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INOVATYON STUDY -International, Randomized Study in Patients With Ovarian Cancer

Phase 3
Completed
Conditions
Ovarian Cancer
Interventions
Drug: Pegylated Lipoxomal Doxorubicin (PLD)
Registration Number
NCT01379989
Lead Sponsor
Mario Negri Institute for Pharmacological Research
Brief Summary

The objective of this multicentric, randomised, Phase III study is to demonstrate superiority, in terms of survival, of trabectedin and Pegylated Liposomal Doxorubicin (PLD) versus carboplatin and PLD in partially-platinum sensitive ovarian cancer patients.

Detailed Description

Patients will be randomised to:

Arm A: PLD 30 mg/m2 and carboplatin AUC 5; Arm B: PLD 30 mg/m2 and trabectedin 1.1 mg/m2. Patients' characteristics: patients over 18 years of age with advanced, progressive ovarian cancer 6-12 months after completion of first line or second line treatment with platinum-based chemotherapy.

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
617
Inclusion Criteria
  1. Female, aged ≥ 18 years
  2. Histologically and/or cytologically proven epithelial ovarian, epithelial fallopian tube cancer or primary peritoneal cancer
  3. Progression free interval between six and twelve (6-12) months (calculated from the first day of the last cycle of the last platinum-based chemotherapy until the date of progression confirmation through radiologic imagery). Patients may have received up to two platinum-based chemotherapy lines, of which at least one must have contained a taxane
  4. Measurable or evaluable disease confirmed by radiological imaging, such as magnetic resonance imaging (MRI), computed tomography (CT) scan, or PET/CT scan at study entry (CA-125 rise not supported by radiological evidence of disease is not accepted as criteria for defining progression) or histological proven recurrent ovarian cancer even in the absence of postoperatively measurable or evaluable lesions.
  5. Eastern Cooperative Oncology Group (ECOG) performance status (PS) ≤ 2
  6. Estimated life expectancy ≥ 12 weeks
  7. Patients must be accessible for treatment and follow-up
  8. Adequate organ function within 14 days prior to first cycle as evidenced
  9. Patients must be able to receive dexamethasone or its equivalent, which is required if randomly assigned to treatment with trabectedin plus PLD
  10. Informed consent of the patient
Exclusion Criteria
  1. Non epithelial ovarian or mixed epithelial/non epithelial tumors (e.g., Mullerian tumors)
  2. Patients who did not respond to last platinum-based therapy or in whom last relapse occurred < 6 months or > 12 months from the last dose of platinum
  3. Bowel obstruction, sub-occlusive disease or the presence of symptomatic brain metastases
  4. Pre-existing grade > 1 motor or sensory neuropathy according to the National Cancer Institute Common Toxicity Criteria Adverse Event (NCI-CTCAE) version 4.0
  5. Myocardial infarct within six months before enrolment, New York Association (NYHA) Class II or worse heart failure (Appendix 1. The New York Heart Association), uncontrolled angina, severe uncontrolled ventricular arrythmias, clinically significant pericardial disease, or electrocardiographic evidence of acute ischemic or active conduction system abnormalities
  6. History of liver disease
  7. Concurrent severe medical problems or any unstable medical condition unrelated to malignancy, which would significantly limit full compliance with the study or expose the patient to extreme risk or decreased life expectancy
  8. Breastfeeding women and women of child bearing potential must use effective contraception during treatment and 3 months thereafter, which may include prescription contraceptives (oral, injection, or patch), intrauterine device, double-barrier method or male partner sterilization (not applicable to patients that are surgically sterile)
  9. Prior exposure to trabectedin
  10. Prior resistance to anthracyclines or PLD defined as a progression during anthracycline-based chemotherapy or a recurrence within 6 months from its ending
  11. Prior severe PLD related toxicity
  12. Prior exposure to cumulative doses of doxorubicin >400mg/m2 or epirubicin >720mg/m2
  13. Treatment with any investigational product within 30 days prior to inclusion in the study

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Carboplatin plus PLDPegylated Lipoxomal Doxorubicin (PLD)Pegylated Lipoxomal Doxorubicin (PLD) 30 mg/ m2 followed by carboplatin AUC 5.
Carboplatin plus PLDCarboplatinPegylated Lipoxomal Doxorubicin (PLD) 30 mg/ m2 followed by carboplatin AUC 5.
Trabectedin plus PLDPegylated Lipoxomal Doxorubicin (PLD)Pegylated Lipoxomal Doxorubicin (PLD) 30 mg/m2 infusion followed by trabectedin 1.1 mg/m2 infusion.
Trabectedin plus PLDTrabectedinPegylated Lipoxomal Doxorubicin (PLD) 30 mg/m2 infusion followed by trabectedin 1.1 mg/m2 infusion.
Primary Outcome Measures
NameTimeMethod
Overall survival (OS)This outcome measure will be assess approximately 4.5-5 years after the last patient enrolled

This is an event driven study. The study will continue until 442 events have occurred.

Secondary Outcome Measures
NameTimeMethod
Time to subsequent chemotherapy administrationThis outcome measure will be assess approximately 4.5-5 years after the last patient enrolled, at the same time points of the Primary Endpoint

The time from randomization to subsequent chemotherapy counted from the administration of subsequent chemotherapy will be evaluated as an exploratory analysis.

CA-125 serological responseThis outcome measure will be assess approximately 4.5-5 years after the last patient enrolled, at the same time points of the Primary Endpoint

CA-125 serological response will be the best response obtained in each arm

OS for Subsequent chemotherapiesThis outcome measure will be assess approximately 4.5-5 years after the last patient enrolled, at the same time points of the Primary Endpoint

the overall survival counted from the administration of subsequent chemotherapy until death

Best response to each Subsequent chemotherapy lineThis outcome measure will be assess approximately 4.5-5 years after the last patient enrolled, at the same time points of the Primary Endpoint

The best response obtained to each Subsequent chemotherapy line calculated as frequency of patients with CR, PR, SD or PD.

Duration of ResponseThis outcome measure will be assess approximately 4.5-5 years after the last patient enrolled, at the same time points of the Primary Endpoint

Duration of response: will be calculated from the date of first documentation of response (CR or partial response \[PR\], whichever occurs first) to the date of documented PD or death.

Progression Free Survival (PFS)This outcome measure will be assess approximately 4.5-5 years after the last patient enrolled, at the same time points of the Primary Endpoint

PFS will be measured from the date of randomization to the date of documented PD or death (regardless of cause of death).

Objective RRThis outcome measure will be assess approximately 4.5-5 years after the last patient enrolled, at the same time points of the Primary Endpoint

Objective RR will be the best response obtained in any evaluation according to RECIST 1.1

PFS for the Subsequent ChemotherapiesThis outcome measure will be assess approximately 4.5-5 years after the last patient enrolled, at the same time points of the Primary Endpoint

the progression free survival counted from the administration of subsequent chemotherapy untill disease progression or death whichever occurs first

Frequency of serious adverse events (SAEs)This outcome measure will be assess approximately 4.5-5 years after the last patient enrolled, at the same time points of the Primary Endpoint

Number of SAEs for each randomization arm

QoL according to the EORTC QLQ-C30 and QLQ-OV28This outcome measure will be assess approximately 4.5-5 years after the last patient enrolled, at the same time points of the Primary Endpoint

Two PRO instruments will be administered in this study: the EORTC QLQ-C30 and QLQ-OV28.PRO instruments will be completed by the patient at screening (before randomization) and within four weeks after the 6th cycle or at the time of progression, whichever occurs first.

Frequency of toxicities leading to dose delaysThis outcome measure will be assess approximately 4.5-5 years after the last patient enrolled, at the same time points of the Primary Endpoint

Clinical and laboratory toxicities

Frequency of toxicities, graded according to the NCI-CTAE version 4.0This outcome measure will be assess approximately 4.5-5 years after the last patient enrolled, at the same time points of the Primary Endpoint

Clinical and laboratory toxicities

Frequency of toxicities leading to treatment discontinuationThis outcome measure will be assess approximately 4.5-5 years after the last patient enrolled, at the same time points of the Primary Endpoint

Clinical and laboratory toxicities

Frequency of toxicities leading to dose modificationsThis outcome measure will be assess approximately 4.5-5 years after the last patient enrolled, at the same time points of the Primary Endpoint

Clinical and laboratory toxicities

Trial Locations

Locations (132)

Krankenhaus Der Barmherzigen Brueder

🇦🇹

Graz, AT, Austria

Univ. Clinic for Gynaecology and Obstetrics - Medical University of Innsbruck

🇦🇹

Innsbruck, AT, Austria

Medizinische Universitat Graz

🇦🇹

Graz, Austria

Univ. Klinik Frauenheilkunde AKH

🇦🇹

Wien, Austria

Imeldaziekenhuis

🇧🇪

Bonheiden, BE, Belgium

AZ Klina

🇧🇪

Brasschaat, BE, Belgium

Antwerp University Hospital

🇧🇪

Edegem, BE, Belgium

UZ Leuven

🇧🇪

Leuven, BE, Belgium

CMSE Clinique et Maternité Sainte-Elisabeth

🇧🇪

Namur, BE, Belgium

Az Damiaan

🇧🇪

Oostende, BE, Belgium

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Krankenhaus Der Barmherzigen Brueder
🇦🇹Graz, AT, Austria

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