PiSARRO: p53 Suppressor Activation in Recurrent High Grade Serous Ovarian Cancer, a Phase Ib/II Study of Systemic Carboplatin/Pegylated Liposomal Doxorubicin Combination Chemotherapy With or Without APR-246
- Conditions
- Patients with high grade serous ovarian cancer1003859410033283
- Registration Number
- NL-OMON47287
- Lead Sponsor
- Aprea Therapeutics AB
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Completed
- Sex
- Not specified
- Target Recruitment
- 29
1. Archived sections from the original FFPE sample reviewed by a gynecological pathologist confirming High Grade Serous Ovarian Cancer, High Grade Serous Peritoneal Cancer or Primary Fallopian Tube Cancer, and positive IHC staining for p53 assessed according to defined standard (as detailed in the laboratory manual). Cases that do not show p53 staining will not be included.
2. Radiologically-confirmed Disease Progression between six and twenty-four (6-24) months after a first or second platinum based regimen.
3. At least a single (RECIST v1.1) measurable lesion.
4. Adequate organ function prior to registration:
a) Bone Marrow Reserve:
* Absolute neutrophil count (ANC) * 1.5 x109/L,
* Platelets * 100 x109/L,
* Hemoglobin * 9 g/dL.
b) Hepatic:
* Total bilirubin level < 1.5 x ULN,
* ALT and AST < 2.5 x ULN.
c) Renal:
* Calculated creatinine clearance > 30 mL/min.
d) Electrolytes
* Potassium within institutional normal ranges.
5. Toxicities from previous cancer therapies, excluding alopecia, must have recovered to grade 1 (defined by CTCAE version 4.0). Chronic stable grade 2 peripheral neuropathy secondary to neurotoxicity from prior therapies may be considered on a case by case basis by the Principal Investigator.
6. If of childbearing potential, negative pre-treatment serum pregnancy test.
7. If of childbearing potential, willing to use an effective form of contraception (see below) during
chemotherapy treatment and for at least six months thereafter. Such methods include: (if using hormonal contraception this method must be supplemented with a barrier
method, preferably male condom).
* Combined (estrogen and progestogen containing) hormonal contraception associated with inhibition of ovulation:
o Oral
o Intravaginal
o Transdermal ;* Progestogen-only hormonal contraception associated with inhibition of ovulation:
o Oral
o Injectable
o Implantable
* Intrauterine device (IUD)
* Intrauterine hormone-releasing system (IUS)
* Bilateral tubal occlusion
* Vasectomized partner
* True sexual abstinence when this is in line with the preferred and usual lifestyle of the patient. Periodic abstinence (e.g., calendar, ovulation, symptothermal, post-ovulation methods), declaration of abstinence for the duration of a trial, and withdrawal are not acceptable methods of contraception.
* Male condom with spermicide (female condom and male condom should not be used together)
8. ECOG performance status of 0 to 1 (Appendix I).
9. * 18 years of age.
10. Written informed consent obtained prior to any screening procedures and in accordance with federal, local, and institutional guidelines.
11. Patient has exhausted all available treatments, including surgery, and is considered a suitable candidate to receive carboplatin/PLD.
1. Prior exposure to cumulative doses of doxorubicin >400 mg/m2 or epirubicin >720 mg/m2.
2. Confirmed cardiac history of any of the following:
a) Myocardial infarct within six months prior to registration,
b) New York Heart Association Class II or worse heart failure (Appendix II),
c) A history of familial long QT syndrome,
d) Clinically significant pericardial disease,
e) Electrocardiographic evidence of acute ischemia,
f) Symptomatic atrial or ventricular arrhythmias not controlled by medications,
g) QTc * 480 msec calculated from a single ECG reading or a mean of 3 ECG readings using
Fridericia*s correction (QTcF = QT/RR0.33),
h) Bradycardia (< 40bpm),
i) Left ventricular ejection fraction (LVEF) < the institution lower limit of normal as assessed by ECHO.
3. Major abdominal surgery or peritonitis within six weeks prior to study treatment.
4. Unresolved bowel obstruction, sub-occlusive disease or the presence of brain metastases.
5. History of uncontrolled allergic reactions to carboplatin, platinum containing compounds or mannitol and/or hypersensitivity to PLD or to any of the excipients.
6. Unable to undergo imaging by either CT scan or MRI.
7. Evidence of any other medical conditions (such as psychiatric illness, infectious diseases, neurological conditions, physical examination or laboratory findings) that may interfere with the planned treatment, affect patient compliance or place the patient at high risk from treatment related complications.
8. Breast feeding.
9. Concurrent malignancy requiring therapy (excluding non-invasive carcinoma or carcinoma in situ).
10. Patients requiring or undergoing concurrent treatment with live vaccines.
11. Patients requiring or undergoing concurrent treatment with phenytoin.
12. Known HIV positive status, active hepatitis B or C status.
13. Is taking any concurrent (or within 4 week prior to registration) anti-cancer therapy, immunotherapy, radiotherapy or any ancillary anti-cancer therapy; or any therapy that is considered to be investigational (i.e., used for non-approved indications(s) and in the context of a research investigation). Supportive care measures are allowed.
14. Patients unable to be regularly followed for any reason (geographic, familiar, social, psychological, housed in an institution e.g., prison because of a court agreement or administrative order). Patients who are dependent on the sponsor/CRO or investigational site as well as on the Investigator.
15. Use of concomitant treatment with QT/QTc prolonging drugs.
Study & Design
- Study Type
- Interventional
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method <p>Primary Endpoints<br /><br>* Progression Free Survival (PFS), defined as the time from registration to the<br /><br>time of disease progression or relapse (according to RECIST 1.1 only) or death,<br /><br>or the date of last tumor assessment without any such event (censored<br /><br>observation).</p><br>
- Secondary Outcome Measures
Name Time Method <p>Secondary Endpoints<br /><br>* PFS by assessment of CA 125 as a tumor marker.<br /><br>* Overall Survival (OS), calculated as the time from registration to the date<br /><br>of death from any cause.<br /><br>* Overall Response Rate (RR), calculated as the proportion of patients with a<br /><br>best overall response of confirmed Complete Response (CR) or Partial Response<br /><br>(PR).<br /><br>* Safety profile (AEs, laboratory assessments and physical findings) of the<br /><br>combined APR-246 and carboplatin/PLD chemotherapy regimen or the<br /><br>carboplatin/PLD chemotherapy regimen alone.<br /><br>* Evaluation of potential biomarkers.<br /><br>* Biological activity in tumor and surrogate tissues.</p><br>