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NCT05836584Active, not recruitingPhase 2

Testing Immunotherapy (Atezolizumab) With or Without Chemotherapy in Locoregional MSI-H/dMMR Gastric and Gastroesophageal Junction (GEJ) Cancer

A Randomized Phase II Study of Perioperative Atezolizumab +/- Chemotherapy in Resectable MSI-H/dMMR Gastric and Gastroesophageal Junction (GEJ) Cancer

Source: ClinicalTrials.gov · Last updated 1 Jul 2026

Brief summary (registry, in English)

This phase II trial compares atezolizumab in combination with chemotherapy (docetaxel, oxaliplatin, leucovorin calcium, fluorouracil, capecitabine) to atezolizumab alone for controlling the growth and/or spreading of the disease in patients with gastric or gastroesophageal junction (JEG) cancer that has not spread from where it first started (local) or only has spread to nearby lymph nodes or tissue (locoregional) and has high microsatellite instability (MSI-H) and mismatch repair deficiency (dMMR). The mismatch repair (MMR) system in the body corrects errors made during the copying of DNA and serves as a proofreading function. If this system isn't working correctly, mutations (changes) in DNA occur which can allow the cancer to grow or spread. This is called dMMR (deficient mismatch repair) . MSI-H describes cancer cells that have a high number of mutations within microsatellites. For example, microsatellite testing that shows mutations in 30% or more microsatellites is called microsatellite instability-high (MSI-H). Microsatellites are short, repeated sequences of DNA. There is evidence that MSI-H/ dMMR gastric or GEJ tumors respond well to immunotherapy. Immunotherapy with monoclonal antibodies, such as atezolizumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Docetaxel is in a class of medications called taxanes. It stops tumor cells from growing and dividing and may kill them. Oxaliplatin is in a class of medications called platinum-containing antineoplastic agents. It damages the cell's DNA and may kill tumor cells. Capecitabine is in a class of medications called antimetabolites. It is taken up by tumor cells and breaks down into fluorouracil, a substance that kills tumor cells. Chemotherapy drugs such as leucovorin calcium and fluorouracil work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Using atezolizumab as immunotherapy with and following chemotherapy versus atezolizumab alone prior to and after surgery may shrink or stabilize the tumor in patients with MSI-H/dMMR localized gastric or GEJ cancer and may increase the length of time after treatment that cancer does not come back or get worse.

Status (registry)
Active, not recruiting
Phase (registry)
Phase 2
Study type
Interventional
Enrollment
2 (actual)
First submitted
26 Apr 2023
Start date
6 Dec 2023
Primary completion date
20 Jan 2026
Lead sponsor
National Cancer Institute (NCI)
NCT number
NCT05836584

What you commit to

  • Study type: Interventional · Phase 2
  • Participants enrolled: 2
  • From 6 Dec 2023 to the primary completion date, 20 Jan 2026
  • 133 sites in 1 country
  • Visits and tests: ask the trial team, the registry does not list them

Built from the registry fields of ClinicalTrials.gov. It describes the study, not your situation.

Who cannot take part

Copied verbatim from ClinicalTrials.gov and grouped by topic. Only the trial team decides who can take part.

Who the study is looking for

  • Patient must be \>= 18 years of age
  • Patient must have histologically or cytologically confirmed diagnosis of gastric or gastroesophageal junction adenocarcinoma that is MSI-H/dMMR (microsatellite instability-high/mismatch repair deficient) as determined by one of three methods:
    • Deficient deoxyribonucleic acid (DNA) mismatch repair protein (MMR) expression status: MMR status must be assessed by immunohistochemistry (IHC) for MMR protein expression (MLH1, MSH2, MSH6, PMS2) where loss of one or more proteins indicates dMMR. dMMR may be determined either locally or by site-selected reference lab by Clinical Laboratory Improvement Act (CLIA)-certified assay
    • NOTE: Loss of MLH1 and PMS2 commonly occur together
    • Polymerase chain reaction (PCR) determined microsatellite instability
    • MSI-H tumor status determined by next-generation sequencing
  • Patient must have previously untreated localized gastric, or Siewert type II or III GEJ (gastroesophageal junction) adenocarcinoma. Tumors must be staged as T2 or greater primary lesion or be any T stage with the presence of positive locoregional lymph nodes- N+ (clinical nodes) without evidence of metastatic disease
    • Siewert type II tumors: tumors located between 1 cm proximal and 2 cm distal to the GEJ
    • Siewert type III tumors: tumors located between 2 and 5 cm distal to GEJ
  • Patient must be amenable to surgical resection with therapeutic intent
  • Patient must have an Eastern Cooperative Oncology Group (ECOG) performance status 0-2
  • Absolute neutrophil count (ANC) \>= 1,500/mcL (obtained =\< 14 days prior to randomization)
  • Platelets \>= 100,000/mcL (obtained =\< 14 days prior to randomization)
  • Hemoglobin \>= 9 g/dL (obtained =\< 14 days prior to randomization)
  • Total bilirubin =\< 1.5 x institutional upper limit of normal (ULN) OR direct bilirubin =\< ULN (for patients with total bilirubin \> 1.5 x ULN) (obtained =\< 14 days prior to randomization)
  • Aspartate aminotransferase (AST) (serum glutamic-oxaloacetic transaminase \[SGOT\])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase \[SGPT\]): x =\< 3 institutional ULN (obtained =\< 14 days prior to randomization)
  • Creatinine =\< 1.5 x institutional ULN OR glomerular filtration rate (GFR) \> 50 mL/min/1.73m\^2 (obtained =\< 14 days prior to randomization)
  • Albumin \>= 2.5 g/dL (obtained =\< 14 days prior to randomization)
  • International normalized ratio (INR) OR prothrombin time (PT) =\< 1.5 x ULN (unless patient is receiving anticoagulant therapy as long as PT or partial thromboplastin time \[PTT\] is within therapeutic range of intended use of anticoagulants) (obtained =\< 14 days prior to randomization)
  • Activated partial thromboplastin time (aPTT) =\< 1.5 x ULN (unless patient is receiving anticoagulant therapy as long as PT or PTT is within therapeutic range of intended use of anticoagulants) (obtained =\< 14 days prior to randomization)
  • Human immunodeficiency virus (HIV)-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months are eligible for this trial
  • Patient must have no contraindications to receive one of the chemotherapy regimens: FLOT or mFOLFOX / CAPOX
  • Patient must not have had prior potentially curative surgery for carcinoma of the stomach/GEJ
  • Patient must not receive any other standard anti-cancer therapy or experimental agent concurrently with the study drugs
  • Patient must have recovered from clinically significant adverse events of their most recent therapy/intervention prior to randomization
  • Patients with known history or current symptoms of cardiac disease, or history of treatment with cardiotoxic agents, should have a clinical risk assessment of cardiac function using the New York Heart Association Functional Classification. To be eligible for this trial, patients should be class 2B or better
  • Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial
  • Patient must have chest/abdomen/pelvis CT completed within 4 weeks prior to randomization
  • Patient may not have received prior treatment with an immune checkpoint inhibitor (anti-PD-1, anti-PDL-1, anti-PDL-2, anti-CTLA4 monoclonal antibody)
  • Patient must not have received any live vaccines within 30 days prior to randomization and while participating in the study. Live vaccines include, but are not limited to, the following: measles, mumps, rubella, chicken pox, yellow fever, rabies, Bacillus Calmette-Guerin (BCG), and typhoid (oral) vaccine. Patients are permitted to receive inactivated vaccines and any non-live vaccines including those for the seasonal influenza and coronavirus disease 2019 (COVID-19) (Note: intranasal influenza vaccines, such as Flu-Mist \[registered trademark\] are live attenuated vaccines and are not allowed). If possible, it is recommended to separate study drug administration from vaccine administration by about a week (primarily, in order to minimize an overlap of adverse events)
  • Patient must not have active autoimmune disease or history of autoimmune disease that might recur, which may affect vital organ function or require immune suppressive treatment including systemic corticosteroids. These include but are not limited to patients with a history of immune related neurologic disease, multiple sclerosis, autoimmune (demyelinating) neuropathy, Guillain- Barre syndrome, myasthenia gravis; systemic autoimmune disease such as systemic lupus erythematosus (SLE), connective tissue disease, scleroderma, inflammatory bowel disease (IBD), Crohn's, ulcerative colitis and hepatitis. Patients with a history of toxic epidermal necrolysis (TEN), Stevens-Johnson syndrome, or phospholipid syndrome are ineligible because of the risk of recurrence or exacerbation of disease. Patients with vitiligo, endocrine deficiencies including thyroiditis managed with replacement hormones including physiologic corticosteroids are eligible. Patients with rheumatoid arthritis and other arthropathies, Sjogren's syndrome and psoriasis controlled with topical medication and patients with positive serology, such as antinuclear antibodies (ANA), anti-thyroid antibodies should be evaluated for the presence of target organ involvement and potential need for systemic treatment but otherwise are eligible.
    • Patients are permitted to enroll if they have vitiligo, type I diabetes mellitus, residual hypothyroidism due to autoimmune condition only requiring hormone replacement, psoriasis not requiring systemic treatment, or conditions not expected to recur in the absence of an external trigger (precipitating event)
  • Patients must not be receiving systemic steroid therapy equivalent to \> 10 mg prednisone per day or any other form of immunosuppressive therapy within 7 days prior to randomization. Topical corticosteroid or occasional inhaled corticosteroids are allowed
  • Patient must not have known interstitial lung disease that is symptomatic or may interfere with the detection or management of suspected drug-related pulmonary toxicity, and must not have a known history of prior pneumonitis requiring treatment with steroids, or any evidence of active, non-infectious pneumonitis
  • Patient must not have a known history of active TB (Bacillus Tuberculosis)
  • Patient must not have any hypersensitivity to atezolizumab or any of its excipients
  • Patient must not have received any prior chemotherapy, targeted small molecule therapy, or radiation therapy for their MSI-H/dMMR gastric and GEJ cancer
  • Patient must not have had an allogeneic bone marrow/stem, cell or solid organ transplant
  • Patient must not have a history or current evidence of any condition (e.g., known deficiency of the enzyme dihydropyrimidine dehydrogenase \[DPD\]), therapy, or laboratory abnormality that might confound the results of the trial, interfere with the patient's participation for the full duration of the trial, or is not in the best interest of the patient to participate, in the opinion of the treating investigator
  • Patient must not have any condition that would interfere with the cooperation with the requirements of this trial
  • Patient must not be pregnant or breast-feeding due to the potential harm to an unborn fetus and possible risk for adverse events in nursing infants with the treatment regimens being used
    • All patients of childbearing potential must have a blood test or urine study within 14 days prior to randomization to rule out pregnancy
    • A patient of childbearing potential is defined as anyone, regardless of sexual orientation or whether they have undergone tubal ligation, who meets the following criteria: 1) has achieved menarche at some point, 2) has not undergone a hysterectomy or bilateral oophorectomy; or 3) has not been naturally postmenopausal (amenorrhea following cancer therapy does not rule out childbearing potential) for at least 24 consecutive months (i.e., has had menses at any time in the preceding 24 consecutive months)
  • Patient must not expect to conceive or father children by using accepted and effective method(s) of contraception or by abstaining from sexual intercourse while on protocol treatment. Patients of childbearing potential must continue contraception measures for 5 months after the last dose of atezolizumab and for 9 months after the last dose of chemotherapy. Male patients with partners of childbearing potential must continue contraception measures for 6 months after the last dose of chemotherapy. Patients of childbearing potential must also not breastfeed while on treatment and for 5 months after the last dose of atezolizumab and for 3 months after the last dose of chemotherapy
  • Patient must have the ability to understand and the willingness to sign a written informed consent document. Patients with impaired decision-making capacity (IDMC) who have a legally authorized representative (LAR) or caregiver and/or family member available will also be considered eligible
  • For patients with evidence of chronic hepatitis B virus (HBV) infection, the HBV viral load must be undetectable on suppressive therapy, if indicated
  • Patients with a history of hepatitis C virus (HCV) infection must have been treated and cured. For patients with HCV infection who are currently on treatment, they are eligible if they have an undetectable HCV viral load
  • The investigator must declare the chemotherapy regimen their patient will receive (FLOT or mFOLFOX / CAPOX) prior to randomization

Age in the registry: 18 years to - · Sex: All · Does not accept healthy volunteers

Full criteria on ClinicalTrials.gov

Sites (133)

Sites in registry order. Pick your city on the disease page to sort them by distance.

SiteCityCountrySite status
McFarland Clinic - Ames
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AmesUnited StatesUnknown status
Mary Greeley Medical Center
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AmesUnited StatesUnknown status
UI Health Care Mission Cancer and Blood - Ankeny Clinic
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AnkenyUnited StatesUnknown status
Trinity Health Saint Joseph Mercy Hospital Ann Arbor
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Ann ArborUnited StatesUnknown status
Bronson Battle Creek
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Battle CreekUnited StatesUnknown status
Illinois CancerCare-Bloomington
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BloomingtonUnited StatesUnknown status
McFarland Clinic - Boone
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BooneUnited StatesUnknown status
Trinity Health IHA Medical Group Hematology Oncology - Brighton
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BrightonUnited StatesUnknown status
Trinity Health Medical Center - Brighton
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BrightonUnited StatesUnknown status
Trinity Health IHA Medical Group Hematology Oncology - Canton
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CantonUnited StatesUnknown status
Trinity Health Medical Center - Canton
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CantonUnited StatesUnknown status
Illinois CancerCare-Canton
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CantonUnited StatesUnknown status
Saint Francis Medical Center
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Cape GirardeauUnited StatesUnknown status
Illinois CancerCare-Carthage
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CarthageUnited StatesUnknown status
Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital
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ChelseaUnited StatesUnknown status
Chelsea Hospital
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ChelseaUnited StatesUnknown status
Siteman Cancer Center at Saint Peters Hospital
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City of Saint PetersUnited StatesUnknown status
Mercy Hospital
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Coon RapidsUnited StatesUnknown status
Siteman Cancer Center at West County Hospital
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Creve CoeurUnited StatesUnknown status
Northwest Cancer Center - Crown Point
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Crown PointUnited StatesUnknown status
Carle at The Riverfront
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DanvilleUnited StatesUnknown status
Cancer Care Specialists of Illinois - Decatur
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DecaturUnited StatesUnknown status
UI Health Care Mission Cancer and Blood - Des Moines Clinic
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Des MoinesUnited StatesUnknown status
Mercy Medical Center - Des Moines
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Des MoinesUnited StatesUnknown status
Iowa Methodist Medical Center
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Des MoinesUnited StatesUnknown status
Henry Ford Health Saint John Hospital
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DetroitUnited StatesUnknown status
Illinois CancerCare-Dixon
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DixonUnited StatesUnknown status
Kaiser Permanente Dublin
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DublinUnited StatesUnknown status
Northwest Oncology LLC
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DyerUnited StatesUnknown status
Henry Ford River District Hospital
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East China TownshipUnited StatesUnknown status
Fairview Southdale Hospital
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EdinaUnited StatesUnknown status
Crossroads Cancer Center
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EffinghamUnited StatesUnknown status
Carle Physician Group-Effingham
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EffinghamUnited StatesUnknown status
Illinois CancerCare-Eureka
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EurekaUnited StatesUnknown status
Parkland Health Center - Farmington
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FarmingtonUnited StatesUnknown status
Cancer Hematology Centers - Flint
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FlintUnited StatesUnknown status
Genesee Hematology Oncology PC
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FlintUnited StatesUnknown status
Genesys Hurley Cancer Institute
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FlintUnited StatesUnknown status
McFarland Clinic - Trinity Cancer Center
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Fort DodgeUnited StatesUnknown status
Kaiser Permanente-Fremont
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FremontUnited StatesUnknown status
Kaiser Permanente-Fresno
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FresnoUnited StatesUnknown status
Illinois CancerCare-Galesburg
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GalesburgUnited StatesUnknown status
Corewell Health Grand Rapids Hospitals - Butterworth Hospital
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Grand RapidsUnited StatesUnknown status
Henry Ford Saint John Hospital - Breast
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Grosse Pointe WoodsUnited StatesUnknown status
Henry Ford Saint John Hospital - Van Elslander
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Grosse Pointe WoodsUnited StatesUnknown status
Saint Mary Medical Center
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HobartUnited StatesUnknown status
Northwest Cancer Center - Hobart
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HobartUnited StatesUnknown status
Kaiser Permanente Moanalua Medical Center
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HonoluluUnited StatesUnknown status
Saint Catherine Hospital
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IndianapolisUnited StatesUnknown status
McFarland Clinic - Jefferson
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JeffersonUnited StatesUnknown status
Bronson Methodist Hospital
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KalamazooUnited StatesUnknown status
Beacon Kalamazoo Cancer Center
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KalamazooUnited StatesUnknown status
West Michigan Cancer Center
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KalamazooUnited StatesUnknown status
Illinois CancerCare-Kewanee Clinic
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KewaneeUnited StatesUnknown status
Trinity Health Saint Mary Mercy Livonia Hospital
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LivoniaUnited StatesUnknown status
Henry Ford Saint John Hospital - Macomb Medical
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MacombUnited StatesUnknown status
Illinois CancerCare-Macomb
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MacombUnited StatesUnknown status
Henry Ford Warren Hospital - Breast Macomb
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MacombUnited StatesUnknown status
University of Wisconsin Carbone Cancer Center - University Hospital
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MadisonUnited StatesUnknown status
University of Wisconsin Carbone Cancer Center - Eastpark Medical Center
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MadisonUnited StatesUnknown status
McFarland Clinic - Marshalltown
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MarshalltownUnited StatesUnknown status
Carle Physician Group-Mattoon/Charleston
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MattoonUnited StatesUnknown status
Beebe South Coastal Health Campus
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MillvilleUnited StatesUnknown status
Abbott-Northwestern Hospital
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MinneapolisUnited StatesUnknown status
Kaiser Permanente-Modesto
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ModestoUnited StatesUnknown status
The Community Hospital
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MunsterUnited StatesUnknown status
Women's Diagnostic Center - Munster
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MunsterUnited StatesUnknown status
Trinity Health Muskegon Hospital
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MuskegonUnited StatesUnknown status
Helen F Graham Cancer Center
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NewarkUnited StatesUnknown status
Medical Oncology Hematology Consultants PA
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NewarkUnited StatesUnknown status
Providence Newberg Medical Center
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NewbergUnited StatesUnknown status
Mount Sinai Hospital
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New YorkUnited StatesUnknown status
Mount Sinai West
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New YorkUnited StatesUnknown status
Corewell Health Lakeland Hospitals - Niles Hospital
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NilesUnited StatesUnknown status
Cancer and Hematology Centers of Western Michigan - Norton Shores
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Norton ShoresUnited StatesUnknown status
Kaiser Permanente-Oakland
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OaklandUnited StatesUnknown status
Cancer Care Center of O'Fallon
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O'FallonUnited StatesUnknown status
University of Oklahoma Health Sciences Center
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Oklahoma CityUnited StatesUnknown status
Providence Willamette Falls Medical Center
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Oregon CityUnited StatesUnknown status
Illinois CancerCare-Ottawa Clinic
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OttawaUnited StatesUnknown status
Illinois CancerCare-Pekin
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PekinUnited StatesUnknown status
Illinois CancerCare-Peoria
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PeoriaUnited StatesUnknown status
Illinois CancerCare-Peru
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PeruUnited StatesUnknown status
Providence Saint Vincent Medical Center
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PortlandUnited StatesUnknown status
Providence Portland Medical Center
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PortlandUnited StatesUnknown status
Illinois CancerCare-Princeton
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PrincetonUnited StatesUnknown status
Corewell Health Reed City Hospital
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Reed CityUnited StatesUnknown status
Beebe Health Campus
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Rehoboth BeachUnited StatesUnknown status
VCU Massey Cancer Center at Stony Point
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RichmondUnited StatesUnknown status
VCU Massey Comprehensive Cancer Center
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RichmondUnited StatesUnknown status
Kaiser Permanente-Roseville
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RosevilleUnited StatesUnknown status
Kaiser Permanente Downtown Commons
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SacramentoUnited StatesUnknown status
Kaiser Permanente-South Sacramento
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SacramentoUnited StatesUnknown status
Oncology Hematology Associates of Saginaw Valley PC
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SaginawUnited StatesUnknown status
MyMichigan Medical Center Saginaw
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SaginawUnited StatesUnknown status
Sainte Genevieve County Memorial Hospital
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Sainte GenevieveUnited StatesUnknown status
Corewell Health Lakeland Hospitals - Marie Yeager Cancer Center
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Saint JosephUnited StatesUnknown status
Park Nicollet Clinic - Saint Louis Park
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Saint Louis ParkUnited StatesUnknown status
Regions Hospital
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Saint PaulUnited StatesUnknown status
United Hospital
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Saint PaulUnited StatesUnknown status
Kaiser Permanente-San Francisco
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San FranciscoUnited StatesUnknown status
Kaiser Permanente-Santa Teresa-San Jose
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San JoseUnited StatesUnknown status
Kaiser Permanente San Leandro
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San LeandroUnited StatesUnknown status
Kaiser San Rafael-Gallinas
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San RafaelUnited StatesUnknown status
Kaiser Permanente Medical Center - Santa Clara
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Santa ClaraUnited StatesUnknown status
Kaiser Permanente-Santa Rosa
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Santa RosaUnited StatesUnknown status
Memorial Hospital East
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ShilohUnited StatesUnknown status
VCU Community Memorial Health Center
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South HillUnited StatesUnknown status
Kaiser Permanente-South San Francisco
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South San FranciscoUnited StatesUnknown status
Springfield Clinic
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SpringfieldUnited StatesUnknown status
Springfield Memorial Hospital
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SpringfieldUnited StatesUnknown status
Southern Illinois University School of Medicine
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SpringfieldUnited StatesUnknown status
Siteman Cancer Center at Christian Hospital
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St LouisUnited StatesUnknown status
Missouri Baptist Medical Center
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St LouisUnited StatesUnknown status
Siteman Cancer Center-South County
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St LouisUnited StatesUnknown status
Washington University School of Medicine
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St LouisUnited StatesUnknown status
Missouri Baptist Sullivan Hospital
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SullivanUnited StatesUnknown status
BJC Outpatient Center at Sunset Hills
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Sunset HillsUnited StatesUnknown status
MyMichigan Medical Center Tawas
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Tawas CityUnited StatesUnknown status
Munson Medical Center
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Traverse CityUnited StatesUnknown status
Carle Cancer Center
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UrbanaUnited StatesUnknown status
Kaiser Permanente-Vallejo
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VallejoUnited StatesUnknown status
Northwest Cancer Center - Valparaiso
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ValparaisoUnited StatesUnknown status
Kaiser Permanente-Walnut Creek
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Walnut CreekUnited StatesUnknown status
Henry Ford Madison Heights Hospital - Breast
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WarrenUnited StatesUnknown status
Henry Ford Warren Hospital - GLCMS
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WarrenUnited StatesUnknown status
Henry Ford Health Warren Hospital
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WarrenUnited StatesUnknown status
Illinois CancerCare - Washington
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WashingtonUnited StatesUnknown status
Saint Mary's Oncology/Hematology Associates of West Branch
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West BranchUnited StatesUnknown status
UMass Memorial Medical Center - University Campus
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WorcesterUnited StatesUnknown status
University of Michigan Health - West
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WyomingUnited StatesUnknown status
Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus
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YpsilantiUnited StatesUnknown status
Huron Gastroenterology PC
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YpsilantiUnited StatesUnknown status

This page is information, not medical advice. Discuss any trial with your doctor.