Tusamitamab Ravtansine (SAR408701) in Combination With Ramucirumab in Pretreated Participants With Gastric Cancer

Primary Objectives:

Part 1: to confirm the recommended tusamitamab ravtansine loading dose Q2W in combination with ramucirumab in advanced gastric or gastroesophageal junction (GEJ) adenocarcinoma population

Part 2: to assess the antitumor activity of tusamitamab ravtansine loading dose Q2W in combination with ramucirumab in advanced gastric or GEJ adenocarcinoma

Secondary Objectives:

* To assess safety and tolerability
* To assess durability of response (DOR)
* To assess progression-free survival (PFS)
* To assess the disease control rate (DCR)
* To assess the pharmacokinetics (PK)
* To assess the immunogenicity

34 weeks (up to 4 weeks for screening, a median of 18 weeks for treatment, and a median of 12 weeks for end-of-treatment assessments and the safety follow-up visit).

Eligibility Criteria:
Inclusion Criteria:

* Histologically or cytologically confirmed diagnosis of gastric or GEJ adenocarcinoma
* Metastatic disease or locally advanced, unresectable disease
* Participants who have measurable target lesion
* Participants with high carcinoembryonic antigen-related cell adhesion molecule (CEACAM5) expression as per central assessment on tumor biospsy
* Eastern Cooperative Oncology Group (ECOG) performance status 0-1
* Female participant who agrees to use effective contraceptive methods during and for at least 7 months after the last dose of treatment administration
* Male participant who agrees to use effective contraception methods during and for at least 4 months after the last dose of treatment administration
* Signed informed consent

Exclusion Criteria:

* Untreated brain metastases, leptomeningeal disease, or uncontrolled spinal cord compression
* Significant concomitant illness
* History within the last 3 years of an invasive malignancy other than that treated in this study
* Known uncontrolled infection
* Nonresolution of any prior treatment-related toxicity
* Unresolved corneal disorder or any previous corneal disorder considered by an ophthalmologist to predict higher risk of drug-induced keratopathy
* Use of contact lenses
* Radiographic evidence of major airway or blood vessel invasion or intratumor cavitation
* History of uncontrolled hereditary or acquired thrombotic disorder or history of aneurism
* Major surgery within 28 days prior to Day 1/first IMP infusion; subcutaneous venous access device placement within 7 days prior to Day 1; or postoperative bleeding complications or wound complications from a surgical procedure performed in the last 2 months
* History of gross hemoptysis (defined as bright red blood or ≥1/2 teaspoon) within 2 months before the first treatment administration
* Any arterial thrombotic event, including myocardial infarction, unstable angina, cerebrovascular accident, or transient ischemic attack, within 6 months before the first administration of treatment administration
* Uncontrolled arterial hypertension (systolic ≥150 mmHg or diastolic ≥90 mmHg) despite standard medical management.
* Serious or nonhealing wound, skin ulcer, or bone fracture within 28 days before the first administration of treatment administration
* Gastrointestinal (GI) perforation and/or fistulae within 6 months prior to first administration of treatment administration
* Significant bleeding disorders, vasculitis, or Grade 3-4 gastrointestinal (GI) bleeding within 3 months before the first administration of study intervention.
* Bowel obstruction, history or presence of inflammatory enteropathy or extensive intestinal resection Crohn's disease, ulcerative colitis, or chronic diarrhea
* Medical condition requiring concomitant administration of a medication with a narrow therapeutic window and metabolized by CYP450 or a strong CYP3A inhibitor
* Concurrent treatment with any other anticancer therapy
* Prior treatment targeting CEACAM5 or containing maytansinoid DM1 or DM4 or ramucirumab or taxane or targeting VEGF/VEGFR Poor organ function

The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.