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A Study Evaluating the Efficacy and Safety of Biomarker-Driven Therapies in Patients With Persistent or Recurrent Rare Epithelial Ovarian Tumors

Registration Number
NCT04931342
Lead Sponsor
Hoffmann-La Roche
Brief Summary

This study will evaluate the efficacy and safety of multiple biomarker-selected treatments in patients with persistent or recurrent rare epithelial ovarian, fallopian tube, or primary peritoneal tumors. Enrollment will take place in two phases: a preliminary phase followed by a potential expansion phase.

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
Female
Target Recruitment
176
Inclusion Criteria
  • Persistent or recurrent EOC that meets the following criteria: Histologically confirmed non-high-grade serous, non-high-grade endometrioid epithelial ovarian, fallopian tube, or primary peritoneal cancer, including but not limited to low-grade serous ovarian carcinoma, clear cell carcinoma, mucinous carcinoma, carcinosarcoma, undifferentiated carcinoma, seromucinous carcinoma, malignant Brenner tumors, Grades 1 or 2 endometrioid carcinoma, mesonephric-like adenocarcinoma and small cell carcinoma of the ovary, hypercalcemic type (SCCOHT). Disease that is not amenable to curative surgery
  • Measurable disease (at least one target lesion) according to RECIST v1.1
  • Previous treatment with one to four lines of therapy, at least one of which was platinum-based. Hormonal therapy does not count as a line of therapy.
  • Platinum-resistant disease, defined as disease progression during or within 6 months of last platinum therapy, with the following exception: Participants with primary platinum-refractory disease are excluded.
  • Submission of a representative tumor specimen that is suitable for next-generation sequencing (NGS) testing and estrogen receptor immunohistochemistry (ER IHC) to determine treatment arm assignment and for central pathology review.
  • Submission of the local pathology report and, if available, any associated stained slides that supported the local diagnosis of the histology (to be used for central pathology review)
  • Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1
  • Adequate hematologic and end-organ function
  • For women of childbearing potential: agreement to remain abstinent or use contraception, and agreement to refrain from donating eggs (if applicable)
  • In addition to the general inclusion criteria above, participants must meet all of the arm-specific inclusion criteria for the respective arm

General

Exclusion Criteria
  • Pregnant or breastfeeding, or intending to become pregnant or breastfeed during the study
  • Primary platinum-refractory disease, defined as progression during or within 4 weeks after the last dose of the first-line platinum treatment
  • Histologic diagnosis of high-grade serous or high-grade endometrioid ovarian, fallopian tube, or primary peritoneal cancer
  • Current diagnosis of solely borderline epithelial ovarian tumor
  • Current diagnosis of non-epithelial ovarian tumors
  • Current diagnosis of synchronous primary endometrial cancer
  • Prior history of primary endometrial cancer, with the following exception: a prior diagnosis of primary endometrial cancer is permitted if it meets all of the following conditions: Stage IA, no lymphovascular invasion, International Federation of Gynecology and Obstetrics Grade 1 or 2, not a high-grade subtype.
  • Uncontrolled pleural effusion, pericardial effusion, or ascites requiring recurrent drainage procedures
  • Symptomatic, untreated, or actively progressing CNS metastases
  • Severe infection within 4 weeks prior to initiation of study treatment
  • Treatment with chemotherapy, radiotherapy, antibody therapy or other immunotherapy, gene therapy, vaccine therapy, or investigational therapy within 28 days prior to initiation of study treatment
  • Treatment with hormonal therapy within 14 days prior to initiation of study treatment
  • In addition to the general exclusion criteria above, participants can not meet any of the arm-specific exclusion criteria for the respective arm

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Giredestrant + Abemaciclib (ER+ tumors)Luteinizing Hormone-Releasing Hormone (LHRH) AgonistsParticipants in the Giredestrant + Abemaciclib arm will receive treatment until unacceptable toxicity or disease progression as determined by the investigator according to RECIST v1.1.
Giredestrant + Abemaciclib (ER+ tumors)GiredestrantParticipants in the Giredestrant + Abemaciclib arm will receive treatment until unacceptable toxicity or disease progression as determined by the investigator according to RECIST v1.1.
Inavolisib + Palbociclib (PIK3CA-altered tumors)InavolisibParticipants in the Inavolisib + Palbociclib arm will receive treatment until unacceptable toxicity or disease progression per RECIST v1.1.
Inavolisib + Palbociclib + Letrozole (ER+ and PIK3CA-altered tumors)Luteinizing Hormone-Releasing Hormone (LHRH) AgonistsParticipants in the Inavolisib + Palbociclib + Letrozole arm will receive treatment until unacceptable toxicity or disease progression per RECIST v1.1.
Inavolisib + Palbociclib + Letrozole (ER+ and PIK3CA-altered tumors)InavolisibParticipants in the Inavolisib + Palbociclib + Letrozole arm will receive treatment until unacceptable toxicity or disease progression per RECIST v1.1.
Inavolisib + Giredestrant (ER+ and PIK3CA-altered tumors)GiredestrantParticipants in the Inavolisib + Giredestrant arm will receive treatment until unacceptable toxicity or disease progression per RECIST v1.1.
Trastuzumab Emtansine (ERBB2-amplified/mutant tumors)Trastuzumab EmtansineParticipants in the Trastuzumab Emtansine arm will receive treatment until unacceptable toxicity or disease progression per RECIST v1.1.
Ipatasertib + Paclitaxel (PIK3CA/AKT1/PTEN-altered tumors)PaclitaxelParticipants in the Ipatasertib + Paclitaxel arm will receive treatment until unacceptable toxicity or disease progression per RECIST v1.1.
Cobimetinib (BRAF/NRAS/KRAS/NF1-altered tumors)CobimetinibParticipants in the Cobimetinib arm will receive treatment until unacceptable toxicity or disease progression per RECIST v1.1.
Atezolizumab + Bevacizumab (Non-matched)AtezolizumabParticipants in the Atezolizumab + Bevacizumab arm will receive treatment until unacceptable toxicity or loss of clinical benefit as determined by the investigator after an integrated assessment of radiographic and biochemical data, local biopsy results (if available), and clinical status.
Atezolizumab + Bevacizumab (Non-matched)BevacizumabParticipants in the Atezolizumab + Bevacizumab arm will receive treatment until unacceptable toxicity or loss of clinical benefit as determined by the investigator after an integrated assessment of radiographic and biochemical data, local biopsy results (if available), and clinical status.
Giredestrant + Abemaciclib (ER+ tumors)AbemaciclibParticipants in the Giredestrant + Abemaciclib arm will receive treatment until unacceptable toxicity or disease progression as determined by the investigator according to RECIST v1.1.
Inavolisib + Palbociclib (PIK3CA-altered tumors)PalbociclibParticipants in the Inavolisib + Palbociclib arm will receive treatment until unacceptable toxicity or disease progression per RECIST v1.1.
Inavolisib + Palbociclib + Letrozole (ER+ and PIK3CA-altered tumors)PalbociclibParticipants in the Inavolisib + Palbociclib + Letrozole arm will receive treatment until unacceptable toxicity or disease progression per RECIST v1.1.
Inavolisib + Palbociclib + Letrozole (ER+ and PIK3CA-altered tumors)LetrozoleParticipants in the Inavolisib + Palbociclib + Letrozole arm will receive treatment until unacceptable toxicity or disease progression per RECIST v1.1.
Inavolisib + Olaparib (Non-matched)OlaparibParticipants in the Inavolisib + Olaparib arm will receive treatment until unacceptable toxicity or disease progression per RECIST v1.1.
Inavolisib + Bevacizumab (PIK3CA-altered tumors)BevacizumabParticipants in the Inavolisib + Bevacizumab arm will receive treatment until unacceptable toxicity or disease progression per RECIST v1.1.
Atezolizumab + Bevacizumab + Cyclophosphamide (Non-matched)CyclophosphamideParticipants in the Atezolizumab + Bevacizumab + Cyclophosphamide arm will receive treatment until unacceptable toxicity or loss of clinical benefit as determined by the investigator after an integrated assessment of radiographic and biochemical data, local biopsy results (if available), and clinical status.
Atezolizumab + Bevacizumab + Cyclophosphamide (Non-matched)AtezolizumabParticipants in the Atezolizumab + Bevacizumab + Cyclophosphamide arm will receive treatment until unacceptable toxicity or loss of clinical benefit as determined by the investigator after an integrated assessment of radiographic and biochemical data, local biopsy results (if available), and clinical status.
Atezolizumab + Bevacizumab + Cyclophosphamide (Non-matched)BevacizumabParticipants in the Atezolizumab + Bevacizumab + Cyclophosphamide arm will receive treatment until unacceptable toxicity or loss of clinical benefit as determined by the investigator after an integrated assessment of radiographic and biochemical data, local biopsy results (if available), and clinical status.
Inavolisib + Giredestrant (ER+ and PIK3CA-altered tumors)InavolisibParticipants in the Inavolisib + Giredestrant arm will receive treatment until unacceptable toxicity or disease progression per RECIST v1.1.
Inavolisib + Olaparib (Non-matched)InavolisibParticipants in the Inavolisib + Olaparib arm will receive treatment until unacceptable toxicity or disease progression per RECIST v1.1.
Inavolisib + Bevacizumab (PIK3CA-altered tumors)InavolisibParticipants in the Inavolisib + Bevacizumab arm will receive treatment until unacceptable toxicity or disease progression per RECIST v1.1.
Ipatasertib + Paclitaxel (PIK3CA/AKT1/PTEN-altered tumors)IpatasertibParticipants in the Ipatasertib + Paclitaxel arm will receive treatment until unacceptable toxicity or disease progression per RECIST v1.1.
Primary Outcome Measures
NameTimeMethod
Confirmed Objective Response Rate (ORR)Up to approximately 5 years

Confirmed ORR is defined as the proportion of participants with a confirmed complete response (CR) or partial response (PR) (demonstrated on two consecutive occasions \>=4 weeks apart), as determined by the investigator according to RECIST v1.1.

Secondary Outcome Measures
NameTimeMethod
Overall Survival (OS)Up to approximately 5 years

OS after start of treatment is defined as the time from start of treatment to death from any cause.

Confirmed ORR as Determined by IRC (Independent Review Committee)Up to approximately 5 years

Confirmed ORR, as determined by the IRC according to RECIST v1.1.

Duration of Response (DOR)Up to approximately 5 years

DOR is defined as the time from the first occurrence of a documented objective response to disease progression or death from any cause (whichever occurs first), as determined by the investigator according to RECIST v1.1.

Disease Contral Rate (DCR)Up to approximately 5 years

DCR is defined as the proportion of participants with a confirmed CR or PR, or stable disease maintained for at least 16 weeks, as determined by the investigator according to RECIST v1.1.

DCR as Determined by IRCUp to approximately 5 years

DCR, as determined by the IRC according to RECIST v1.1

6-Month PFS RateUp to 6 month

6-month PFS rate is defined as the proportion of participants who remained alive and progression-free at 6 months after start of treatment, as determined by the investigator according to RECIST v1.1.

DOR as Determined by IRCUp to approximately 5 years

DOR, as determined by the IRC according to RECIST v1.1

Progression Free Survival (PFS)Up to approximately 5 years

PFS after start of treatment is defined as the time from start of treatment to the first occurrence of disease progression or death from any cause (whichever occurs first), as determined by the investigator according to RECIST v1.1.

PFS as Determined by IRCUp to approximately 5 years

PFS, as determined by the IRC according to RECIST v1.1

Percentage of Participants With Adverse EventsUp to approximately 5 years

Percentage of participants with adverse events.

Trial Locations

Locations (39)

Institut Claudius Regaud

🇫🇷

Toulouse, France

Gustave Roussy

🇫🇷

Villejuif CEDEX, France

UCSF Helen Diller Family CCC

🇺🇸

San Francisco, California, United States

Washington University School of Medicine

🇺🇸

Saint Louis, Missouri, United States

Levine Cancer Institute

🇺🇸

Charlotte, North Carolina, United States

Ohio State University

🇺🇸

Columbus, Ohio, United States

University of Oklahoma Health Sciences Center

🇺🇸

Oklahoma City, Oklahoma, United States

Texas Oncology - Gulf Coast

🇺🇸

The Woodlands, Texas, United States

Virginia Oncology Associates

🇺🇸

Norfolk, Virginia, United States

University of Washington - Seattle Cancer Care Alliance

🇺🇸

Seattle, Washington, United States

Cabrini Hospital

🇦🇺

Malvern, Victoria, Australia

Princess Margaret Cancer Center

🇨🇦

Toronto, Ontario, Canada

McGill University Health Centre - Glen Site

🇨🇦

Montreal, Quebec, Canada

Gynekologicko-porodnicka klinika

🇨🇿

Prague, Czechia

CHU Besançon - Hôpital Jean Minjoz

🇫🇷

Besançon Cedex, France

Centre Francois Baclesse

🇫🇷

Caen, France

Centre Leon Berard

🇫🇷

Lyon, France

Groupe Hospitalier Diaconesses

🇫🇷

Paris, France

Centre Eugène Marquis

🇫🇷

Rennes, France

Kliniken Essen-Mitte Evang. Huyssens-Stiftung, Klinik für Gynäkologie und gynäkologische Onkologie

🇩🇪

Essen, Germany

Universitätsklinikum Mannheim

🇩🇪

Mannheim, Germany

Istituto Tumori Napoli

🇮🇹

Napoli, Campania, Italy

Policlinico Universitario Agostino Gemelli

🇮🇹

Roma, Lazio, Italy

IRCCS S. Raffaele

🇮🇹

Milano, Lombardia, Italy

A.O. U. Consorziale Policlinico di Bari

🇮🇹

Bari, Puglia, Italy

Samsung Medical Center

🇰🇷

Seoul, Korea, Republic of

Seoul National University Hospital

🇰🇷

Seoul, Korea, Republic of

Severance Hospital, Yonsei University Health System

🇰🇷

Seoul, Korea, Republic of

Asan Medical Center

🇰🇷

Seoul, Korea, Republic of

Institutio Catalan De Oncologia

🇪🇸

Barcelona, Spain

Hospital Universitario 12 de Octubre

🇪🇸

Madrid, Spain

Hospital Universitario La Paz

🇪🇸

Madrid, Spain

Hospital Clinico Universitario Virgen de la Victoria

🇪🇸

Malaga, Spain

Hôpitaux Universitaires de Genève

🇨🇭

Genève, Switzerland

Adana Baskent University Medical Faculty; Oncology

🇹🇷

Adana, Turkey

Baskent Universitesi Ankara Hastanesi; Tıbbi Onkoloji Bölümü

🇹🇷

Ankara, Turkey

Koc University Medical Faculty; Department of Gynecology & Obstetrics

🇹🇷

Istanbul, Turkey

Western General Hospital

🇬🇧

Edinburgh, United Kingdom

University College London Hospitals NHS Foundation Trust - University College Hospital

🇬🇧

London, United Kingdom

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