Safety and Efficacy of Bevacizumab in Combination With Carboplatin and Paclitaxel for Metastatic, Recurrent or Persistent Cervical Cancer
Primary Purpose
Cervical Cancer
Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Bevacizumab
Carboplatin
Paclitaxel
Sponsored by
About this trial
This is an interventional treatment trial for Cervical Cancer
Eligibility Criteria
Inclusion Criteria:
- Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1
- Life expectancy greater than or equal to (>=3) months
- For women who are not postmenopausal or surgically sterile, agreement to remain abstinent or use single or combined contraceptive methods that result in a failure rate of less than (<) 1 percent (%) per year during the treatment period and for at least 6 months after the last dose of study drug
- Distant metastatic, recurrent or persistent squamous cell carcinoma, adenosquamous carcinoma or adenocarcinoma of the cervix that is not amenable to curative treatment with surgery and/or radiation therapy
- Either measurable or non-measurable disease. If disease is non-measurable or limited to the radiation field, a biopsy or fine-needle aspiration is required to confirm malignancy
- Eligible for carboplatin and paclitaxel chemotherapy in accordance with local standards of care
- Adequate hematological, renal and hepatic function
- Normal blood coagulation parameters
- Recovered (to Grade less than or equal to [<=] 1) from the effects of prior surgery, radiation therapy or chemoradiotherapy
Exclusion Criteria:
- Pregnant or lactating
- History of other malignancy within 5 years before screening, except for non-melanoma skin carcinoma
- Ongoing disease involving the bladder or rectum at screening/baseline. In participants with pelvic disease, absence of tumor in the bladder or rectal mucosa must be demonstrated by magnetic resonance imaging (MRI) (preferred method, or endoscopy/cystoscopy if MRI is not easily accessible) within 28 days before enrolment
- Evidence of abdominal free air
- Bilateral hydronephrosis
- Untreated central nervous system (CNS) metastases
- Prior chemotherapy for recurrent, persistent or metastatic cervical cancer. Prior adjuvant or neoadjuvant chemotherapy for Stage I-IVA disease (i.e. for non-metastatic disease) is permitted if completed greater than (>) 6 months before first study dose
- Prior chemoradiation within the 3 months preceding first study dose
- Prior radiotherapy delivered using cobalt
- Prior or current bevacizumab or other anti-angiogenic treatment
- Requirement for treatment with any medicinal product that contraindicates the use of any of the study drugs, may interfere with the planned treatment, affects participant compliance or puts the participant at high risk for treatment-related complications
- Treatment with another investigational agent within 28 days or 2 investigational agent half-lives before first study dose
- Major surgical procedure, open biopsy or significant traumatic injury within 28 days before the first dose of bevacizumab or anticipation of the need for major surgery during the course of study treatment
- Minor surgical procedure within 2 days before the first dose of study drug
- Any prior history of fistula or GI perforation
- Known hypersensitivity to bevacizumab or any of its excipients, Chinese hamster ovary cell products or other recombinant human or humanized antibodies to any planned chemotherapy
- Active GI bleeding or ulcer
- Uncontrolled hypertension
- Clinically significant active cardiovascular disease
- National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) Version 4.0, Grade greater than or equal to (>=) 2 peripheral vascular disease
Sites / Locations
- Centro Oncologico Riojano Integral (CORI)
- Hospital das Clinicas - UFMG
- Oncologica Brasil S/S LTDA - EPP
- Instituto Nacional de Cancer - INCa; Pesquisa Clinica
- Instituto do Cancer do Estado de Sao Paulo - ICESP
- Complex Oncological Center - Plovdiv, EOOD
- MHAT Nadezhda
- Oncomedica S.A.
- Oncólogos de Occidente
- Clinica CIMCA
- Centre Francois Baclesse; Urologie Gynecologie
- Institut Gustave Roussy; Oncologie Medicale
- Alexandras General Hospital of Athens; Oncology Department
- IASO
- Istituto Tumori Napoli;Unità Operativa Oncologia Medica Uro-Ginecologica
- Universita' Cattolica Del Sacro Cuore; Reparto Ginecologia Oncologica
- Istituto Nazionale dei Tumori; Divisione Oncologia Chirurgica e Ginecologica
- Irccs Istituto Europeo Di Oncologia (IEO); Oncologia Medica
- Consultorio de Medicina Especializada
- Instituto Nacional de Cancerologia; Oncology
- Centro Oncologico Estatal ISSEMYM
- Centro Oncológico de Panamá
- Centro Hemato Oncologico Panama
- Bialostockie Centrum Onkologi
- Centrum Onkologii Instytut im. M.Sklodowskiej-Curie; Klinika Ginekologii Onkologicznej
- Wielkopolskie Centrum Onkologii im. M. Sklodowskiej-Curie
- Centrum Onkologii - Instytut M.Sklodowskiej-Curie; Klinika Ginekologii Onkologicznej
- IPO do Porto; Servico de Oncologia Medica
- Centrul de Oncologie Sfantul Nectarie
- Regional Institute of Oncology Iasi
- Russian Oncology Research Center n.a. N.N. Blokhin Dpt of Clinical Pharmacology and Chemotherapy
- St. Petersburg Oncology & Gynecology; City Clinical Oncology Dispensary
- Institute for Onc/Rad Serbia
- Wits Clinical Research
- University of Pretoria; Department of Medical Oncology
- Complejo Hospitalario Universitario de Santiago (CHUS) ; Servicio de Oncologia
- Hospital Duran i Reynals; Oncologia
- Centro Oncologico MD Anderson International Espana
- Hospital Universitario La Paz; Servicio de Oncologia
- Instituto Valenciano Oncologia; Oncologia Medica
- Hospital Universitario la Fe; Servicio de Oncologia
- Ankara Baskent University Medicine Faculty; Gynaecology
- Istanbul Uni of Medicine Faculty; Oncology Dept
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Bevacizumab in Combination with Carboplatin and Paclitaxel
Arm Description
Administration of bevacizumab, carboplatin and paclitaxel once every 3 weeks, for at least 6 cycles, until disease progression (as assessed by the investigator), unacceptable toxicity, physician or participant decision or withdrawal of consent. If either chemotherapy or bevacizumab is discontinued, the participant may continue to receive the other ongoing therapy.
Outcomes
Primary Outcome Measures
Percentage of Participants with GI Perforation/Fistula Events by Grade According to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) Version 4.0
Percentage of Participants with GI-Vaginal Fistula Events by Grade According to NCI-CTCAE Version 4.0
Percentage of Participants with GU Fistula Events by Grade According to NCI-CTCAE Version 4.0
Secondary Outcome Measures
Time to First GI Perforation/Fistula
Time to First GI-Vaginal Fistula
Time to First GU Fistula
Dose Intensity (Ratio of Actual Dose Administered Versus Intended Dose) for Bevacizumab During the Treatment Period
Dose Intensity (Ratio of Actual Dose Administered Versus Intended Dose) for Carboplatin During the Treatment Period
Dose Intensity (Ratio of Actual Dose Administered Versus Intended Dose) for Paclitaxel During the Treatment Period
Duration of Treatment for Bevacizumab
Duration of Treatment for Carboplatin
Duration of Treatment for Paclitaxel
Percentage of Participants with Adverse Events (AEs)
Percentage of Participants with Serious Adverse Events (SAEs)
Percentage of Participants with Adverse Events of Special Interest (AESIs)
Percentage of Participants with AEs Leading to Treatment Interruption or Permanent discontinuation
Percentage of Deaths Causally Related to Treatment
Progression-Free Survival (PFS) According to Response Evaluation Criteria for Solid Tumors (RECIST) Version 1.1
Overall Survival (OS)
Percentage of Participants with a Best Overall Response of Complete Response (CR) or Partial Response (PR) According to RECIST Version 1.1
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT02467907
Brief Title
Safety and Efficacy of Bevacizumab in Combination With Carboplatin and Paclitaxel for Metastatic, Recurrent or Persistent Cervical Cancer
Official Title
A Multicenter Open-Label Single-Arm Phase II Study Evaluating the Safety and Efficacy of Bevacizumab in Combination With Carboplatin and Paclitaxel in Patients With Metastatic, Recurrent or Persistent Cervical Cancer
Study Type
Interventional
2. Study Status
Record Verification Date
May 2019
Overall Recruitment Status
Completed
Study Start Date
July 28, 2015 (Actual)
Primary Completion Date
December 31, 2018 (Actual)
Study Completion Date
January 15, 2019 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Hoffmann-La Roche
4. Oversight
5. Study Description
Brief Summary
This study is to assess safety as defined by the frequency and severity of gastrointestinal (GI) perforation/fistula, GI-vaginal fistula and genitourinary (GU) fistula in participants treated with bevacizumab 15 milligrams per kilogram (mg/kg) in combination with paclitaxel and carboplatin, all repeated every 3 weeks, for recurrent, persistent or metastatic cervical cancer. In addition, this study will include evaluation of the overall safety profile of bevacizumab in combination with paclitaxel and carboplatin in this setting, assessment of GI perforation/fistula, GI-vaginal fistula and GU fistula events over time, and evaluation of efficacy.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cervical Cancer
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
152 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Bevacizumab in Combination with Carboplatin and Paclitaxel
Arm Type
Experimental
Arm Description
Administration of bevacizumab, carboplatin and paclitaxel once every 3 weeks, for at least 6 cycles, until disease progression (as assessed by the investigator), unacceptable toxicity, physician or participant decision or withdrawal of consent. If either chemotherapy or bevacizumab is discontinued, the participant may continue to receive the other ongoing therapy.
Intervention Type
Drug
Intervention Name(s)
Bevacizumab
Other Intervention Name(s)
Avastin, RO4876646
Intervention Description
Intravenous (i.v.) administration of 15 mg/kg bevacizumab once every 3 weeks
Intervention Type
Drug
Intervention Name(s)
Carboplatin
Intervention Description
Administration of carboplatin at 5 milligrams per milliliter*minute (mg/mL*min) on Day 1 every 3 weeks for at least 6 cycles
Intervention Type
Drug
Intervention Name(s)
Paclitaxel
Intervention Description
Administration of paclitaxel at a dose of 175 milligrams per square meter (mg/m^2) on Day 1 every 3 weeks for at least 6 cycles
Primary Outcome Measure Information:
Title
Percentage of Participants with GI Perforation/Fistula Events by Grade According to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) Version 4.0
Time Frame
Baseline up to 24 months
Title
Percentage of Participants with GI-Vaginal Fistula Events by Grade According to NCI-CTCAE Version 4.0
Time Frame
Baseline up to 24 months
Title
Percentage of Participants with GU Fistula Events by Grade According to NCI-CTCAE Version 4.0
Time Frame
Baseline up to 24 months
Secondary Outcome Measure Information:
Title
Time to First GI Perforation/Fistula
Time Frame
Baseline up to 24 months
Title
Time to First GI-Vaginal Fistula
Time Frame
Baseline up to 24 months
Title
Time to First GU Fistula
Time Frame
Baseline up to 24 months
Title
Dose Intensity (Ratio of Actual Dose Administered Versus Intended Dose) for Bevacizumab During the Treatment Period
Time Frame
Baseline up to 24 months
Title
Dose Intensity (Ratio of Actual Dose Administered Versus Intended Dose) for Carboplatin During the Treatment Period
Time Frame
Baseline up to 24 months
Title
Dose Intensity (Ratio of Actual Dose Administered Versus Intended Dose) for Paclitaxel During the Treatment Period
Time Frame
Baseline up to 24 months
Title
Duration of Treatment for Bevacizumab
Time Frame
Baseline up to 24 months
Title
Duration of Treatment for Carboplatin
Time Frame
Baseline up to 24 months
Title
Duration of Treatment for Paclitaxel
Time Frame
Baseline up to 24 months
Title
Percentage of Participants with Adverse Events (AEs)
Time Frame
Baseline up to 24 months
Title
Percentage of Participants with Serious Adverse Events (SAEs)
Time Frame
Baseline up to 24 months
Title
Percentage of Participants with Adverse Events of Special Interest (AESIs)
Time Frame
Baseline up to 24 months
Title
Percentage of Participants with AEs Leading to Treatment Interruption or Permanent discontinuation
Time Frame
Baseline up to 24 months
Title
Percentage of Deaths Causally Related to Treatment
Time Frame
Baseline up to 24 months
Title
Progression-Free Survival (PFS) According to Response Evaluation Criteria for Solid Tumors (RECIST) Version 1.1
Time Frame
Baseline up to 24 months
Title
Overall Survival (OS)
Time Frame
Baseline up to 24 months
Title
Percentage of Participants with a Best Overall Response of Complete Response (CR) or Partial Response (PR) According to RECIST Version 1.1
Time Frame
Baseline up to 24 months
10. Eligibility
Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1
Life expectancy greater than or equal to (>=3) months
For women who are not postmenopausal or surgically sterile, agreement to remain abstinent or use single or combined contraceptive methods that result in a failure rate of less than (<) 1 percent (%) per year during the treatment period and for at least 6 months after the last dose of study drug
Distant metastatic, recurrent or persistent squamous cell carcinoma, adenosquamous carcinoma or adenocarcinoma of the cervix that is not amenable to curative treatment with surgery and/or radiation therapy
Either measurable or non-measurable disease. If disease is non-measurable or limited to the radiation field, a biopsy or fine-needle aspiration is required to confirm malignancy
Eligible for carboplatin and paclitaxel chemotherapy in accordance with local standards of care
Adequate hematological, renal and hepatic function
Normal blood coagulation parameters
Recovered (to Grade less than or equal to [<=] 1) from the effects of prior surgery, radiation therapy or chemoradiotherapy
Exclusion Criteria:
Pregnant or lactating
History of other malignancy within 5 years before screening, except for non-melanoma skin carcinoma
Ongoing disease involving the bladder or rectum at screening/baseline. In participants with pelvic disease, absence of tumor in the bladder or rectal mucosa must be demonstrated by magnetic resonance imaging (MRI) (preferred method, or endoscopy/cystoscopy if MRI is not easily accessible) within 28 days before enrolment
Evidence of abdominal free air
Bilateral hydronephrosis
Untreated central nervous system (CNS) metastases
Prior chemotherapy for recurrent, persistent or metastatic cervical cancer. Prior adjuvant or neoadjuvant chemotherapy for Stage I-IVA disease (i.e. for non-metastatic disease) is permitted if completed greater than (>) 6 months before first study dose
Prior chemoradiation within the 3 months preceding first study dose
Prior radiotherapy delivered using cobalt
Prior or current bevacizumab or other anti-angiogenic treatment
Requirement for treatment with any medicinal product that contraindicates the use of any of the study drugs, may interfere with the planned treatment, affects participant compliance or puts the participant at high risk for treatment-related complications
Treatment with another investigational agent within 28 days or 2 investigational agent half-lives before first study dose
Major surgical procedure, open biopsy or significant traumatic injury within 28 days before the first dose of bevacizumab or anticipation of the need for major surgery during the course of study treatment
Minor surgical procedure within 2 days before the first dose of study drug
Any prior history of fistula or GI perforation
Known hypersensitivity to bevacizumab or any of its excipients, Chinese hamster ovary cell products or other recombinant human or humanized antibodies to any planned chemotherapy
Active GI bleeding or ulcer
Uncontrolled hypertension
Clinically significant active cardiovascular disease
National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) Version 4.0, Grade greater than or equal to (>=) 2 peripheral vascular disease
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Clinical Trials
Organizational Affiliation
Hoffmann-La Roche
Official's Role
Study Director
Facility Information:
Facility Name
Centro Oncologico Riojano Integral (CORI)
City
La Rioja
ZIP/Postal Code
F5300COE
Country
Argentina
Facility Name
Hospital das Clinicas - UFMG
City
Belo Horizonte
State/Province
MG
ZIP/Postal Code
31270-901
Country
Brazil
Facility Name
Oncologica Brasil S/S LTDA - EPP
City
Belem
State/Province
PA
ZIP/Postal Code
66053-000
Country
Brazil
Facility Name
Instituto Nacional de Cancer - INCa; Pesquisa Clinica
City
Rio De Janerio
State/Province
RJ
ZIP/Postal Code
20560-120
Country
Brazil
Facility Name
Instituto do Cancer do Estado de Sao Paulo - ICESP
City
Sao Paulo
State/Province
SP
ZIP/Postal Code
01246-000
Country
Brazil
Facility Name
Complex Oncological Center - Plovdiv, EOOD
City
Plovdiv
ZIP/Postal Code
4004
Country
Bulgaria
Facility Name
MHAT Nadezhda
City
Sofia
ZIP/Postal Code
1330
Country
Bulgaria
Facility Name
Oncomedica S.A.
City
Monteria
ZIP/Postal Code
230002
Country
Colombia
Facility Name
Oncólogos de Occidente
City
Pereira
ZIP/Postal Code
600004
Country
Colombia
Facility Name
Clinica CIMCA
City
San Jose
ZIP/Postal Code
10103
Country
Costa Rica
Facility Name
Centre Francois Baclesse; Urologie Gynecologie
City
Caen
ZIP/Postal Code
14076
Country
France
Facility Name
Institut Gustave Roussy; Oncologie Medicale
City
Villejuif
ZIP/Postal Code
94800
Country
France
Facility Name
Alexandras General Hospital of Athens; Oncology Department
City
Athens
ZIP/Postal Code
115280
Country
Greece
Facility Name
IASO
City
Athens
ZIP/Postal Code
151 23
Country
Greece
Facility Name
Istituto Tumori Napoli;Unità Operativa Oncologia Medica Uro-Ginecologica
City
Napoli
State/Province
Campania
ZIP/Postal Code
80131
Country
Italy
Facility Name
Universita' Cattolica Del Sacro Cuore; Reparto Ginecologia Oncologica
City
Roma
State/Province
Lazio
ZIP/Postal Code
00168
Country
Italy
Facility Name
Istituto Nazionale dei Tumori; Divisione Oncologia Chirurgica e Ginecologica
City
Milano
State/Province
Lombardia
ZIP/Postal Code
20133
Country
Italy
Facility Name
Irccs Istituto Europeo Di Oncologia (IEO); Oncologia Medica
City
Milano
State/Province
Lombardia
ZIP/Postal Code
20141
Country
Italy
Facility Name
Consultorio de Medicina Especializada
City
Mexico
State/Province
Mexico CITY (federal District)
ZIP/Postal Code
03100
Country
Mexico
Facility Name
Instituto Nacional de Cancerologia; Oncology
City
Distrito Federal
ZIP/Postal Code
14080
Country
Mexico
Facility Name
Centro Oncologico Estatal ISSEMYM
City
Toluca
ZIP/Postal Code
50180
Country
Mexico
Facility Name
Centro Oncológico de Panamá
City
Panama
ZIP/Postal Code
0801
Country
Panama
Facility Name
Centro Hemato Oncologico Panama
City
Panama
ZIP/Postal Code
0832
Country
Panama
Facility Name
Bialostockie Centrum Onkologi
City
Bialystok
ZIP/Postal Code
15-027
Country
Poland
Facility Name
Centrum Onkologii Instytut im. M.Sklodowskiej-Curie; Klinika Ginekologii Onkologicznej
City
Krakow
ZIP/Postal Code
31-115
Country
Poland
Facility Name
Wielkopolskie Centrum Onkologii im. M. Sklodowskiej-Curie
City
Poznan
ZIP/Postal Code
61-866
Country
Poland
Facility Name
Centrum Onkologii - Instytut M.Sklodowskiej-Curie; Klinika Ginekologii Onkologicznej
City
Warszawa
ZIP/Postal Code
02-781
Country
Poland
Facility Name
IPO do Porto; Servico de Oncologia Medica
City
Porto
ZIP/Postal Code
4200-072
Country
Portugal
Facility Name
Centrul de Oncologie Sfantul Nectarie
City
Craiova
ZIP/Postal Code
200347
Country
Romania
Facility Name
Regional Institute of Oncology Iasi
City
Iasi
ZIP/Postal Code
700483
Country
Romania
Facility Name
Russian Oncology Research Center n.a. N.N. Blokhin Dpt of Clinical Pharmacology and Chemotherapy
City
Moscow
ZIP/Postal Code
115478
Country
Russian Federation
Facility Name
St. Petersburg Oncology & Gynecology; City Clinical Oncology Dispensary
City
Saint-Petersburg
ZIP/Postal Code
197022
Country
Russian Federation
Facility Name
Institute for Onc/Rad Serbia
City
Belgrade
ZIP/Postal Code
11000
Country
Serbia
Facility Name
Wits Clinical Research
City
Johannesberg
ZIP/Postal Code
2013
Country
South Africa
Facility Name
University of Pretoria; Department of Medical Oncology
City
Pretoria
ZIP/Postal Code
0002
Country
South Africa
Facility Name
Complejo Hospitalario Universitario de Santiago (CHUS) ; Servicio de Oncologia
City
Santiago de Compostela
State/Province
LA Coruña
ZIP/Postal Code
15706
Country
Spain
Facility Name
Hospital Duran i Reynals; Oncologia
City
Barcelona
ZIP/Postal Code
08907
Country
Spain
Facility Name
Centro Oncologico MD Anderson International Espana
City
Madrid
ZIP/Postal Code
28033
Country
Spain
Facility Name
Hospital Universitario La Paz; Servicio de Oncologia
City
Madrid
ZIP/Postal Code
28046
Country
Spain
Facility Name
Instituto Valenciano Oncologia; Oncologia Medica
City
Valencia
ZIP/Postal Code
46009
Country
Spain
Facility Name
Hospital Universitario la Fe; Servicio de Oncologia
City
Valencia
ZIP/Postal Code
46026
Country
Spain
Facility Name
Ankara Baskent University Medicine Faculty; Gynaecology
City
Ankara
ZIP/Postal Code
06500
Country
Turkey
Facility Name
Istanbul Uni of Medicine Faculty; Oncology Dept
City
Istanbul
ZIP/Postal Code
34390
Country
Turkey
12. IPD Sharing Statement
Citations:
PubMed Identifier
32763109
Citation
Redondo A, Colombo N, McCormack M, Dreosti L, Nogueira-Rodrigues A, Scambia G, Lorusso D, Joly F, Schenker M, Ruff P, Estevez-Diz M, Irahara N, Donica M, Gonzalez-Martin A. Primary results from CECILIA, a global single-arm phase II study evaluating bevacizumab, carboplatin and paclitaxel for advanced cervical cancer. Gynecol Oncol. 2020 Oct;159(1):142-149. doi: 10.1016/j.ygyno.2020.07.026. Epub 2020 Aug 4.
Results Reference
derived
Learn more about this trial
Safety and Efficacy of Bevacizumab in Combination With Carboplatin and Paclitaxel for Metastatic, Recurrent or Persistent Cervical Cancer
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