Randomized, Double-Blind, Phase III Trial of Olaparib vs. Placebo in Patients withAdvanced FIGO Stage IIIB – IV High Grade Serous or Endometrioid Ovarian, FallopianTube, or Peritoneal Cancer treated with standard First-Line Treatment, CombiningPlatinum-Taxane Chemotherapy and Bevacizumab Concurrent with Chemotherapyand in Maintenance
- Conditions
- Patients withAdvanced FIGO Stage IIIB – IV High Grade Serous or Endometrioid Ovarian, FallopianTube, or Peritoneal Cancer treated with standard First-Line Treatment, CombiningPlatinum-Taxane Chemotherapy and Bevacizumab Concurrent with Chemotherapyand in MaintenanceMedDRA version: 21.1Level: PTClassification code 10070907Term: Ovarian cancer stage IIISystem Organ Class: 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)MedDRA version: 21.1Level: PTClassification code 10070908Term: Ovarian cancer stage IVSystem Organ Class: 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)Therapeutic area: Diseases [C] - Cancer [C04]
- Registration Number
- EUCTR2014-004027-52-IT
- Lead Sponsor
- ARCAGY-GINECO
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Authorised-recruitment may be ongoing or finished
- Sex
- Female
- Target Recruitment
- 636
I-1.Female Patient must be =18 years of age.
I-2.Signed informed consent and ability to comply with treatment and follow-up.
I-3.Patient with newly diagnosed
I-3-1 Ovarian cancer, primary peritoneal cancer and/or fallopian-tube cancer,
I-3-2 Histologically confirmed (based on local histopathological findings):
•high grade serous (see appendix 2) or
•high grade endometrioid (see appendix 2) or
•other epithelial non mucinous ovarian cancer in a patient with germline BRCA 1 or 2 deleterious mutation
I-3-3 at an advanced stage: FIGO stage IIIB, IIIC, or IV of the 1988 FIGO classification (see appendix 1).
I-4.Patient who has completed prior to randomization first line platinum-taxane chemotherapy:
a.Platinum-taxane based regimen must have consisted of a minimum of 6 treatment cycles and a maximum of 9. However if platinum based therapy must be discontinued early as a result of non hematological toxicity specifically related to the platinum regimen, (i.e. neurotoxicity, hypersensitivity etc.), patient must have received a minimum of 4 cycles of the platinum regimen.
b.Intravenous, intraperitoneal, or neoadjuvant platinum based chemotherapy is allowed; for weekly therapy, three weeks are considered one cycle. Interval debulking is allowed.
I-5.Patient must have received prior to randomization a minimum of 3 cycles of bevacizumab in combination with the 3 last cycles of platinum-based chemotherapy. Only in case of interval debulking surgery, it is allowed to realize only 2 cycles of bevacizumab in combination with the last 3 cycles of platinium-based chemotherapy. Bevacizumab treatment should be administered at a dose 15mg/kg q3 weeks up to a total of 15 months.
I-6.Patient must be prior to randomization without evidence of disease (NED) or in complete response (CR) or partial response (PR) from her first line treatment. There should be no clinical evidence of disease progression (physical exam, imagery, CA 125) throughout her first line treatment and prior to study randomization.
I-7.Patient must be randomized at least 3 weeks and no more than 9 weeks after her last dose of chemotherapy (last dose is the day of the last infusion) and all major toxicities from the previous chemotherapy must have resolved to CTC AE grade 1 or better (except alopecia and peripheral neuropathy).
I-8.Patient must have normal organ and bone marrow function:
a.Hemoglobin = 10.0 g/dL.
b.Absolute neutrophil count (ANC) = 1.5 x 109/L.
c.Platelet count = 100 x 109/L.
d.Total bilirubin = 1.5 x institutional upper limit of normal (ULN).
e.Aspartate aminotransferase /Serum Glutamic Oxaloacetic Transaminase (ASAT/SGOT)) and Alanine aminotransferase /Serum Glutamic Pyruvate Transaminase (ALAT/SGPT)) = 2.5 x ULN, unless liver metastases are present in which case they must be = 5 x ULN.
f.Serum creatinine = 1.25 x institutional ULN and creatinine clearance > 50 mL/min.
g.Patient not receiving anticoagulant medication who has an International Normalized Ratio (INR) =1.5 and an Activated ProThrombin Time (aPTT) =1.5 x ULN.
The use of full-dose oral or parenteral anticoagulants is permitted as long as the INR or APTT is within therapeutic limits (according to site medical standard) the patient is on oral anticoagulants, dose has to be stable for at least two weeks at the time of randomization.
h.Urine dipstick for proteinuria < 2+. If urine dipstick is =2+, 24-hour urine must demonstrate <1 g of protein in 24 hours.
i.Normal bloo
1-Non-epithelial origin of the ovary, the fallopian tube or the peritoneum(i.e. germ cell tumors).2-Ovarian tumors of low malignant potential (e.g. borderline tumors), ormucinous carcinoma.3-Patients with synchronous primary endometrial cancer unless both of
the following criteria are met:-stage < II,-Less than 60 years old at the time of diagnosis of endometrial cancerwith stage IA or IB grade 1 or 2, or stage IA grade III endometrial carcinoma OR = 60 years old at the time of diagnosis of endometrial cancer withstage IA grade 1 or 2 endometrioid adenocarcinoma.-Patients with serous or clear cell adenocarcinoma or carcinosarcoma of
the endometrium are not eligible.4-Other malignancy within the last 5 years except: adequately treatednon-melanoma skin cancer curatively treated in situ cancer of the cervix,ductal carcinoma in situ .Patients with history of primary triple negative breast cancer may beeligible provided they completed their definitive anticancer treatmentmore than 3 years ago and they remain breast cancer disease free priorto start of study treatment.5-Patients with myelodysplastic syndrome/acute myeloid leukemia
history.6-Patients having experienced a delay > 2 weeks in the chemotherapycourse administration due to prolonged hematological recovery.7-Patients receiving radiotherapy within 6 weeks prior to studytreatment.8-Major surgery within 4 weeks of starting study treatment and patientsmust have recovered from any effects of any major surgery.9-Previous allogenic bone marrow transplant.
10-Any previous treatment with PARP inhibitor, including olaparib.11-Administration of other simultaneous chemotherapy drugs, any otheranticancer therapy or anti-neoplastic hormonal therapy, or simultaneousradiotherapy during the trial treatment period
12-Current or recent (within 10 days prior to randomization) chronic use ofaspirin > 325 mg/day.13-Concomitant use of known potent CYP3A4 inhibitors such asketoconazole, itraconazole, ritonavir, indinavir, saquinavir,telithromycin, clarithromycin and nelfinavir.14-Prior history of hypertensive crisis (CTC-AE grade 4) or hypertensiveencephalopathy.15-Clinically significant cardiovascular disease, including:-Myocardial infarction or unstable angina within = 6 months ofrandomization,-NYH = grade 2 congestive heart failure (CHF),-Poorly controlled cardiac arrhythmia despite medication (patients withrate controlled atrial fibrillation are eligible), or any clinically significantabnormal finding on resting ECG,-Peripheral vascular disease grade = 3 (e.g. symptomatic and interferingwith activities of daily living [ADL] requiring repair or revision).16-Previous Cerebro-Vascular Accident, Transient Ischemic Attack or Sub-Arachnoids Hemorrhage within 6 months prior to randomization.
17-History or evidence of hemorrhagic disorders within 6 months prior torandomization.18-Evidence of bleeding diathesis or significant coagulopathy19-History or clinical suspicion of brain metastases or spinal cordcompression. CT/MRI of the brain is mandatory (within 4 weeks prior torandomization) in case of suspected brain metastases. Spinal MRI ismandatory (within 4 weeks prior to randomization) in case of suspectedspinal cord compression.20-History or evidence upon neurological examination of central nervoussystem disease, unless adequately treated with standard medicaltherapy .21-Significant traumatic injury during 4 weeks prior to randomization.22-Non-healing wound, active ulcer or bone fracture. Patients withgranula
Study & Design
- Study Type
- Interventional clinical trial of medicinal product
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method
- Secondary Outcome Measures
Name Time Method