Condition or disease | Intervention/treatment | Phase |
---|---|---|
Epithelial Ovarian Cancer Relapse | Drug: Bevacizumab (FKB238), Olaparib and Durvalumab (MEDI 4736) combination | Phase 2 |
Bevacizumab and olaparib have already been tested on 12 patients in a phase I trial at their usual doses (10 mg/kg q2w and 400 mg bid - 50 mg capsules -, respectively), and no DLTs were observed. The addition of an anti-VEGF small molecule, cediranib, to olaparib doubled the median PFS in a randomized phase II trial in patients with platinum sensitive relapse, with a manageable safety profile.
A recently reported phase I trial established the RDP2D of Durvalumab and Olaparib - 150 mg tablets -, when given in combination, at 1500 mg every 4 weeks, and 300 mg bid, respectively. In addition, the ENGOT/GINECO PAOLA phase III trial is currently evaluating the combination of Olaparib and Bevacizumab as first-line maintenance after platinum-paclitaxel combination, in patients with advanced high-grade serous ovarian carcinoma. Under the hypothesis of a survival benefit in favor of this combination, it would also be of interest to assess the value of adding Durvalumab in order to improve the efficacy of the overall combination.
There are no trials to date assessing anti-VEGF in combination with anti-PARP and anti-PD-L1 therapy.
Beside additive efficacy, a synergistic effect could be expected :
For those reasons the sponsor propose a phase II trial of Olaparib, Bevacizumab and Durvalumab combination, in patients with relapsing AO high grade carcinoma :
In platinum sensitive relapse (PSR), whatever the line, in patients not amenable to frontline surgery of the relapse and previously-treated by a platinum-containing chemotherapy in first line and
In platinum-resistant relapse (PRR), in previously untreated patients for their relapse, or in patients who received a maximum of 1 chemotherapy regimen in this setting and either
The trial will also propose translational research, including :
Study Type : | Interventional (Clinical Trial) |
Actual Enrollment : | 74 participants |
Allocation: | N/A |
Intervention Model: | Single Group Assignment |
Intervention Model Description: | Patients will be treated the same way in the PRR and PSR cohorts: Durvalumab 1.12 g IV on Day 1 Q3W Bevacizumab (FKB238) 15 mg/kg Day 1 Q3W Olaparib 300 mg bid po, continuously Patients will be treated upon disease progression, unacceptable toxicity or consent withdrawal. |
Masking: | None (Open Label) |
Primary Purpose: | Treatment |
Official Title: | A GINECO Phase II Trialo Assessing the Safety and the Efficacy of the Bevacizumab (FKB238), Olaparib and Durvalumab (MEDI 4736) Combination in Patients With Advanced Epithelial Ovarian Cancer in Relapse |
Actual Study Start Date : | February 12, 2019 |
Actual Primary Completion Date : | June 30, 2020 |
Estimated Study Completion Date : | April 30, 2024 |
Arm | Intervention/treatment |
---|---|
Experimental: Bevacizumab, Olaparib and Durvalumab
Single arm study
|
Drug: Bevacizumab (FKB238), Olaparib and Durvalumab (MEDI 4736) combination
Patients will receive a combination of these 3 drugs : Bevacizumab (FKB238) 15mg/kg q3w IV, Olaparib 300mg BD Per Os; and Durvalumab (MEDI 4736) 1.12g IV q3w Other Name: Experimental treatment
|
Frequency and percentages of patients who had at least one AE will be calculated by category:
When n = 5 for PRR cohort and n = 10 for PSR cohort, treatment toxicity datas will be reviewed to the IDMC for validation and agreement to continue the study.
TMB will be categorised as high/intermediate/low. TMB after 6 weeks of treatment will be compared to TMB at baseline. Increase is defined as a change in the TMB category.
Response is defined as clinical and radiological non-progressive disease, as assessed by immune-related response criteria (irRC) (Wolchok et al. 2009) at 3 months in the PRR cohort and 6 months in the PSR cohort.
HR status will be categorised as deficient versus proficient based on genotyping of the baseline biopsy with an HR-genes panel.
Response is defined as clinical and radiological non-progressive disease, as assessed by immune-related response criteria (irRC) (Wolchok et al. 2009) at 3 months in the PRR cohort and 6 months in the PSR cohort.
Immune infiltrate and ICP status of the baseline tumour will be assessed by a targeted transcriptomic approach (IO360 panel, NanoString). Tumours will be categorised as inflamed/excluded/deserted. ICP status will be categorised as "PD-1/PD-L1 driven" versus "others ICPs involved".
Response is defined as clinical and radiological non-progressive disease, as assessed by immune-related response criteria (irRC) (Wolchok et al. 2009) at 3 months in the PRR cohort and 6 months in the PSR cohort.
The translational research will provide informations on:
-Characterization of immune response in the tumor by Nanostring immuno-oncology panel on tumours.
Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | Female |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Patients with platinum resistant relapse
Patient must have normal organ and bone marrow function:
Patients with platinum sensitive relapse
Patient must have normal organ and bone marrow function:
Exclusion Criteria:
Patient with synchronous primary endometrial cancer unless both of the following criteria are met:
Patient with serous or clear cell adenocarcinoma or carcinosarcoma of the endometrium is not eligible.
Any unresolved toxicity NCI CTCAE Grade ≥2 from previous anticancer therapy with the exception of alopecia, vitiligo, and the laboratory values defined in the inclusion criteria
France | |
Institut Bergonié | |
Bordeaux, France, 33076 | |
Centre Oscar Lambret | |
Lille, France, 59000 | |
Centre Léon Bérard | |
Lyon, France, 69008 | |
ICM Val d'Aurelle | |
Montpellier, France, 34298 | |
Groupe Hospitalier des Diaconesses Croix Saint-Simon | |
Paris, France, 75960 | |
Centre Hospitalier Lyon Sud | |
Pierre-Bénite, France, 69495 | |
Institut Curie - Site Saint Cloud | |
Saint-Cloud, France, 92210 | |
Institut Claudius Régaud | |
Toulouse, France, 31059 | |
Institut Gustave Roussy | |
Villejuif, France, 94805 |
Principal Investigator: | Gilles Freyer | Centre Hospitalier Lyon Sud |
Tracking Information | |||||||
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First Submitted Date ICMJE | January 2, 2019 | ||||||
First Posted Date ICMJE | July 11, 2019 | ||||||
Last Update Posted Date | December 17, 2020 | ||||||
Actual Study Start Date ICMJE | February 12, 2019 | ||||||
Actual Primary Completion Date | June 30, 2020 (Final data collection date for primary outcome measure) | ||||||
Current Primary Outcome Measures ICMJE |
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Original Primary Outcome Measures ICMJE | Same as current | ||||||
Change History | |||||||
Current Secondary Outcome Measures ICMJE |
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Original Secondary Outcome Measures ICMJE | Same as current | ||||||
Current Other Pre-specified Outcome Measures |
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Original Other Pre-specified Outcome Measures | Same as current | ||||||
Descriptive Information | |||||||
Brief Title ICMJE | Tri Association in Patient With Advanced Epithelial Ovarian Cancer in Relapse | ||||||
Official Title ICMJE | A GINECO Phase II Trialo Assessing the Safety and the Efficacy of the Bevacizumab (FKB238), Olaparib and Durvalumab (MEDI 4736) Combination in Patients With Advanced Epithelial Ovarian Cancer in Relapse | ||||||
Brief Summary | Assessing the safety and efficacy of the bevacizumab (FKB238), Olaparib and Durvalumab (MEDI 4736) combination in patient with high grade serous or high grade endometrioid or other high grade epithelial non mucinous ovarian tumor, with at least one previous line of platinum-taxane chemotherapy, and present with platinum resistant disease (PRR) or platinum-sensitive relapse (PSR), whatever the line of chemotherapy given at relapse. | ||||||
Detailed Description |
Bevacizumab and olaparib have already been tested on 12 patients in a phase I trial at their usual doses (10 mg/kg q2w and 400 mg bid - 50 mg capsules -, respectively), and no DLTs were observed. The addition of an anti-VEGF small molecule, cediranib, to olaparib doubled the median PFS in a randomized phase II trial in patients with platinum sensitive relapse, with a manageable safety profile. A recently reported phase I trial established the RDP2D of Durvalumab and Olaparib - 150 mg tablets -, when given in combination, at 1500 mg every 4 weeks, and 300 mg bid, respectively. In addition, the ENGOT/GINECO PAOLA phase III trial is currently evaluating the combination of Olaparib and Bevacizumab as first-line maintenance after platinum-paclitaxel combination, in patients with advanced high-grade serous ovarian carcinoma. Under the hypothesis of a survival benefit in favor of this combination, it would also be of interest to assess the value of adding Durvalumab in order to improve the efficacy of the overall combination. There are no trials to date assessing anti-VEGF in combination with anti-PARP and anti-PD-L1 therapy. Beside additive efficacy, a synergistic effect could be expected :
For those reasons the sponsor propose a phase II trial of Olaparib, Bevacizumab and Durvalumab combination, in patients with relapsing AO high grade carcinoma :
The trial will also propose translational research, including :
|
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Study Type ICMJE | Interventional | ||||||
Study Phase ICMJE | Phase 2 | ||||||
Study Design ICMJE | Allocation: N/A Intervention Model: Single Group Assignment Intervention Model Description: Patients will be treated the same way in the PRR and PSR cohorts: Durvalumab 1.12 g IV on Day 1 Q3W Bevacizumab (FKB238) 15 mg/kg Day 1 Q3W Olaparib 300 mg bid po, continuously Patients will be treated upon disease progression, unacceptable toxicity or consent withdrawal. Primary Purpose: Treatment |
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Condition ICMJE |
|
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Intervention ICMJE | Drug: Bevacizumab (FKB238), Olaparib and Durvalumab (MEDI 4736) combination
Patients will receive a combination of these 3 drugs : Bevacizumab (FKB238) 15mg/kg q3w IV, Olaparib 300mg BD Per Os; and Durvalumab (MEDI 4736) 1.12g IV q3w Other Name: Experimental treatment
|
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Study Arms ICMJE | Experimental: Bevacizumab, Olaparib and Durvalumab
Single arm study
Intervention: Drug: Bevacizumab (FKB238), Olaparib and Durvalumab (MEDI 4736) combination
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Publications * | Not Provided | ||||||
* Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline. |
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Recruitment Information | |||||||
Recruitment Status ICMJE | Active, not recruiting | ||||||
Actual Enrollment ICMJE |
74 | ||||||
Original Estimated Enrollment ICMJE |
63 | ||||||
Estimated Study Completion Date ICMJE | April 30, 2024 | ||||||
Actual Primary Completion Date | June 30, 2020 (Final data collection date for primary outcome measure) | ||||||
Eligibility Criteria ICMJE |
Inclusion Criteria: Patients with platinum resistant relapse
Patients with platinum sensitive relapse
Exclusion Criteria:
Patient with serous or clear cell adenocarcinoma or carcinosarcoma of the endometrium is not eligible.
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Sex/Gender ICMJE |
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Ages ICMJE | 18 Years and older (Adult, Older Adult) | ||||||
Accepts Healthy Volunteers ICMJE | No | ||||||
Contacts ICMJE | Contact information is only displayed when the study is recruiting subjects | ||||||
Listed Location Countries ICMJE | France | ||||||
Removed Location Countries | |||||||
Administrative Information | |||||||
NCT Number ICMJE | NCT04015739 | ||||||
Other Study ID Numbers ICMJE | GINECO OV 238 | ||||||
Has Data Monitoring Committee | Yes | ||||||
U.S. FDA-regulated Product |
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IPD Sharing Statement ICMJE |
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Responsible Party | ARCAGY/ GINECO GROUP | ||||||
Study Sponsor ICMJE | ARCAGY/ GINECO GROUP | ||||||
Collaborators ICMJE | Not Provided | ||||||
Investigators ICMJE |
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PRS Account | ARCAGY/ GINECO GROUP | ||||||
Verification Date | March 2020 | ||||||
ICMJE Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP |