Biliary Tract CancerPhase 2/3NCT04066491
Gemcitabine Plus Cisplatin With or Without Bintrafusp Alfa (M7824) in Participants With 1L BTC
A Phase 2/3 study testing M7824, Gemcitabine and Cisplatin in people with Biliary Tract Cancer and Cholangiocarcinoma, run by EMD Serono Research & Development Institute, Inc. at 99 sites in 15 countries.
Trial summary
Study consisted of an open-label, safety run-in part and a randomized, double-blind, placebo-controlled Phase 2/3 part. In the Phase 2/3 part, the study was evaluated whether bintrafusp alfa in combination with the current standard of care (SoC) (gemcitabine plus cisplatin) improves overall survival (OS) in… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Biliary Tract Cancer, Cholangiocarcinoma, Gallbladder Cancer
- What is being tested?
- M7824, Gemcitabine and Cisplatin
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 309 participants
- Where
- 99 sitesin 15 countries
- Study dates
- 20 Sep 2019to 10 Nov 2022
- Phase
- Phase 2/3
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Are participants with histologically or cytologically confirmed locally advanced or metastatic BTC
- Participants must have available tumor tissue (primary or metastatic) (archival or fresh biopsies) before the first administration of study treatment
- At least 1 measurable lesion according to RECIST 1.1
- Eastern Cooperative Oncology Group Performance Status (ECOG PS) of 0 or 1 at study entry and at Week 1, Day 1 prior to dosing
- Life expectancy of >= 12 weeks, as judged by the Investigator
- Adequate hematological function, hepatic function, renal function, coagulation function as defined in the protocol
- Hepatitis B virus (HBV) deoxyribonucleic acid (DNA) positive participants must be treated and on a stable dose of antivirals
- Other protocol defined inclusion criteria could apply
Who cannot join
- Previous and/or intercurrent cancers
- Receipt of any organ transplantation, including allogeneic stem-cell transplantation, but with the exception of transplants that do not require immunosuppression
- Participants with symptomatic central nervous system (CNS) metastases
- Significant acute or chronic infection including known history of positive test for human immunodeficiency virus (HIV), active tuberculosis, uncontrolled biliary infection and active bacterial or fungal infection requiring systemic therapy (with the exception of hepatitis B and hepatitis C) requiring systemic therapy at study entry and at Week 1 Day 1 prior to dosing.
- Active autoimmune disease that might deteriorate when receiving an immunostimulatory agent
- History of or concurrent interstitial lung disease
Show all 10Show fewer
- History of hypersensitivity reactions to bintrafusp alfa, anaphylaxis, or recent (within 5 months) uncontrolled asthma, cardiovascular/cerebrovascular disease
- Chronic obstructive pulmonary disease exacerbation or other respiratory illness requiring hospitalization or precluding study therapy within 30 days before randomization
- Prior therapy with any antibody/drug targeting T-cell coregulatory proteins (immune checkpoints)
- Other protocol defined exclusion criteria could apply
Trial locations and contacts
99 sites in 15 countries.
99 sites in 15 countries
United States12 sites
Sidney Kimmel Comprehensive Cancer Center at John Hopkins
Baltimore, Maryland, 21287
Beverly Hills Cancer Center
Beverly Hills, California, 90211
Ironwood Cancer & Research Centers - Chandler II
Chandler, Arizona, 85224
Methodist Transplant Physicians
Dallas, Texas, 75203
Banner MD Anderson Cancer Center
Gilbert, Arizona, 85234
MD Anderson Cancer Center - Unit 429
Houston, Texas, 77030
Mayo Clinic in Florida - Department of Neurology
Jacksonville, Florida, 32224
Mount Sinai Medical Center
Miami Beach, Florida, 33140
Mayo Clinic Arizona
Phoenix, Arizona, 85054
Mayo Clinic - Rochester
Rochester, Minnesota, 55905
Renovatio Clinical - CENTRAL SITE
The Woodlands, Texas, 77380
University of Kansas Medical Center Research Institute, Inc. - University of Kansas Cancer Center/Bloch Pavilion
Westwood, Kansas, 66216
China10 sites
Beijing Cancer Hospital
Beijing
Beijing Chao Yang Hospital
Beijing
Beijing Friendship Hospital, Capital Medical University
Beijing
West China Hospital, Sichuan University
Chengdu
Sir Run Run Shaw Hospital, Zhejiang University, School of Medicine
Hangzhou
The Affiliated Hospital of Qingdao University
Qingdao
Fudan University Shanghai Cancer Hospital
Shanghai
The Second Affiliated Hospital of Soochow University
Suzhou
Tianjin Medical University Cancer Institute & Hospital
Tianjin
Union Hospital Tongji Medical College Huazhong University of Science and Technology
Wuhan
Japan10 sites
Chiba Cancer Center
Chiba
National Cancer Center Hospital - Dept of Hepatobiliary and Pancreatic Oncology
Chūōku
NHO Kyushu Cancer Center - Dept of Gastroenterology/Hepatology/Pancreatology
Fukuoka
National Cancer Center Hospital East
Kashiwa-shi
Cancer Institute Hospital of JFCR - Dept of Hepato,Biliary and Pancreatic Medicine
Kōtoku
Kyorin University Hospital
Mitaka-shi
Aichi Cancer Center Hospital
Nagoya
Osaka City University Hospital
Osaka
Kindai University Hospital
Osakasayama-shi
Kanagawa Cancer Center
Yokohama
Spain10 sites
Hospital Clinic i Provincial de Barcelona - Servicio de Oncologia
Barcelona
Hospital Universitari Vall d'Hebron - Dept of Oncology
Barcelona
Hospital San Pedro de Alcantara - Servicio de Oncologia
Cáceres
Hospital Universitario Reina Sofia - Dept of Oncology
Córdoba
ICO l´Hospitalet - Hospital Duran i Reynals
L'Hospitalet de Llobregat
Hospital General Universitario Gregorio Marañon - Servicio de Oncologia Medica
Madrid
Hospital Universitario Clinico San Carlos - Servicio de Oncologia
Madrid
Hospital Universitario HM Madrid Sanchinarro - Servicio de Oncologia
Madrid
Hospital Clinico Universitario de Valencia - Servicio de Hematologia y Oncologia Medica
Valencia
Hospital Universitari i Politecnic La Fe - Servicio de Oncologia Medica
Valencia
South Korea9 sites
Chungnam National University Hospital - Department of Internal Medicine (Rheumatology)
Daejeon
Seoul National University Bundang Hospital
Seongnam-si
Asan Medical Center
Seoul
Korea University Anam Hospital
Seoul
Korea University Guro Hospital
Seoul
Samsung Medical Center
Seoul
Seoul National University Hospital
Seoul
Severance Hospital, Yonsei University Health System
Seoul
The Catholic University of Korea, Seoul St. Mary's Hospital
Seoul
Argentina7 sites
Hospital de Gastroenterologia Dr. Carlos Bonorino Udaondo
Ciudad Autonoma Buenos Aires
Instituto de Investigaciones Metabolicas (IDIM)
Ciudad Autonoma Buenos Aires
Instituto Medico Especializado Alexander Fleming
Ciudad Autonoma Buenos Aires
Centro Oncologico Riojano Integral (CORI)
La Rioja
CEDIT
Salta
Centro Medico San Roque S.R.L.
San Miguel de Tucumán
Fundacion ARS Medica
San Salvador de Jujuy
Taiwan7 sites
Kaohsiung Chang Gung Memorial Hospital
Kaohsiung City
China Medical University Hospital
Taichung
Taichung Veterans General Hospital
Taichung
National Cheng Kung University Hospital
Tainan
National Taiwan University Hospital
Taipei
Taipei Veterans General Hospital
Taipei
Chang Gung Memorial Hospital, Linkou
Taoyuan
Brazil6 sites
Hospital de Câncer de Barretos - Fundação Pio XII
Barretos
INCA - Instituto Nacional de Câncer
Rio de Janeiro
CEPHO - Centro de Estudos e Pesquisas de Hematologia e Oncologia
Santo André
Fundação Faculdade Regional de Medicina de São José do Rio Preto
Sao Jose Rio Preto
A. C. Camargo Cancer Center
São Paulo
ICESP - Instituto do Câncer do Estado de São Paulo Octavio Frias de Oliveira
São Paulo
Chile5 sites
IC la serena Research
La Serena
Centro de Investigación Clínica Bradford Hill
Santiago
Hospital Clínico Universidad de Chile
Santiago
Prosalud
Santiago
Instituto Clinico Oncologico del Sur (ICOS)
Temuco
France5 sites
ICO - Site Paul Papin - service d'oncologie medicale
Angers
Centre Georges François Leclerc - Oncologie Médicale
Dijon
CHU Lille - Hôpital Claude Huriez
Lille
ICO - Site René Gauducheau
Saint-Herblain
CHU de Toulouse - Hôpital Ranguei
Toulouse
Germany5 sites
Vivantes Klinikum Neukoelln - Haematologie und Onkologie
Berlin
Universitaetsklinikum Bonn AoeR - Medizinische Klinik I Gastroenterologie
Bonn
Universitaetsklinikum Carl Gustav Carus TU Dresden - Medizinische Klinik I
Dresden
Klinikum der Johann Wolfgang Goethe-Universitaet
Frankfurt
Universitaetsmedizin der Johannes Gutenberg-Universitaet Mainz - Medizinische Klinik I - HCC Ambulanz
Mainz
Australia4 sites
Blacktown Hospital - PARENT
Blacktown
Monash Health
Clayton
Epworth Freemasons
Melbourne
Icon Cancer Care South Brisbane
South Brisbane
Italy4 sites
Fondazione IRCCS Istituto Nazionale dei Tumori Milano
Milan
IOV - Istituto Oncologico Veneto IRCCS - S.Semplice Dip.Oncologia dei Melanomi
Padova
Università Campus Bio-Medico di Roma
Roma
Azienda Ospedaliera Universitaria Integrata Verona (Ospedale Borgo Roma) - UOC Oncologia
Verona
Poland4 sites
Centrum Onkologii-Instytut im.M.Sklodowskiej Curie
Gliwice
Pratia
Krakow
Narodowy Instytut Onkologii im. Marii Skłodowskiej-Curie - Państwowy Instytut Badawczy
Warsaw
ETG Zamosc
Zamość
About this study
Official title: A Phase II/III, Multicenter, Randomized, Placebo-controlled Study of Gemcitabine Plus Cisplatin With or Without Bintrafusp Alfa (M7824) as First-line Treatment of Biliary Tract Cancer
Study consisted of an open-label, safety run-in part and a randomized, double-blind, placebo-controlled Phase 2/3 part. In the Phase 2/3 part, the study was evaluated whether bintrafusp alfa in combination with the current standard of care (SoC) (gemcitabine plus cisplatin) improves overall survival (OS) in chemotherapy and immunotherapy-naïve participants with locally advanced or metastatic Biliary Tract Cancer (BTC) compared to placebo, gemcitabine and cisplatin.
- Conditions
- Biliary Tract Cancer, Cholangiocarcinoma, Gallbladder Cancer
- Being tested
- M7824, Placebo, Gemcitabine, Cisplatin
- Keywords
- Metastatic Biliary Tract Cancer, Cholangiocarcinoma, Gallbladder Cancer, Ampullary cancer, M7824, Bintrafusp alfa, Transforming growth factor-beta, Programmed death-ligand 1
- Medical subject headings
- Biliary Tract Neoplasms, Cholangiocarcinoma, Gallbladder Neoplasms, Camurati-Engelmann Syndrome
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
M7824Drug
Participants received intravenous infusion of M7824 at a dose of 2400 milligrams (mg), once every 3 weeks (Q3W) 2 years (in case of Complete Response), otherwise until criterion pre-sepcified in protocol for discontinuation is met, in combination with intravenous infusion of Gemcitabine and Cisplatin at a dose of 1000 milligram per meter square (mg/m^2) and 25 mg/m^2 respectively on Day 1 and Day 8 of 21- day cycle, for 8 cycles every 3 weeks.
PlaceboDrug
Participants received intravenous infusion of M7824 matched placebo, once every 3 weeks (Q3W) until 2 years (in case of CR), otherwise until crtiterion pre-sepcified in protocol for discontinuation is met.
GemcitabineDrug
Gemcitabine was received intravenously at a dose of 1000 milligram per meter square (mg/m^2) on Day 1 and Day 8 of 21- day cycle, for 8 cycles every 3 weeks (Q3W).
CisplatinDrug
Cisplatin was received intravenously at a dose of 25 mg/m^2 on Day 1 and Day 8 of 21-day cycle, for 8 cycles every 3 weeks (Q3W).
| Study group | Role | What they receive |
|---|---|---|
| Safety Run-In Part: M7824 + Gemcitabine + Cisplatin | Experimental | Not described Receives: Drug: M7824; Drug: Gemcitabine; Drug: Cisplatin |
| Double-blinded Part: M7824 + Gemcitabine + Cisplatin | Experimental | Not described Receives: Drug: M7824; Drug: Gemcitabine; Drug: Cisplatin |
| Double-blinded Part: Placebo + Gemcitabine + Cisplatin | Placebo comparator | Not described Receives: Drug: Placebo; Drug: Gemcitabine; Drug: Cisplatin |
What is being measured
The primary outcome is the main question the study is designed to answer.
Safety Run-in Part: Number of Participants Who Experienced Dose Limiting Toxicities (DLTs)
A DLT is a toxicity related to the study intervention that meets the following criteria as evaluated in the open-label, safety run-in: Grade 3 or 4 Immune-related adverse event (irAE) that needs permanent discontinuation of M7824 treatment; a malignant skin lesion induced by M7824 that is local and can be resected with a negative resection margin is not a DLT; Grade 3 or 4 nonhematologic toxicity other than irAE, A life threatening hematological toxicity (unless clearly attributable to chemotherapy alone), which is hardly medically manageable, including a bleeding event resulting in urgent intervention and admission to an intensive care unit and Grade 5 toxicity.
Measured: Day 1 up to Day 21 of Cycle 1 (each Cycle is of 21 days)
Double-blind Part: Overall Survival
Overall Survival was defined as the time from study day 1 to the date of death due to any cause. The overall survival was analyzed by using the Kaplan-Meier method.
Measured: Time from study day 1 up to data cutoff (assessed up to 609 days)
Secondary outcomes (7)
Safety Run-in Part: Number of Participants With Treatment-Emergent Adverse Events (TEAEs), Serious TEAEs (SAEs) and Treatment Related TEAEs According to National Cancer Institute-Common Terminology Criteria for Adverse Events (NCI-CTCAE) Version 5.0
Adverse Event (AE) was defined any untoward medical occurrence in a participant administered with a study drug, which does not necessarily had a causal relationship with this treatment. Serious AE was defined AE that resulted in any of the following outcomes: death; life threatening; persistent/significant disability/incapacity; initial/prolonged inpatient hospitalization; congenital anomaly/birth defect. TEAE was defined as events with onset date or worsening during the on treatment period. TEAEs included serious TEAEs and non-serious TEAEs.
Measured: Time from first treatment up to data cutoff (assessed up to 609 days)
Safety Run-in Part: Number of Participants With Grade Greater Than or Equal (>=) 3 Laboratory Abnormalities
Laboratory investigation included hematology and biochemistry. The number of participants with Grade >=3 laboratory abnormalities were reported. Severity of grade 3 or higher TEAEs were graded using NCI-CTCAE v5.0 toxicity grades, as follows: Grade 3 = Severe; Grade 4 = Life-threatening and Grade 5 = Death.
Measured: Time from first treatment up to data cutoff (assessed up to 609 days)
Double-blind Part: Progression-Free Survival (PFS) According to Response Evaluation Criteria in Solid Tumors (RECIST Version 1.1) Assessed by Independent Review Committee (IRC)
Progression free survival was defined as the time from randomization of study intervention until the first documentation of disease progression (PD) or death due to any cause in the absence of documented PD, whichever occurred first. PD: At least a 20 percent (%) increase in the sum of the longest diameter (SLD) taking as reference the smallest SLD recorded from baseline or the appearance of 1 or more new lesions.
Measured: Time from randomization of study drug until the first documentation of PD or death, assessed up to 609 days
Double-blind Part: Percentage of Participants With Confirmed Objective Response According to Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1) as Assessed by Independent Review Committee (IRC)
Percentage of participants with confirmed objective response that is at least one overall assessment of complete response (CR) or partial response (PR) reported here. CR: Disappearance of all evidence of target and non-target lesions. PR: At least 30% reduction from baseline in the sum of the longest diameter (SLD) of all lesions. Confirmed CR = at least 2 determinations of CR at least 4 weeks apart and before progression. Confirmed PR = at least 2 determinations of PR at least 4 weeks apart and before progression (and not qualifying for a CR). Confirmed objective response was determined according to RECIST v1.1 and as adjudicated by IRC.
Measured: Time from randomization of study drug up to data cut off (assessed up to 609 days)
Double-blind Part: Duration of Response (DOR) According to Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1) as Assessed by Independent Review Committee (IRC)
DOR was defined for participants with objective response, as the time from first documentation of objective response (confirmed Complete Response [CR] or Partial Response [PR]) to the date of first documentation of progression disease (PD) or death due to any cause, whichever occurred first. CR: Disappearance of all evidence of target and non-target lesions. PR: At least 30% reduction from baseline in the SLD of all lesions. PD: At least a 20 percent (%) increase in the SLD, taking as reference the smallest SLD recorded from baseline or the appearance of 1 or more new lesions. DOR was determined according to RECIST v1.1 and assessed by IRC. Results were calculated based on Kaplan-Meier estimates.
Measured: From first documented objective response to PD or death due to any cause, assessed up to 609 days
Double-blind Part: Durable Response of at Least 6 Months According to Response Evaluation Criteria In Solid Tumors (RECIST) Version 1.1 as Assessed by Investigator
Durable Response was defined as the number of participants with confirmed objective response (CR or PR) according to RECIST 1.1, determined by Investigator with duration of at least 6 months. CR: Disappearance of all evidence of target and non-target lesions. PR: At least 30% reduction from baseline in the SLD of all lesions.
Measured: Time from first treatment assessed up to 1148 days
Double-blind Part: Number of Participants With Treatment-Emergent Adverse Events (TEAEs), Serious TEAEs (SAEs), Treatment Related TEAEs and Adverse Events of Special Interest (AESIs) According to NCI-CTCAE Version 5.0
AE was defined any untoward medical occurrence in a participant administered with a study drug, which does not necessarily had a causal relationship with this treatment. Serious AE was defined AE that resulted in any of the following outcomes: death; life threatening; persistent/significant disability/incapacity; initial/prolonged inpatient hospitalization; congenital anomaly/birth defect. TEAE was defined as events with onset date or worsening during the on treatment period. TEAEs included serious TEAEs and non-serious TEAEs. Adverse events of special interest (AESI) are serious or non-serious AEs that are of clinical interest and should be closely followed. For this study, AESIs include the following: Infusion-related reactions including immediate hypersensitivity; Immune-related AEs; Transforming growth factor beta (TGFβ) inhibition mediated skin reactions; Anemia; Bleeding AEs.
Measured: Time from first treatment up to data cutoff (assessed up to 609 days)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted26 Aug 2019
- Study start20 Sep 2019
- Primary completion20 May 2021
- Study completion10 Nov 2022
Why it stopped: Based on a review of data conducted by the Independent Data Monitoring Committee (IDMC), Sponsor decided to discontinue this study as the study was unlikely to achieve the primary objective of overall survival.
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for Biliary Tract CancerStudies of the same condition, open and under way.
- More trials run by EMD Serono Research & Development Institute, Inc.The sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2/3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 309 participants (actual)
Sponsor and investigators
- Sponsor type
- Industry (pharma, biotech, devices)
- Collaborators
- Merck KGaA, Darmstadt, Germany
- Responsible party
- Sponsor
- Investigators
- Medical Responsible, Study director, Merck Healthcare KGaA, Darmstadt, Germany, an affiliate of Merck KGaA, Darmstadt, Germany
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04066491
- Sponsor's protocol ID
- MS200647_0055
- Other IDs
- 2019-001992-35, 2019
- Status last verified
- Oct 2023
- First submitted
- 22 Aug 2019
- Last updated
- 14 Nov 2023
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Yes: We are committed to enhancing public health through responsible sharing of clinical trial data. Following approval of a new product or a new indication for an approved product in both the US and European Union, the study sponsor and/or its affiliated companies will share study protocols, anonymized patient data and study level data, and redacted clinical study reports with qualified scientific and medical researchers, upon request, as necessary for conducting legitimate research. Further information on how to request data can be found on our website bit.ly/IPD21
Publications
Yoo C, Oh DY, Choi HJ, Kudo M, Ueno M, Kondo S, Chen LT, Osada M, Helwig C, Dussault I, Ikeda M. Phase I study of bintrafusp alfa, a bifunctional fusion protein targeting TGF-beta and PD-L1, in patients with pretreated biliary tract cancer. J Immunother Cancer. 2020 May;8(1):e000564. doi: 10.1136/jitc-2020-000564.
PubMed 32461347Oh DY, Ikeda M, Lee CK, Rojas C, Hsu CH, Kim JW, Shen L, Furuse J, Park JO, Borad M, de Braud F, Bridgewater J, Lee SS, Moehler M, Audhuy F, Osada M, Sato M, Yoo C. Bintrafusp alfa and chemotherapy as first-line treatment in biliary tract cancer: A randomized phase 2/3 trial. Hepatology. 2025 Mar 1;81(3):823-836. doi: 10.1097/HEP.0000000000000965. Epub 2024 Jun 14.
PubMed 38875119
Study at a glance
From the registry record, last updated by the sponsor on 14 Nov 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase II/III, Multicenter, Randomized, Placebo-controlled Study of Gemcitabine Plus Cisplatin With or Without Bintrafusp Alfa (M7824) as First-line Treatment of Biliary Tract Cancer
- ClinicalTrials.gov ID
- NCT04066491
- Acronym / sponsor ID
- MS200647_0055
- Conditions
- Biliary Tract Cancer, Cholangiocarcinoma, Gallbladder Cancer
- Keywords
- Metastatic Biliary Tract Cancer, Cholangiocarcinoma, Gallbladder Cancer, Ampullary cancer, M7824, Bintrafusp alfa, Transforming growth factor-beta, Programmed death-ligand 1
- Phase
- Phase 2/3
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: Based on a review of data conducted by the Independent Data Monitoring Committee (IDMC), Sponsor decided to discontinue this study as the study was unlikely to achieve the primary objective of overall survival.
- Enrolment
- 309 participants (actual)
- Lead sponsor
- EMD Serono Research & Development Institute, Inc.Industry (pharma, biotech, devices)
- Collaborators
- Merck KGaA, Darmstadt, Germany
- Study start
- 20 Sep 2019 (actual)
- Primary completion
- 20 May 2021 (actual)
- Study completion
- 10 Nov 2022 (actual)
- First posted
- 26 Aug 2019 (actual)
- Results
- Posted 13 Jun 2022
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Study consisted of an open-label, safety run-in part and a randomized, double-blind, placebo-controlled Phase 2/3 part. In the Phase 2/3 part, the study was evaluated whether bintrafusp alfa in combination with the current standard of care (SoC) (gemcitabine plus cisplatin) improves overall survival (OS) in chemotherapy and immunotherapy-naïve participants with locally advanced or metastatic Biliary Tract Cancer (BTC) compared to placebo, gemcitabine and cisplatin.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Safety Run-In Part: M7824 + Gemcitabine + Cisplatin | Experimental | Drug: M7824, Drug: Gemcitabine, Drug: Cisplatin |
| Double-blinded Part: M7824 + Gemcitabine + Cisplatin | Experimental | Drug: M7824, Drug: Gemcitabine, Drug: Cisplatin |
| Double-blinded Part: Placebo + Gemcitabine + Cisplatin | Placebo comparator | Drug: Placebo, Drug: Gemcitabine, Drug: Cisplatin |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (8 listed)
- Are participants with histologically or cytologically confirmed locally advanced or metastatic BTC
- Participants must have available tumor tissue (primary or metastatic) (archival or fresh biopsies) before the first administration of study treatment
- At least 1 measurable lesion according to RECIST 1.1
- Eastern Cooperative Oncology Group Performance Status (ECOG PS) of 0 or 1 at study entry and at Week 1, Day 1 prior to dosing
- Life expectancy of >= 12 weeks, as judged by the Investigator
Key exclusion criteria (10 listed)
- Previous and/or intercurrent cancers
- Receipt of any organ transplantation, including allogeneic stem-cell transplantation, but with the exception of transplants that do not require immunosuppression
- Participants with symptomatic central nervous system (CNS) metastases
- Significant acute or chronic infection including known history of positive test for human immunodeficiency virus (HIV), active tuberculosis, uncontrolled biliary infection and active bacterial or fungal infection requiring systemic therapy (with the exception of hepatitis B and hepatitis C) requiring systemic therapy at study entry and at Week 1 Day 1 prior to dosing.
- Active autoimmune disease that might deteriorate when receiving an immunostimulatory agent
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| M7824Participants received intravenous infusion of M7824 at a dose of 2400 milligrams (mg), once every 3 weeks (Q3W) 2 years (in case of Complete Response), otherwise until criterion pre-sepcified in protocol for discontinuation is met, in combination with intravenous infusion of Gemcitabine and Cisplatin at a dose of 1000 milligram per meter square (mg/m^2) and 25 mg/m^2 respectively on Day 1 and Day 8 of 21- day cycle, for 8 cycles every 3 weeks. | Drug | Double-blinded Part: M7824 + Gemcitabine + Cisplatin, Safety Run-In Part: M7824 + Gemcitabine + Cisplatin |
| PlaceboParticipants received intravenous infusion of M7824 matched placebo, once every 3 weeks (Q3W) until 2 years (in case of CR), otherwise until crtiterion pre-sepcified in protocol for discontinuation is met. | Drug | Double-blinded Part: Placebo + Gemcitabine + Cisplatin |
| GemcitabineGemcitabine was received intravenously at a dose of 1000 milligram per meter square (mg/m^2) on Day 1 and Day 8 of 21- day cycle, for 8 cycles every 3 weeks (Q3W). | Drug | Double-blinded Part: M7824 + Gemcitabine + Cisplatin, Double-blinded Part: Placebo + Gemcitabine + Cisplatin, Safety Run-In Part: M7824 + Gemcitabine + Cisplatin |
| CisplatinCisplatin was received intravenously at a dose of 25 mg/m^2 on Day 1 and Day 8 of 21-day cycle, for 8 cycles every 3 weeks (Q3W). | Drug | Double-blinded Part: M7824 + Gemcitabine + Cisplatin, Double-blinded Part: Placebo + Gemcitabine + Cisplatin, Safety Run-In Part: M7824 + Gemcitabine + Cisplatin |
Primary outcome
Safety Run-in Part: Number of Participants Who Experienced Dose Limiting Toxicities (DLTs)
Time frame: Day 1 up to Day 21 of Cycle 1 (each Cycle is of 21 days)
A DLT is a toxicity related to the study intervention that meets the following criteria as evaluated in the open-label, safety run-in: Grade 3 or 4 Immune-related adverse event (irAE) that needs permanent discontinuation of M7824 treatment; a malignant skin lesion induced by M7824 that is local and can be resected with a negative resection margin is not a DLT; Grade 3 or 4 nonhematologic toxicity other than irAE, A life threatening hematological toxicity (unless clearly attributable to chemotherapy alone), which is hardly medically manageable, including a bleeding event resulting in urgent intervention and admission to an intensive care unit and Grade 5 toxicity.
Double-blind Part: Overall Survival
Time frame: Time from study day 1 up to data cutoff (assessed up to 609 days)
Overall Survival was defined as the time from study day 1 to the date of death due to any cause. The overall survival was analyzed by using the Kaplan-Meier method.
7 secondary outcomes
Safety Run-in Part: Number of Participants With Treatment-Emergent Adverse Events (TEAEs), Serious TEAEs (SAEs) and Treatment Related TEAEs According to National Cancer Institute-Common Terminology Criteria for Adverse Events (NCI-CTCAE) Version 5.0
Time frame: Time from first treatment up to data cutoff (assessed up to 609 days)
Safety Run-in Part: Number of Participants With Grade Greater Than or Equal (>=) 3 Laboratory Abnormalities
Time frame: Time from first treatment up to data cutoff (assessed up to 609 days)
Double-blind Part: Progression-Free Survival (PFS) According to Response Evaluation Criteria in Solid Tumors (RECIST Version 1.1) Assessed by Independent Review Committee (IRC)
Time frame: Time from randomization of study drug until the first documentation of PD or death, assessed up to 609 days
Double-blind Part: Percentage of Participants With Confirmed Objective Response According to Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1) as Assessed by Independent Review Committee (IRC)
Time frame: Time from randomization of study drug up to data cut off (assessed up to 609 days)
Double-blind Part: Duration of Response (DOR) According to Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1) as Assessed by Independent Review Committee (IRC)
Time frame: From first documented objective response to PD or death due to any cause, assessed up to 609 days
Double-blind Part: Durable Response of at Least 6 Months According to Response Evaluation Criteria In Solid Tumors (RECIST) Version 1.1 as Assessed by Investigator
Time frame: Time from first treatment assessed up to 1148 days
Double-blind Part: Number of Participants With Treatment-Emergent Adverse Events (TEAEs), Serious TEAEs (SAEs), Treatment Related TEAEs and Adverse Events of Special Interest (AESIs) According to NCI-CTCAE Version 5.0
Time frame: Time from first treatment up to data cutoff (assessed up to 609 days)
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 14 Nov 2023.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Results publication: PubMed 32461347Yoo C, Oh DY, Choi HJ, Kudo M, Ueno M, Kondo S, Chen LT, Osada M, Helwig C, Dussault I, Ikeda M. Phase I study of bintrafusp alfa, a bifunctional fusion protein targeting TGF-beta and PD-L1, in patients with pretreated biliary tract cancer. J Immunother Cancer. 2020 May;8(1):e000564. doi: 10.1136/jitc-2020-000564.
- Derived from this study: PubMed 38875119Oh DY, Ikeda M, Lee CK, Rojas C, Hsu CH, Kim JW, Shen L, Furuse J, Park JO, Borad M, de Braud F, Bridgewater J, Lee SS, Moehler M, Audhuy F, Osada M, Sato M, Yoo C. Bintrafusp alfa and chemotherapy as first-line treatment in biliary tract cancer: A randomized phase 2/3 trial. Hepatology. 2025 Mar 1;81(3):823-836. doi: 10.1097/HEP.0000000000000965. Epub 2024 Jun 14.
- Trial Awareness and Transparency websiteLink provided by the sponsor.
- US Medical Information website, Medical ResourcesLink provided by the sponsor.
- Individual participant dataSharing planned: Yes. We are committed to enhancing public health through responsible sharing of clinical trial data. Following approval of a new product or a new indication for an approved product in both the US and European Union, the study sponsor and/or its affiliated companies will share study protocols, anonymized patient data and study level data, and redacted clinical study reports with qualified scientific and medical researchers, upon request, as necessary for conducting legitimate research. Further information on how to request data can be found on our website bit.ly/IPD21
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Medical Responsible study director
Merck Healthcare KGaA, Darmstadt, Germany, an affiliate of Merck KGaA, Darmstadt, Germany
99 sites in 15 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2/3 study testing M7824, Gemcitabine and Cisplatin in people with Biliary Tract Cancer and Cholangiocarcinoma, run by EMD Serono Research & Development Institute, Inc. at 99 sites in 15 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 8 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: stopped early, as of the sponsor's last update on 14 Nov 2023. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 99 sites in United States, China, Japan, Spain, South Korea and 10 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this combined phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 13 Jun 2022). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Safety Run-in Part: Number of Participants Who Experienced Dose Limiting Toxicities (DLTs) (time frame: Day 1 up to Day 21 of Cycle 1 (each Cycle is of 21 days)). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT04066491, which also lists 2 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 Nov 2023.