Recruiting
Phase 1
Phase 2

Zongertinib & Trastuzumab

Sponsor:

Boehringer Ingelheim

Code:

NCT06324357

Conditions

Metastatic Breast Cancer

Metastatic Gastric Adenocarcinoma

Gastroesophageal Junction Adenocarcinoma

Esophageal Adenocarcinoma

Colorectal Cancer

Eligibility Criteria

Sex: All

Age: 18+

Healthy Volunteers: Not accepted

Interventions

Zongertinib

Trastuzumab deruxtecan

Trastuzumab emtansine

Trastuzumab

Capecitabine

Study Details

Brief summary:

This study is open to adults aged 18 years and older with different types of HER2+ cancer that has spread and cannot be removed by surgery. People can take part in this study if their tumours show HER2 aberrations and previous treatment was not successful. The purpose of this study is to find a suitable dose of zongertinib that people with different types of HER2+ cancer that has spread can tolerate best when taken together with trastuzumab deruxtecan (T-DXd), with trastuzumab emtansine (T-DM1), with trastuzumab and capecitabine, with zanidatamab, or with mFOLFOX6 (with or without trastuzumab). Another purpose is to check whether zongertinib alone and in combination with other treatments can make tumours shrink. Zongertinib inhibits HER2. HER2 causes cancer cells to grow.

In this study, participants receive treatment in cycles. Study participants are treated with zongertinib alone or in combination with other treatments. This study has 2 parts. In Part 1, participants in different groups receive increasing doses of zongertinib. In Part 2, participants are put into different groups by chance. Each group receives a different dose of zongertinib. Every participant has an equal chance of being in each group.

During the study, the participants visit the study site regularly. In this study, researchers want to find the highest dose of zongertinib that participants can tolerate when taken together with other treatments. To find this out, researchers look at certain severe health problems that a number of participants have. The doctors regularly check the size of the tumour with imaging methods (CT/MRI) during the study. The doctors also regularly check participants' health and take note of any unwanted effects.

Conditions

Metastatic Breast Cancer

Metastatic Gastric Adenocarcinoma

Gastroesophageal Junction Adenocarcinoma

Esophageal Adenocarcinoma

Colorectal Cancer

Study ID

NCT06324357

Start date

Jun 28, 2024

Status verified date

Sep, 2026

Completion date

Jan 8, 2029

Anticipated

Primary completion date

Jan 8, 2029

Anticipated

Eligibility Criteria

Eligibility Criteria

Sex: All

Age: 18+

Healthy Volunteers: Not accepted

Inclusion criteria:

  • Patients ≥18 years of age or over the legal age of consent in countries where that is greater than 18 years at the time of signature of the informed consent form (ICF)
  • Cohorts A to K and Cohort O: Documented Human epidermal growth factor receptor 2 overexpressing and/or amplified (HER2+), metastatic breast cancer (mBC) or metastatic gastric adenocarcinoma, gastroesophageal junction adenocarcinoma, or esophageal adenocarcinoma (mGEAC).
  • Cohorts L (L-ext), M, and N (metastatic colorectal cancer (mCRC)): Documented Human epidermal growth factor receptor 2 (HER2) overexpression/amplification according to American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) gastric cancer guidelines and according to the result of local testing.
  • For dose optimization and justification (Phase II): Patient must provide tumor tissue from locations not radiated prior to biopsy, if possible, collected through archival tissue
  • History of prior treatment lines in palliative setting:

  • For cohorts A, B, C, D, E, F, G, H, I, I-ext, J, J-ext, K and O documented investigator assessed progression after HER2-directed treatment for unresectable locally advanced or metastatic disease (For Cohorts D, H, I (I-ext), J (J-ext) - patients must have been pretreated with trastuzumab deruxtecan (T-DXd) and have progressed or have been intolerant to previous T-DXd).
  • For cohorts L, L-ext, M and N documented progression or recurrence of disease during or following their latest line of therapy. Patients must have had at least one prior line of therapy for locally advanced unresectable disease or metastatic disease (adjuvant and neoadjuvant therapy excluded) and documented disease progression or recurrence of disease during or following their latest line of therapy. In the opinion of the Investigator, patients must be unlikely to tolerate or derive clinically meaningful benefit from further standard of care therapy known to prolong survival.
  • Presence of at least one measurable lesion according to RECIST 1.1
  • Eastern Cooperative Oncology Group (ECOG) score of 0 or 1
  • Adequate organ function based on laboratory values Further inclusion criteria apply.

Exclusion criteria:

  • Previous treatment with:

  • Any small molecule HER2 inhibitor in the palliative setting in Cohorts D, E, F, H, L, L-ext, M, and N. In Cohort D allowed in up to 15 patients in each dose level (DL).
  • T-DXd in Cohorts E and F. In Cohort E allowed in up to 15 patients in each DL.
  • trastuzumab emtansine (T-DM1) in the palliative setting in Cohort D and H. In Cohort H allowed in up to 15 patients in each DL.
  • Capecitabine in Cohort D and H. In Cohort D allowed in up to 15 patients in each DL
  • Presence of uncontrolled and/or symptomatic brain metastases, or leptomeningeal disease
  • Mean resting corrected QT interval (QT interval corrected for heart rate by Fridericia´s formula (QTcF)) >470 msec.
  • Any factors that increase the risk of QT interval corrected for heart rate (QTc) prolongation or risk of arrhythmic events such as heart failure, hypokalemia, congenital long QT syndrome, personal or family history of long QT syndrome or unexplained sudden death under 40 years-of-age.
  • Ejection fraction <50% or the lower limit of normal of the institutional standard within 28 days prior to randomization
  • History of (non-infectious) interstitial lung disease (ILD)/pneumonitis that required steroids, current ILD/pneumonitis, or where suspected ILD/pneumonitis cannot be ruled out by imaging at screening Further exclusion criteria apply.

Study Design

Enrollment

768 participants

Anticipated

Allocation

Randomized

Intervention Model

Sequential

Primary purpose

Treatment

Interventions and Outcome Measures

Arms

experimental: Phase Ib - Cohort A: zongertinib + Trastuzumab emtansine

Dose escalation (Phase Ib)

experimental: Phase Ib - Cohort B: zongertinib + Trastuzumab deruxtecan

Dose escalation (Phase Ib)

experimental: Phase Ib - Cohort C: zongertinib + Trastuzumab deruxtecan

Dose escalation (Phase Ib)

experimental: Phase II - Cohort D: zongertinib + Trastuzumab emtansine

Dose optimization (Phase II).

experimental: Phase II - Cohort E: zongertinib + Trastuzumab deruxtecan

Dose optimization (Phase II).

experimental: Phase II - Cohort F: zongertinib + Trastuzumab deruxtecan

Dose optimization (Phase II).

experimental: Phase Ib - Cohort G: zongertinib + trastuzumab + capecitabine

Dose escalation (Phase Ib)

experimental: Phase Ib - Cohort K: zongertinib + trastuzumab

Dose escalation (Phase Ib)

experimental: Phase II - Cohort H: zongertinib + trastuzumab + capecitabine

Dose optimization (Phase II).

experimental: Phase II - Cohort I: zongertinib

Dose optimization (Phase II).

experimental: Phase II - Cohort J: zongertinib + trastuzumab

Dose optimization (Phase II).

experimental: Phase II - Cohort I-ext: zongertinib

Extension Phase II

experimental: Phase II - Cohort J-ext: zongertinib + trastuzumab

Extension Phase II

experimental: Phase Ib - Cohort M: zongertinib + mFOLFOX6

Dose escalation (Phase Ib)

experimental: Phase Ib - Cohort N: zongertinib + trastuzumab + mFOLFOX6

Dose escalation (Phase Ib)

experimental: Phase Ib - Cohort O: zongertinib + zanidatamab

Dose escalation (Phase Ib) - is not conducted in China or South Korea

experimental: Phase II - Cohort L: zongertinib + trastuzumab

Dose justification (Phase II)

experimental: Phase II - Cohort L-ext: zongertinib + trastuzumab

Extension Phase II

Interventions

Zongertinib

Zongertinib

Trastuzumab deruxtecan

Trastuzumab deruxtecan

Trastuzumab emtansine

Trastuzumab emtansine

Trastuzumab

Herceptin®

Capecitabine

Xeloda®

mFOLFOX6

mFOLFOX6

zanidatamab

zanidatamab

Primary outcome measure

  • Dose escalation (Phase Ib): Occurrence of dose-limiting toxicities (DLTs) in the maximum tolerated dose (MTD) evaluation period [ Time Frame: up to 21 days ]
  • Dose optimization and justification (Phase II): Objective response (OR) [ Time Frame: up to 50 months ]

Central Contacts and Locations

Central contacts

Locations

The Oncology Institute of Hope and Innovation

Recruiting

Cerritos, California, United States, 90703

Contacts

Ellison Medical Institute

Recruiting

Los Angeles, California, United States, 90064

Contacts

Valkyrie Clinical Trials

Recruiting

Los Angeles, California, United States, 90067

Contacts

University of California Los Angeles

Recruiting

Los Angeles, California, United States, 90095

Contacts

University of California Irvine

Recruiting

Orange, California, United States, 92868

Contacts

Sharp Memorial Hospital

Recruiting

San Diego, California, United States, 92123

Contacts

Yale University School of Medicine

Recruiting

New Haven, Connecticut, United States, 06510

Contacts

Helios CR Inc

Recruiting

Lakeland, Florida, United States, 33812

Contacts

H. Lee Moffitt Cancer Center and Research Institute

Recruiting

Tampa, Florida, United States, 33612

Contacts

Orchard Healthcare Research Inc.- Skokie

Recruiting

Skokie, Illinois, United States, 60077

Contacts

Community Health Network

Recruiting

Indianapolis, Indiana, United States, 46250

Contacts

University of Iowa Hospitals and Clinics

Recruiting

Iowa City, Iowa, United States, 52242

Contacts

Dana-Farber Cancer Institute

Recruiting

Boston, Massachusetts, United States, 02215

Contacts

Memorial Sloan-Kettering Cancer Center

Recruiting

New York, New York, United States, 10065

Contacts

New York Cancer & Blood Specialists

Recruiting

Shirley, New York, United States, 11967

Contacts

Penn State Milton S. Hershey Medical Center

Recruiting

Hershey, Pennsylvania, United States, 17033

Contacts

Avera Cancer Institute

Recruiting

Sioux Falls, South Dakota, United States, 57105

Contacts

Baptist Cancer Center - Memphis

Recruiting

Memphis, Tennessee, United States, 38120

Contacts

SCRI Oncology Partners

Recruiting

Nashville, Tennessee, United States, 37203

Contacts

Tennessee Oncology, Pllc

Recruiting

Nashville, Tennessee, United States, 37203

Contacts

The Methodist Hospital Research Institute

Recruiting

Houston, Texas, United States, 77030

Contacts

The University of Texas MD Anderson Cancer Center

Recruiting

Houston, Texas, United States, 77030

Contacts

Inova Schar Cancer Institute

Recruiting

Fairfax, Virginia, United States, 22031

Contacts

Virginia Cancer Specialists, PC

Recruiting

Fairfax, Virginia, United States, 22031

Contacts

Fred Hutchinson Cancer Research Center

Recruiting

Seattle, Washington, United States, 98109

Contacts

More Information

Sponsor

Boehringer Ingelheim

Last update posted

Sep 30, 2026

Last verified

Sep, 2026

Trial information was received from ClinicalTrials.gov and was last updated on 2026-10-02. This information was provided to ClinicalTrials.gov by Boehringer Ingelheim on 2026-09-30. Recruitment status is synced daily from ClinicalTrials.gov and may not reflect the sponsor's current status. Confirm during your call.