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Study of Tremelimumab Alone or Combined With Olaparib for Patients With Persistent EOC (Epithelial Ovarian, Fallopian Tube or Primary Peritoneal Carcinoma)

Phase 1
Terminated
Conditions
Primary Peritoneal Carcinoma
Interventions
Registration Number
NCT02485990
Lead Sponsor
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Brief Summary

This study will be looking at what dose of tremelimumab and olaparib is safe and effective in patients with persistent EOC (Epithelial Ovarian, Fallopian Tube or Primary Peritoneal Carcinoma).

Detailed Description

This clinical trial was initially intended to be a Phase 1/2 trial, but the trial never moved forward to Phase 2 prior to termination.

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
24
Inclusion Criteria
  1. Signed informed consent form
  2. Age ≥ 18 years
  3. Recurrent or persistent EOC (epithelial ovarian, fallopian tube or primary peritoneal carcinoma)
  4. Have archival tissue or willingness to undergo a tumor biopsy
  5. Have measurable disease
  6. Have had one prior taxane-platinum-based chemotherapeutic regimen
  7. Have had a treatment-free interval following platinum-based therapy of less than 12 months, have progressed during platinum-based therapy, or had persistent disease after a platinum-based regimen
  8. Have received hormonal therapy
  9. ECOG Performance Status of 0 to 1
  10. Ability to take oral medications
  11. HIV, HTLV-1, HBV, and HCV negative
  12. Adequate organ and bone marrow function as defined by study-specified laboratory tests
  13. Normal blood coagulation parameters
  14. Life expectancy greater than 16 weeks
  15. Must use acceptable form of birth control through the study and for 28 days after final dose of study drug
  16. Willing and able to comply with study procedures
Exclusion Criteria
  1. Prior therapy with an anti-CTLA-4 antibody or PARP inhibitor
  2. Active infection requiring antibiotics
  3. Active autoimmune disease
  4. Active and uncontrolled intercurrent illness
  5. History of other cancers within the past 5 years
  6. Systemically active steroid use
  7. Receiving systemic chemotherapy or radiotherapy within 4 weeks prior to the first dose of study drug
  8. Use of ketoconazole, itraconazole, ritonavir, indinavir, saquinavir, telithromycin, clarithromycin and nelfinavir
  9. Requirement for chronic parenteral hydration/nutrition
  10. Vaccination with live attenuated vaccine within 1 month prior to first dose of study drug
  11. Patients with untreated brain metastases, treated brain metastases that are not stable, leptomeningeal disease, or seizures uncontrolled with standard medical therapy
  12. Patients with myelodysplastic syndrome/acute myeloid leukaemia
  13. History of diverticulitis
  14. History of bleeding disorder or diathesis.
  15. Serious or nonhealing wound, ulcer, bone fracture, or osteonecrosis of the jaw
  16. Major surgical procedure within 28 days of study enrollment, or anticipated while on study.
  17. Pregnant or breast feeding woman

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Arm A: Tremelimumab AloneTremelimumab25 patients will receive tremelimumab alone at 10 mg/kg IV every 4 weeks for 7 doses then every 12 weeks until disease progression.
Arm B1: DESE Tremelimumab and OlaparibOlaparib18 patients will receive tremelimumab (3 or 10 mg/kg IV) every 4 weeks for 7 doses then every 12 weeks and olaparib (150 or 300 mg orally twice a day) until disease progression.
Arm B1: DESE Tremelimumab and OlaparibTremelimumab18 patients will receive tremelimumab (3 or 10 mg/kg IV) every 4 weeks for 7 doses then every 12 weeks and olaparib (150 or 300 mg orally twice a day) until disease progression.
Arm B2: Tremelimumab and OlaparibOlaparib25 patients will receive tremelimumab (every 4 weeks for 7 doses then every 12 weeks) and olaparib (daily) until disease progression. Dose of tremelimumab and olaparib will be determined during the DESE (Arm B1).
Arm B2: Tremelimumab and OlaparibTremelimumab25 patients will receive tremelimumab (every 4 weeks for 7 doses then every 12 weeks) and olaparib (daily) until disease progression. Dose of tremelimumab and olaparib will be determined during the DESE (Arm B1).
Primary Outcome Measures
NameTimeMethod
Adverse events as a measure of the safety and tolerability profile of tremelimumab in combination with olaparib4 years

Number of participants experiencing study drug-related dose limiting toxicities (DLTs). Dose escalation (phase I) portion of the trial only.

Maximum Tolerated Dose (MTD) of tremelimumab combined with olaparib4 years

Dose escalation (phase I) portion of the trial only.

Fold change from baseline in the ratio of peripheral CD4+ICOShi T cells and Regulatory T cells4 years

Dose escalation (phase I) portion of the trial only.

Secondary Outcome Measures
NameTimeMethod
Progression Free Survival (PFS) Rate at 6 months by irRECIST6 months

PFS rate is defined as the percentage of patients with disease progression (irPD or relapse from irCR as assessed using irRECIST criteria) or death due to any cause at 6 months. Per irRECIST criteria, irCR = disappearance of all lesions, irPR is =\>30% decrease in tumor burden, irPD is \>20% increase in tumor burden compared with nadir, irSD is \<30% decrease in tumor burden compared with baseline cannot be established nor \<20% increase compared with nadir. Estimation based on the Kaplan-Meier curve.

Objective Response Rate (ORR) by RECIST4 years

Objective Response Rate (ORR) is defined as the percentage of patients achieving a complete response (CR) or partial response (PR) based on RECIST 1.1 criteria. Per RECIST 1.1 criteria, CR = disappearance of all target lesions and PR is =\>30% decrease in sum of diameters of target lesions.

Objective Response Rate (ORR) by irRECIST4 years

Objective Response Rate (irORR) is defined as the percentage of patients achieving a complete response (irCR) or partial response (irPR) based on irRECIST criteria. Per irRECIST criteria, irCR = disappearance of all lesions and irPR is =\>30% decrease in tumor burden.

Disease Control Rate (DCR)4 years

DCR is defined as the number of patients achieving a complete response (CR) or partial response (PR) or stable disease (SD) based on RECIST 1.1 criteria at any time during the study. CR = disappearance of all target lesions, PR is =\>30% decrease in sum of diameters of target lesions, PD is \>20% increase in sum of diameters of target lesions, SD is \<30% decrease or \<20% increase in sum of diameters of target lesions. Estimation based on the Kaplan-Meier curve.

Progression-Free Survival (PFS)4 years

PFS is defined as the number of patients with disease progression (progressive disease \[PD\] or relapse from complete response \[CR\] as assessed using RECIST 1.1 criteria) or death due to any cause. Per RECIST 1.1 criteria, CR = disappearance of all target lesions, Partial Response (PR) is =\>30% decrease in sum of diameters of target lesions, Progressive Disease (PD) is \>20% increase in sum of diameters of target lesions, Stable Disease (SD) is \<30% decrease or \<20% increase in sum of diameters of target lesions. Estimation based on the Kaplan-Meier curve.

Overall Survival (OS)4 years

OS will be measured from date of first dose until death or end of followup (OS will be censored on the date the subject was last known to be alive for subjects without documentation of death at the time of analysis). Estimation based on the Kaplan-Meier curve.

Progression Free Survival (PFS) Rate at 6 months by RECIST6 months

PFS rate is defined as the percentage of patients with disease progression (PD or relapse from CR as assessed using RECIST 1.1 criteria) or death due to any cause at 6 months. Per RECIST 1.1 criteria, Complete Response (CR) = disappearance of all target lesions, Partial Response (PR) is =\>30% decrease in sum of diameters of target lesions, Progressive Disease (PD) is \>20% increase in sum of diameters of target lesions, Stable Disease (SD) is \<30% decrease or \<20% increase in sum of diameters of target lesions. Estimation based on the Kaplan-Meier curve.

Duration of Response by irRECIST4 years

Number of months from the start date of irPR or irCR (whichever response is recorded first) and subsequently confirmed to the first date that recurrent or progressive disease or death is documented. Per irRECIST criteria, irCR = disappearance of all lesions, irPR is =\>30% decrease in tumor burden, and irPD is is \>20% increase in tumor burden compared with nadir.

Duration of Response by RECIST4 years

Number of months from the start date of PR or CR (whichever response is recorded first) and subsequently confirmed to the first date that recurrent or progressive disease or death is documented. Per RECIST 1.1 criteria, CR = disappearance of all target lesions, PR is =\>30% decrease in sum of diameters of target lesions, and PD is \>20% increase in sum of diameters of target lesions.

Trial Locations

Locations (1)

Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

🇺🇸

Baltimore, Maryland, United States

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