kingswood
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Wollongong Hospital ( Site 2307) - Wollongong
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Royal Brisbane and Women s Hospital ( Site 2304) - Herston
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Hollywood Private Hospital-Medical Oncology ( Site 2308) - Nedlands
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Recruitment postcode(s) [1]
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2747 - Kingswood
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2500 - Wollongong
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4029 - Herston
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Recruitment postcode(s) [4]
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6009 - Nedlands
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Recruitment outside Australia
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California
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Maule
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Be'er Sheva
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Israel
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Hadera
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Israel
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Haifa
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Israel
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Jerusalem
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Israel
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Kfar-Saba
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Israel
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Petah Tikva
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Israel
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Tel Aviv
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Italy
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Abruzzo
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Italy
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Friuli-Venezia Giulia
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Italy
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Lombardia
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Italy
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Veneto
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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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Napoli
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Japan
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Aichi
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Japan
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Chiba
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Japan
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Ehime
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Japan
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Hyogo
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Japan
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State/province [86]
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Ibaraki
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Japan
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Kagawa
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Country [88]
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Japan
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Kanagawa
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Japan
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Osaka
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Japan
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Saitama
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Japan
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State/province [91]
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Fukuoka
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Japan
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Hiroshima
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Japan
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Tokyo
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Korea, Republic of
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Kyonggi-do
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Korea, Republic of
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Seoul
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Korea, Republic of
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State/province [96]
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Taejon-Kwangyokshi
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Country [97]
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Poland
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State/province [97]
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Dolnoslaskie
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Country [98]
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Poland
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State/province [98]
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Mazowieckie
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Country [99]
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Poland
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Podkarpackie
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Poland
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Wielkopolskie
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Country [101]
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Russian Federation
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State/province [101]
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Chelyabinskaya Oblast
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Country [102]
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Russian Federation
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State/province [102]
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Moskva
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Russian Federation
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Samarskaya Oblast
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Russian Federation
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Sankt-Peterburg
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Russian Federation
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Yaroslavskaya Oblast
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Spain
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Asturias
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Spain
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Cantabria
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Spain
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Barcelona
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Spain
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Madrid
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Taiwan
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State/province [110]
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Taichung
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Country [111]
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Taiwan
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Tainan
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Taiwan
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Taipei
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Taiwan
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Taoyuan
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Country [114]
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Turkey
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Istanbul
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Turkey
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Ankara
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Turkey
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Edirne
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Turkey
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Erzurum
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Turkey
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Izmir
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Country [119]
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United Kingdom
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Cambridgeshire
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Country [120]
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United Kingdom
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Dundee City
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Country [121]
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United Kingdom
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Glasgow City
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Country [122]
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United Kingdom
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London, City Of
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Country [123]
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United Kingdom
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Surrey
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Country [124]
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United Kingdom
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Warwickshire
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Country [125]
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United Kingdom
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Manchester
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Merck Sharp & Dohme LLC
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Address
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Other collaborator category [1]
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Commercial sector/industry
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Name [1]
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Eisai Inc.
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Address [1]
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Ethics approval
Ethics application status
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Summary
Brief summary
The purpose of this study is to assess the efficacy and safety of lenvatinib (E7080/MK-7902) plus pembrolizumab (MK-3475) plus chemotherapy compared with chemotherapy alone in participants with advanced/metastatic gastroesophageal cancer. The primary study hypotheses are that lenvatinib plus pembrolizumab plus chemotherapy is superior to chemotherapy alone for both overall survival (OS) and progression-free survival (PFS) per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1) as assessed by blinded independent central review (BICR), in participants with programmed cell death-ligand 1 (PD-L1) Combined Positive Score (CPS) =1 and in all participants.
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Trial website
https://clinicaltrials.gov/study/NCT04662710
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
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Medical Director
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Address
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Merck Sharp & Dohme LLC
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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)?
Yes
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What data in particular will be shared?
http://engagezone.msd.com/doc/ProcedureAccessClinicalTrialData.pdf
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When will data be available (start and end dates)?
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Available to whom?
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Available for what types of analyses?
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How or where can data be obtained?
IPD available at link: http://engagezone.msd.com/ds_documentation.php
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT04662710