EUCTR2021-002124-21-IT招募中1 期
Randomized phase III trial in MMR deficient endometrial cancer patients comparing chemotherapy alone versus Dostarlimab in first line advanced/metastatic setting: DOMENICA STUDY (GINECO-EN105b/ENGOT-en13 study) - DOMENICA
适应症
相关药物
试验速览
- 阶段
- 1 期
- 状态
- 招募中
- 入组人数
- 142
研究概览
简要总结
暂无简介。
研究设计
- 研究类型
- Interventional
入排标准
- 性别
- Female
入选标准
- •1. Female patient is at least 18 years of age,
- •2. Patient has signed the Informed Consent (ICF) and is able to comply with protocol requirements.
- •3. Patient with histologically proven endometrial adenocarcinoma with recurrent or advanced disease.
- •4. Patient with an Eastern Cooperative Oncology Group (ECOG) performance status score of 0 or 1.
- •5. Patient must have primary Stage IIIC2 or Stage IV disease or first recurrent endometrial cancer (see International Federation of Gynecology and Obstetrics staging FIGO Staging – Appendix 18.1) without curative treatment by radiation therapy or surgery alone or in combination, and meet at least one of the following situations:
- •a) Patient has primary Stage IIIC2 (with nodes involvement from the outset, not allowing a curative radiotherapy, or with remaining measurable lumbo-aortic nodes after lumbo-aortic dissection, which cannot be treated by curative radiotherapy) or Stage IV disease.
- •b) Patient has first recurrent disease and is chemotherapy naïve for this 1st recurrence or metastatic setting.
- •c) Patient may have received prior neo-adjuvant/adjuvant systemic chemotherapy or loco-regional concomitant radio-chemotherapy for the primary cancer and had a recurrence = 6 months after completing treatment (first recurrence only).
- •6. All histologic subtypes of endometrial adenocarcinoma could be included if MMRd/MSI-H,
- •7. MMRd/MSI-H tumor (defined in routine local IHC), is mandatory for inclusion. In case of ambiguous result of IHC (lack of positive internal control, heterogeneous loss of MMR protein expression), the MMRd/MSI-H status will be assessed by PCR/NGS.
- •8. Availability of 1 block for MMR/MSI status centralized confirmation for IHC or PCR/ NGS, and additional block(s) for Translational Research
- •9. Patient with measurable disease according RECIST 1.1 criteria 10. Patient could have been previously treated with hormone therapy, for the metastatic/advanced disease
- •11. Patient may have received pelvic and lombo-aortic external beam +/- vaginal brachytherapy.
- •12. Patient has adequate organ function, defined as follows:
- •a) Absolute neutrophil count = 1,500 cells/µL
- •b) Platelets = 100,000 cells/µL
- •c) Hemoglobin = 9 g/dL or = 5.6 mmol/L
- •d) Serum creatinine = 1.5× upper limit of normal (ULN) or calculated creatinine clearance = 50 mL/min using the Cockcroft-Gault equation for patients with creatinine levels > 1.5× institutional ULN
- •e) Total bilirubin = 1.5× ULN (= 2.0 x ULN in patients with known Gilbert’s syndrome) or direct bilirubin = 1× ULN
- •f) Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) = 2.5× ULN unless liver metastases are present, in which case they must be = 5× ULN
- •g) International normalized ratio or prothrombin time (PT) =1.5× ULN and activated partial thromboplastin time =1.5× ULN. Patients receiving anticoagulant therapy must have a PT or partial thromboplastin within the therapeutic range of intended use of anticoagulants.
- •13. Patient must have a negative serum pregnancy test within 72 hours of the first dose of study medication, unless they are of nonchildbearing potential. Nonchildbearing potential is defined as follows:
- •a) Patient is = 45 years of age and has not had menses for > 1 year.
- •b) A follicle-stimulating hormone value in the postmenopausal range upon screening evaluation if amenorrhoeic for < 2 years without a hysterectomy and oophorectomy.
- •c) Post-hysterectomy, post-bilateral oophorectomy, or post-tubal ligation:
- •- Documented hysterectomy or oophorecto
排除标准
- •1. Patient has received neoadjuvant/adjuvant systemic chemotherapy for primary Stage IIIc2 or IV disease and has had a recurrence or PD within 6 months of completing chemotherapy treatment prior to entering the study.
- •Note: Low-dose cisplatin given as a radiation sensitizer or hormonal therapies do not exclude patients from study participation.
- •2. Patient has had > 1 recurrence of endometrial cancer, treated with chemotherapy. Surgery of the recurrence is allowed.
- •3. Patient previously treated with chemotherapy for non-curable advanced disease or metastatic disease.
- •4. Patient has received prior therapy with an anti-PD-1, anti-PD-L1, or anti-PD-L2 agent.
- •5. Patient has received prior anticancer therapy (chemotherapy, targeted therapies, hormonal therapy, radiotherapy) within 21 days or < 5 times the half-life of the most recent therapy prior to Study Day 1, whichever is shorter.
- •Note: Palliative radiation therapy to a small field = 1 week prior to Day 1 of study treatment may be allowed.
- •6. Patient with contraindication to chemotherapy or checkpoint inhibitor treatments
- •7. Patient has a concomitant malignancy, or patient has a prior non-endometrial invasive malignancy who has been disease-free for < 3 years or who received any active treatment in the last 3 years for that malignancy. Non-melanoma skin cancer is allowed.
- •8. Patient has known uncontrolled central nervous system metastases, carcinomatosis meningitis, or both.
- •9. Patient has a known history of human immunodeficiency virus (HIV; HIV ½ antibodies).
- •10. Patient has known active hepatitis B (eg, hepatitis B surface antigen reactive) or hepatitis C (eg, hepatitis C virus ribonucleic acid [qualitative] is detected).
- •11. Patient has an active autoimmune disease that has required systemic treatment in the past 2 years. Replacement therapy is not considered a form of systemic therapy (eg, thyroid hormone or insulin).
- •12. Patient has a diagnosis of immunodeficiency or is receiving systemic steroid therapy or any other form of systemic immunosuppressive therapy within 7 days prior to the first dose of study treatment.
- •13. Patient has not recovered (ie, to Grade = 1 or to baseline) from cytotoxic therapy-induced adverse events (AEs).
- •14. Patient has not recovered adequately from AEs or complications from any major surgery prior to starting therapy.
- •15. Patient has a known hypersensitivity to carboplatin, paclitaxel, or dostarlimab components or excipients.
- •16. Patient is currently participating and receiving study treatment or has participated in a study of an investigational agent and received study treatment or used an investigational device within 4 weeks of the first dose of treatment.
- •17. Patient is considered a poor medical risk due to a serious, uncontrolled medical disorder, non-malignant systemic disease, or active infection requiring systemic therapy. Specific examples include, but are not limited to, active, non-infectious pneumonitis; uncontrolled ventricular arrhythmia; recent (within 90 days) myocardial infarction; uncontrolled major seizure disorder; unstable spinal cord compression; superior vena cava syndrome; or any psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the study (including obtaining informed consent).
- •18. Use of any of the following immunomodulatory agents within 30 days prior to the first dose of study drug:
- •Systemic corticosteroids (at dose higher than 10 mg/day equivalent prednisone); if systemi
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