Clinical trial for Advanced Esophageal Adenocarcinoma
Official title Adding Nivolumab to Usual Treatment for People With Advanced Stomach or Esophageal Cancer, PARAMUNE Trial
ClinicalTrials.gov ID: NCT06203600
What this study is testing
What is Nivolumab?
An investigational intravenous medicine being studied for advanced esophageal adenocarcinoma. It is designed to block a protein that helps cancer cells hide from the immune system.
Also referred to as Opdivo.
Plain-language explanation of the investigational treatment. It is being studied and is not an approved or proven therapy. The study team can confirm the details.
- What it's testing
- The study wants to see if adding nivolumab improves outcomes compared with the usual chemo drugs paclitaxel and ramucirumab alone.
- Who it's for
- It is looking for adults with advanced or metastatic stomach or esophageal adenocarcinoma, including those whose cancer has spread to nearby tissue, lymph nodes, or distant sites.
- What's involved
- Participants will receive the standard chemo drugs paclitaxel and ramucirumab, and those in the experimental group will also get the immunotherapy drug nivolumab. They will have regular clinic visits for treatment and monitoring tests.
- Time commitment
- The trial lasts about 12–18 months, with frequent visits for drug administration and health checks throughout the study period.
- Phase 3: a large, late-stage study
- Time commitment: about 3 years
- Which group you join is decided by chance.
A plain-language read of the study's public ClinicalTrials.gov listing. The study team confirms the details.
Who can take part
Ages 18 and older
You may be able to join if
- Participants must have advanced or locally unresectable gastric, gastroesophageal junction or esophageal adenocarcinoma
- Participants must have PD-L1 CPS (Combined Positive Score) ≥ 1. This test would have been performed as part of standard of care (SOC) pathology...
- Participants must have a histologically confirmed diagnosis of microsatellite stable (MSS) and HER2 negative gastric, gastroesophageal junction, or...
- Participants must have documented unresectable and/or metastatic disease on CT or MRI imaging completed prior to registration.
- Participants with treated brain metastases must have no evidence of progression on the follow-up brain imaging after central nervous system...
See the full eligibility criteria
Who can join
- Participants must have advanced or locally unresectable gastric, gastroesophageal junction or esophageal adenocarcinoma
- Participants must have PD-L1 CPS (Combined Positive Score) ≥ 1. This test would have been performed as part of standard of care (SOC) pathology testing, using tissue obtained within two years prior to registration and...
- Participants must have a histologically confirmed diagnosis of microsatellite stable (MSS) and HER2 negative gastric, gastroesophageal junction, or esophageal adenocarcinoma
- Participants must have documented unresectable and/or metastatic disease on CT or MRI imaging completed prior to registration.
- Participants with treated brain metastases must have no evidence of progression on the follow-up brain imaging after central nervous system (CNS)-directed therapy.
- Participants must have disease progression or intolerance to frontline standard of care (SOC) chemotherapy plus either nivolumab, pembrolizumab or any other PD-1 or PD-L1 inhibitor.
- Participants must not have received more than one prior line of systemic therapy defined as chemotherapy plus either nivolumab, pembrolizumab, or any other PD-1 or PD-L1 inhibitor, in the stage IV or unresectable...
- Note: Radiation or any other regional therapy options done to address local residual disease or metastatic disease would not count as a line of therapy.
- Participants must not have a condition requiring systemic treatment with either corticosteroids (\> 10 mg daily prednisone equivalents) or other immunosuppressive medications within 14 days of registration.
- Participants must not have prior significant immunotherapy related adverse events requiring permanent discontinuation of the immunotherapy agent including events like pneumonitis, myocarditis, renal failure, Guillain...
- Participants must not have received a live attenuated vaccination within 28 days prior to registration
- Participants must not have had a major surgery within 28 days or subcutaneous venous access device placement within 7 days prior registration
- Participants must have fully recovered from the effects of prior surgery in the opinion of the treating investigator.
- Participants must not have plans to undergo elective or planned major surgery during the clinical trial
- Participants must not have active bleeding or prior history of gastrointestinal (GI) perforation, fistula or significant GI bleeding (requiring transfusion, endoscopic or surgical intervention) within 84 days prior to...
- Participants must not be planning to receive any concurrent chemotherapy, immunotherapy, investigational agents, biologic or hormonal therapy for cancer treatment while receiving treatment on this study
- Participants must not have a history of a grade 3 or 4 allergic reaction attributed to humanized or human monoclonal antibody therapy
- Participants must not have a history of grade 3 or 4 immunotherapy related toxicities with the exception of hormonal abnormalities like thyroiditis or thyroid derangements
- Participants must be ≥ 18 years old
- Participants must have Zubrod Performance Status of 0-2
- Participants must have a complete medical history and physical exam within 28 days prior to registration
- Leukocytes ≥ 2 x 10\^3/uL (within 28 days prior to registration)
- Absolute neutrophil count ≥ 1.2 x 10\^3/uL (within 28 days prior to registration)
- Hemoglobin ≥ 9.0 g/dL (within 28 days prior to registration)
- Platelets ≥ 100 x 10\^3/uL (within 28 days prior to registration)
- Total bilirubin ≤ 1.5 x institutional upper limit of normal (ULN) (within 28 days prior to registration) unless history of Gilbert's disease.
- Aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ≤ 3 × institutional ULN (within 28 days prior to registration) (unless liver metastases are present, in which case they must be ≤ 5 x ULN)
- Participants must have a calculated creatinine clearance ≥ 40 mL/min using the following Cockcroft-Gault Formula. This specimen must have been drawn and processed within 28 days prior to registration
- Participants' urinary protein must be ≤ 1+ on dipstick or routine urinalysis (UA) within 28 days of registration. Random analysis of urine protein with a normal value is sufficient.
- Participants must have adequate cardiac function. Participants with known history or current symptoms of cardiac disease, or history of treatment with cardiotoxic agents, must have a clinical risk assessment of cardiac...
- Participants must have recovered to baseline or \< grade 2 CTCAE version (v) 5.0 from toxicities related to any prior treatments, unless AE(s) are clinically stable on supportive therapy
- Participants must not have experienced arterial thromboembolic events, including but not limited to myocardial infarction, transient ischemic attack, cerebrovascular accident, or unstable angina, within 6 months prior...
- Participants must not have uncontrolled blood pressure within 28 days prior to registration as determined by the treating investigator
- Participants with known human immunodeficiency virus (HIV)-infection must be on effective anti-retroviral therapy at registration and have undetectable viral load on the most recent test results obtained within 6 months...
- Participants with evidence of chronic hepatitis B virus (HBV) infection must have undetectable HBV viral load while on suppressive therapy on the most recent test results obtained within 6 months prior to registration...
- Participants with a history of hepatitis C virus (HCV) infection must have been treated and cured.
- Participants must not have a prior or concurrent malignancy whose natural history or treatment (in the opinion of the treating physician) has the potential to interfere with the safety or how well it works assessment of...
- Participants must not be pregnant or nursing (nursing includes breast milk fed to an infant by any means, including from the breast, milk expressed by hand, or pumped).
- Participants must not have a history of inflammatory bowel disease, (including ulcerative colitis and Crohn's disease), symptomatic autoimmune disease (e.g., rheumatoid arthritis, systemic progressive sclerosis...
- Participants must not have a history of pneumonitis that has required oral or IV steroids within the last 12 months prior to registration
- Participants must be offered the opportunity to participate in specimen banking. With participant consent, specimens must be collected and submitted via the Southwest Oncology Group (SWOG) Specimen Tracking System
- Participants who can complete patient reported outcomes (FACT-Ga and PRO-CTCAE) questionnaires in English or Spanish must participate in the quality of life studies
- Participants must be informed of the investigational nature of this study and must sign and give informed consent in accordance with institutional and federal guidelines.
The study team makes the final eligibility decision.
Where it is enrolling
- Little Rock, Arkansas, United States
- Anaheim, California, United States
- Baldwin Park, California, United States
- Bellflower, California, United States
- Beverly Hills, California, United States
- Dublin, California, United States
- Fontana, California, United States
- Fremont, California, United States
- Fresno, California, United States
- Harbor City, California, United States
- Irvine, California, United States
- La Jolla, California, United States
- Los Angeles, California, United States
- Modesto, California, United States
- Newport Beach, California, United States
- Oakland, California, United States
- Ontario, California, United States
- Panorama City, California, United States
- Riverside, California, United States
- Roseville, California, United States
+ 242 more site(s).
Questions & answers
Do participants get paid in this trial?
This listing doesn't specify compensation. Many trials still reimburse travel or offer a stipend, so it's worth asking the study team when you connect.
Is it free to join, and do I need insurance?
Searching and applying through BridgeMD is free. In clinical trials the study-related treatment and visits are generally provided at no cost to you. You usually don't need insurance to take part, but confirm specifics with the study team.
How long does this study last?
The study runs about 3 years per participant, based on its public description. The team confirms the exact schedule and number of visits before you enroll.
Who can join this trial?
This study is enrolling all sexes, 18 years and older. The study team makes the final eligibility decision.
Where is this trial taking place?
This study is enrolling now at Little Rock, Arkansas, United States; Anaheim, California, United States; Baldwin Park, California, United States; Bellflower, California, United States; Beverly Hills, California, United States; Dublin, California, United States and 256 more locations. Enter your location above to see the nearest enrolling site and check your eligibility.
Explore other conditions
BridgeMD is an information and trial-matching tool that is independent of the study sponsor. Details come from ClinicalTrials.gov. The study team decides eligibility, and your own doctor gives medical advice.