Telmisartan in Combination With Cytotoxic Regimens in Platinum-Resistant Ovarian Cancer

Phase 2

Not yet recruiting

• Conditions: Ovarian Cancer
• Interventions: Drug: Telmisartan

• Registration Number: NCT06815497
• Lead Sponsor: Tyler J Curiel

Brief Summary

The primary study objective is to assess progression-free survival in patients with ovarian cancer receiving telmisartan plus selected standard of care chemotherapy regimens versus historical controls.

Detailed Description

This is an open label, single-arm Phase II trial of telmisartan plus selected standard of care chemotherapy regimens containing an anthracycline or taxane. The primary study objective is to assess progression-free survival.

Study Timeline

• Study First Submitted: 2025-02-03
• Study First Submitted QC: 2025-02-03
• Study First Posted: 2025-02-07
• Status Verified: 2025-07
• Last Update Submitted: 2025-07-28
• Last Update Posted: 2025-07-30
• Study Start: 2025-08-14
• Primary Completion: 2027-04-14
• Study Completion: 2029-05-14

Recruitment & Eligibility

• Status: NOT_YET_RECRUITING
• Sex: Female
• Target Recruitment: 33

Inclusion Criteria

• ≥18 years of age
• Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1 or 2
• Able and willing to provide informed consent.
• Histologically proven high-grade serous ovarian carcinomas (HGSOC)
• Platinum-resistant or refractory ovarian cancer (OC) defined as progression of disease on carboplatin or growth of disease as detected on computed tomography (CT) scan within 6 months of last platinum treatment
• To receive the allowable standard of care (SOC) chemotherapy regimens for OC
• Life expectancy ≥2 months
• Adequate organ and bone marrow reserve function as indicated by the following:
• Adequate hematological function, defined as absolute neutrophil count (ANC) ≥1.5 x 10^9/L, platelet count ≥100 x 10^9/L, and hemoglobin ≥8 g/dL without recent transfusion (defined as a transfusion that has occurred within 2 weeks of the hemoglobin measurement)
• Adequate liver function, defined as total bilirubin level ≥1.5 x institutional upper limit of normal (IULN), aspartate aminotransferase (AST) ≤ 2.5 x IULN, and alanine aminotransferase (ALT) ≤ 2.5 x IULN
• Adequate renal function defined as creatinine ≤ 1.5 x IULN or measured or calculated creatinine clearance ≥ 40 mL/min per institutional standard. Assessment methods must be recorded.
• Adequate coagulation, defined as international normalized ratio (INR) or prothrombin time ≤ 1.5 x IULN and activated partial thromboplastin time (aPTT) ≤ 1.5 x IULN (unless patient receiving anticoagulant therapy).
• Female patients of childbearing potential (FCBP) must agree to use highly effective contraceptive method(s) while on this study and for at least 3 months after the last dose of chemotherapy
• FCBP must have a negative serum pregnancy test at screening (within 72 hours of first dose of study medication). Non-childbearing potential is defined as 1 of the following:
• ≥ 45 years of age and has not had menses for >1 year
• Amenorrheic for > 2 years without a hysterectomy and/or oophorectomy and follicle stimulating hormone value in the postmenopausal range upon pretrial (screening) evaluation
• Status is post-hysterectomy, -oophorectomy, or -tubal ligation
• Genetic defect precluding pregnancy
• No contraindication to telmisartan*, including angiotensin converting enzyme (ACE) inhibitor use in the 6 weeks prior to telmisartan start on trial
• Systolic blood pressure maintained at ≥ 110 mm Hg during study enrollment assessment and throughout the study.

Exclusion Criteria

Patients who meet any of the criteria below may NOT be eligible to participate in this study:

• Patients who are unable to provide informed consent.
• Patients with known clinically significant liver disease, including active viral, alcoholic, or other hepatitis; and cirrhosis. For patients with evidence of chronic hepatitis B virus (HBV) infection, the HBV viral load must be undetectable on suppressive therapy, if indicated. Patients with a history of hepatitis C virus (HCV) infection must have been treated and cured. For patients with HCV infection who are currently on treatment, they must have an undetectable HCV viral load
• Hypertensive urgency or emergency as defined
• Incarcerated or homeless
• Pregnant or lactating.
• Individuals who are not yet adults <18 years of age.
• On lithium therapy in any form
• Received rituximab or amifostine within 30 days prior to first telmisartan dose on this study
• Active, serious infection requiring treatment
• Clinically significant (i.e., active) cardiovascular disease, cerebral vascular accident/stroke or myocardial infarction within 6 months of enrollment, unstable angina, congestive heart failure (New York Heart Association class ≥II), or serious uncontrolled cardiac arrhythmia requiring medication
• History or current evidence of any condition, therapy, and active infections, or laboratory abnormality that might confound the results of the trial, interfere with the patient's participation for the full duration of the trial, or is not in the best interest of the patient to participate, in the opinion of the treating investigator
• Taking ramapril
• Using bevacizumab as part of their SOC chemotherapy regimen
• If known to be HIV-infected, have undetectable HIV viral load by any accepted standard of care HIV detection method

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Telmisartan with Standard of Care Treatment	Telmisartan	oral telmisartan in combination with standard of care chemotherapy. chemotherapy regimen is preferably doxorubicin (preferably liposomal doxorubicin) but paclitaxel, nab-paclitaxel, or docetaxel are allowed per investigator or patient preference

Primary Outcome Measures

Name	Time	Method
Progression free survival	48 months	Progression free survival is defined as the time between the initiation of telmisartan to progression, as defined by RECIST criteria, on a computed tomography scan.

Secondary Outcome Measures

Name	Time	Method
Treatment tolerability	24 months	Treatment tolerability will be quantified as the proportion of patients with a toxicity related to telmisartan and the proportion of patients who stopped telmisartan due to its toxicity
Circulating tumor DNA changes	24 months	Peripheral blood will be drawn throughout the study and tested for circulating tumor DNA (ctDNA) damage. The goal is to understand tumor genetic changes in response to adding telmisartan to test if changes predictive of treatment response or failure can be detected.

Trial Locations

Locations (1)

Dartmouth Hitchcock; 🇺🇸 Lebanon, New Hampshire, United States