Trifluridine/tipiracil + oxaliplatin ± nivolumab vs FOLFOX ± nivolumab in HER2 negative advanced oesogastric adenocarcinoma: The PRODIGE73-UCGI40-LOGICAN trial

Dig Liver Dis. 2024 Aug;56(8):1281-1287. doi: 10.1016/j.dld.2024.04.032. Epub 2024 May 17.

Abstract

Background: Trifluridine/tipiracil (FTD/TPI) is approved in third-line treatment of patients with advanced/metastatic gastric and gastroesophageal junction adenocarcinomas (aGA/GEJA). The association of oxaliplatin with FTD/TPI is promising and the combination of FTD/TPI + oxaliplatin + nivolumab has shown a predictable and manageable safety profile.

Aims: The aim is to evaluate the efficacy and safety of FTD/TPI plus oxaliplatin with or without nivolumab in patients, with HER2 negative aGA/GEJA, unfit for triplet chemotherapy (TFOX/mFLOT regimen), in the first-line metastatic setting in comparison with the standard of care FOLFOX with or without nivolumab.

Methods: This study is a prospective randomised, open label, comparative, multicentre, phase II trial designed to include 118 patients. The primary objective is to evaluate the superiority of FTD/TPI plus oxaliplatin with or without nivolumab over FOLFOX regimen with or without nivolumab in terms of PFS in a population of patients non candidate for triplet chemotherapy. Nivolumab will be used for patients whose tumour express PD-L1 with a CPS score ≥5.

Discussion: PRODIGE73-UCGI40-LOGICAN study will provide efficacy and safety data on the association of FTD/TPI plus oxaliplatin with or without nivolumab versus FOLFOX regimen with or without nivolumab in first-line palliative setting, in patients with aGA/GEJA (NCT05476796).

Keywords: (2 à 4): Trifluridine/tipiracil; Advanced/metastatic gastric and gastroesophageal junction adenocarcinomas.

Publication types

  • Clinical Trial Protocol

MeSH terms

  • Adenocarcinoma* / drug therapy
  • Adenocarcinoma* / pathology
  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols* / therapeutic use
  • Drug Combinations*
  • Esophageal Neoplasms / drug therapy
  • Esophageal Neoplasms / pathology
  • Esophagogastric Junction* / pathology
  • Female
  • Fluorouracil* / administration & dosage
  • Fluorouracil* / therapeutic use
  • Humans
  • Leucovorin* / administration & dosage
  • Leucovorin* / therapeutic use
  • Male
  • Middle Aged
  • Multicenter Studies as Topic
  • Nivolumab* / administration & dosage
  • Nivolumab* / adverse effects
  • Nivolumab* / therapeutic use
  • Non-Randomized Controlled Trials as Topic
  • Organoplatinum Compounds / administration & dosage
  • Organoplatinum Compounds / therapeutic use
  • Oxaliplatin / administration & dosage
  • Oxaliplatin / therapeutic use
  • Prospective Studies
  • Pyrrolidines* / administration & dosage
  • Pyrrolidines* / therapeutic use
  • Receptor, ErbB-2 / metabolism
  • Stomach Neoplasms* / drug therapy
  • Stomach Neoplasms* / pathology
  • Thymine*
  • Trifluridine* / administration & dosage
  • Trifluridine* / therapeutic use

Substances

  • Drug Combinations
  • ERBB2 protein, human
  • Fluorouracil
  • Leucovorin
  • Nivolumab
  • Organoplatinum Compounds
  • Oxaliplatin
  • Pyrrolidines
  • Receptor, ErbB-2
  • Thymine
  • Trifluridine
  • trifluridine tipiracil drug combination

Supplementary concepts

  • Adenocarcinoma Of Esophagus
  • Folfox protocol

Associated data

  • ClinicalTrials.gov/NCT05476796