Clinical Trials /

Adavosertib Plus Chemotherapy in Platinum-Resistant Epithelial Ovarian, Fallopian Tube, or Primary Peritoneal Cancer

NCT02272790

Description:

Adavosertib in combination with carboplatin, paclitaxel, gemcitabine, or PLD.

Related Conditions:
  • Fallopian Tube Carcinoma
  • Ovarian Carcinoma
  • Primary Peritoneal Carcinoma
Recruiting Status:

Active, not recruiting

Phase:

Phase 2

Trial Eligibility

Document

Title

  • Brief Title: Adavosertib Plus Chemotherapy in Platinum-Resistant Epithelial Ovarian, Fallopian Tube, or Primary Peritoneal Cancer
  • Official Title: A Multicentre Phase II Study of Adavosertib Plus Chemotherapy in Patients With Platinum-Resistant Epithelial Ovarian, Fallopian Tube, or Primary Peritoneal Cancer

Clinical Trial IDs

  • ORG STUDY ID: D6010C00004
  • SECONDARY ID: GYN 49
  • NCT ID: NCT02272790

Conditions

  • Ovarian, Fallopian Tube, Peritoneal Cancer, P53 Mutation

Interventions

DrugSynonymsArms
AdavosertibMK1775Arm A (adavosertib + gemcitabine)
PaclitaxelTaxolArm B (adavosertib + paclitaxel)
CarboplatinParaplatinArm C/C2 (adavosertib + carboplatin)
GemcitabineArm A (adavosertib + gemcitabine)
PLDArm D (adavosertib + PLD)

Purpose

Adavosertib in combination with carboplatin, paclitaxel, gemcitabine, or PLD.

Detailed Description

      This is an open-label, four-arm lead-in safety and efficacy study in which adavosertib will
      be combined in four separate treatment arms as follows: adavosertib plus gemcitabine (Arm A);
      adavosertib plus weekly paclitaxel (Arm B); adavosertib plus carboplatin (Arm C); and
      adavosertib plus PLD (Arm D). A subset of patients will be evaluated for the safety
      assessment of each treatment arm.

      The adavosertib plus paclitaxel arm (Arm B) will enrol approximately 30 additional patients
      at selected sites as part of a further efficacy evaluation based on emerging data that
      suggests clinical activity.

      In addition, the adavosertib plus carboplatin arm (Arm C) will enrol approximately 23
      patients overall at selected sites as part of a further efficacy evaluation based on emerging
      data that suggests clinical activity.

      To further optimise the dosing schedule of adavosertib in Arm C, a safety expansion arm
      (referred to as Arm C2) of approximately 12 additional patients will be enrolled at selected
      sites to explore emerging pre-clinical and clinical data that suggest that prolonged
      adavosertib exposure may increase the clinical activity.
    

Trial Arms

NameTypeDescriptionInterventions
Arm A (adavosertib + gemcitabine)ExperimentalAdavosertib (175 mg PO) will be taken on Days 1-2, 8-9, and 15-16. Gemcitabine 800 mg/m² will be administered IV on days 1, 8, and 15 of each 28 day cycle.
  • Adavosertib
  • Gemcitabine
Arm B (adavosertib + paclitaxel)ExperimentalFive doses of adavosertib (225 mg PO BID) will be taken in approximate 12 hour intervals over 2.5 days weekly (Days 1-3, 8-10, and 15-17). Weekly paclitaxel 80 mg/m² IV will be administered according to institutional standards on Day 1, 8, and 15 of each 28 day cycle.
  • Adavosertib
  • Paclitaxel
Arm C/C2 (adavosertib + carboplatin)ExperimentalArm C: Five doses of adavosertib (225 mg PO BID) will be taken in approximate 12 hour intervals over 2.5 days (Days 1-3). Carboplatin AUC 5 IV will be administered according to institutional standards on Day 1 of each 21-Day cycle. Arm C2: Five doses of adavosertib (225 mg PO BID) 2.5 days per dosing week (QW), on Weeks 1 (D1-3), 2 (D8-10) and 3 (D15-17), or on Weeks 1 (D1-3) and 2 (D8-10) ( 2 weeks on followed by 1 week off.) Carboplatin AUC 5 IV will be administered according to institutional standards on Day 1 of each 21 day cycle.
  • Adavosertib
  • Carboplatin
Arm D (adavosertib + PLD)ExperimentalFive doses of adavosertib (175 mg or 225 mg) will be taken in approximate 12 hour intervals over 2.5 days (Days 1, 2, and 3) of each 28-day cycle. PLD will administered IV on Day 1 of each cycle.
  • Adavosertib
  • PLD

Eligibility Criteria

        Inclusion

          -  Has read and understands the informed consent form (ICF) and has given written IC
             prior to any study specific procedures.

          -  Histologic or cytologic diagnosis of epithelial ovarian, fallopian tube, or primary
             peritoneal cancer.

          -  Progressed within 6 months of completing at least 4 cycles of a first-line
             platinum-containing regimen for Stage III/IV disease. Patients with refractory disease
             (progression during platinum-containing therapy) are ineligible.

          -  No more than 2-4 prior treatment regimens for Stage III/IV disease, defined as
             investigational, chemotherapy, hormonal, biologic, or targeted therapy.

          -  Prior doxorubicin (or other anthracycline) at a cumulative dose of ≤ 360 mg/m² or
             cumulative epirubicin dose of ≤ 720 mg/m² (calculated using doxorubicin equivalent
             doses: 1 mg of doxorubicin = 1 mg PLD = 0.3 mg mitoxantrone = 0.25 mg idarubicin).
             Subjects without any prior anthracycline exposure can also be included. Applies to Arm
             D only.

          -  At least 1 measurable lesion according to RECIST v1.1.

          -  Any prior palliative radiation therapy must be completed at least 7 days prior to
             start of study treatment and patients must have recovered from any acute adverse
             effects prior to start of study treatment.

          -  Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) score of 0 - 1.

          -  Baseline Laboratory Values:

               1. ANC ≥1500/μL

               2. HgB ≥ 9 g/dL with no blood transfusions in the past 28 days

               3. Platelets ≥ 100,000/μL

               4. ALT & AST ≤3 x ULN or ≤5 x ULN if known hepatic metastases

               5. Serum bilirubin within normal limits (WNL) or ≤1.5 x the ULN in patients with
                  liver metastases; or total bilirubin ≤3.0 x ULN with direct bilirubin WNL in
                  patients with well documented Gilbert's Syndrome.

               6. Serum creatinine ≤1.5 x the ULN and a calculated creatinine clearance (CrCl) ≥45
                  mL/min by the Cockcroft-Gault method.

          -  Left ventricular ejection fraction (LVEF) WNL of the institution as determined by
             multiple uptake gated acquisition (MUGA) or echocardiography (ECHO) (applies to Arm D
             only).

          -  Female patients, ≥18, (not of childbearing potential and fertile female patients of
             childbearing potential) who agree to use adequate contraceptive measures from 2 weeks
             prior to the study and until 1 month after study treatment discontinuation, who are
             not breastfeeding, and who have a negative serum or urine pregnancy test within 72
             hours prior to start.

          -  Predicted life expectancy ≥ 12 weeks

        Exclusion

          -  Use of a study drug (approved or investigational drug therapy) ≤21 days or 5
             half-lives (whichever is shorter) prior to the first dose of study treatment. For
             study drugs for which 5 half-lives is ≤21 days, a minimum of 10 days between
             termination of the study drug and administration of study treatment is required.

          -  Major surgical procedures ≤ 28 days of beginning study, or minor surgical procedures ≤
             7 days. No waiting period following port-a-cath placement, or any other central venous
             access placement.

          -  Grade >1 toxicity from prior therapy (except alopecia or anorexia).

          -  Known malignant CNS disease other than neurologically stable, treated brain
             metastases, defined as metastasis having no evidence of progression or haemorrhage
             after treatment for at least 2 weeks (including brain radiotherapy). Must be off any
             systemic corticosteroids for the treatment of brain metastases for at least 14 days
             prior to enrolment.

          -  Patient has had prescription or non-prescription drugs or other products (i.e.
             grapefruit juice) known to be sensitive CYP3A4 substrates or CYP3A4 substrates with a
             narrow therapeutic index, or to be moderate to strong inhibitors or inducers of CYP3A4
             which cannot be discontinued 2 weeks prior to Day 1 of dosing and withheld throughout
             the study until 2 weeks after last dose of study drug.

          -  Caution should be exercised when inhibitors or substrates of P-gP, substrates of
             CYP1A2 with a narrow therapeutic range, sensitive substrates of CYP2C19 or CYP2C19
             substrates with a narrow therapeutic range are administered with adavosertib.

          -  Herbal medications should be discontinued 7 days prior to the first dose of study
             treatment.

          -  Any of the following cardiac diseases currently or within the last 6 months as defined
             by New York Heart Association (NYHA) ≥ Class 2:

               1. Unstable angina pectoris

               2. Congestive heart failure

               3. Acute myocardial infarction

               4. Conduction abnormality not controlled with pacemaker or medication

               5. Significant ventricular or supraventricular arrhythmias (patients with chronic
                  rate controlled atrial fibrillation in the absence of other cardiac abnormalities
                  are eligible).

          -  Adavosertib should not be given to patients who have a history of Torsades de pointes
             unless all risk factors that contributed to Torsades have been corrected. Adavosertib
             has not been studied in patients with ventricular arrhythmias or recent myocardial
             infarction.

          -  Corrected QT interval (QTc) >470 msec at study entry or congenital long QT syndrome.

          -  Pregnant or lactating.

          -  Serious active infection at the time of enrolment, or another serious underlying
             medical condition that would impair the patient's ability to receive study treatment.

          -  Presence of other active cancers, or history of treatment for invasive cancer within 3
             years. Patients with Stage I cancer who have received definitive local treatment
             within 3 years, and whom are considered unlikely to recur, are eligible. Patients with
             previously treated in-situ carcinoma (i.e., non-invasive) are eligible, as are
             patients with prior non-melanoma skin cancers.
      
Maximum Eligible Age:130 Years
Minimum Eligible Age:18 Years
Eligible Gender:Female
Healthy Volunteers:No

Primary Outcome Measures

Measure:Objective Response Rate (ORR)
Time Frame:Throughout the duration of the study (up to 19 months)
Safety Issue:
Description:Objective response rate is defined as the proportion of patients achieving a complete or partial tumour response according to RECIST v1.1 criteria.

Secondary Outcome Measures

Measure:Disease Control Rate (DCR)
Time Frame:Throughout the duration of the study (up to 19 months)
Safety Issue:
Description:The Disease Control Rate is defined as the proportion of patients achieving a complete response (CR), partial response (PR), or stable disease (SD) according to RECIST v1.1 criteria.
Measure:Duration of Response (DoR)
Time Frame:Throughout the duration of the study, approximately 19 months.
Safety Issue:
Description:Duration of Response (DoR) is defined as the time from first documented tumour response until the date of documented progression or death from any cause.
Measure:Progression Free Survival (Median, 80% CI)
Time Frame:Throughout the Study, Approximately 4 years
Safety Issue:
Description:Progression-free survival (PFS) was defined as the elapsed time from date of first dose of AZD1775 until the date of objective disease progression or death (by any cause in the absence of progression) regardless of whether the patient withdrew from therapy or received another anti-cancer therapy prior to progression. Patients who had not progressed or died at the time of analysis were censored at the time of the latest date of assessment from their last evaluable RECIST assessment. Progression-free survival was derived based on scan/assessment dates, not visit dates.
Measure:Progression Free Survival (Median, 95% CI)
Time Frame:Throughout the Study, Approximately 4 years
Safety Issue:
Description:Progression-free survival (PFS) was defined as the elapsed time from date of first dose of AZD1775 until the date of objective disease progression or death (by any cause in the absence of progression) regardless of whether the patient withdrew from therapy or received another anti-cancer therapy prior to progression. Patients who had not progressed or died at the time of analysis were censored at the time of the latest date of assessment from their last evaluable RECIST assessment. Progression-free survival was derived based on scan/assessment dates, not visit dates.
Measure:Overall Survival (Median, 80% CI)
Time Frame:Throughout the Study, Approximately 4 years
Safety Issue:
Description:Overall survival (OS) was defined as the elapsed time from the date of first dose of AZD1775 until death due to any cause. Any patient not known to have died at the time of the analysis was censored based on the last recorded date on which the patient was known to be alive.
Measure:Overall Survival (Median, 95% CI)
Time Frame:Throughout the Study, Approximately 4 years
Safety Issue:
Description:Overall survival (OS) was defined as the elapsed time from the date of first dose of AZD1775 until death due to any cause. Any patient not known to have died at the time of the analysis was censored based on the last recorded date on which the patient was known to be alive.
Measure:Gynecologic Cancer Intergroup (GCIG) CA-125 Response
Time Frame:Throughout the study, approximately 4 years
Safety Issue:
Description:The GCIG CA-125 response is defined as the proportion of patients achieving a 50% reduction in CA-125 levels from baseline, if baseline level is ≥2 x the upper limit of normal (ULN) within 2 weeks prior to starting treatment. Response must be confirmed and maintained for at least 28 days.
Measure:The Number of Patients Experiencing Treatment-emergent Adverse Events (TEAEs) by Maximum CTCAE Grade.
Time Frame:Throughout the duration of the study (up to 19 months)
Safety Issue:
Description:The number of patients experiencing at least one treatment-related adverse event (TEAE) by maximum CTCAE grade. Severity Grade 1 = Mild; Severity Grade 2 = Moderate; Severity Grade 3 = Severe; Severity Grade 4 = Life Threatening; Severity Grade 5 = Fatal
Measure:The Number of Patients Experiencing Treatment-emergent Adverse Events (TEAEs) Related to Adavosertib by Maximum CTCAE Grade
Time Frame:Throughout the duration of the study (up to 19 months)
Safety Issue:
Description:The number and proportion of patients experiencing at least one treatment-related adverse event (TEAE) related to adavosertib by maximum CTCAE grade Severity Grade 1 = Mild; Severity Grade 2 = Moderate; Severity Grade 3 = Severe; Severity Grade 4 = Life Threatening; Severity Grade 5 = Fatal
Measure:The Number of Patients Experiencing Treatment-emergent Adverse Events (TEAEs) Related to Chemotherapy by Maximum CTCAE Grade
Time Frame:Throughout the duration of the study (up to 19 months)
Safety Issue:
Description:The number of patients experiencing at least one treatment-related adverse event (TEAE) related to chemotherapy by maximum CTCAE grade. Severity Grade 1 = Mild; Severity Grade 2 = Moderate; Severity Grade 3 = Severe; Severity Grade 4 = Life Threatening; Severity Grade 5 = Fatal
Measure:Serious Adverse Events
Time Frame:Throughout the duration of the study (up to 19 months)
Safety Issue:
Description:The number of patients experiencing at least one serious adverse event (SAE).
Measure:Serious Adverse Events Leading to Death
Time Frame:Throughout the duration of the study (up to 19 months)
Safety Issue:
Description:The number of patients experiencing at least one serious adverse event (SAE) leading to death.
Measure:Treatment-Related Adverse Events Related to Adavosertib Leading to Treatment Discontinuation
Time Frame:Throughout the duration of the study (up to 19 months)
Safety Issue:
Description:The number of patients experiencing at least one treatment-related adverse event related to adavosertib leading to treatment discontinuation.
Measure:Treatment-Related Adverse Events Related to Adavosertib Leading to Dose Reduction
Time Frame:Throughout the duration of the study (up to 19 months)
Safety Issue:
Description:The number of patients experiencing at least one treatment-related adverse event related to adavosertib leading to dose reduction.
Measure:Treatment-Related Adverse Events Related to Adavosertib Leading to Treatment Interruption
Time Frame:Throughout the duration of the study (up to 19 months)
Safety Issue:
Description:The number of patients experiencing at least one treatment-related adverse event related to adavosertib leading to treatment interruption.
Measure:Treatment-Related Adverse Events Related to Chemotherapy Leading to Treatment Discontinuation
Time Frame:Throughout the duration of the study (up to 19 months)
Safety Issue:
Description:The number of patients experiencing at least one treatment-related adverse event related to chemotherapy leading to treatment discontinuation.
Measure:Treatment-Related Adverse Events Related to Chemotherapy Leading to Dose Reduction
Time Frame:Throughout the duration of the study (up to 19 months)
Safety Issue:
Description:The number of patients experiencing at least one treatment-related adverse event related to chemotherapy leading to dose reduction.
Measure:Treatment-Related Adverse Events Related to Chemotherapy Leading to Treatment Interruption
Time Frame:Throughout the duration of the study (up to 19 months)
Safety Issue:
Description:The number of patients experiencing at least one treatment-related adverse event related to chemotherapy leading to treatment interruption.
Measure:Single Dose Adavosertib Cmax
Time Frame:Pre-dose, 0.5 hr, 1 hr, 2 hr, 4 hr, 6 hr, and 8 hr
Safety Issue:
Description:Maximum plasma concentration of adavosertib after a single oral dose (Cycle 1 Day 1) in combination with IV infusion of commonly used chemotherapy agents, including gemcitabine, paclitaxel, and carboplatin.
Measure:Multiple Dose Adavosertib Cmax
Time Frame:Pre-dose, 1 hr, 2 hr, 4 hr, 6 hr, and 8 hr
Safety Issue:
Description:Maximum plasma concentration of adavosertib after a multiple oral doses (Cycle 1 Day 3) in combination with IV infusion of 40 mg/m² pegylated liposomal doxorubicin.
Measure:Single Dose Adavosertib Tmax
Time Frame:Pre-dose, 0.5 hr, 1 hr, 2 hr, 4 hr, 6 hr, and 8 hr
Safety Issue:
Description:The time to reach maximum plasma concentration of adavosertib after a single oral dose (Cycle 1 Day 1) in combination with IV infusion of commonly used chemotherapy agents, including gemcitabine, paclitaxel, and carboplatin.
Measure:Multiple Dose Adavosertib Tmax
Time Frame:Pre-dose, 1 hr, 2 hr, 4 hr, 6 hr, and 8 hr
Safety Issue:
Description:The time to reach maximum plasma concentration of adavosertib after multiple oral doses (Cycle 1 Day 3) in combination with IV infusion of 40 mg/m² pegylated liposomal doxorubicin.

Details

Phase:Phase 2
Primary Purpose:Interventional
Overall Status:Active, not recruiting
Lead Sponsor:AstraZeneca

Trial Keywords

  • Ovarian, Fallopian Tube, or Primary Peritoneal Cancer

Last Updated

July 12, 2021