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A Study of the Safety, Tolerability and Effectiveness of Hydroxychloroquine and Itraconazole in Platinum-resistant Epithelial Ovarian Cancer

Primary Purpose

Platinum-resistant Epithelial Ovarian Cancer

Status
Completed
Phase
Phase 1
Locations
Canada
Study Type
Interventional
Intervention
Hydroxychloroquine
Itraconazole
Sponsored by
University Health Network, Toronto
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Platinum-resistant Epithelial Ovarian Cancer

Eligibility Criteria

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

Inclusion Criteria:

  • Aged 18 years or older.
  • Histologically or cytologically confirmed epithelial ovarian cancer.
  • Platinum-resistant or refractory disease defined as a radiological or clinical progression less than six months after having finished platinum-based chemotherapy.
  • ECOG performance status equal to or less than 1.
  • Have clinically or radiographically documented measurable disease.
  • All systemic therapy must have been completed 4 weeks or greater prior to enrollment with radiologic evidence of radiological disease progression.
  • Life expectancy should be more than 3 months.
  • Receiving any medications or substances that are inhibitors or inducers of CYP3A4 are ineligible.
  • Acceptable laboratory requirements within 7 days prior to enrollment
  • Treated and asymptomatic brain metastases are eligible. Patients that received palliative radiation (for brain metastases) are eligible if they have been asymptomatic for at least 2 weeks with use of maintenance steroid therapy, and last received radiation at least 4 weeks prior to start of therapy.
  • Have the ability to understand and willing to sign a written informed consent document.

Exclusion Criteria:

  • Have not recovered (grade 1 or less) from adverse events related to previous treatments are excluded with the exception of alopecia and lymphopenia. Peripheral sensory neuropathy must be at grade 2 or less.
  • Have any other prior malignancy from which the patient has been disease free for less than 3 years, with the exception of adequately treated and cured basal or squamous cell skin cancer, superficial bladder cancer, carcinoma in situ of any site or any other cancer.
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to itraconazole or hydroxychloroquine.
  • Known G6PD deficiency due to the risk of hemolytic anemia with the use of hydroxychloroquine.
  • Known retinopathy due to the risk of worsening retinopathy with hydroxychloroquine.
  • Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic or asymptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
  • Chronic Hepatitis B or hepatitis C infections should be excluded because of potential effects on hepatic function and/ or drug interactions.
  • Human Immunodeficiency Virus (HIV) infection.
  • Already have a clinical indication for treatment with itraconazole (e.g. chronic candidiasis or other fungal infection) or hydroxychloroquine (e.g. lupus).

Sites / Locations

  • Princess Margaret Cancer Centre

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Hydroxychloroquine and Itraconazole

Arm Description

Hydroxychloroquine, orally (by mouth), at a dose of 100 mg, 200 mg, 400 mg, or 600 mg, twice a day, every day. Itraconazole, orally (by mouth) at 300 mg, twice a day, every day.

Outcomes

Primary Outcome Measures

Maximum tolerated dose of hydroxychloroquine
Highest dose of hydroxychloroquine that is safe and tolerable that can be given in combination with itraconazole.

Secondary Outcome Measures

Median progression-free survival
Median duration of time from start of treatment to time of progression or death.
Overall response rate
Proportion of patients achieving complete response or partial response.

Full Information

First Posted
March 10, 2017
Last Updated
April 1, 2021
Sponsor
University Health Network, Toronto
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1. Study Identification

Unique Protocol Identification Number
NCT03081702
Brief Title
A Study of the Safety, Tolerability and Effectiveness of Hydroxychloroquine and Itraconazole in Platinum-resistant Epithelial Ovarian Cancer
Official Title
A Phase I/II Trial Investigating the Tolerability, Toxicity and Efficacy of Hydroxychloroquine and Itraconazole in Patients With Advanced Platinum-resistant Epithelial Ovarian Cancer (EOC) (HYDRA-1 Study)
Study Type
Interventional

2. Study Status

Record Verification Date
April 2021
Overall Recruitment Status
Completed
Study Start Date
July 25, 2017 (Actual)
Primary Completion Date
August 27, 2019 (Actual)
Study Completion Date
August 27, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University Health Network, Toronto

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a phase I/II study to find the highest dose of hydroxychloroquine that can be given safely with itraconazole in patients with advanced platinum-resistant epithelial ovarian cancer. The study will also determine the safety, tolerability, and initially determine whether the combination is useful in the treatment of patients with advanced platinum-resistant epithelial ovarian cancer.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Platinum-resistant Epithelial Ovarian Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
13 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Hydroxychloroquine and Itraconazole
Arm Type
Experimental
Arm Description
Hydroxychloroquine, orally (by mouth), at a dose of 100 mg, 200 mg, 400 mg, or 600 mg, twice a day, every day. Itraconazole, orally (by mouth) at 300 mg, twice a day, every day.
Intervention Type
Drug
Intervention Name(s)
Hydroxychloroquine
Intervention Description
Hydroxychloroquine is approved/used for the treatment of rheumatoid arthritis, and discoid and systemic lupus erythematosus, as well as suppressive treatment and treatment of acute attacks of malaria.
Intervention Type
Drug
Intervention Name(s)
Itraconazole
Intervention Description
Itraconazole is approved and used for the treatment of certain systemic fungal infections.
Primary Outcome Measure Information:
Title
Maximum tolerated dose of hydroxychloroquine
Description
Highest dose of hydroxychloroquine that is safe and tolerable that can be given in combination with itraconazole.
Time Frame
5 years
Secondary Outcome Measure Information:
Title
Median progression-free survival
Description
Median duration of time from start of treatment to time of progression or death.
Time Frame
5 years
Title
Overall response rate
Description
Proportion of patients achieving complete response or partial response.
Time Frame
5 years

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Aged 18 years or older. Histologically or cytologically confirmed epithelial ovarian cancer. Platinum-resistant or refractory disease defined as a radiological or clinical progression less than six months after having finished platinum-based chemotherapy. ECOG performance status equal to or less than 1. Have clinically or radiographically documented measurable disease. All systemic therapy must have been completed 4 weeks or greater prior to enrollment with radiologic evidence of radiological disease progression. Life expectancy should be more than 3 months. Receiving any medications or substances that are inhibitors or inducers of CYP3A4 are ineligible. Acceptable laboratory requirements within 7 days prior to enrollment Treated and asymptomatic brain metastases are eligible. Patients that received palliative radiation (for brain metastases) are eligible if they have been asymptomatic for at least 2 weeks with use of maintenance steroid therapy, and last received radiation at least 4 weeks prior to start of therapy. Have the ability to understand and willing to sign a written informed consent document. Exclusion Criteria: Have not recovered (grade 1 or less) from adverse events related to previous treatments are excluded with the exception of alopecia and lymphopenia. Peripheral sensory neuropathy must be at grade 2 or less. Have any other prior malignancy from which the patient has been disease free for less than 3 years, with the exception of adequately treated and cured basal or squamous cell skin cancer, superficial bladder cancer, carcinoma in situ of any site or any other cancer. History of allergic reactions attributed to compounds of similar chemical or biologic composition to itraconazole or hydroxychloroquine. Known G6PD deficiency due to the risk of hemolytic anemia with the use of hydroxychloroquine. Known retinopathy due to the risk of worsening retinopathy with hydroxychloroquine. Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic or asymptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements. Chronic Hepatitis B or hepatitis C infections should be excluded because of potential effects on hepatic function and/ or drug interactions. Human Immunodeficiency Virus (HIV) infection. Already have a clinical indication for treatment with itraconazole (e.g. chronic candidiasis or other fungal infection) or hydroxychloroquine (e.g. lupus).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Stephanie Lheureux, M.D.
Organizational Affiliation
Princess Margaret Cancer Centre
Official's Role
Principal Investigator
Facility Information:
Facility Name
Princess Margaret Cancer Centre
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5G 2M9
Country
Canada

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Study of the Safety, Tolerability and Effectiveness of Hydroxychloroquine and Itraconazole in Platinum-resistant Epithelial Ovarian Cancer

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