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p53 Suppressor Activation in Recurrent High Grade Serous Ovarian Cancer, a Phase Ib/II Study of Systemic Carboplatin Combination Chemotherapy With or Without APR-246

Phase 1
Completed
Conditions
Platinum Sensitive Recurrent High-grade Serous Ovarian Cancer With Mutated p53
Interventions
Registration Number
NCT02098343
Lead Sponsor
Aprea Therapeutics
Brief Summary

The purpose of this study is to make a preliminary assessment of the efficacy of a combined APR-246 and carboplatin/PLD chemotherapy regimen, compared with carboplatin/PLD chemotherapy regimen alone, in patients with platinum sensitive recurrent high grade serous ovarian cancer (HGSOC) with mutated p53. In addition, the study aims to assess the safety profile of the combined APR-246 and carboplatin/PLD chemotherapy regimen compared with carboplatin/PLD chemotherapy regimen alone, to evaluate potential biomarkers, and to assess the biological activity in tumor and surrogate tissues. The trial will enroll up to a maximum of 400 patients.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
247
Inclusion Criteria
  • Confirmed High Grade Serous Ovarian Cancer, and positive nuclear immunohistochemical (IHC) staining for p53
  • Disease Progression between 6-24 months after a first or second platinum based regimen
  • At least a single measurable lesion. Phase II patients only
  • Adequate organ function prior to registration
  • Toxicities from previous cancer therapies must have recovered to grade 1 (defined by Common Terminology Criteria for Adverse Events [CTCAE] 4.0) Chronic stable grade 2 peripheral neuropathy secondary to neurotoxicity from prior therapies may be considered on a case by case basis
  • ECOG performance status of 0 to 1
Exclusion Criteria
  • Prior exposure to cumulative doses of doxorubicin >400 mg/m2 or epirubicin >720 mg/m2
  • History of allergic reactions to carboplatin, platinum containing compounds or mannitol and/or hypersensitivity to PLD or to any of the excipients
  • Unable to undergo imaging by either CT scan or MRI
  • Evidence of any other medical conditions (such as psychiatric illness, infectious diseases, neurological conditions, physical examination or laboratory findings) that may interfere with the planned treatment, affect patient compliance or place the patient at high risk from treatment related complications
  • Concurrent malignancy requiring therapy (excluding non-invasive carcinoma or carcinoma in situ)
  • Is taking concurrent (or within 4 week prior to registration) chemotherapy, immunotherapy, radiotherapy, or any ancillary therapy that is considered to be investigational (i.e., used for non-approved indications(s) and in the context of a research investigation). Supportive care measures are allowed

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Phase Ib. APR-246 (35mg/kg) + Carboplatin/PLD.APR-246Dose escalation of APR-246.
Phase Ib. APR-246 (35mg/kg) + Carboplatin/PLD.Carboplatin and Pegylated Liposomal Doxorubicin Hydrochloride (PLD)Dose escalation of APR-246.
Phase II: Arm A. APR-246 + Carboplatin/PLD.APR-246Experimental
Phase II: Arm A. APR-246 + Carboplatin/PLD.Carboplatin and Pegylated Liposomal Doxorubicin Hydrochloride (PLD)Experimental
Phase II: Arm B. Carboplatin/PLD.Carboplatin and Pegylated Liposomal Doxorubicin Hydrochloride (PLD)Active Comparator
Phase Ib. APR-246 (50mg/kg) + Carboplatin/PLD.APR-246Dose escalation of APR-246.
Phase Ib. APR-246 (50mg/kg) + Carboplatin/PLD.Carboplatin and Pegylated Liposomal Doxorubicin Hydrochloride (PLD)Dose escalation of APR-246.
Phase Ib. APR-246 (67.5mg/kg) + Carboplatin/PLD.APR-246Dose escalation of APR-246.
Phase Ib. APR-246 (67.5mg/kg) + Carboplatin/PLD.Carboplatin and Pegylated Liposomal Doxorubicin Hydrochloride (PLD)Dose escalation of APR-246.
Primary Outcome Measures
NameTimeMethod
Phase Ib: Dose-limiting Toxicities (DLT) (See Description) of Combined APR-246 and Carboplatin/PLD RegimenUntil the end of the first treatment cycle, i.e., Day 28

DLT: Hematological and non-hematological toxicities according to grade/days stated in the protocol.

Phase Ib and II: Progression Free Survival (PFS)Up to 24 months

Phase Ib: Progression-free Survival is calculated from date of enrollment to the date of disease progression or death due to any cause, whichever occurs first. Symptomatic deterioration is not considered PD. For a patient without evidence of disease progression or death, Progression-free survival will be censored at the date of last evaluable tumor assessment. Patients with no evaluable tumor assessments will be censored at the date of first study drug administration.

Phase II: Progression-free survival (PFS) based on Blinded Independent Central Review (BICR) is the primary endpoint and is defined as the number of days from the date of randomization to the date of objective disease progression or relapse (according to RECIST v1.1 only) or death due to any cause, whichever occurs first. If neither event occurs, PFS is censored at the date of the last evaluable tumor assessment. Symptomatic deterioration is not considered objective disease progression.

Secondary Outcome Measures
NameTimeMethod
Phase Ib and Phase II: Overall Response Rate (RR)Up to 24 months

Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), \>=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR.

Trial Locations

Locations (55)

University of Texas Southwestern Medical Center

🇺🇸

Dallas, Texas, United States

Dana Farber Cancer Institute

🇺🇸

Boston, Massachusetts, United States

Centre Léon Bérard

🇫🇷

Lyon, France

University of Chicago

🇺🇸

Chicago, Illinois, United States

Massachusetts General Hospital

🇺🇸

Boston, Massachusetts, United States

Leuven University Hospitals

🇧🇪

Leuven, Belgium

Universitätsklinikum Carl Gustav Carus

🇩🇪

Dresden, Germany

Institut Curie

🇫🇷

Paris, France

Charité Campus Virchow-Klinikum

🇩🇪

Berlin, Germany

Universitätsklinikum Hamburg-Eppendorf

🇩🇪

Hamburg, Germany

Centre Catherine de Sienne

🇫🇷

Nantes, France

Swedish Cancer Institute

🇺🇸

Seattle, Washington, United States

Cliniques Universitaires Saint Luc

🇧🇪

Brussels, Belgium

Medische oncologie, Universitair Ziekenhuis Gent

🇧🇪

Gent, Belgium

Centre Hospitalier Lyon Sud

🇫🇷

Lyon, France

Praxisklinik, Krebsheilkunde für Frauen

🇩🇪

Berlin, Germany

Institut Gustave Roussy

🇫🇷

Villejuif, France

Academisch Medisch Centrum

🇳🇱

Amsterdam, Netherlands

Universitair Medisch Centrum Groningen

🇳🇱

Groningen, Netherlands

Universitätsfrauenklinik Ulm

🇩🇪

Ulm, Germany

Leids Universitair Medisch Centrum

🇳🇱

Leiden, Netherlands

Hospital Vall d'Hebron

🇪🇸

Barcelona, Spain

Academisch Ziekenhuis Maastricht

🇳🇱

Maastricht, Netherlands

Centro Oncologico MD Anderson

🇪🇸

Madrid, Spain

Hospital Universitario Ramón y Cajal

🇪🇸

Madrid, Spain

Bristol Haematology & Oncology Centre, University Hospitals Bristol

🇬🇧

Bristol, United Kingdom

Hospital Universitario Reina Sofia

🇪🇸

Córdoba, Spain

Karolinska University Hospital

🇸🇪

Stockholm, Sweden

Hospital Universitario Fundación Jiménez Díaz

🇪🇸

Madrid, Spain

Edinburgh Cancer Research Centre, The University of Edinburgh

🇬🇧

Edinburgh, United Kingdom

The Clatterbridge Cancer Center NHS Foundation Trust

🇬🇧

Liverpool, United Kingdom

Imperial College London, Hammersmith Hospital Campus

🇬🇧

London, United Kingdom

The Christie NHS Foundation Trust

🇬🇧

Manchester, United Kingdom

Hôpital des Diaconesses (Site Reuilly)

🇫🇷

Paris, France

Centre Paul Strass

🇫🇷

Strasbourg, France

Hospital Universitario HM Sanchinarro

🇪🇸

Madrid, Spain

Hospital Universitario Virgen de la Victoria

🇪🇸

Málaga, Spain

Hospital Clínico Universitario Lozano Blesa

🇪🇸

Zaragosa, Spain

UCLA

🇺🇸

Los Angeles, California, United States

Parkland, UT Southwestern Medical Center

🇺🇸

Dallas, Texas, United States

The University of Pennsylvania

🇺🇸

Philadelphia, Pennsylvania, United States

Institut Català d'Oncologia, Hospital Germans Trias i Pujol

🇪🇸

Badalona, Spain

Hospital Clinico Universitario de Valencia

🇪🇸

Valencia, Spain

Cambridge Cancer Trials Centre, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital

🇬🇧

Cambridge, United Kingdom

The Royal Marsden NHS Foundation Trust

🇬🇧

London, United Kingdom

Fox Chase Cancer Center

🇺🇸

Philadelphia, Pennsylvania, United States

Hospital Universitario Araba

🇪🇸

Vitoria-Gasteiz, Spain

UPMC Hillman Cancer Center, Magee-Womens Hospital

🇺🇸

Pittsburgh, Pennsylvania, United States

Institut Jules Bordet

🇧🇪

Brussels, Belgium

Antwerp University Hospital

🇧🇪

Antwerpen, Belgium

Massey Cancer Center, Virginia Commonwealth University

🇺🇸

Richmond, Virginia, United States

Barbara Ann Karmanos Cancer Institute

🇺🇸

Detroit, Michigan, United States

Oregon Health & Science University

🇺🇸

Portland, Oregon, United States

Vanderbilt University Medical Center

🇺🇸

Nashville, Tennessee, United States

The University of Texas MD Anderson Cancer Center

🇺🇸

Houston, Texas, United States

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