Testing the Combination of Cediranib and Olaparib in Comparison to Each Drug Alone or Other Chemotherapy in Recurrent Platinum-Resistant Ovarian Cancer

Phase 2

Active, not recruiting

Conditions: Fallopian Tube Clear Cell Adenocarcinoma
Fallopian Tube Endometrioid Adenocarcinoma
Fallopian Tube Serous Adenocarcinoma
Fallopian Tube Transitional Cell Carcinoma
Fallopian Tube Undifferentiated Carcinoma
Ovarian Clear Cell Adenocarcinoma
Ovarian Endometrioid Adenocarcinoma
Ovarian Seromucinous Carcinoma
Ovarian Serous Adenocarcinoma
Ovarian Transitional Cell Carcinoma

Interventions: Procedure: Computed Tomography
Drug: Cediranib
Procedure: Magnetic Resonance Imaging
Drug: Cediranib Maleate
Drug: Paclitaxel
Drug: Pegylated Liposomal Doxorubicin Hydrochloride
Other: Questionnaire Administration
Drug: Olaparib
Drug: Topotecan
Drug: Topotecan Hydrochloride

Registration Number: NCT02502266

Lead Sponsor: National Cancer Institute (NCI)

Brief Summary: This randomized phase II/III trial studies how well cediranib maleate and olaparib work when given together or separately, and compares them to standard chemotherapy in treating patients with ovarian, fallopian tube, or primary peritoneal cancer that has returned (recurrent) after receiving chemotherapy with drugs that contain platinum (platinum-resistant) or continued to grow while being treated with platinum-based chemotherapy drugs (platinum-refractory). Cediranib maleate and olaparib may stop the growth of tumor cells by blocking enzymes needed for cell growth. Chemotherapy drugs work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. It is not yet known whether giving cediranib maleate and olaparib together may cause more damage to cancer cells when compared to either drug alone or standard chemotherapy.

Detailed Description: PRIMARY OBJECTIVES:

I. To assess the efficacy and identify (in)active arm(s) of the combination of cediranib maleate (cediranib) and olaparib, cediranib alone, olaparib alone, and physician's choice standard of care chemotherapy, as measured by progression-free survival (PFS) in the setting of recurrent platinum-resistant or-refractory ovarian, primary peritoneal or fallopian tube cancer. (Phase II) II. To assess the efficacy of the combination of cediranib and olaparib, and cediranib monotherapy, as measured by overall survival (OS) and PFS, as compared to physician's choice standard of care chemotherapy in women with recurrent platinum-resistant or-refractory ovarian, primary peritoneal or fallopian tube cancer. (Phase III)

SECONDARY OBJECTIVES:

I. To assess the efficacy of the combination of cediranib and olaparib, cediranib alone, olaparib alone, and physician's choice standard of care chemotherapy, as measured by objective response rate (ORR: partial or complete response) by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria, in the setting of recurrent platinum-resistant or-refractory ovarian, primary peritoneal or fallopian tube cancer. (Phase II) II. To assess safety endpoints, as measured by frequency and severity of adverse events by Common Terminology Criteria for Adverse Events (CTCAE). (Phase II and Phase III) III. To assess the efficacy of the combination of cediranib and olaparib, and cediranib monotherapy, as measured by ORR as compared to physician's choice standard of care chemotherapy in the setting of recurrent platinum-resistant or-refractory ovarian, primary peritoneal or fallopian tube cancer. (Phase III)

OBJECTIVES WITH INTEGRATED BIOMARKERS:

I. To assess correlation of homologous recombination deficiency (HRD) status, as assessed via BROCA-HR assay with response, as measured by PFS and ORR. (Phase II) II. To evaluate the prognostic and predictive role of circulating endothelial cells (CEC) on comparative effectiveness of targeted therapies and reference chemotherapy. (Phase II) III. To evaluate quality of life data compliance, as measured by the 9-item Disease Related Symptoms (DRS-9) subscale of the National Comprehensive Cancer Network (NCCN)-Functional Assessment of Cancer Therapy (FACT) Ovarian Symptom Index (NFOSI) for utilization and analysis in the Phase III study. (Phase II) IV. To assess correlation of HRD status, as assessed via BROCA-HR assay with response, as measured by OS, PFS and ORR. (Phase III) V. To evaluate the prognostic and predictive role of circulating endothelial cells (CEC) on comparative effectiveness of targeted therapies and reference chemotherapy. (Phase III) VI. To assess the effect on disease-related symptoms (DRS) as measured by the 9-item DRS-P subscale of the NCCN-FACT Ovarian Symptom Index-18 (NFOSI-18), of single agent cediranib and cediranib/olaparib combination, compared to standard chemotherapy, in the setting of recurrent platinum-resistant or-refractory ovarian, primary peritoneal or fallopian tube cancer. (Phase III)

EXPLORATORY OBJECTIVES:

I. To assess exploratory biomarkers of potential HRD, including genomic scarring, BRCA1 methylation, BRCA1 protein expression, and mutations in NHEJ, and other genes that might modify HRD. (Phase II and Phase III) II. To evaluate the prognostic and predictive role of angiogenic biomarkers, as assessed by the Duke plasma angiome. (Phase II and Phase III) III. To assess the effect on secondary measures of quality of life, as assessed by the treatment side effects (TSE) and function/well-being (F/WB) subscales of the NFOSI-18, sensory neuropathy as measured by the FACT/GOG-Ntx-4, and health utility as measured by the EQ-5D, of single agent cediranib and cediranib/olaparib combination, compared to standard chemotherapy, in the setting of recurrent platinum-resistant or-refractory ovarian, primary peritoneal or fallopian tube cancer. (Phase III)

OUTLINE:

PHASE II: Patients are randomized to 1 of 4 treatment arms.

ARM I (REFERENCE REGIMEN): Patients undergo physician's choice of standard of care chemotherapy, comprising either paclitaxel intravenously (IV) over 60 minutes on days 1, 8, 15, and 22 every 28 days (Regimen I); pegylated liposomal doxorubicin hydrochloride IV over 60 minutes on day 1 every 28 days (Regimen II); or topotecan hydrochloride IV over 30 minutes on days 1, 8, and 15 every 28 days or days 1-5 every 21 days (Regimen III). Treatment continues in the absence of disease progression or unacceptable toxicity. No modification of the assigned regimens, such as additional drugs (gemcitabine, or bevacizumab) is allowed. Patients also undergo computed tomography (CT) and magnetic resonance imaging (MRI) throughout the study. (12/05/2016)

ARM II (CEDIRANIB MALEATE AND OLAPARIB): Patients receive cediranib maleate orally (PO) once daily (QD) and olaparib PO twice daily (BID). Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo CT and MRI throughout the study.

ARM III (CEDIRANIB): Patients receive cediranib maleate PO daily continuously. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo CT and MRI throughout the study.

ARM IV (OLAPARIB): Patients receive olaparib PO BID on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo CT and MRI throughout the study. (In July 2018, the Data Monitoring Committee voted to exclude the olaparib alone regimen).

PHASE III: Patients are randomized to 1 of 3 treatment arms.

ARM I (REFERENCE REGIMEN): Patients undergo physician's choice standard of care chemotherapy as in Phase II Arm I. No modification of the assigned regimens, such as additional drugs (gemcitabine or bevacizumab) is allowed. Patients also undergo CT and MRI throughout the study. (12/05/2016)

ARM II (CEDIRANIB AND OLAPARIB): Patients receive cediranib maleate PO and olaparib PO as in Phase II Arm II. Patients also undergo CT and MRI throughout the study.

ARM III (SINGLE AGENT): Patients receive cediranib maleate PO as determined by the Phase II study. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo CT and MRI throughout the study.

After completion of study treatment, patients are followed up every 3 months for 2 years and then every 6 months for up to 3 years.

Recruitment & Eligibility

Status: ACTIVE_NOT_RECRUITING

Sex: Female

Target Recruitment: 587

Inclusion Criteria

Patients must have histologically or cytologically confirmed ovarian cancer, peritoneal cancer or fallopian tube cancer and must have a histological diagnosis of either serous or endometrioid cancer based on local histopathological findings; both endometrioid and serous histology should be high-grade for eligibility of non-mutation carriers; patients with clear cell, mixed epithelial, undifferentiated carcinoma, or transitional cell carcinoma histologies are also eligible, provided that the patient has a known deleterious germline BRCA1 or BRCA2 mutation identified through testing at a clinical laboratory
- Note: Due to the long acceptance of BRCA testing through Myriad, Myriad testing will be accepted; if testing for BRCA is done by other organizations, documentation from a qualified medical professional (e.g., ovarian cancer specialty physician involved in the field, high risk genetics physician, genetics counselor) listing the mutation and confirming that the laboratory results showed a recognized germ line deleterious BRCA 1 or BRCA 2 mutation or BRCA rearrangement is required (12/05/2016); a copy of Myriad or other BRCA mutational analysis (positive or variants of unknown significance [VUS] or negative) reports will be requested but not required for study enrollment
Patients should have recurrent platinum-resistant or- refractory disease - defined as disease that has progressed by imaging while receiving platinum or had recurrence within 6 months of the last receipt of platinum-based chemotherapy; rising CA125 only is not considered as platinum-resistant or refractory disease (12/05/2016)
Phase II study: measurable disease by RECIST 1.1 criteria; if archival tumor sample is not available tumor sample from fresh biopsy is acceptable (12/05/2016)
Phase III study: evaluable disease - defined as RECIST 1.1 measurable disease OR non-measurable disease (defined as solid and/or cystic abnormalities on radiographic imaging that do not meet RECIST 1.1 definitions for target lesions OR ascites and/or pleural effusion that has been pathologically demonstrated to be disease-related in the setting of a cancer antigen [CA]125 >= 2 x upper limit of normal [ULN])
No more than 3 prior treatment regimens (including primary therapy; no more than 1 prior non-platinum based therapy in the platinum-resistant/-refractory setting); hormonal therapies used as single agents (i.e. tamoxifen, aromatase inhibitors) will not count towards this line limit (12/05/2016)
Patients may not have had a prior anti-angiogenic agent in the recurrent setting; prior use of bevacizumab in the upfront or upfront maintenance setting is allowed
Patients may not have previously received a PARP-inhibitor
Patient must have provided study specific informed consent prior to study entry
Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1 or 2
Absolute neutrophil count >= 1,500/mcL (12/05/2016)
Platelets >= 100,000/mcL (12/05/2016)
Hemoglobin >= 10 g/dL (12/05/2016)
Total bilirubin within =< 1.5 times the upper limit of normal (ULN) institutional limits (12/05/2016)
Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) =< 3 x institutional ULN; if intrahepatic liver metastases are present, AST and ALT must be =< 5 times institutional ULN (12/05/2016)
Creatinine =< 1.5 x the institutional ULN (12/05/2016)
Urine protein: creatinine ratio urine protein creatinine (UPC) of =< 1 OR less than or equal to 2+ proteinuria on two consecutive dipsticks taken no less than 1 week apart; UPC is the preferred test; patients with 2+ proteinuria on dipstick must also have a 24-hour urine collection demonstrating protein of =< 500 mg over 24 hours (12/05/2016)
Toxicities of prior therapy (excepting alopecia) should be resolved to less than or equal to grade 1 as per CTCAE; patients with long-standing stable grade 2 neuropathy may be considered after discussion with the study chair.
Adequately controlled blood pressure (systolic blood pressure [SBP] =< 140; diastolic blood pressure [DBP] =< 90 mmHg) on maximum of three antihypertensive medications; patients must have a BP of =< 140/90 mmHg taken in the clinic setting by a medical professional within 2 weeks prior to starting study; it is strongly recommended that patients who are on three antihypertensive medications be followed by a cardiologist or a primary care physician for management of BP while on protocol; patients must be willing and able to check and record daily blood pressure readings; blood pressure cuffs will be provided to patients randomized to cediranib alone and the combination of olaparib and cediranib arms (12/05/2016)
Adequately controlled thyroid function, with no symptoms of thyroid dysfunction and thyroid-stimulating hormone (TSH) within normal limits (12/05/2016)
Able to swallow and retain oral medications and without gastrointestinal (GI) illnesses that would preclude absorption of cediranib or olaparib
Age >= 18 years
Cediranib has been shown to terminate fetal development in the rat, as expected for a process dependent on VEGF signaling; for this reason, women of child-bearing potential must have a negative pregnancy test prior to study entry; women of child-bearing potential must agree to use two reliable forms of contraception (hormonal or barrier method of birth control; abstinence) prior to study entry, for the duration of study participation, and for 6 weeks after cediranib discontinuation; should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately
Olaparib adversely affects embryofetal survival and development in the rat; for this reason, women of child-bearing potential must have a negative pregnancy test prior to study entry; women of child-bearing potential must agree to use must agree to use two reliable forms of contraception (hormonal or barrier method of birth control; abstinence) prior to study entry, for the duration of study participation, and for 3 months after the last dose of olaparib; should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately

Exclusion Criteria

Patients who have had chemotherapy or radiotherapy within 4 weeks (6 weeks for nitrosoureas or mitomycin C) of starting treatment or those who have not recovered from adverse events due to agents administered more than 4 weeks earlier; patients may not have had hormonal therapy within 2 weeks prior to entering the study; patients receiving raloxifene for bone health as per Food and Drug Administration (FDA) indication may remain on raloxifene absent other drug interactions (12/05/2016)
Any other investigational agents within the past 4 weeks
Prior treatment affecting the VEGF/VEGFR pathway or the angiopoietin pathway in the recurrent setting, including but not limited to thalidomide, bevacizumab, sunitinib, sorafenib, pazopanib, cediranib, nintedanib, and trebananib; bevacizumab used in the upfront setting in conjunction with chemotherapy and/or as maintenance to treat newly diagnosed disease will be allowed
Prior use of PARP-inhibitors
CA-125 only disease without Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 measurable or otherwise evaluable disease
Major surgical procedure, open biopsy, or significant traumatic injury within 28 days prior to starting cediranib
Current signs and/or symptoms of bowel obstruction or signs and/or symptoms of bowel obstruction within 3 months prior to starting study drugs
History of intra-abdominal abscess within the past 3 months
History of gastrointestinal perforation; patients with a history of abdominal fistula will be considered eligible if the fistula was surgically repaired or has healed, there has been no evidence of fistula for at least 6 months, and patient is deemed to be at low risk of recurrent fistula (12/05/2016)
Dependency on IV hydration or total parenteral nutrition (TPN)
Any concomitant or prior invasive malignancies with the following curatively treated exceptions:
- Treated limited stage basal cell or squamous cell carcinoma of the skin
- Carcinoma in situ of the breast or cervix
- Primary endometrial cancer meeting the following conditions: stage not greater than IA, grade 1 or 2, no more than superficial myometrial invasion, without vascular or lymphatic invasion; no poorly differentiated subtypes, including papillary serous/serous, clear cell, or other Federation of Gynecology and Obstetrics (FIGO) grade 3 lesions (12/05/2016)
- Prior cancer treated with a curative intent with no evidence of recurrent disease 5 years following diagnosis and judged by the investigator to be at low risk of recurrence
Patients with untreated brain metastases, spinal cord compression, or evidence of symptomatic brain metastases or leptomeningeal disease as noted on computed tomography (CT) or magnetic resonance imaging (MRI) scans should not be included on this study, since neurologic dysfunction may confound the evaluation of neurologic and other adverse events; patients with treated brain metastases and resolution of any associated symptoms must demonstrate stable post-therapeutic imaging for at least 6 months following therapy prior to starting study drug
Patients with any of the following:
- History of myocardial infarction within six months
- Unstable angina
- Resting electrocardiogram (ECG) with clinically significant abnormal findings
- New York Heart Association functional classification of III or IV
If cardiac function assessment is clinically indicated or performed: left ventricular ejection fraction (LVEF) less than normal per institutional guidelines, or < 55%, if threshold for normal not otherwise specified by institutional guidelines
- Patients with the following risk factors should have a baseline cardiac function assessment:
  - Prior treatment with anthracyclines
  - Prior treatment with trastuzumab
  - Prior central thoracic radiation therapy (RT), including RT to the heart
  - History of myocardial infarction within 6 to 12 months (Patients with history of myocardial infarction within 6 months are excluded from the study)
  - Prior history of impaired cardiac function
History of stroke or transient ischemic attack within six months
Clinical significant peripheral vascular disease or vascular disease (aortic aneurysm or aortic dissection)
Evidence of coagulopathy or bleeding diathesis; therapeutic anticoagulation for prior thromboembolic events is permitted
Evidence suggestive of myelodysplastic syndrome (MDS) or acute myelogenous leukemia (AML) on peripheral blood smear or bone marrow biopsy, if clinically indicated
- No prior allogeneic bone marrow transplant or double umbilical cord blood transplantation (dUBCT)
Patients may not use any complementary or alternative medicines including natural herbal products or folk remedies as they may interfere with the effectiveness of the study treatments
Uncontrolled intercurrent illness including, but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia (other than atrial fibrillation with controlled ventricular rate), or psychiatric illness/social situations that would limit compliance with study requirements (12/05/2016)
Known human immunodeficiency virus (HIV)-positive individuals are ineligible because of the potential for pharmacokinetic interactions with cediranib or olaparib; in addition, these individuals are at increased risk of lethal infections when treated with marrow-suppressive therapy
Participants receiving any medications or substances that are strong inhibitors or inducers of CYP3A4 are ineligible
- Strong inhibitors and inducers of UGT/PgP should be used with caution (12/05/2016)
Pregnant women are excluded from this study because cediranib and olaparib are agents with the potential for teratogenic or abortifacient effects; because there is an unknown but potential risk of adverse events in nursing infants secondary to treatment of the mother with cediranib and olaparib, breastfeeding should be discontinued if the mother is treated with cediranib or olaparib; these potential risks may also apply to other agents used in this study

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Phase II Arm I (reference regimen)	Computed Tomography	Patients undergo physician's choice of standard of care chemotherapy, comprising either paclitaxel IV over 60 minutes on days 1, 8, 15, and 22 every 28 days (Regimen I); pegylated liposomal doxorubicin hydrochloride IV over 60 minutes on day 1 every 28 days (Regimen II); or topotecan hydrochloride IV over 30 minutes on days 1, 8, and 15 every 28 days or days 1-5 every 21 days (Regimen III). Treatment continues in the absence of disease progression or unacceptable toxicity. No modification of the assigned regimens, such as additional drugs (gemcitabine, or bevacizumab) is allowed. Patients also undergo CT and MRI throughout the study. (12/05/2016)
Phase II Arm I (reference regimen)	Magnetic Resonance Imaging	Patients undergo physician's choice of standard of care chemotherapy, comprising either paclitaxel IV over 60 minutes on days 1, 8, 15, and 22 every 28 days (Regimen I); pegylated liposomal doxorubicin hydrochloride IV over 60 minutes on day 1 every 28 days (Regimen II); or topotecan hydrochloride IV over 30 minutes on days 1, 8, and 15 every 28 days or days 1-5 every 21 days (Regimen III). Treatment continues in the absence of disease progression or unacceptable toxicity. No modification of the assigned regimens, such as additional drugs (gemcitabine, or bevacizumab) is allowed. Patients also undergo CT and MRI throughout the study. (12/05/2016)
Phase II Arm I (reference regimen)	Paclitaxel	Patients undergo physician's choice of standard of care chemotherapy, comprising either paclitaxel IV over 60 minutes on days 1, 8, 15, and 22 every 28 days (Regimen I); pegylated liposomal doxorubicin hydrochloride IV over 60 minutes on day 1 every 28 days (Regimen II); or topotecan hydrochloride IV over 30 minutes on days 1, 8, and 15 every 28 days or days 1-5 every 21 days (Regimen III). Treatment continues in the absence of disease progression or unacceptable toxicity. No modification of the assigned regimens, such as additional drugs (gemcitabine, or bevacizumab) is allowed. Patients also undergo CT and MRI throughout the study. (12/05/2016)
Phase II Arm I (reference regimen)	Questionnaire Administration	Patients undergo physician's choice of standard of care chemotherapy, comprising either paclitaxel IV over 60 minutes on days 1, 8, 15, and 22 every 28 days (Regimen I); pegylated liposomal doxorubicin hydrochloride IV over 60 minutes on day 1 every 28 days (Regimen II); or topotecan hydrochloride IV over 30 minutes on days 1, 8, and 15 every 28 days or days 1-5 every 21 days (Regimen III). Treatment continues in the absence of disease progression or unacceptable toxicity. No modification of the assigned regimens, such as additional drugs (gemcitabine, or bevacizumab) is allowed. Patients also undergo CT and MRI throughout the study. (12/05/2016)
Phase II Arm I (reference regimen)	Topotecan	Patients undergo physician's choice of standard of care chemotherapy, comprising either paclitaxel IV over 60 minutes on days 1, 8, 15, and 22 every 28 days (Regimen I); pegylated liposomal doxorubicin hydrochloride IV over 60 minutes on day 1 every 28 days (Regimen II); or topotecan hydrochloride IV over 30 minutes on days 1, 8, and 15 every 28 days or days 1-5 every 21 days (Regimen III). Treatment continues in the absence of disease progression or unacceptable toxicity. No modification of the assigned regimens, such as additional drugs (gemcitabine, or bevacizumab) is allowed. Patients also undergo CT and MRI throughout the study. (12/05/2016)
Phase II Arm I (reference regimen)	Topotecan Hydrochloride	Patients undergo physician's choice of standard of care chemotherapy, comprising either paclitaxel IV over 60 minutes on days 1, 8, 15, and 22 every 28 days (Regimen I); pegylated liposomal doxorubicin hydrochloride IV over 60 minutes on day 1 every 28 days (Regimen II); or topotecan hydrochloride IV over 30 minutes on days 1, 8, and 15 every 28 days or days 1-5 every 21 days (Regimen III). Treatment continues in the absence of disease progression or unacceptable toxicity. No modification of the assigned regimens, such as additional drugs (gemcitabine, or bevacizumab) is allowed. Patients also undergo CT and MRI throughout the study. (12/05/2016)
Phase II Arm II (cediranib maleate, olaparib)	Cediranib	Patients receive cediranib maleate PO QD and olaparib PO BID. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo CT and MRI throughout the study.
Phase II Arm II (cediranib maleate, olaparib)	Cediranib Maleate	Patients receive cediranib maleate PO QD and olaparib PO BID. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo CT and MRI throughout the study.
Phase II Arm III (cediranib maleate)	Cediranib	Patients receive cediranib maleate PO daily continuously. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo CT and MRI throughout the study.
Phase II Arm II (cediranib maleate, olaparib)	Computed Tomography	Patients receive cediranib maleate PO QD and olaparib PO BID. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo CT and MRI throughout the study.
Phase II Arm II (cediranib maleate, olaparib)	Magnetic Resonance Imaging	Patients receive cediranib maleate PO QD and olaparib PO BID. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo CT and MRI throughout the study.
Phase II Arm II (cediranib maleate, olaparib)	Questionnaire Administration	Patients receive cediranib maleate PO QD and olaparib PO BID. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo CT and MRI throughout the study.
Phase II Arm III (cediranib maleate)	Cediranib Maleate	Patients receive cediranib maleate PO daily continuously. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo CT and MRI throughout the study.
Phase II Arm III (cediranib maleate)	Computed Tomography	Patients receive cediranib maleate PO daily continuously. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo CT and MRI throughout the study.
Phase II Arm III (cediranib maleate)	Magnetic Resonance Imaging	Patients receive cediranib maleate PO daily continuously. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo CT and MRI throughout the study.
Phase II Arm III (cediranib maleate)	Questionnaire Administration	Patients receive cediranib maleate PO daily continuously. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo CT and MRI throughout the study.
Phase II Arm IV (olaparib)	Computed Tomography	Patients receive olaparib PO BID on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo CT and MRI throughout the study. (In July 2018, the Data Monitoring Committee voted to exclude the olaparib alone regimen).
Phase II Arm IV (olaparib)	Magnetic Resonance Imaging	Patients receive olaparib PO BID on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo CT and MRI throughout the study. (In July 2018, the Data Monitoring Committee voted to exclude the olaparib alone regimen).
Phase II Arm IV (olaparib)	Questionnaire Administration	Patients receive olaparib PO BID on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo CT and MRI throughout the study. (In July 2018, the Data Monitoring Committee voted to exclude the olaparib alone regimen).
Phase III Arm I (reference regimen)	Computed Tomography	Patients undergo physician's choice standard of care chemotherapy as in Phase II Arm I. No modification of the assigned regimens, such as additional drugs (gemcitabine or bevacizumab) is allowed. Patients also undergo CT and MRI throughout the study. (12/05/2016)
Phase III Arm I (reference regimen)	Magnetic Resonance Imaging	Patients undergo physician's choice standard of care chemotherapy as in Phase II Arm I. No modification of the assigned regimens, such as additional drugs (gemcitabine or bevacizumab) is allowed. Patients also undergo CT and MRI throughout the study. (12/05/2016)
Phase III Arm I (reference regimen)	Paclitaxel	Patients undergo physician's choice standard of care chemotherapy as in Phase II Arm I. No modification of the assigned regimens, such as additional drugs (gemcitabine or bevacizumab) is allowed. Patients also undergo CT and MRI throughout the study. (12/05/2016)
Phase III Arm I (reference regimen)	Questionnaire Administration	Patients undergo physician's choice standard of care chemotherapy as in Phase II Arm I. No modification of the assigned regimens, such as additional drugs (gemcitabine or bevacizumab) is allowed. Patients also undergo CT and MRI throughout the study. (12/05/2016)
Phase III Arm I (reference regimen)	Topotecan Hydrochloride	Patients undergo physician's choice standard of care chemotherapy as in Phase II Arm I. No modification of the assigned regimens, such as additional drugs (gemcitabine or bevacizumab) is allowed. Patients also undergo CT and MRI throughout the study. (12/05/2016)
Phase III Arm II (cediranib maleate, olaparib)	Cediranib Maleate	Patients receive cediranib maleate PO and olaparib PO as in Phase II Arm II. Patients also undergo CT and MRI throughout the study.
Phase III Arm II (cediranib maleate, olaparib)	Computed Tomography	Patients receive cediranib maleate PO and olaparib PO as in Phase II Arm II. Patients also undergo CT and MRI throughout the study.
Phase III Arm II (cediranib maleate, olaparib)	Magnetic Resonance Imaging	Patients receive cediranib maleate PO and olaparib PO as in Phase II Arm II. Patients also undergo CT and MRI throughout the study.
Phase III Arm II (cediranib maleate, olaparib)	Questionnaire Administration	Patients receive cediranib maleate PO and olaparib PO as in Phase II Arm II. Patients also undergo CT and MRI throughout the study.
Phase III Arm III (single-agent cediranib maleate)	Cediranib Maleate	Patients receive cediranib maleate PO as determined by the Phase II study. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo CT and MRI throughout the study.
Phase III Arm III (single-agent cediranib maleate)	Computed Tomography	Patients receive cediranib maleate PO as determined by the Phase II study. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo CT and MRI throughout the study.
Phase III Arm III (single-agent cediranib maleate)	Magnetic Resonance Imaging	Patients receive cediranib maleate PO as determined by the Phase II study. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo CT and MRI throughout the study.
Phase III Arm III (single-agent cediranib maleate)	Questionnaire Administration	Patients receive cediranib maleate PO as determined by the Phase II study. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo CT and MRI throughout the study.
Phase II Arm I (reference regimen)	Pegylated Liposomal Doxorubicin Hydrochloride	Patients undergo physician's choice of standard of care chemotherapy, comprising either paclitaxel IV over 60 minutes on days 1, 8, 15, and 22 every 28 days (Regimen I); pegylated liposomal doxorubicin hydrochloride IV over 60 minutes on day 1 every 28 days (Regimen II); or topotecan hydrochloride IV over 30 minutes on days 1, 8, and 15 every 28 days or days 1-5 every 21 days (Regimen III). Treatment continues in the absence of disease progression or unacceptable toxicity. No modification of the assigned regimens, such as additional drugs (gemcitabine, or bevacizumab) is allowed. Patients also undergo CT and MRI throughout the study. (12/05/2016)
Phase III Arm I (reference regimen)	Pegylated Liposomal Doxorubicin Hydrochloride	Patients undergo physician's choice standard of care chemotherapy as in Phase II Arm I. No modification of the assigned regimens, such as additional drugs (gemcitabine or bevacizumab) is allowed. Patients also undergo CT and MRI throughout the study. (12/05/2016)
Phase II Arm II (cediranib maleate, olaparib)	Olaparib	Patients receive cediranib maleate PO QD and olaparib PO BID. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo CT and MRI throughout the study.
Phase II Arm IV (olaparib)	Olaparib	Patients receive olaparib PO BID on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo CT and MRI throughout the study. (In July 2018, the Data Monitoring Committee voted to exclude the olaparib alone regimen).
Phase III Arm I (reference regimen)	Topotecan	Patients undergo physician's choice standard of care chemotherapy as in Phase II Arm I. No modification of the assigned regimens, such as additional drugs (gemcitabine or bevacizumab) is allowed. Patients also undergo CT and MRI throughout the study. (12/05/2016)
Phase III Arm II (cediranib maleate, olaparib)	Cediranib	Patients receive cediranib maleate PO and olaparib PO as in Phase II Arm II. Patients also undergo CT and MRI throughout the study.
Phase III Arm II (cediranib maleate, olaparib)	Olaparib	Patients receive cediranib maleate PO and olaparib PO as in Phase II Arm II. Patients also undergo CT and MRI throughout the study.
Phase III Arm III (single-agent cediranib maleate)	Cediranib	Patients receive cediranib maleate PO as determined by the Phase II study. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo CT and MRI throughout the study.

Primary Outcome Measures

Name	Time	Method
Progression-free survival (PFS) (Phase II and Phase III)	Time from study enrollment to the onset of progression as determined by Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST) criteria, or death due to any cause, whichever occurs first, assessed up to 5 years	Progression-free survival will be assessed. The primary analysis of PFS will be assessed using a proportional hazards model with patients analyzed according to the arm to which they were randomized, regardless of whether treatment is received.
Overall survival (OS) (Phase III)	Time from study enrollment to death due to any cause, assessed up to 5 years	Overall survival will be evaluated. To allow for better understanding of time to subsequent therapy and OS, patients on experimental study drug(s) or standard chemotherapy arm will be followed after progression, with data capture to include the date of initiation of the subsequent therapy, detailed information on the type of subsequent therapy received, and time to progression on the subsequent therapy.

Secondary Outcome Measures

Name	Time	Method
Incidence of adverse events (Phase II and Phase III)	Up to 5 years	Frequency and severity of adverse events measured by Common Terminology Criteria for Adverse Events version 4.0
Objective response rate (partial or complete response) (Phase II and Phase III)	Up to 5 years	Objective response rate will be defined by RECIST 1.1.

Trial Locations

Locations (400): West Penn Hospital
🇺🇸
Pittsburgh, Pennsylvania, United States
Pacific Gynecology Specialists
🇺🇸
Seattle, Washington, United States
Women's Cancer Center of Seattle
🇺🇸
Seattle, Washington, United States
University of Washington Medical Center - Montlake
🇺🇸
Seattle, Washington, United States
Good Samaritan Hospital - Cincinnati
🇺🇸
Cincinnati, Ohio, United States
TriHealth Cancer Institute-Westside
🇺🇸
Cincinnati, Ohio, United States
UC San Diego Moores Cancer Center
🇺🇸
La Jolla, California, United States
Palo Alto Medical Foundation-Camino Division
🇺🇸
Mountain View, California, United States
Kaiser Permanente-Oakland
🇺🇸
Oakland, California, United States
Alaska Women's Cancer Care
🇺🇸
Anchorage, Alaska, United States
Mercy San Juan Medical Center
🇺🇸
Carmichael, California, United States
Pacific Central Coast Health Center-San Luis Obispo
🇺🇸
San Luis Obispo, California, United States
The Hospital of Central Connecticut
🇺🇸
New Britain, Connecticut, United States
Palo Alto Medical Foundation-Gynecologic Oncology
🇺🇸
Mountain View, California, United States
Alta Bates Summit Medical Center-Herrick Campus
🇺🇸
Berkeley, California, United States
Mercy Cancer Center - Elk Grove
🇺🇸
Elk Grove, California, United States
Providence Alaska Medical Center
🇺🇸
Anchorage, Alaska, United States
Emory University Hospital Midtown
🇺🇸
Atlanta, Georgia, United States
UCHealth Highlands Ranch Hospital
🇺🇸
Highlands Ranch, Colorado, United States
Wellstar Kennestone Hospital
🇺🇸
Marietta, Georgia, United States
Saint Luke's Cancer Institute - Meridian
🇺🇸
Meridian, Idaho, United States
Saint Alphonsus Cancer Care Center-Boise
🇺🇸
Boise, Idaho, United States
UCHealth Memorial Hospital Central
🇺🇸
Colorado Springs, Colorado, United States
Kaiser Permanente-Vallejo
🇺🇸
Vallejo, California, United States
Sutter Roseville Medical Center
🇺🇸
Roseville, California, United States
Kaiser Permanente Medical Center - Santa Clara
🇺🇸
Santa Clara, California, United States
Kaiser Permanente-Rock Creek
🇺🇸
Lafayette, Colorado, United States
Smilow Cancer Hospital Care Center-Trumbull
🇺🇸
Trumbull, Connecticut, United States
Helen F Graham Cancer Center
🇺🇸
Newark, Delaware, United States
Kaiser Permanente-Walnut Creek
🇺🇸
Walnut Creek, California, United States
WellStar North Fulton Hospital
🇺🇸
Roswell, Georgia, United States
Smilow Cancer Hospital Care Center at Saint Francis
🇺🇸
Hartford, Connecticut, United States
Middlesex Hospital
🇺🇸
Middletown, Connecticut, United States
Saint Luke's Cancer Institute - Nampa
🇺🇸
Nampa, Idaho, United States
Sibley Memorial Hospital
🇺🇸
Washington, District of Columbia, United States
Augusta University Medical Center
🇺🇸
Augusta, Georgia, United States
Lewis Cancer and Research Pavilion at Saint Joseph's/Candler
🇺🇸
Savannah, Georgia, United States
WellStar Health System Inc
🇺🇸
Marietta, Georgia, United States
Penrose-Saint Francis Healthcare
🇺🇸
Colorado Springs, Colorado, United States
Northside Hospital
🇺🇸
Atlanta, Georgia, United States
Centralia Oncology Clinic
🇺🇸
Centralia, Illinois, United States
Illinois CancerCare-Carthage
🇺🇸
Carthage, Illinois, United States
Associates In Womens Health
🇺🇸
Wichita, Kansas, United States
WellStar Cobb Hospital
🇺🇸
Austell, Georgia, United States
WellStar Vinings Health Park
🇺🇸
Smyrna, Georgia, United States
Saint Luke's Cancer Institute - Fruitland
🇺🇸
Fruitland, Idaho, United States
Rush University Medical Center
🇺🇸
Chicago, Illinois, United States
Saint Luke's Cancer Institute - Boise
🇺🇸
Boise, Idaho, United States
Parkview Regional Medical Center
🇺🇸
Fort Wayne, Indiana, United States
Northwestern Medicine Cancer Center Delnor
🇺🇸
Geneva, Illinois, United States
Illinois CancerCare-Eureka
🇺🇸
Eureka, Illinois, United States
Mary Bird Perkins Cancer Center
🇺🇸
Baton Rouge, Louisiana, United States
Eastern Maine Medical Center
🇺🇸
Bangor, Maine, United States
University of Iowa/Holden Comprehensive Cancer Center
🇺🇸
Iowa City, Iowa, United States
Memorial Health University Medical Center
🇺🇸
Savannah, Georgia, United States
Lafayette Family Cancer Center-EMMC
🇺🇸
Brewer, Maine, United States
Northwestern University
🇺🇸
Chicago, Illinois, United States
Springfield Clinic
🇺🇸
Springfield, Illinois, United States
Hematology/Oncology Clinic PLLC
🇺🇸
Baton Rouge, Louisiana, United States
Decatur Memorial Hospital
🇺🇸
Decatur, Illinois, United States
Memorial Medical Center
🇺🇸
Springfield, Illinois, United States
Illinois CancerCare-Galesburg
🇺🇸
Galesburg, Illinois, United States
Illinois CancerCare-Peru
🇺🇸
Peru, Illinois, United States
OSF Saint Francis Hospital and Medical Group
🇺🇸
Escanaba, Michigan, United States
Henry Ford Cancer Institute-Downriver
🇺🇸
Brownstown, Michigan, United States
John H Stroger Jr Hospital of Cook County
🇺🇸
Chicago, Illinois, United States
Indiana University/Melvin and Bren Simon Cancer Center
🇺🇸
Indianapolis, Indiana, United States
Woman's Hospital
🇺🇸
Baton Rouge, Louisiana, United States
Illinois CancerCare-Princeton
🇺🇸
Princeton, Illinois, United States
Crossroads Cancer Center
🇺🇸
Effingham, Illinois, United States
Sudarshan K Sharma MD Limited-Gynecologic Oncology
🇺🇸
Hinsdale, Illinois, United States
Mercy Cancer Center-West Lakes
🇺🇸
Clive, Iowa, United States
Illinois CancerCare-Canton
🇺🇸
Canton, Illinois, United States
Women's Cancer Care-Covington
🇺🇸
Covington, Louisiana, United States
Cancer Care Specialists of Illinois - Decatur
🇺🇸
Decatur, Illinois, United States
Saint Elizabeth Healthcare Edgewood
🇺🇸
Edgewood, Kentucky, United States
Mission Cancer and Blood - West Des Moines
🇺🇸
Clive, Iowa, United States
Memorial Hospital of South Bend
🇺🇸
South Bend, Indiana, United States
Ascension Via Christi Hospitals Wichita
🇺🇸
Wichita, Kansas, United States
West Michigan Cancer Center
🇺🇸
Kalamazoo, Michigan, United States
MedStar Franklin Square Medical Center/Weinberg Cancer Institute
🇺🇸
Baltimore, Maryland, United States
Reid Health
🇺🇸
Richmond, Indiana, United States
TidalHealth Richard A Henson Cancer Institute
🇺🇸
Ocean Pines, Maryland, United States
Illinois CancerCare-Ottawa Clinic
🇺🇸
Ottawa, Illinois, United States
NorthShore University HealthSystem-Highland Park Hospital
🇺🇸
Highland Park, Illinois, United States
Illinois CancerCare-Pekin
🇺🇸
Pekin, Illinois, United States
Cancer Care Center of O'Fallon
🇺🇸
O'Fallon, Illinois, United States
TidalHealth Peninsula Regional
🇺🇸
Salisbury, Maryland, United States
Ascension Saint Vincent Indianapolis Hospital
🇺🇸
Indianapolis, Indiana, United States
University of Michigan Health - Sparrow Lansing
🇺🇸
Lansing, Michigan, United States
Morristown Medical Center
🇺🇸
Morristown, New Jersey, United States
Saint Francis Medical Center
🇺🇸
Cape Girardeau, Missouri, United States
UMass Memorial Medical Center - Memorial Division
🇺🇸
Worcester, Massachusetts, United States
Margaret R Pardee Memorial Hospital
🇺🇸
Hendersonville, North Carolina, United States
Cooper Hospital University Medical Center
🇺🇸
Camden, New Jersey, United States
Munson Medical Center
🇺🇸
Traverse City, Michigan, United States
Maine Medical Center- Scarborough Campus
🇺🇸
Scarborough, Maine, United States
Mercy Hospital Joplin
🇺🇸
Joplin, Missouri, United States
Mercy Hospital
🇺🇸
Coon Rapids, Minnesota, United States
Roswell Park Cancer Institute
🇺🇸
Buffalo, New York, United States
CHI Health Good Samaritan
🇺🇸
Kearney, Nebraska, United States
Laura and Isaac Perlmutter Cancer Center at NYU Langone
🇺🇸
New York, New York, United States
Greater Baltimore Medical Center
🇺🇸
Baltimore, Maryland, United States
Fairview Ridges Hospital
🇺🇸
Burnsville, Minnesota, United States
Johns Hopkins University/Sidney Kimmel Cancer Center
🇺🇸
Baltimore, Maryland, United States
Brigham and Women's Hospital
🇺🇸
Boston, Massachusetts, United States
Dana-Farber Cancer Institute
🇺🇸
Boston, Massachusetts, United States
Henry Ford Macomb Hospital-Clinton Township
🇺🇸
Clinton Township, Michigan, United States
Sanford Joe Lueken Cancer Center
🇺🇸
Bemidji, Minnesota, United States
UM Upper Chesapeake Medical Center
🇺🇸
Bel Air, Maryland, United States
Henry Ford West Bloomfield Hospital
🇺🇸
West Bloomfield, Michigan, United States
AdventHealth Infusion Center Haywood
🇺🇸
Clyde, North Carolina, United States
AdventHealth Infusion Center Asheville
🇺🇸
Asheville, North Carolina, United States
Memorial Medical Center - Las Cruces
🇺🇸
Las Cruces, New Mexico, United States
Regions Hospital
🇺🇸
Saint Paul, Minnesota, United States
Nebraska Cancer Specialists/Oncology Hematology West PC
🇺🇸
Grand Island, Nebraska, United States
MU Health - University Hospital/Ellis Fischel Cancer Center
🇺🇸
Columbia, Missouri, United States
Dickstein Cancer Treatment Center
🇺🇸
White Plains, New York, United States
Park Nicollet Clinic - Saint Louis Park
🇺🇸
Saint Louis Park, Minnesota, United States
Women's Cancer Care Associates LLC
🇺🇸
Albany, New York, United States
Sanford Broadway Medical Center
🇺🇸
Fargo, North Dakota, United States
State University of New York Downstate Medical Center
🇺🇸
Brooklyn, New York, United States
Legacy Mount Hood Medical Center
🇺🇸
Gresham, Oregon, United States
Mayo Clinic Health Systems-Mankato
🇺🇸
Mankato, Minnesota, United States
Minnesota Oncology Hematology PA-Woodbury
🇺🇸
Woodbury, Minnesota, United States
Barnes-Jewish Hospital
🇺🇸
Saint Louis, Missouri, United States
CoxHealth South Hospital
🇺🇸
Springfield, Missouri, United States
University of Rochester
🇺🇸
Rochester, New York, United States
Sanford Bismarck Medical Center
🇺🇸
Bismarck, North Dakota, United States
Overlook Hospital
🇺🇸
Summit, New Jersey, United States
Stony Brook University Medical Center
🇺🇸
Stony Brook, New York, United States
MD Anderson Cancer Center at Cooper-Voorhees
🇺🇸
Voorhees, New Jersey, United States
State University of New York Upstate Medical University
🇺🇸
Syracuse, New York, United States
Riverside Methodist Hospital
🇺🇸
Columbus, Ohio, United States
The Mark H Zangmeister Center
🇺🇸
Columbus, Ohio, United States
Sanford Roger Maris Cancer Center
🇺🇸
Fargo, North Dakota, United States
Cleveland Clinic Cancer Center/Fairview Hospital
🇺🇸
Cleveland, Ohio, United States
Miami Valley Hospital South
🇺🇸
Centerville, Ohio, United States
Hillcrest Hospital Cancer Center
🇺🇸
Mayfield Heights, Ohio, United States
Grandview Hospital
🇺🇸
Dayton, Ohio, United States
Cleveland Clinic Foundation
🇺🇸
Cleveland, Ohio, United States
FHCC South Lake Union
🇺🇸
Seattle, Washington, United States
Gachon University Gil Hospital
🇰🇷
Incheon, Korea, Republic of
Marshfield Clinic - Wisconsin Rapids Center
🇺🇸
Wisconsin Rapids, Wisconsin, United States
Ehime University Hospital
🇯🇵
Toon, Ehime, Japan
ProHealth Waukesha Memorial Hospital
🇺🇸
Waukesha, Wisconsin, United States
Juravinski Cancer Centre at Hamilton Health Sciences
🇨🇦
Hamilton, Ontario, Canada
Aurora Cancer Care-Milwaukee West
🇺🇸
Wauwatosa, Wisconsin, United States
Ascension Saint Michael's Hospital
🇺🇸
Stevens Point, Wisconsin, United States
Marshfield Medical Center - Weston
🇺🇸
Weston, Wisconsin, United States
London Regional Cancer Program
🇨🇦
London, Ontario, Canada
National Cancer Center Hospital
🇯🇵
Tokyo, Japan
Saint Vincent Hospital Cancer Center at Saint Mary's
🇺🇸
Green Bay, Wisconsin, United States
Keimyung University-Dongsan Medical Center
🇰🇷
Dalseo-gu, Daegu, Korea, Republic of
Gangnam Severance Hospital
🇰🇷
Seoul, Korea, Republic of
Marshfield Clinic-Wausau Center
🇺🇸
Wausau, Wisconsin, United States
University Health Network-Princess Margaret Hospital
🇨🇦
Toronto, Ontario, Canada
Seoul National University Bundang Hospital
🇰🇷
Seongnam City, Kyeonggi-do, Korea, Republic of
Marshfield Medical Center-Rice Lake
🇺🇸
Rice Lake, Wisconsin, United States
CHUM - Centre Hospitalier de l'Universite de Montreal
🇨🇦
Montreal, Quebec, Canada
Saint Vincent Hospital Cancer Center at Sturgeon Bay
🇺🇸
Sturgeon Bay, Wisconsin, United States
Aurora West Allis Medical Center
🇺🇸
West Allis, Wisconsin, United States
Kindai University
🇯🇵
Osaka, Japan
Saitama Medical University International Medical Center
🇯🇵
Saitama, Japan
Algoma District Cancer Program Sault Area Hospital
🇨🇦
Sault Ste Marie, Ontario, Canada
Kagoshima City Hospital
🇯🇵
Kagoshima City, Kagoshima, Japan
CHUM - Hopital Notre-Dame
🇨🇦
Montreal, Quebec, Canada
Vince Lombardi Cancer Clinic-Two Rivers
🇺🇸
Two Rivers, Wisconsin, United States
Centro Comprensivo de Cancer de UPR
🇵🇷
San Juan, Puerto Rico
Abbott-Northwestern Hospital
🇺🇸
Minneapolis, Minnesota, United States
University of Minnesota/Masonic Cancer Center
🇺🇸
Minneapolis, Minnesota, United States
Duke University Medical Center
🇺🇸
Durham, North Carolina, United States
California Pacific Medical Center-Pacific Campus
🇺🇸
San Francisco, California, United States
Kaiser Permanente-San Francisco
🇺🇸
San Francisco, California, United States
UCSF Medical Center-Mission Bay
🇺🇸
San Francisco, California, United States
Vanderbilt University/Ingram Cancer Center
🇺🇸
Nashville, Tennessee, United States
Utah Cancer Specialists-Salt Lake City
🇺🇸
Salt Lake City, Utah, United States
Huntsman Cancer Institute/University of Utah
🇺🇸
Salt Lake City, Utah, United States
University of Mississippi Medical Center
🇺🇸
Jackson, Mississippi, United States
Mercy Hospital Springfield
🇺🇸
Springfield, Missouri, United States
The Cancer Institute Hospital Of JFCR
🇯🇵
Koto-ku, Tokyo, Japan
MetroHealth Medical Center
🇺🇸
Cleveland, Ohio, United States
Billings Clinic Cancer Center
🇺🇸
Billings, Montana, United States
Bozeman Health Deaconess Hospital
🇺🇸
Bozeman, Montana, United States
Cancer Treatment Centers of America
🇺🇸
Tulsa, Oklahoma, United States
Benefis Sletten Cancer Institute
🇺🇸
Great Falls, Montana, United States
Wayne State University/Karmanos Cancer Institute
🇺🇸
Detroit, Michigan, United States
Henry Ford Hospital
🇺🇸
Detroit, Michigan, United States
University of Oklahoma Health Sciences Center
🇺🇸
Oklahoma City, Oklahoma, United States
University of Alabama at Birmingham Cancer Center
🇺🇸
Birmingham, Alabama, United States
Kaiser Permanente-Franklin
🇺🇸
Denver, Colorado, United States
Rocky Mountain Cancer Centers-Rose
🇺🇸
Denver, Colorado, United States
Mayo Clinic in Rochester
🇺🇸
Rochester, Minnesota, United States
Odette Cancer Centre- Sunnybrook Health Sciences Centre
🇨🇦
Toronto, Ontario, Canada
Alegent Health Lakeside Hospital
🇺🇸
Omaha, Nebraska, United States
Nebraska Methodist Hospital
🇺🇸
Omaha, Nebraska, United States
Aurora Cancer Care-Milwaukee
🇺🇸
Milwaukee, Wisconsin, United States
Ascension Columbia Saint Mary's Hospital - Milwaukee
🇺🇸
Milwaukee, Wisconsin, United States
Aurora Saint Luke's Medical Center
🇺🇸
Milwaukee, Wisconsin, United States
Medical College of Wisconsin
🇺🇸
Milwaukee, Wisconsin, United States
Aurora Sinai Medical Center
🇺🇸
Milwaukee, Wisconsin, United States
Korea Cancer Center Hospital
🇰🇷
Seoul, Korea, Republic of
Washington University School of Medicine
🇺🇸
Saint Louis, Missouri, United States
Ballad Health Cancer Care - Kingsport
🇺🇸
Kingsport, Tennessee, United States
Saint Francis Regional Medical Center
🇺🇸
Shakopee, Minnesota, United States
United Hospital
🇺🇸
Saint Paul, Minnesota, United States
National Institutes of Health Clinical Center
🇺🇸
Bethesda, Maryland, United States
Corewell Health Grand Rapids Hospitals - Butterworth Hospital
🇺🇸
Grand Rapids, Michigan, United States
Weisberg Cancer Treatment Center
🇺🇸
Farmington Hills, Michigan, United States
Sarasota Memorial Hospital
🇺🇸
Sarasota, Florida, United States
NorthShore University HealthSystem-Evanston Hospital
🇺🇸
Evanston, Illinois, United States
Illinois CancerCare-Kewanee Clinic
🇺🇸
Kewanee, Illinois, United States
Illinois CancerCare-Macomb
🇺🇸
Macomb, Illinois, United States
Illinois CancerCare-Peoria
🇺🇸
Peoria, Illinois, United States
Midwestern Regional Medical Center
🇺🇸
Zion, Illinois, United States
Northwestern Medicine Cancer Center Warrenville
🇺🇸
Warrenville, Illinois, United States
Mercy Medical Center-West Lakes
🇺🇸
West Des Moines, Iowa, United States
Siouxland Regional Cancer Center
🇺🇸
Sioux City, Iowa, United States
Woodland Memorial Hospital
🇺🇸
Woodland, California, United States
Aurora Medical Center in Summit
🇺🇸
Summit, Wisconsin, United States
AdventHealth Hendersonville
🇺🇸
Hendersonville, North Carolina, United States
NorthShore University HealthSystem-Glenbrook Hospital
🇺🇸
Glenview, Illinois, United States
UChicago Medicine Comprehensive Cancer Center - Saint Joseph Hospital
🇺🇸
Chicago, Illinois, United States
University of Arkansas for Medical Sciences
🇺🇸
Little Rock, Arkansas, United States
Sutter Auburn Faith Hospital
🇺🇸
Auburn, California, United States
Marin Cancer Care Inc
🇺🇸
Greenbrae, California, United States
Palo Alto Medical Foundation Health Care
🇺🇸
Palo Alto, California, United States
Mercy Cancer Center - Rocklin
🇺🇸
Rocklin, California, United States
Sutter Pacific Medical Foundation
🇺🇸
Santa Rosa, California, United States
Palo Alto Medical Foundation-Santa Cruz
🇺🇸
Santa Cruz, California, United States
Palo Alto Medical Foundation-Sunnyvale
🇺🇸
Sunnyvale, California, United States
UCHealth University of Colorado Hospital
🇺🇸
Aurora, Colorado, United States
Poudre Valley Hospital
🇺🇸
Fort Collins, Colorado, United States
Danbury Hospital
🇺🇸
Danbury, Connecticut, United States
Smilow Cancer Hospital Care Center-Fairfield
🇺🇸
Fairfield, Connecticut, United States
Medical Oncology Hematology Consultants PA
🇺🇸
Newark, Delaware, United States
Hartford Hospital
🇺🇸
Hartford, Connecticut, United States
Norwalk Hospital
🇺🇸
Norwalk, Connecticut, United States
Christiana Care Health System-Christiana Hospital
🇺🇸
Newark, Delaware, United States
Mount Sinai Medical Center
🇺🇸
Miami Beach, Florida, United States
Emory University Hospital/Winship Cancer Institute
🇺🇸
Atlanta, Georgia, United States
Piedmont Hospital
🇺🇸
Atlanta, Georgia, United States
Illinois CancerCare-Bloomington
🇺🇸
Bloomington, Illinois, United States
Rush - Copley Medical Center
🇺🇸
Aurora, Illinois, United States
Fairview Southdale Hospital
🇺🇸
Edina, Minnesota, United States
Fairview Clinics and Surgery Center Maple Grove
🇺🇸
Maple Grove, Minnesota, United States
Saint John's Hospital - Healtheast
🇺🇸
Maplewood, Minnesota, United States
Alegent Health Bergan Mercy Medical Center
🇺🇸
Omaha, Nebraska, United States
Women's Cancer Center of Nevada
🇺🇸
Las Vegas, Nevada, United States
Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
🇺🇸
Lebanon, New Hampshire, United States
Dartmouth Cancer Center - Nashua
🇺🇸
Nashua, New Hampshire, United States
The Cancer Institute of New Jersey Hamilton
🇺🇸
Hamilton, New Jersey, United States
Jersey Shore Medical Center
🇺🇸
Neptune, New Jersey, United States
Rutgers Cancer Institute of New Jersey
🇺🇸
New Brunswick, New Jersey, United States
Robert Wood Johnson University Hospital Somerset
🇺🇸
Somerville, New Jersey, United States
Southeastern Medical Oncology Center-Goldsboro
🇺🇸
Goldsboro, North Carolina, United States
Southeastern Medical Oncology Center-Jacksonville
🇺🇸
Jacksonville, North Carolina, United States
FirstHealth of the Carolinas-Moore Regional Hospital
🇺🇸
Pinehurst, North Carolina, United States
Duke Raleigh Hospital
🇺🇸
Raleigh, North Carolina, United States
Novant Health New Hanover Regional Medical Center
🇺🇸
Wilmington, North Carolina, United States
University of Cincinnati Cancer Center-UC Medical Center
🇺🇸
Cincinnati, Ohio, United States
Cleveland Clinic Akron General
🇺🇸
Akron, Ohio, United States
Aultman Health Foundation
🇺🇸
Canton, Ohio, United States
Ohio State University Comprehensive Cancer Center
🇺🇸
Columbus, Ohio, United States
ProMedica Flower Hospital
🇺🇸
Sylvania, Ohio, United States
Saint Charles Health System
🇺🇸
Bend, Oregon, United States
Orion Cancer Care
🇺🇸
Findlay, Ohio, United States
University of Cincinnati Cancer Center-West Chester
🇺🇸
West Chester, Ohio, United States
ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital
🇺🇸
Toledo, Ohio, United States
Oklahoma Cancer Specialists and Research Institute-Tulsa
🇺🇸
Tulsa, Oklahoma, United States
Wright-Patterson Medical Center
🇺🇸
Wright-Patterson Air Force Base, Ohio, United States
Legacy Good Samaritan Hospital and Medical Center
🇺🇸
Portland, Oregon, United States
Ephrata Cancer Center
🇺🇸
Ephrata, Pennsylvania, United States
Saint Luke's University Hospital-Bethlehem Campus
🇺🇸
Bethlehem, Pennsylvania, United States
Legacy Meridian Park Hospital
🇺🇸
Tualatin, Oregon, United States
Jefferson Abington Hospital
🇺🇸
Abington, Pennsylvania, United States
Geisinger Medical Center
🇺🇸
Danville, Pennsylvania, United States
Bryn Mawr Hospital
🇺🇸
Bryn Mawr, Pennsylvania, United States
Adams Cancer Center
🇺🇸
Gettysburg, Pennsylvania, United States
Ephrata Community Hospital
🇺🇸
Ephrata, Pennsylvania, United States
WellSpan Medical Oncology and Hematology
🇺🇸
Hanover, Pennsylvania, United States
UPMC Pinnacle Cancer Center/Community Osteopathic Campus
🇺🇸
Harrisburg, Pennsylvania, United States
Sechler Family Cancer Center
🇺🇸
Lebanon, Pennsylvania, United States
Paoli Memorial Hospital
🇺🇸
Paoli, Pennsylvania, United States
University of Pennsylvania/Abramson Cancer Center
🇺🇸
Philadelphia, Pennsylvania, United States
Geisinger Medical Oncology-Lewisburg
🇺🇸
Lewisburg, Pennsylvania, United States
Guthrie Medical Group PC-Robert Packer Hospital
🇺🇸
Sayre, Pennsylvania, United States
Wexford Health and Wellness Pavilion
🇺🇸
Wexford, Pennsylvania, United States
UPMC Susquehanna
🇺🇸
Williamsport, Pennsylvania, United States
Lankenau Medical Center
🇺🇸
Wynnewood, Pennsylvania, United States
Asplundh Cancer Pavilion
🇺🇸
Willow Grove, Pennsylvania, United States
Women and Infants Hospital
🇺🇸
Providence, Rhode Island, United States
WellSpan Health-York Hospital
🇺🇸
York, Pennsylvania, United States
AnMed Health Cancer Center
🇺🇸
Anderson, South Carolina, United States
Gibbs Cancer Center-Gaffney
🇺🇸
Gaffney, South Carolina, United States
Saint Francis Cancer Center
🇺🇸
Greenville, South Carolina, United States
Saint Francis Hospital
🇺🇸
Greenville, South Carolina, United States
Gibbs Cancer Center-Pelham
🇺🇸
Greer, South Carolina, United States
Spartanburg Medical Center
🇺🇸
Spartanburg, South Carolina, United States
South Carolina Cancer Specialists PC
🇺🇸
Hilton Head Island, South Carolina, United States
Sanford Cancer Center Oncology Clinic
🇺🇸
Sioux Falls, South Dakota, United States
MGC Hematology Oncology-Union
🇺🇸
Union, South Carolina, United States
Sanford USD Medical Center - Sioux Falls
🇺🇸
Sioux Falls, South Dakota, United States
Wellmont Holston Valley Hospital and Medical Center
🇺🇸
Kingsport, Tennessee, United States
Thompson Cancer Survival Center - West
🇺🇸
Knoxville, Tennessee, United States
Houston Methodist Hospital
🇺🇸
Houston, Texas, United States
Methodist Willowbrook Hospital
🇺🇸
Houston, Texas, United States
Parkland Memorial Hospital
🇺🇸
Dallas, Texas, United States
Houston Methodist Sugar Land Hospital
🇺🇸
Sugar Land, Texas, United States
Saint George Regional Medical Center
🇺🇸
Saint George, Utah, United States
Intermountain Medical Center
🇺🇸
Murray, Utah, United States
South Jordan Health Center
🇺🇸
South Jordan, Utah, United States
University of Vermont Medical Center
🇺🇸
Burlington, Vermont, United States
University of Vermont and State Agricultural College
🇺🇸
Burlington, Vermont, United States
University of Virginia Cancer Center
🇺🇸
Charlottesville, Virginia, United States
Central Vermont Medical Center/National Life Cancer Treatment
🇺🇸
Berlin, Vermont, United States
PeaceHealth Saint Joseph Medical Center
🇺🇸
Bellingham, Washington, United States
Swedish Cancer Institute-Edmonds
🇺🇸
Edmonds, Washington, United States
Kadlec Clinic Hematology and Oncology
🇺🇸
Kennewick, Washington, United States
Skagit Regional Health Cancer Care Center
🇺🇸
Mount Vernon, Washington, United States
Fred Hutchinson Cancer Center
🇺🇸
Seattle, Washington, United States
Swedish Medical Center-First Hill
🇺🇸
Seattle, Washington, United States
University of Washington Medical Center - Northwest
🇺🇸
Seattle, Washington, United States
Legacy Salmon Creek Hospital
🇺🇸
Vancouver, Washington, United States
Wenatchee Valley Hospital and Clinics
🇺🇸
Wenatchee, Washington, United States
West Virginia University Healthcare
🇺🇸
Morgantown, West Virginia, United States
Ascension Saint Elizabeth Hospital
🇺🇸
Appleton, Wisconsin, United States
Edwards Comprehensive Cancer Center
🇺🇸
Huntington, West Virginia, United States
Monongalia Hospital
🇺🇸
Morgantown, West Virginia, United States
West Virginia University Charleston Division
🇺🇸
Charleston, West Virginia, United States
Marshfield Clinic-Chippewa Center
🇺🇸
Chippewa Falls, Wisconsin, United States
Aurora Cancer Care-Southern Lakes VLCC
🇺🇸
Burlington, Wisconsin, United States
Aurora Health Center-Fond du Lac
🇺🇸
Fond Du Lac, Wisconsin, United States
Aurora Health Care Germantown Health Center
🇺🇸
Germantown, Wisconsin, United States
Marshfield Clinic Cancer Center at Sacred Heart
🇺🇸
Eau Claire, Wisconsin, United States
Aurora Cancer Care-Grafton
🇺🇸
Grafton, Wisconsin, United States
Saint Vincent Hospital Cancer Center Green Bay
🇺🇸
Green Bay, Wisconsin, United States
Aurora Cancer Care-Kenosha South
🇺🇸
Kenosha, Wisconsin, United States
Aurora BayCare Medical Center
🇺🇸
Green Bay, Wisconsin, United States
Gundersen Lutheran Medical Center
🇺🇸
La Crosse, Wisconsin, United States
Marshfield Medical Center - Ladysmith
🇺🇸
Ladysmith, Wisconsin, United States
Saint Vincent Hospital Cancer Center at Marinette
🇺🇸
Marinette, Wisconsin, United States
Marshfield Medical Center-Marshfield
🇺🇸
Marshfield, Wisconsin, United States
Aurora Bay Area Medical Group-Marinette
🇺🇸
Marinette, Wisconsin, United States
Ascension Columbia Saint Mary's Hospital Ozaukee
🇺🇸
Mequon, Wisconsin, United States
ProHealth Oconomowoc Memorial Hospital
🇺🇸
Oconomowoc, Wisconsin, United States
Marshfield Clinic-Minocqua Center
🇺🇸
Minocqua, Wisconsin, United States
ProHealth D N Greenwald Center
🇺🇸
Mukwonago, Wisconsin, United States
Saint Vincent Hospital Cancer Center at Oconto Falls
🇺🇸
Oconto Falls, Wisconsin, United States
Ascension Mercy Hospital
🇺🇸
Oshkosh, Wisconsin, United States
Vince Lombardi Cancer Clinic - Oshkosh
🇺🇸
Oshkosh, Wisconsin, United States
Aurora Cancer Care-Racine
🇺🇸
Racine, Wisconsin, United States
Vince Lombardi Cancer Clinic-Sheboygan
🇺🇸
Sheboygan, Wisconsin, United States
Kingston Health Sciences Centre
🇨🇦
Kingston, Ontario, Canada
CIUSSSEMTL-Hopital Maisonneuve-Rosemont
🇨🇦
Montreal, Quebec, Canada
CHU de Quebec-L'Hotel-Dieu de Quebec (HDQ)
🇨🇦
Quebec City, Quebec, Canada
Jewish General Hospital
🇨🇦
Montreal, Quebec, Canada
Kyung Hee University Hospital at Gangdong
🇰🇷
Seoul, Korea, Republic of
Asan Medical Center
🇰🇷
Seoul, Korea, Republic of
Reading Hospital
🇺🇸
West Reading, Pennsylvania, United States
Trinity Health Saint Joseph Mercy Oakland Hospital
🇺🇸
Pontiac, Michigan, United States
Kaiser Permanente-Lone Tree
🇺🇸
Lone Tree, Colorado, United States
Rapid City Regional Hospital
🇺🇸
Rapid City, South Dakota, United States
UT Southwestern/Simmons Cancer Center-Dallas
🇺🇸
Dallas, Texas, United States
Avera Cancer Institute
🇺🇸
Sioux Falls, South Dakota, United States
Thompson Cancer Survival Center
🇺🇸
Knoxville, Tennessee, United States
Marshfield Medical Center-River Region at Stevens Point
🇺🇸
Stevens Point, Wisconsin, United States
Skagit Valley Hospital
🇺🇸
Mount Vernon, Washington, United States
Hokkaido University Hospital
🇯🇵
Sapporo, Hokkaido, Japan
Kaiser Permanente Downtown Commons
🇺🇸
Sacramento, California, United States
Mercy Cancer Center - Sacramento
🇺🇸
Sacramento, California, United States
Sutter Medical Center Sacramento
🇺🇸
Sacramento, California, United States
Trinity Health Saint Joseph Mercy Hospital Ann Arbor
🇺🇸
Ann Arbor, Michigan, United States
University of California Davis Comprehensive Cancer Center
🇺🇸
Sacramento, California, United States
Kaiser Permanente - Sacramento
🇺🇸
Sacramento, California, United States
University of Michigan Comprehensive Cancer Center
🇺🇸
Ann Arbor, Michigan, United States
Wake Forest University Health Sciences
🇺🇸
Winston-Salem, North Carolina, United States
Yale University
🇺🇸
New Haven, Connecticut, United States
Orlando Health Cancer Institute
🇺🇸
Orlando, Florida, United States
UW Cancer Center at ProHealth Care
🇺🇸
Waukesha, Wisconsin, United States
Hackensack University Medical Center
🇺🇸
Hackensack, New Jersey, United States
UNC Lineberger Comprehensive Cancer Center
🇺🇸
Chapel Hill, North Carolina, United States
Ochsner Medical Center Jefferson
🇺🇸
New Orleans, Louisiana, United States
VCU Massey Cancer Center at Stony Point
🇺🇸
Richmond, Virginia, United States
Virginia Commonwealth University/Massey Cancer Center
🇺🇸
Richmond, Virginia, United States
University of Florida Health Science Center - Gainesville
🇺🇸
Gainesville, Florida, United States
Queen's Medical Center
🇺🇸
Honolulu, Hawaii, United States
Kapiolani Medical Center for Women and Children
🇺🇸
Honolulu, Hawaii, United States
Montefiore Medical Center-Einstein Campus
🇺🇸
Bronx, New York, United States
Mercy Medical Center - Des Moines
🇺🇸
Des Moines, Iowa, United States
Iowa Methodist Medical Center
🇺🇸
Des Moines, Iowa, United States
Mission Cancer and Blood - Laurel
🇺🇸
Des Moines, Iowa, United States
Mission Cancer and Blood - Des Moines
🇺🇸
Des Moines, Iowa, United States
University of Kentucky/Markey Cancer Center
🇺🇸
Lexington, Kentucky, United States
University of Wisconsin Carbone Cancer Center - University Hospital
🇺🇸
Madison, Wisconsin, United States
Cross Cancer Institute
🇨🇦
Edmonton, Alberta, Canada
Southwest Gynecologic Oncology Associates Inc
🇺🇸
Albuquerque, New Mexico, United States
University of New Mexico Cancer Center
🇺🇸
Albuquerque, New Mexico, United States
Tom Baker Cancer Centre
🇨🇦
Calgary, Alberta, Canada
Royal Victoria Regional Health Centre
🇨🇦
Barrie, Ontario, Canada

Testing the Combination of Cediranib and Olaparib in Comparison to Each Drug Alone or Other Chemotherapy in Recurrent Platinum-Resistant Ovarian Cancer

Recruitment & Eligibility

Study & Design

Trial Locations

Instant Trial Alerts

Instant Trial Alerts