Some cancers of the oesophagus and stomach express excessive copies of either the cMYC
(Myelocytomatosis oncogene) gene, the HER2 (Human epidermal growth factor receptor 2) gene or
both. These genes may potentially contribute to the growth and spread of cancer.Ibrutinib is
a drug that is already used in the treatment of certain cancers of the immune system.
There is preclinical evidence that it shows activity against gastric and stomach cancer cells
over-expressing cMYC and HER2 genes.
The iMYC study will assess the activity of ibrutinib in cancers of the oesophagus and stomach
which over-express these genes and which have previously been treated with standard
Any anti-cancer activity seen will be measured and correlated with metabolic changes on FDG
(18F-2-fluoro-2-deoxy-D-glucose fluorodeoxyglucose) - PET (positron emission tomography)
scan, changes in DNA and circulating tumour cells in the blood, and molecular changes in the
cancer itself through the use of optional repeat tumour biopsies. If an effect is seen it
could provide justification for further research in this group of patients.
Patients will be eligible if they have advanced cancer of the oesophagus or stomach and have
been treated with at least one line of prior therapy. The study will be conducted at the
Royal Marsden Hospital at its Sutton and Chelsea sites.
It will involve an initial group of up to 17 patients. Screening, recruitment and follow up
will last for 3 years in total.
Patients wishing to take part must consent to having their cancer biopsied to test for cMYC
and HER2 amplification, as well as a number of imaging and blood tests. There are optional
further tumour biopsies whilst on study.
Patients will be treated with ibrutinib until progression of their disease or unacceptable