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Ketoconazole as Inhibitor of the Enzyme CYP17 in Locally Advanced or Disseminated Granulosa Cell Tumour of Ovary (GreKo)

Primary Purpose

Granulosa Cell Tumour of the Ovary

Status
Terminated
Phase
Phase 2
Locations
Spain
Study Type
Interventional
Intervention
Ketoconazole
Sponsored by
Grupo Español de Tumores Huérfanos e Infrecuentes
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Granulosa Cell Tumour of the Ovary focused on measuring Granulosa Cell Tumour

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  • Patients obtained their written informed consent.
  • Women ≥18 years old.
  • ECOG ≤ 1.
  • Histologically confirmed carcinoma of granulosa cell in ovary.
  • Availability of sufficient biopsy material to confirm the diagnosis by a centralized pathologist and determination of the FOXL2 402C mutation → G (C134W).
  • Metastatic or unresectable disease.
  • Imaging measurable disease.
  • Life expectancy ≥ 12 weeks.
  • Patients with adequate hepatic function, defined by:
  • Serum values of AST and ALT ≤ 3 x UNL (except in the presence of metastases then allowed values ≤ 5 x UNL)
  • Total bilirubin ≤ 1.5 x UNL
  • Patients with adequate bone marrow function, defined by:
  • Absolute neutrophil count ≥ 1.5 x 10*9 / L
  • Platelets ≥ 100 x 10*9 / L
  • Hb > 9 g / dL
  • Patients with adequate renal function: serum creatinine ≤ 1.5 x UNL.
  • Absence of any impediment to comply with the study protocol.
  • Women of childbearing potential, sexually active, not under hysterectomy or bilateral adnexectomy, should follow the following guidelines on contraception:
  • Negative serum or urine pregnancy test within 72 hours before the start of treatment.
  • Use of a medically accepted contraceptive method during: the 2 months prior to study treatment, during the study and 3 months after the last dose of study treatment.

Exclusion Criteria:

  • Patients with another primary tumor 2 years before starting the study drug, with the exception of cervical carcinoma in situ or adequately treated or removed completely or basalioma or superficial bladder carcinoma.
  • Patients received radical radiotherapy ≤ 4 weeks before starting the study treatment or who have not recovered from the toxicities of radiotherapy. Palliative radiotherapy of painful bone lesions is allowed up to 14 days before the start of study treatment.
  • Patients with heart failure or clinically significant heart disease, including any of the following:
  • History or presence of uncontrolled severe ventricular arrhythmia.
  • Clinically significant bradycardia at rest.
  • LVEF <45% assessed by 2-D echocardiogram (ECHO) or MUGA.
  • Any of the following diseases within 6 months prior to the start of study drug: Myocardial infarction (MI), severe or unstable angina, coronary revascularization, congestive heart failure (CHF), stroke (CVA), transient ischemic attack (TIA).
  • Patients with gastrointestinal function failure or gastric disease that significantly alter the ketoconazole absorption, for example, severe ulcerative disease, uncontrolled nausea, vomiting, diarrhea, malabsorption, extensive resection (> 1m) of the small intestine or inability to swallow oral medication. The partial or total gastrectomy is not an exclusion criteria.
  • Diagnosis of infection with human immunodeficiency virus (HIV).
  • Pregnant women or nursing.
  • Women of childbearing potential not using effective contraceptive method.
  • Patients who are unwilling or unable to comply with the protocol.

Sites / Locations

  • Complejo Hospitalario Universitario de Santiago de Compostela
  • Hospital Central de Asturias
  • Hospital Universitario Fundación Alcorcón
  • Hospital del Mar
  • Hospital Reina Sofía
  • Hospital La Paz
  • Hospital Morales Meseguer
  • Complejo Hospitalario de Navarra
  • Hospital Son Llatzer
  • Hospital Universitario y Politécnico La Fe

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Ketoconazole

Arm Description

Patients will receive ketoconazole, 400 mg three times a day. Study treatment period will be during 6 months or up to progression disease, unacceptable toxicity, death or withdraw from the study for any reason.

Outcomes

Primary Outcome Measures

Overall response rate
The primary endpoint is overall response rate, defined as the proportion of patients with response defined as complete or partial response according to RECIST CRITERIA 1.1 measured by an external evaluator

Secondary Outcome Measures

Clinical benefit
Clinical benefit defined as stable disease for more than 6 months plus complete and partial response rates, measured by an external evaluator.
Progression-free survival
Progression-free survival is defined as the time since the start of treatment until progressive disease assessed (through evaluation by an external radiologist) according to RECIST 1.1, or death by any cause.
Overall survival
Overall survival, defined as the time since the start of treatment until the patient dies by any cause.
Quality of life
Quality of life measured by the validated in Spanish EORTC QLQ-C30 questionnaire.
Safety profile
Toxicities will be classified according to the NCI-CTCAE v4.03

Full Information

First Posted
April 22, 2012
Last Updated
January 19, 2015
Sponsor
Grupo Español de Tumores Huérfanos e Infrecuentes
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1. Study Identification

Unique Protocol Identification Number
NCT01584297
Brief Title
Ketoconazole as Inhibitor of the Enzyme CYP17 in Locally Advanced or Disseminated Granulosa Cell Tumour of Ovary
Acronym
GreKo
Official Title
Open Phase II Study of Ketoconazole as Inhibitor of the Enzyme CYP17 in Locally Advanced or Disseminated Granulosa Cell Tumour of Ovary. GreKo Study.
Study Type
Interventional

2. Study Status

Record Verification Date
January 2015
Overall Recruitment Status
Terminated
Why Stopped
Insufficient recruitment rate
Study Start Date
October 2012 (undefined)
Primary Completion Date
November 2014 (Actual)
Study Completion Date
November 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Grupo Español de Tumores Huérfanos e Infrecuentes

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Our proposal is to conduct an open phase II clinical trial that allows us to explore the activity of ketoconazole, an inhibitor of the enzyme CYP17, in ovarian granulosa tumors similar to what has been done in prostate cancer. The rational is based on dysregulation that FOXL2 mutations present in almost all granulosa tumors result in the expression of CYP17 that appears to be key in the development and progression of the disease. This work would represent the first attempt to address the treatment of ovarian granulosa cancer with a molecular solid rational, drawing on the recent identification of the mutation "leader" of this tumor. If succeed provide a widely available therapeutic alternative compared with current cancer therapies, with low toxicity. In addition it would open a new line of research with CYP17 enzyme inhibitors that could alter the course and outcome, usually fatal, in advanced stages of disease.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Granulosa Cell Tumour of the Ovary
Keywords
Granulosa Cell Tumour

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
6 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Ketoconazole
Arm Type
Experimental
Arm Description
Patients will receive ketoconazole, 400 mg three times a day. Study treatment period will be during 6 months or up to progression disease, unacceptable toxicity, death or withdraw from the study for any reason.
Intervention Type
Drug
Intervention Name(s)
Ketoconazole
Other Intervention Name(s)
Fungarest
Intervention Description
Patients will receive ketoconazole, 400 mg three times a day. Study treatment period will be during 6 months or up to progression disease, unacceptable toxicity, death or withdraw from the study for any reason.
Primary Outcome Measure Information:
Title
Overall response rate
Description
The primary endpoint is overall response rate, defined as the proportion of patients with response defined as complete or partial response according to RECIST CRITERIA 1.1 measured by an external evaluator
Time Frame
Every 8 weeks
Secondary Outcome Measure Information:
Title
Clinical benefit
Description
Clinical benefit defined as stable disease for more than 6 months plus complete and partial response rates, measured by an external evaluator.
Time Frame
Every 8 weeks
Title
Progression-free survival
Description
Progression-free survival is defined as the time since the start of treatment until progressive disease assessed (through evaluation by an external radiologist) according to RECIST 1.1, or death by any cause.
Time Frame
Every 8 weeks
Title
Overall survival
Description
Overall survival, defined as the time since the start of treatment until the patient dies by any cause.
Time Frame
Untill death
Title
Quality of life
Description
Quality of life measured by the validated in Spanish EORTC QLQ-C30 questionnaire.
Time Frame
Every 4 weeks
Title
Safety profile
Description
Toxicities will be classified according to the NCI-CTCAE v4.03
Time Frame
Every 4 weeks

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients obtained their written informed consent. Women ≥18 years old. ECOG ≤ 1. Histologically confirmed carcinoma of granulosa cell in ovary. Availability of sufficient biopsy material to confirm the diagnosis by a centralized pathologist and determination of the FOXL2 402C mutation → G (C134W). Metastatic or unresectable disease. Imaging measurable disease. Life expectancy ≥ 12 weeks. Patients with adequate hepatic function, defined by: Serum values of AST and ALT ≤ 3 x UNL (except in the presence of metastases then allowed values ≤ 5 x UNL) Total bilirubin ≤ 1.5 x UNL Patients with adequate bone marrow function, defined by: Absolute neutrophil count ≥ 1.5 x 10*9 / L Platelets ≥ 100 x 10*9 / L Hb > 9 g / dL Patients with adequate renal function: serum creatinine ≤ 1.5 x UNL. Absence of any impediment to comply with the study protocol. Women of childbearing potential, sexually active, not under hysterectomy or bilateral adnexectomy, should follow the following guidelines on contraception: Negative serum or urine pregnancy test within 72 hours before the start of treatment. Use of a medically accepted contraceptive method during: the 2 months prior to study treatment, during the study and 3 months after the last dose of study treatment. Exclusion Criteria: Patients with another primary tumor 2 years before starting the study drug, with the exception of cervical carcinoma in situ or adequately treated or removed completely or basalioma or superficial bladder carcinoma. Patients received radical radiotherapy ≤ 4 weeks before starting the study treatment or who have not recovered from the toxicities of radiotherapy. Palliative radiotherapy of painful bone lesions is allowed up to 14 days before the start of study treatment. Patients with heart failure or clinically significant heart disease, including any of the following: History or presence of uncontrolled severe ventricular arrhythmia. Clinically significant bradycardia at rest. LVEF <45% assessed by 2-D echocardiogram (ECHO) or MUGA. Any of the following diseases within 6 months prior to the start of study drug: Myocardial infarction (MI), severe or unstable angina, coronary revascularization, congestive heart failure (CHF), stroke (CVA), transient ischemic attack (TIA). Patients with gastrointestinal function failure or gastric disease that significantly alter the ketoconazole absorption, for example, severe ulcerative disease, uncontrolled nausea, vomiting, diarrhea, malabsorption, extensive resection (> 1m) of the small intestine or inability to swallow oral medication. The partial or total gastrectomy is not an exclusion criteria. Diagnosis of infection with human immunodeficiency virus (HIV). Pregnant women or nursing. Women of childbearing potential not using effective contraceptive method. Patients who are unwilling or unable to comply with the protocol.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jesus Garcia-Donas, MD
Organizational Affiliation
Hospital Universitario Fundación de Alcorcón, Servicio de Oncología Médica, c/ Budapest, 1,28922 Alcorcón (Madrid), Spain
Official's Role
Study Director
Facility Information:
Facility Name
Complejo Hospitalario Universitario de Santiago de Compostela
City
Santiago de Compostela
State/Province
A Coruña
ZIP/Postal Code
15706
Country
Spain
Facility Name
Hospital Central de Asturias
City
Oviedo
State/Province
Asturias
ZIP/Postal Code
33006
Country
Spain
Facility Name
Hospital Universitario Fundación Alcorcón
City
Alcorcón
State/Province
Madrid
ZIP/Postal Code
28922
Country
Spain
Facility Name
Hospital del Mar
City
Barcelona
ZIP/Postal Code
08003
Country
Spain
Facility Name
Hospital Reina Sofía
City
Cordoba
ZIP/Postal Code
14004
Country
Spain
Facility Name
Hospital La Paz
City
Madrid
ZIP/Postal Code
28046
Country
Spain
Facility Name
Hospital Morales Meseguer
City
Murcia
ZIP/Postal Code
30008
Country
Spain
Facility Name
Complejo Hospitalario de Navarra
City
Navarra
ZIP/Postal Code
31008
Country
Spain
Facility Name
Hospital Son Llatzer
City
Palma de Mallorca
ZIP/Postal Code
07198
Country
Spain
Facility Name
Hospital Universitario y Politécnico La Fe
City
Valencia
ZIP/Postal Code
46026
Country
Spain

12. IPD Sharing Statement

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Ketoconazole as Inhibitor of the Enzyme CYP17 in Locally Advanced or Disseminated Granulosa Cell Tumour of Ovary

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