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A Study to Evaluate Dostarlimab Plus Carboplatin-paclitaxel Versus Placebo Plus Carboplatin-paclitaxel in Participants With Recurrent or Primary Advanced Endometrial Cancer

NCT03981796

Description:

This is a 2 part study. Part 1 is to evaluate the efficacy and safety of dostarlimab plus carboplatin-paclitaxel followed by dostarlimab versus placebo plus carboplatin-paclitaxel followed by placebo; and Part 2 is to evaluate the efficacy and safety of dostarlimab plus carboplatin-paclitaxel followed by dostarlimab plus niraparib versus placebo plus carboplatin-paclitaxel followed by placebo in participants with recurrent or primary advanced (Stage III or IV) endometrial cancer. Part 1 has completed enrollment, and Part 2 is open for enrollment. Both Parts consist of a Screening Period, Treatment Period, an End of Treatment (EOT) Visit, a Safety Follow-up Visit, and a Survival Assessment Period. In Part 2, participants will be randomized 1:2 to receive either carboplatin/paclitaxel/placebo or Dostarlimab/carboplatin/paclitaxel followed by Dostarlimab/niraparib or placebo iv/oral maintenance.

Related Conditions:
  • Endometrial Carcinoma
Recruiting Status:

Recruiting

Phase:

Phase 3

Trial Eligibility

Document

Title

  • Brief Title: A Study to Evaluate Dostarlimab Plus Carboplatin-paclitaxel Versus Placebo Plus Carboplatin-paclitaxel in Participants With Recurrent or Primary Advanced Endometrial Cancer
  • Official Title: A Phase 3, Randomized, Double-blind, Multicenter Study of Dostarlimab (TSR-042) Plus Carboplatin-paclitaxel Versus Placebo Plus Carboplatin-paclitaxel in Patients With Recurrent or Primary Advanced Endometrial Cancer (RUBY)

Clinical Trial IDs

  • ORG STUDY ID: 213361
  • SECONDARY ID: ENGOT-EN6
  • SECONDARY ID: GOG-3031
  • SECONDARY ID: 4010-03-001
  • NCT ID: NCT03981796

Conditions

  • Neoplasms

Interventions

DrugSynonymsArms
DostarlimabTSR-042Arm 1: Participants receiving dostarlimab + Carboplatin-paclitaxel followed by dostarlimab
PlaceboArm 2: Participants receiving placebo + carboplatin-paclitaxel followed by placebo
CarboplatinArm 1: Participants receiving dostarlimab + Carboplatin-paclitaxel followed by dostarlimab
PaclitaxelArm 1: Participants receiving dostarlimab + Carboplatin-paclitaxel followed by dostarlimab
NiraparibArm 3: Participants receiving dostarlimab + carboplatin-paclitaxel followed by dostarlimab+niraparib

Purpose

This is a 2 part study. Part 1 is to evaluate the efficacy and safety of dostarlimab plus carboplatin-paclitaxel followed by dostarlimab versus placebo plus carboplatin-paclitaxel followed by placebo; and Part 2 is to evaluate the efficacy and safety of dostarlimab plus carboplatin-paclitaxel followed by dostarlimab plus niraparib versus placebo plus carboplatin-paclitaxel followed by placebo in participants with recurrent or primary advanced (Stage III or IV) endometrial cancer. Part 1 has completed enrollment, and Part 2 is open for enrollment. Both Parts consist of a Screening Period, Treatment Period, an End of Treatment (EOT) Visit, a Safety Follow-up Visit, and a Survival Assessment Period. In Part 2, participants will be randomized 1:2 to receive either carboplatin/paclitaxel/placebo or Dostarlimab/carboplatin/paclitaxel followed by Dostarlimab/niraparib or placebo iv/oral maintenance.

Trial Arms

NameTypeDescriptionInterventions
Arm 1: Participants receiving dostarlimab + Carboplatin-paclitaxel followed by dostarlimabActive Comparator
  • Dostarlimab
  • Carboplatin
  • Paclitaxel
Arm 2: Participants receiving placebo + carboplatin-paclitaxel followed by placeboPlacebo Comparator
  • Placebo
  • Carboplatin
  • Paclitaxel
Arm 3: Participants receiving dostarlimab + carboplatin-paclitaxel followed by dostarlimab+niraparibActive Comparator
  • Dostarlimab
  • Carboplatin
  • Paclitaxel
  • Niraparib
Arm 4: Participants receiving placebo + carboplatin-paclitaxel followed by placeboPlacebo Comparator
  • Placebo
  • Carboplatin
  • Paclitaxel

Eligibility Criteria

        Inclusion Criteria:

        Part 1 and Part 2:

          -  Female participant is at least 18 years of age

          -  Participant has histologically or cytologically proven endometrial cancer with
             recurrent or advanced disease.

          -  Participant must have primary Stage III or Stage IV disease or first recurrent
             endometrial cancer with a low potential for cure by radiation therapy or surgery alone
             or in combination and meet at least one of the following criteria; a) Participant has
             primary Stage IIIA to IIIC1 disease with presence of evaluable or measurable disease
             per RECIST v.1.1 based on Investigator's assessment. Lesions that are equivocal or can
             be representative of post-operative change should be biopsied and confirmed for the
             presence of tumor; b) Participant has primary Stage IIIC1 disease with carcinosarcoma,
             clear cell, serous, or mixed histology (containing >=10 percent carcinosarcoma, clear
             cell, or serous histology) regardless of presence of evaluable or measurable disease
             on imaging; c) Participant has primary Stage IIIC2 or Stage IV disease regardless of
             the presence of evaluable or measurable disease; d) Participant has first recurrent
             disease and is naïve to systemic anticancer therapy; e) Participant has received prior
             neo-adjuvant/adjuvant systemic anticancer therapy and had a recurrence or PD >=6
             months after completing treatment (first recurrence only).

          -  Participant has an Eastern Cooperative Oncology Group (ECOG) performance status of 0
             or 1.

          -  Participant has adequate organ function.

          -  Part 2 only:

          -  Participants must have normal blood pressure (BP) or adequately treated and controlled
             hypertension (systolic BP <=140 millimeter of mercury (mmHg) and diastolic BP <=90
             mmHg).

          -  Participants must be able to take medication orally, by mouth (PO).

        Exclusion Criteria:

          -  Part 1 and Part 2:

          -  Participant has received neo-adjuvant/adjuvant systemic anticancer therapy for primary
             Stage III or IV disease and: a) has not had a recurrence or PD prior to first dose on
             the study OR b) has had a recurrence or PD within 6 months of completing systemic
             anticancer therapy treatment prior to first dose on the study.

          -  Participant has had >1 recurrence of endometrial cancer.

          -  Participant has received prior therapy with an anti-programmed cell death protein 1
             (anti-PD-1), anti-PD-ligand 1 (anti-PD-L1), or anti-PD-ligand 2 (anti-PD-L2) agent.

          -  Participant has received prior anticancer therapy (chemotherapy, targeted therapies,
             hormonal therapy, radiotherapy, or immunotherapy) within 21 days or <5 times the
             half-life of the most recent therapy prior to Study Day 1, whichever is shorter.

          -  Participant has a concomitant malignancy, or participant 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.

          -  Participant has known uncontrolled central nervous system metastases, carcinomatosis
             meningitis, or both.

          -  Participant has not recovered (i.e., to Grade <=1 or to Baseline) from cytotoxic
             therapy induced AEs or has received transfusion of blood products (including platelets
             or red blood cells) or administration of colony-stimulating factors (including
             granulocyte colony-stimulating factor [G-CSF], granulocyte macrophage
             colony-stimulating factor [GM-CSF], or recombinant erythropoietin) within 21 days
             prior to the first dose of study drug.

          -  Participant is considered a poor medical risk due to a serious, uncontrolled medical
             disorder, nonmalignant systemic disease, or active infection requiring systemic
             therapy.

          -  Participant has received, or is scheduled to receive, a live vaccine within 30 days
             before first dose of study treatment, during study treatment, and for up to 180 days
             after receiving the last dose of study treatment.

          -  Part 2 only:

          -  Participant has clinically significant cardiovascular disease

          -  Participant has any known history or current diagnosis of myelodysplastic syndrome
             (MDS) or acute myeloid leukemia (AML).

          -  Participant is at increased bleeding risk due to concurrent conditions.

          -  Participant has participated in Part 1 of this study.
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:Female
Healthy Volunteers:No

Primary Outcome Measures

Measure:Part 1 and 2: Progression-Free Survival (PFS) - based on blinded independent central review (BICR)
Time Frame:Up to 6 years and 9 months
Safety Issue:
Description:PFS is based on BICR and is defined as the time from the date of randomization to the earliest date of radiographic assessment of progression of disease (PD) or death by any cause in the absence of (PD), whichever occurs first as per Response Evaluation Criteria in Solid Tumors (RECIST) version (v) 1.1.

Secondary Outcome Measures

Measure:Part 1 and 2: Overall survival (OS)
Time Frame:Up to 6 years and 9 months
Safety Issue:
Description:OS is defined as the time from randomization to the date of death by any cause.
Measure:Part 1 and 2: Progression free survival (PFS) - Investigator assessment
Time Frame:Up to 6 years and 9 months
Safety Issue:
Description:PFS based on Investigator Assessment is defined as the time from the date of randomization to the earliest date of assessment of PD or death by any cause in the absence of PD whichever occurs first per RECIST v.1.1.
Measure:Part 1 and 2: Objective response rate (ORR) - BICR and Investigator assessment
Time Frame:Up to 6 years and 9 months
Safety Issue:
Description:ORR based on BICR and Investigator assessment is defined as the proportion of participants with a best overall response (BOR) of complete response (CR) or partial response (PR).
Measure:Part 1 and 2: Duration of response (DOR) - BICR and Investigator assessment
Time Frame:Up to 6 years and 9 months
Safety Issue:
Description:DOR based on BICR and Investigator assessment is defined as the time from first documentation of CR or PR until the time of first documentation of subsequent PD per RECIST v.1.1 or death by any cause in the absence of PD per RECIST v.1.1, whichever occurs first.
Measure:Part 1 and 2: Disease control rate (DCR) - BICR and Investigator assessment
Time Frame:Up to 6 years and 9 months
Safety Issue:
Description:DCR based on BICR and Investigator assessment is defined as the proportion of participants who have achieved a BOR of CR, PR, or stable disease (SD) per RECIST v.1.1.
Measure:Part 1 and 2: Patient-reported outcomes (PROs) in the European Quality of Life scale, 5-Dimensions, 5-Levels (EQ-5D-5L)
Time Frame:Up to 6 years and 9 months
Safety Issue:
Description:EQ-5D-5L is a validated questionnaire to assess the overall health-related quality of life in participants across diseases.
Measure:Part 1 and 2: PROs in the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-C30 [Core])
Time Frame:Up to 6 years and 9 months
Safety Issue:
Description:EORTC QLQ-C30 is validated questionnaire to assess overall health-related quality of life in participants with cancer.
Measure:Part 1 and 2: PROs in the EORTC Quality of Life Questionnaire (QLQ-EN24 [Endometrial Cancer Module])
Time Frame:Up to 6 years and 9 months
Safety Issue:
Description:EORTC QLQ-EN24 is a validated questionnaire to assess the overall health-related quality of life in participants with all stages of endometrial cancer.
Measure:Part 1 and 2: Progression-free survival 2 (PFS2)
Time Frame:Up to 6 years and 9 months
Safety Issue:
Description:PFS2 is defined as the time from treatment randomization to the date of assessment of progression on the first subsequent anticancer therapy following study treatment or death by any cause, whichever is earlier.
Measure:Part 1 and 2: Number of participants with adverse events (AEs), Serious adverse events (SAEs), adverse event of special interests (AESIs), suspected unexpected serious adverse reaction (SUSAR) and treatment-emergent adverse events (TEAEs)
Time Frame:Up to 6 years and 9 months
Safety Issue:
Description:
Measure:Part 1 and 2: Number of participants with clinically significant changes in clinical laboratory parameters, vital signs, physical examination, electrocardiogram (ECG) and participants reporting the intake of concomitant medication
Time Frame:Up to 6 years and 9 months
Safety Issue:
Description:
Measure:Part 1 and 2: Number of participants with Eastern Cooperative Oncology Group (ECOG) Performance Status Scores
Time Frame:Up to 6 years and 9 months
Safety Issue:
Description:Performance status will be assessed using the ECOG scale, with Grades ranging from 0 to 5.
Measure:Part 1 and 2: Minimum observed concentration (Cmin) and maximum observed concentration (Cmax) of dostarlimab (micrograms per milliliter)
Time Frame:Predose (Day 1) and postdose (Day 1) of Cycles 1, 2, 6, 7, 10, 15, and 20 (Cycle 1, 2, 6 is 21 days and Cycle 7, 10, 15, 20 is 42 days)
Safety Issue:
Description:Blood samples to be collected predose (within 1 hour prior to infusion) and postdose (within 1 hour after the end of infusion) on Day 1 of Cycles 1, 2, 6, 7, 10, 15, and 20.
Measure:Part 1 and 2: Cmin and Cmax at steady state of dostarlimab (micrograms per milliliter)
Time Frame:Predose (Day 1) and postdose (Day 1) of Cycles 1, 2, 6, 7, 10, 15, and 20 (Cycle 1, 2, 6 is 21 days and Cycle 7, 10, 15, 20 is 42 days)
Safety Issue:
Description:Blood samples to be collected predose (within 1 hour prior to infusion) and postdose (within 1 hour after the end of infusion) on Day 1 of Cycles 1, 2, 6, 7, 10, 15, and 20.
Measure:Part 2: Cmin and Cmax of niraparib (micrograms per milliliter)
Time Frame:Predose (Day 1) and 3 hours postdose (Day 1) of Cycles 7 and 8 and Predose (Day 1) of Cycles 10 and 14 (each cycle is 42 days)
Safety Issue:
Description:Blood samples for niraparib PK to be collected predose (within 30 minutes before scheduled dose) and 3 hours postdose (+/-30 minutes) on Day 1 of Cycle 7 and Cycle 8. Additional blood samples for PK on Day 1 of Cycle 10 and Cycle 14 will be collected at predose (within 30 minutes before scheduled dose).
Measure:Part 2: Cmin and Cmax at steady state of niraparib (micrograms per milliliter)
Time Frame:Predose (Day 1) and 3 hours postdose (Day 1) of Cycles 7 and 8 and Predose (Day 1) of Cycles 10 and 14 (each cycle is 42 days)
Safety Issue:
Description:Blood samples for niraparib PK to be collected predose (within 30 minutes before scheduled dose) and 3 hours postdose (+/-30 minutes) on Day 1 of Cycle 7 and Cycle 8. Additional blood samples for PK on Day 1 of Cycle 10 and Cycle 14 will be collected at predose (within 30 minutes before scheduled dose).
Measure:Part 1 and 2: Number of participants with anti-drug antibodies (ADA) against dostarlimab
Time Frame:Predose (Day 1)
Safety Issue:
Description:All the predose samples collected for Dostarlimab PK analysis to be evaluated for the presence of ADAs and neutralizing antibody in a tiered approach using electrochemiluminescence.

Details

Phase:Phase 3
Primary Purpose:Interventional
Overall Status:Recruiting
Lead Sponsor:Tesaro, Inc.

Trial Keywords

  • Dostarlimab
  • Carboplatin
  • Paclitaxel
  • Niraparib
  • Recurrent or primary advanced endometrial cancer
  • TSR-042

Last Updated

July 27, 2021