Description:
The DOMEC trial is designed as a Dutch Gynecological Oncology Group (DGOG), prospective,
multi-center, phase II study for 55 patients with advanced (recurrent, refractory or
metastatic) endometrial cancer or carcinosarcoma of the uterus to investigate the efficacy of
the combination therapy of olaparib tablets and durvalumab IV.
Title
- Brief Title: Durvalumab and Olaparib in Metastatic or Recurrent Endometrial Cancer
- Official Title: Durvalumab and Olaparib in Metastatic or Recurrent Endometrial Cancer
Clinical Trial IDs
- ORG STUDY ID:
DOMEC
- NCT ID:
NCT03951415
Conditions
- Endometrial Neoplasms
- Uterine Neoplasms
- Endometrium Cancer
Interventions
Drug | Synonyms | Arms |
---|
PARP inhibitor and Anti-PD-L1 | olaparib, durvalumab, PARP inhibitor, Anti-PD-L1 Monoclonal Antibody | PARP inhibitor and Anti-PD-L1 |
Purpose
The DOMEC trial is designed as a Dutch Gynecological Oncology Group (DGOG), prospective,
multi-center, phase II study for 55 patients with advanced (recurrent, refractory or
metastatic) endometrial cancer or carcinosarcoma of the uterus to investigate the efficacy of
the combination therapy of olaparib tablets and durvalumab IV.
Detailed Description
The prognosis of recurrent or persistent endometrial carcinoma not amenable to local therapy
is poor. First line therapy exists of platinum-based chemotherapy or hormonal therapy. No
standard subsequent-line therapy has been described.The combination of Poly(ADP-ribose)
polymerases (PARP) inhibition and Programmed death-ligand 1 (PD-L1) blocking has great
potential in the treatment of recurrent endometrial cancer. The DOMEC trial is designed to
investigate this treatment combination among all molecular subgroups.
The DOMEC trial is designed as a DGOG, prospective, multi-center, phase II study for 55
patients with advanced (recurrent, refractory or metastatic) endometrial cancer, including
carcinosarcoma of the uterus. Patients must have had one prior platinum-based
chemotherapeutic regimen or not be able/willing to get chemotherapy. The aim is to
investigate the efficacy of the combination therapy of olaparib tablets 300mg twice daily
orally and durvalumab 1500mg by IV infusion every 4 weeks in terms of progression free
survival. Secondary objectives are to investigate objective response rate, overall survival,
safety and predictive biomarkers.
Trial Arms
Name | Type | Description | Interventions |
---|
PARP inhibitor and Anti-PD-L1 | Experimental | olaparib tablets 300mg twice daily orally and durvalumab 1500mg by IV infusion every 4 weeks | - PARP inhibitor and Anti-PD-L1
|
Eligibility Criteria
Inclusion criteria:
- Written informed consent
- Age > 18 years old
- Histologically confirmed diagnosis of endometrial cancer or carcinosarcoma of the
endometrium.
- Metastatic disease or locally advanced tumor not amenable to local therapy.
- Documented progressive disease before enrolment.
- Measurable lesions outside irradiated field or progressive measurable lesions in
irradiated area
- Not eligible for hormonal therapy (because of negative hormone receptor/poor
differentiation, or after failure of hormonal therapy).
- Previous failure of chemotherapy, or refusal to undergo chemotherapy or chemo-naive
patients not suitable for chemotherapy.
- WHO performance 0-1
- Adequate organ system function as measured within 28 days prior to administration of
study treatment, as defined below:
- Haemoglobin ≥ 10.0 g/dL, with no blood transfusion in the past 28 days.
- Absolute neutrophil count (ANC) ≥ 1.5 x 109/L
- Platelet count ≥ 100 x 109/L
- Total bilirubin ≤ 1.5 x institutional upper limit of normal (ULN) (not applicable
to Gilbert's syndrome)
- Aspartate aminotransferase (AST) (Serum Glutamic Oxaloacetic Transaminase (SGOT))
/ Alanine aminotransferase (ALT) (Serum Glutamic Pyruvate Transaminase (SGPT)) ≤
2.5 x ULN unless liver metastases are present in which case they must be ≤ 5x ULN
- Patients must have creatinine clearance estimated of ≥51 mL/min estimated using
the Cockcroft-Gault equation or 24 hr urine clearance.
- Life expectancy of at least 16 weeks.
- Measurable disease as defined by RECIST 1.1 criteria
- Able to swallow and retain oral medication.
- A female is eligible to enter and participate in this study if there is:
Exclusion criteria:
- Participation in another clinical study with an investigational product during the
last month or previous enrolment in the present study.
- Any previous treatment with PARP inhibitor, including olaparib and/or any previous
treatment with a PD1 or PD-L1 inhibitor
- History of another primary malignancy except for malignancy treated with curative
intent and with no known active disease ≥5 years before the first dose of
investigational product and of low potential risk for recurrence or adequately treated
non-melanoma skin cancer, lentigo maligna or carcinoma in situ.
- History of leptomeningeal carcinomatosis, symptomatic uncontrolled brain metastases
(≤2mg/ day corticosteroids started ≥4 weeks prior to treatment is accepted) and spinal
cord compression (unless received definitive treatment and clinically stable for 28
days) .
- Resting ECG with QTc > 470 msec on 2 or more time points within a 24 hour period or
family history of long QT syndrome
- Concomitant use of known strong or moderate CYP3A inhibitors and inducers.
- Any unresolved toxicity NCI CTCAE Grade ≥2 from previous anticancer therapy with the
exception of alopecia, vitiligo, and the laboratory values defined in the inclusion
criteria.
- Current or prior use of immunosuppressive medication within 14 days before the first
dose of durvalumab (except intranasal and inhaled corticosteroids or systemic
prednisone ≤ 10 mg/day)
- Major surgery ≤2 weeks of starting study treatment
- History of active primary immunodeficiency
- Active or prior documented autoimmune or inflammatory disorders, with exception of:
vitiligo or alopecia, hypothyroidism stable on hormone replacement, any chronic skin
condition that does not require systemic therapy, celiac disease controlled by diet
alone
- Patients unable to swallow orally administered medication and patients with
gastrointestinal disorders likely to interfere with absorption of the study
medication.
- Active infection including tuberculosis, hepatitis B/C and HIV
- Patients with an expected or known hypersensitivity to olaparib or durvalumab or any
of the excipients of the products.
- Previous allogenic bone marrow transplant or double umbilical cord blood
transplantation (dUCBT).
- Receipt of live attenuated vaccine within 30 days prior to the first dose of IP.
- Pregnancy or breastfeeding
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | Female |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Progression free survival (PFS) |
Time Frame: | 6 months |
Safety Issue: | |
Description: | PFS will be counted from the date of registration until the first observation of radiological progressive disease according to RECIST 1.1 criteria or death due to any cause, whichever occurred first. |
Secondary Outcome Measures
Measure: | Objective response rate (ORR) |
Time Frame: | 12 weeks |
Safety Issue: | |
Description: | according to RECIST 1.1 criteria |
Measure: | Overall survival (OS) |
Time Frame: | Through study completion, up to 36 months |
Safety Issue: | |
Description: | OS will be determined from the date of registration until death from any cause. |
Measure: | Adverse events |
Time Frame: | Through study completion, up to 36 months |
Safety Issue: | |
Description: | Assessed by NCI Common Terminology Criteria for adverse Events (CTCAE) version 5.0 |
Measure: | Predictive biomarkers in tumor biopsy |
Time Frame: | At baseline |
Safety Issue: | |
Description: | MMRd/POLE, HR status, quantification of CD3,CD4,CD8,CD103,CD161,PD-1,LAG3,CTLA-4,NKG2A,GOXp3 positieve T cells, NK cells, percentage PD-L1 on myeloid cells/tumorcells, quantification of myeloid cell infiltration (CD68,CD14,CD33,CD163) in tumor biopsies. |
Details
Phase: | Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Active, not recruiting |
Lead Sponsor: | Leiden University Medical Center |
Trial Keywords
- Poly (ADP-ribose) Polymerase Inhibitors
- Antibodies, Monoclonal
- Checkpoint Inhibitors
- olaparib
- durvalumab
- Anti-PD-L1
Last Updated
April 1, 2021