A Study of ASP546C in Adults With Gastroesophageal Cancer, Pancreatic Cancer or Other Solid Tumors
A Phase 1b/2 Open-label Study to Assess the Safety and Efficacy of ASP546C in Participants With CLDN18.2-expressing Locally Advanced Unresectable or Metastatic Gastroesophageal Adenocarcinoma, Pancreatic Adenocarcinoma or Other Solid Tumor Types
Who can join
As published by the study on ClinicalTrials.gov. "Not stated" means the study hasn't said — ask the study team.
- Age
- 18 Years and older
- Sex
- All sexes
- Healthy volunteers
- Not accepted
- Compensation
- Not stated
Other requirements are listed under Eligibility below. Only the study team can confirm whether you can join.
What to expect
No one can promise a trial will help you personally — that is what the research is trying to find out.
What participation involves
- Procedures mentioned: Infusions
Only what the study's summary and detailed description on ClinicalTrials.gov say. Time periods may describe the whole study or a part of it — ask the study team what applies to you.
Show the study's own words
- "This is called an infusion."
- "They will receive an infusion of either a higher dose or a lower dose of ASP546C."
- "All people in this part of the study will receive an infusion of the higher dose of ASP546C."
- "The number of visits and checks done during the study will depend on the health of each person and whether they are still receiving infusions of ASP546C."
- Compensation
- Not stated
- Study-related exams and procedures are typically provided at no cost. This is how many trials work in general — confirm the details for this study with the study team.
- Participants are monitored closely by the research team throughout the study.
- Some participants may receive access to an investigational treatment, which is still being studied.
- Your participation helps researchers learn whether this approach could help future patients.
About this study
In plain language
This study tests which dose of ASP546C is most suitable for adults with stomach cancer, cancer where the food pipe joins the stomach, pancreatic cancer, or certain other solid tumors. The drug is given slowly through a tube into a vein once every 3 weeks.
This study will help find the most suitable dose of ASP546C in people with gastric cancer, gastroesophageal junction (GEJ) cancer, pancreatic cancer, and other specific solid tumors. GEJ is where the food pipe (esophagus) joins the stomach. This study is in 2 parts. In both parts of the study, ASP546C will be given once in 3-week cycles. It will be given slowly through a tube into a vein. This is called an infusion. In Part 1, people with gastric cancer or GEJ cancer can take part. They will receive an infusion of either a higher dose or a lower dose of ASP546C. In Part 2, people with pancreatic cancer or who have one of the other solid tumors can take part. Part 2 doesn't include people with gastric cancer or GEJ cancer. All people in this part of the study will receive an infusion of the higher dose of ASP546C. People will visit the clinic on certain days to receive ASP546C and have health checks. The number of visits and checks done during the study will depend on the health of each person and whether they are still receiving infusions of ASP546C.
Compensation is read from the study's own description and may be missing — always confirm with the study team.
Eligibility
Who can join
- Have an allowed type of cancer confirmed by a tissue test, such as certain stomach, food pipe, pancreatic, bile duct, colon, lung, ovarian, or breast cancers.
- Have scans within 28 days before treatment showing cancer that has spread or cannot be removed by surgery.
- Have cancer that can be measured or checked on scans, as required for your study group.
- Have a tumor with a protein called CLDN18.2, and provide enough tumor tissue for testing.
- Have received at least one treatment for cancer that has spread or cannot be removed by surgery.
- Be fully active or able to do light work, and be expected to live at least 12 weeks.
- Meet the study’s lab test requirements and agree not to join another treatment study while receiving ASP546C.
- Not be pregnant or breastfeeding. Follow the study’s rules for pregnancy testing, birth control, and avoiding egg or sperm donation during and after treatment.
Who can't join
- For groups 1–3: have a cancer type other than adenocarcinoma, including a mixed type, or have had more than two treatments for advanced cancer. Group 4 has separate rules about standard treatment options.
- Have a blocked stomach outlet, or a partly blocked outlet with repeated vomiting; serious stomach or bowel bleeding; or an untreated ulcer that makes joining unsafe.
- Have a serious bleeding disorder, recent blood vessel swelling, or a hole or abnormal passage in the stomach or bowel within the past 6 months.
- Have untreated brain cancer spread that causes symptoms, or cancer in the lining around the brain and spinal cord. Stable spread may be allowed under study rules.
- Have lung swelling that has not cleared, or certain past lung swelling requiring steroids within 6 months; HIV; active hepatitis B or C; or a recent infection needing treatment throughout the body. Some treated or inactive hepatitis C cases are allowed.
- Have another cancer needing treatment or certain cancers within the past 5 years, or fluid around the lungs or in the belly that needs frequent draining.
- Have more than mild lasting side effects from past cancer treatment, except hair loss; certain nerve damage; or an immune disease or other condition needing high-dose steroids.
- Have a mental illness that is hard to control or serious heart or blood vessel disease, including certain recent heart problems or a stroke.
Simplified for readability. The official criteria below are what the study team uses.
Official eligibility criteria
Inclusion Criteria: * Participant has a histologically confirmed diagnosis of gastroesophageal (gastric/GEJ/esophageal) adenocarcinoma, pancreatic adenocarcinoma, or pan-tumor (cholangiocarcinoma, colorectal adenocarcinoma, NSCLC \[adenocarcinoma\], SCLC, ovarian mucinous carcinoma or invasive breast cancer \[ER/PR+HER2-; ER/PR-HER2+; ER/PR+HER2+ (triple positive); ER/PR-HER2- (triple negative)\]. * Participant has radiologically confirmed uLA/m gastroesophageal (gastric/GEJ/esophageal) adenocarcinoma, pancreatic adenocarcinoma or pan-tumor within 28 days prior to the first dose of study intervention. * Cohorts 1 to 3 only: Participant has measurable disease according to RECIST v1.1 within 28 days prior to the first dose of study intervention. For participants with only 1 measurable lesion and prior radiotherapy, the lesion must be outside the field of prior radiotherapy or must have documented progression following radiation therapy. * Cohort 4 only: Participant has radiologically evaluable disease (measurable and/or non-measurable) according to RECIST v1.1, within 28 days prior to the first dose of study intervention. For participants with only 1 evaluable lesion and prior radiotherapy, the lesion must be outside the field of prior radiotherapy or must have documented progression following radiation therapy. * Participant's tumor expresses CLDN18.2. * Participant has received at least 1 line of therapy for uLA/m disease. * Participant has an ECOG performance status of 0 or 1. * Participant has a predicted life expectancy \>= 12 weeks. * Female participant is not pregnant and at least 1 of the following conditions apply: * Not a women of childbearing potential (WOCBP) * WOCBP who has a negative urine or serum pregnancy test at screening (Specific to Japan: with a medical interview), and agrees to follow the contraceptive guidance from the time of informed consent through at least 5 half-lives (45 days) plus 6 months after final investigational study intervention administration. * Female participant must not be breastfeeding or lactating starting at screening and throughout the investigational period and for 5 half-lives (45 days) plus 6 months after final investigational study intervention administration. * Female participant must not donate ova starting at first administration of study intervention and throughout the investigational period and for 5 half-lives (45 days) plus 6 months after final investigational study intervention administration. * Male participant must agree to use contraception with female partner(s) of childbearing potential (including breastfeeding partner) throughout the treatment period and for 5 half-lives (45 days) plus 3 months after final investigational study intervention administration. * Male participant must agree to remain abstinent or use a condom with pregnant partner(s) for the duration of the pregnancy throughout the investigational period and for 5 half-lives (45 days) plus 3 months after final investigational study intervention administration. * Male participant must not donate sperm during the treatment period and for 5 half-lives (45 days) plus 3 months after final investigational study intervention administration. * Participant must meet all of the criteria based on the locally analyzed laboratory tests collected within 14 days prior to the first dose of study intervention. In case of multiple local laboratory tests within this period, the most recent data should be used. * Participant is willing to provide or has sufficient tumor tissue for central biomarker assessment. * Participant agrees not to participate in another interventional study while receiving study intervention in the present study. Exclusion Criteria: * Cohorts 1, 2 and 3 only: Participant's disease is of the non-adenocarcinoma histology or mixed histology containing adenocarcinoma. * Cohorts 1, 2 and 3 only: Participant has received \> 2 prior lines of therapy for uLA/m disease. * Participants in Cohort 4 (pan-tumor) may enroll regardless of the number of prior lines of therapy, if they are not eligible for, decline, or do not have any available standard of care treatment options. * Participant has complete gastric outlet syndrome or a partial gastric outlet syndrome with persistent recurrent vomiting. * Participant has significant gastric bleeding or had a significant bleeding episode from the gastrointestinal tract within 3 months prior to the first dose of study intervention and/or an untreated peptic ulcer disease that would preclude the participant from participation. * Participant has significant bleeding disorders or has had vasculitis within 3 months prior to the first dose of study intervention. * Participant has a history of gastrointestinal perforation and/or fistula within 6 months prior to the first dose of study intervention. * Participant has symptomatic, untreated brain metastases or meningeal carcinomatosis (carcinomatous meningitis) from the primary malignancy. A participant with stable central nervous system metastases for \> 3 months without need of steroids for \>= 2 weeks prior to the first dose of study intervention is eligible. * Participant has a past or current mental illness that is difficult to control. * Participant has unresolved pneumonitis or a history of non-infectious pneumonitis such as immune-related pneumonitis or radiation-induced pneumonitis for which the participant is taking glucocorticoids or needed glucocorticoids within 6 months prior to the first dose of study intervention. * Participant has a known history of a positive test for human immunodeficiency virus (HIV) infection or known active hepatitis B (positive hepatitis B surface antigen \[HBsAg\]) or hepatitis C infection. Screening for these infections should be conducted if indicated per local requirements. * If participant is negative for HBsAg, but hepatitis B core antibody (HBcAb) and/or hepatitis B surface antibody (HBsAb) positive, a hepatitis B DNA test will be performed; if the test is positive, the participant will be excluded. * Participant with positive hepatitis C virus (HCV) serology, but negative HCV RNA test results, is eligible. * Participant treated for HCV with undetectable viral load results is eligible. * Participant has an active infection requiring systemic therapy that has not completely resolved within 7 days prior to the first dose of study intervention. * Participant has a malignancy for which treatment is required, has a history of another malignancy within the past 5 years, except malignancies for which participant received curative therapy without recurrence for the last 5 years (e.g., adequately resected non-melanoma skin cancer, localized prostate cancer), or had treatment for carcinoma in situ. * Participant has clinically significant third spacing (large amount of pleural fluid or ascites) that requires frequent percutaneous draining or requires placement of a drainage catheter for adequate control. * Participant has any AE from prior antitumor treatments that has not yet recovered to grade 0 or 1 per National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) v6.0 (except alopecia). * Participant has an active autoimmune disease or other medical condition that has required high dose systemic steroids at the time of screening. * Participant has known peripheral neuropathy \> grade 1 (except when the sole neurological abnormality is absence of deep tendon reflexes). * Participant has sinusoidal obstruction syndrome, formerly known as veno-occlusive disease; if present, should be stable or improving. * Participant has significant cardiovascular disease, including any of the following: * Congestive heart failure (defined as New York Heart Association Class III or IV), myocardial infarction, unstable angina, coronary angioplasty, coronary stenting, coronary artery bypass graft, cerebrovascular accident or hypertensive crisis within 6 months prior to the first dose of study intervention. * History of clinically significant ventricular arrhythmias (i.e., sustained ventricular tachycardia, ventricular fibrillation or Torsades de Pointes), cardiac arrhythmias requiring anti-arrhythmic medications (a participant with rate controlled atrial fibrillation for \> 1 month prior to the first dose of study intervention is eligible) or obligate use of cardiac pacemaker. * QTc interval \> 470 msec * Documented history or family history of congenital long QT syndrome. * Participant has ongoing or previous interstitial lung disease, active diverticulitis or solid organ or stem cell transplant. * Participant has a serious non-healing wound or bone fracture within 28 days prior to study intervention. * Participant has had a major surgical procedure within 28 days prior to the first dose of study intervention and has not completely recovered from the surgical procedure \<= 14 days prior to the first dose of study intervention. * Participant has received chemotherapy, immunotherapy or investigational therapy \<= 14 days prior to the first dose of study intervention and has not recovered from any related toxicity. Palliative radiotherapy is allowed and must be completed \> 14 days prior to the first dose of study intervention. * Participant has received prior CLDN18.2 ADC. Prior treatment with CLDN18.2 monoclonal antibody or bi-specific T-cell engager is allowed. * Participant has received a live or live-attenuated vaccine within 30 days prior to the first dose of study intervention. * Participant has a known or suspected hypersensitivity to ASP546C or any components of the formulation used. * Participant has a clinically significant disease or comorbidity that in the opinion of the investigator may adversely affect the safe delivery of treatment within this study or make the participant unsuitable for study participation. * Cohorts 1 and 2 (gastroesophageal adenocarcinoma) only: Participant has known HER2 positive status defined as immunohistochemistry (IHC) 3+ or IHC 2+/ in situ hybridization (ISH) +. ISH positive is defined as HER2/ chromosome enumeration probe 17 (CEP17) ratio ≥ 2.0 or an average HER2 copy number ≥ 6.0 signals/cell.
Study sites (18)
AL
- UAB Medicine - UAB Hospital · Birmingham, AL 35249More trials in Birmingham
CA
- START Los Angeles · Los Angeles, CA 90025More trials in Los Angeles
FL
- Miami Cancer Institute · Miami, FL 33176More trials in Miami
GA
- Winship Cancer Institute at Emory University · Atlanta, GA 30322More trials in Atlanta
IN
- Indiana University (IU) Health - Multi-D Oncology Clinic · Indianapolis, IN 46202More trials in Indianapolis
MI
- Barbara Ann Karmanos Cancer Center · Detroit, MI 48201More trials in Detroit
- START Midwest · Grand Rapids, MI 49546More trials in Grand Rapids
NC
- Duke Cancer Center Durham · Durham, NC 27710More trials in Durham
NJ
- Hackensack University Medical Center · Hackensack, NJ 07601More trials in Hackensack
- Rutgers Cancer Institute of New Jersey · New Brunswick, NJ 08903More trials in New Brunswick
NY
- START New York · Lake Success, NY 10042More trials in Lake Success
TX
- Next Oncology - Austin · Austin, TX 78758More trials in Austin
- Next Oncology - Houston · Houston, TX 77054More trials in Houston
- Next Oncology - Dallas · Irving, TX 75039More trials in Irving
- START San Antonio (STSA) · San Antonio, TX 78229More trials in San Antonio
UT
- START Mountain Region · West Valley City, UT 84119More trials in West Valley City
VA
- Inova Schar Cancer Institute Clinical Trials · Fairfax, VA 22031More trials in Fairfax
WI
- UW Health Carbone Cancer Center · Madison, WI 53792More trials in Madison