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Newton Study (NEW Dosing mainTenance Therapy Ovarian caNcer) (Newton)

Primary Purpose

Ovarian Cancer, Fallopian Tube Cancer, Primary Peritoneal Carcinoma

Status
Recruiting
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Niraparib
Sponsored by
Mario Negri Institute for Pharmacological Research
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Ovarian Cancer focused on measuring Ovarian Cancer, Fallopian Tube Cancer, Primary Peritoneal Cancer, Platinum Senitive, Recurrent Cancer, Niraparib, Thrombocytopenia, Neutropenia, Anemia, RADAR dosing, Maintenance Therapy, PARP-inhibitor

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)FemaleAccepts Healthy Volunteers

Inclusion Criteria:

  1. 18 years of age or older, female, any race
  2. Histologically diagnosed ovarian cancer, fallopian tube cancer or primary peritoneal cancer
  3. High grade (or grade 3) serous histology or known to have gBRCAmut
  4. Has received at least 2 previous lines of platinum-containing therapy (not necessarily consecutive), and has disease that was considered platinum sensitive following the penultimate platinum line (more than 6-months period between penultimate platinum regimen and progression of disease)
  5. Has responded to the last platinum line (PR or CR)
  6. No more than 8 weeks have elapsed from completion of the last platinum regimen and the patient is still not progressing after response
  7. Eastern Cooperative Oncology Group (ECOG) performance status of ≤ 1
  8. Adequate bone marrow, kidney and liver function, defined as follows:

    1. Absolute neutrophil count ≥ 1,500/µL
    2. Platelets ≥ 100,000/µL
    3. Hemoglobin ≥ 9 g/dL
    4. Serum creatinine ≤ 1.5 x upper limit of normal (ULN) or calculated creatinine clearance ≥ 30 mL/min using the Cockcroft-Gault equation
    5. Total bilirubin ≤ 1.5 x ULN (≤2.0 in patients with known Gilberts syndrome) OR direct bilirubin ≤ 1 x ULN
    6. Aspartate aminotransferase and alanine aminotransferase ≤ 2.5 x ULN unless liver metastases are present, in which case they must be ≤ 5 x ULN
  9. Patient receiving corticosteroids may continue as long as their dose is stable for least 4 weeks prior to initiating protocol therapy.
  10. Patient must have a negative urine or serum pregnancy test within 7 days prior to taking study treatment if childbearing potential and agrees to abstain from activities that could result in pregnancy from screening through 180 days after the last dose of study treatment or use adequate barrier methods throughout the study. Non-childbearing potential is defined as follows (by other than medical reasons): ≥45 years of age and has not had menses for >1 year; patients with amenorrhea for <2 years without history of a hysterectomy and oophorectomy must have a follicle stimulating hormone value in the postmenopausal range upon screening evaluation; Post-hysterectomy, post-bilateral oophorectomy, or post-tubal ligation. Documented hysterectomy or oophorectomy must be confirmed with medical records of the actual procedure or confirmed by an ultrasound. Tubal ligation must be confirmed with medical records, otherwise the patient must be willing to use 2 adequate barrier methods throughout the study, starting with the screening visit through 180 days after the last dose of study treatment.
  11. Patient must agree to not breastfeed during the study or for 180 days after the last dose of study treatment.
  12. Patient must be able to understand the study procedures and agree to participate in the study by providing written informed consent.
  13. Patients must have normal blood pressure or adequately treated and controlled hypertension. (i.e. systolic BP ≤ 140 mmHg and diastolic BP ≤ 90 mmHg)

Exclusion Criteria:

  1. Patient simultaneously enrolled in any interventional clinical trial
  2. Invasive cancer other than ovarian cancer within 2 years (except basal or squamous cell carcinoma of the skin that has been definitely treated)
  3. Patient with known, symptomatic brain or leptomeningeal metastases
  4. Patient with immunocompromised status
  5. Patient with known active hepatic disease
  6. Prior treatment with a known PARP inhibitor
  7. Patient who has had major surgery ≤ 3 weeks prior to initiating protocol therapy and participant must have recovered from any surgical effects.
  8. Patient who has received investigational therapy ≤ 4 weeks, or within a time interval less than at least 5 half-lives of the investigational agent, whichever is shorter, prior initiating protocol therapy.
  9. Patient has had radiation therapy encompassing >20% of the bone marrow within 2 weeks prior to day 1 of protocol therapy
  10. Patient has had any radiation therapy within 1 week prior to day 1 of protocol therapy.
  11. Patient with known hypersensitivity to niraparib components or excipients.
  12. Patient has received a transfusion (platelets or red blood cells) ≤ 4 weeks prior to initiating protocol therapy.
  13. Patient has received colony stimulating factors (e.g., granulocyte colony-stimulating factor, granulocyte macrophage colony stimulating factor, or recombinant erythropoietin) within 4 weeks prior initiating protocol therapy.
  14. Patient has had any known Grade 3 or 4 anemia, neutropenia or thrombocytopenia due to prior chemotherapy that persisted > 4 weeks and was related to the most recent treatment.
  15. Patient with any known history of myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML)
  16. Patient with a serious, uncontrolled medical disorder. Examples include, but are not limited to, nonmalignant systemic disease, active, uncontrolled infection, uncontrolled ventricular arrhythmia, recent (within 90 days) myocardial infarction, uncontrolled major seizure disorder, unstable spinal cord compression, superior vena cava syndrome, or any psychiatric disorder that prohibits obtaining informed consent

Sites / Locations

  • Charité - Universitätsmedizin Berlin
  • University Hospital Dresden
  • Kliniken Essen Mitte
  • ASST degli Spedali Civili di BresciaRecruiting
  • ASST di Lecco
  • Istituto Europeo di OncologiaRecruiting
  • Ospedale San GerardoRecruiting
  • Istituto Oncologico Veneto (IOV)Recruiting
  • AO Arcispedale Santa Maria NuovaRecruiting
  • Policlinico Umberto I, Università di Roma "La Sapienza"
  • AO Ordine MaurizianoRecruiting
  • AOU Città della Salute e della Scienza di Torino - Ospedale Sant'AnnaRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Active Comparator

Other

Arm Label

Niraparib 200 mg

Niraparib 300 mg

Niraparib 200mg/300mg

Arm Description

Niraparib will be administered every day as oral at a fixed dose of 200 mg

Niraparib will be administered every day as oral at a fixed dose of 300 mg

Niraparib will be administered every day as oral at a fixed dose of 200 mg or 300 mg

Outcomes

Primary Outcome Measures

Safety: Occurrence of grade ≥3 thrombocytopenia
Rate of patients experiencing a grade ≥3 thrombocytopenia during the first three cycles

Secondary Outcome Measures

Safety: Occurrence of grade ≥ 3 thrombocytopenia
Rate of patients experiencing a grade ≥3 thrombocytopenia during the first six cycles
Safety: Maximum toxicity grade
Maximum toxicity grade experienced by each patient, for each toxicity, according to NCI-CTCAE v. 4.03
Safety: Grade 3-4 toxicities
Patient experiencing grade 3-4 for each toxicity
Safety: SAE
Type, frequency and nature of SAEs
Safety: Number of patients with at least a SAE
Number of patients with at least a SAE
Safety: Number of patients with at least a SADR
Number of patients with at least a SADR
Safety: Number of patients with at least a SUSAR
Number of patients with at least a SUSAR
Efficacy: PFS-6
PFS rate at 6 months, defines as the proportion of patients alive and free from progression at 6 months after randomization
Efficacy: PFS
PFS, defined as the time from the date of treatment randomization to the date of first documentation of progression or death whichever occurs first
Efficacy: OS
OS at 24 months, defined as the rate of patients who are alive at 24 months from randomization
Pharmacokinetic
Trough level of niraparib concentration at steady state (Css) and peak level at 2 hours after dosing
Compliance
Number of administered cycles
Compliance
Frequency and reasons for drug discontinuation and treatment modification
Compliance
Dose intensity

Full Information

First Posted
March 25, 2019
Last Updated
September 26, 2022
Sponsor
Mario Negri Institute for Pharmacological Research
Collaborators
North Eastern German Society of Gynaecological Oncology
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1. Study Identification

Unique Protocol Identification Number
NCT03891576
Brief Title
Newton Study (NEW Dosing mainTenance Therapy Ovarian caNcer)
Acronym
Newton
Official Title
A Multicenter, Open-label Phase II Trial of a New Customized Dosing (RADAR Dosing) of Niraparib as Maintenance Therapy in Platinum Sensitive Ovarian, Fallopian Tube or Primary Peritoneal Recurrent Cancer Patients
Study Type
Interventional

2. Study Status

Record Verification Date
September 2022
Overall Recruitment Status
Recruiting
Study Start Date
November 13, 2019 (Actual)
Primary Completion Date
December 31, 2023 (Anticipated)
Study Completion Date
December 31, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Mario Negri Institute for Pharmacological Research
Collaborators
North Eastern German Society of Gynaecological Oncology

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
No

5. Study Description

Brief Summary
This study evaluates whether the adoption of the RADAR dosing strategy could further reduce treatment related toxicities improving the safety profile of niraparib.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Ovarian Cancer, Fallopian Tube Cancer, Primary Peritoneal Carcinoma
Keywords
Ovarian Cancer, Fallopian Tube Cancer, Primary Peritoneal Cancer, Platinum Senitive, Recurrent Cancer, Niraparib, Thrombocytopenia, Neutropenia, Anemia, RADAR dosing, Maintenance Therapy, PARP-inhibitor

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
This is a study built up by a randomized and a no-randomized part. Randomized part: Patients who either have a baseline body weight ≥58 and <77kg, or have a baseline body weight ≥77kg and baseline platelet count <150,000/µL (named as restricted population) will be randomly assigned to receive RADAR dosing or the SmPC dosing. Randomization ratio will be 1:1 and will be based on a minimization procedure accounting for the following factors: i. platinum sensitivity; ii. use of bevacizumab in conjunction with the penultimate platinum based therapy; iii. best response (complete or partial) during the last platinum regimen. No-randomized part: Patients with weight <58 or ≥77kg and baseline platelet count ≥150,000/µL will be enrolled into the study but not randomized.
Masking
None (Open Label)
Allocation
Randomized
Enrollment
105 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Niraparib 200 mg
Arm Type
Experimental
Arm Description
Niraparib will be administered every day as oral at a fixed dose of 200 mg
Arm Title
Niraparib 300 mg
Arm Type
Active Comparator
Arm Description
Niraparib will be administered every day as oral at a fixed dose of 300 mg
Arm Title
Niraparib 200mg/300mg
Arm Type
Other
Arm Description
Niraparib will be administered every day as oral at a fixed dose of 200 mg or 300 mg
Intervention Type
Drug
Intervention Name(s)
Niraparib
Other Intervention Name(s)
Zejula
Intervention Description
Niraparib is a potent, orally active PARP1 and PARP2 inhibitor being developed as a treatment for patients with tumors that harbor defects in the homologous recombination DNA repair pathway or that are driven by PARP-mediated transcription factors.
Primary Outcome Measure Information:
Title
Safety: Occurrence of grade ≥3 thrombocytopenia
Description
Rate of patients experiencing a grade ≥3 thrombocytopenia during the first three cycles
Time Frame
3 months
Secondary Outcome Measure Information:
Title
Safety: Occurrence of grade ≥ 3 thrombocytopenia
Description
Rate of patients experiencing a grade ≥3 thrombocytopenia during the first six cycles
Time Frame
6 months
Title
Safety: Maximum toxicity grade
Description
Maximum toxicity grade experienced by each patient, for each toxicity, according to NCI-CTCAE v. 4.03
Time Frame
Up to two years after the last patient enrolled
Title
Safety: Grade 3-4 toxicities
Description
Patient experiencing grade 3-4 for each toxicity
Time Frame
Up to two years after the last patient enrolled
Title
Safety: SAE
Description
Type, frequency and nature of SAEs
Time Frame
Up to two years after the last patient enrolled
Title
Safety: Number of patients with at least a SAE
Description
Number of patients with at least a SAE
Time Frame
Up to two years after the last patient enrolled
Title
Safety: Number of patients with at least a SADR
Description
Number of patients with at least a SADR
Time Frame
Up two years after last patient enrolled
Title
Safety: Number of patients with at least a SUSAR
Description
Number of patients with at least a SUSAR
Time Frame
Up two years after last patient enrolled
Title
Efficacy: PFS-6
Description
PFS rate at 6 months, defines as the proportion of patients alive and free from progression at 6 months after randomization
Time Frame
6 months
Title
Efficacy: PFS
Description
PFS, defined as the time from the date of treatment randomization to the date of first documentation of progression or death whichever occurs first
Time Frame
Up two years after last patient enrolled
Title
Efficacy: OS
Description
OS at 24 months, defined as the rate of patients who are alive at 24 months from randomization
Time Frame
Up two years after last patient enrolled
Title
Pharmacokinetic
Description
Trough level of niraparib concentration at steady state (Css) and peak level at 2 hours after dosing
Time Frame
Up to two years after the last patient enrolled
Title
Compliance
Description
Number of administered cycles
Time Frame
Up to two years after the last patient enrolled
Title
Compliance
Description
Frequency and reasons for drug discontinuation and treatment modification
Time Frame
Up to two years after the last patient enrolled
Title
Compliance
Description
Dose intensity
Time Frame
Up to two years after the last patient enrolled

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: 18 years of age or older, female, any race Histologically diagnosed ovarian cancer, fallopian tube cancer or primary peritoneal cancer High grade (or grade 3) serous histology or known to have gBRCAmut Has received at least 2 previous lines of platinum-containing therapy (not necessarily consecutive), and has disease that was considered platinum sensitive following the penultimate platinum line (more than 6-months period between penultimate platinum regimen and progression of disease) Has responded to the last platinum line (PR or CR) No more than 8 weeks have elapsed from completion of the last platinum regimen and the patient is still not progressing after response Eastern Cooperative Oncology Group (ECOG) performance status of ≤ 1 Adequate bone marrow, kidney and liver function, defined as follows: Absolute neutrophil count ≥ 1,500/µL Platelets ≥ 100,000/µL Hemoglobin ≥ 9 g/dL Serum creatinine ≤ 1.5 x upper limit of normal (ULN) or calculated creatinine clearance ≥ 30 mL/min using the Cockcroft-Gault equation Total bilirubin ≤ 1.5 x ULN (≤2.0 in patients with known Gilberts syndrome) OR direct bilirubin ≤ 1 x ULN Aspartate aminotransferase and alanine aminotransferase ≤ 2.5 x ULN unless liver metastases are present, in which case they must be ≤ 5 x ULN Patient receiving corticosteroids may continue as long as their dose is stable for least 4 weeks prior to initiating protocol therapy. Patient must have a negative urine or serum pregnancy test within 7 days prior to taking study treatment if childbearing potential and agrees to abstain from activities that could result in pregnancy from screening through 180 days after the last dose of study treatment or use adequate barrier methods throughout the study. Non-childbearing potential is defined as follows (by other than medical reasons): ≥45 years of age and has not had menses for >1 year; patients with amenorrhea for <2 years without history of a hysterectomy and oophorectomy must have a follicle stimulating hormone value in the postmenopausal range upon screening evaluation; Post-hysterectomy, post-bilateral oophorectomy, or post-tubal ligation. Documented hysterectomy or oophorectomy must be confirmed with medical records of the actual procedure or confirmed by an ultrasound. Tubal ligation must be confirmed with medical records, otherwise the patient must be willing to use 2 adequate barrier methods throughout the study, starting with the screening visit through 180 days after the last dose of study treatment. Patient must agree to not breastfeed during the study or for 180 days after the last dose of study treatment. Patient must be able to understand the study procedures and agree to participate in the study by providing written informed consent. Patients must have normal blood pressure or adequately treated and controlled hypertension. (i.e. systolic BP ≤ 140 mmHg and diastolic BP ≤ 90 mmHg) Exclusion Criteria: Patient simultaneously enrolled in any interventional clinical trial Invasive cancer other than ovarian cancer within 2 years (except basal or squamous cell carcinoma of the skin that has been definitely treated) Patient with known, symptomatic brain or leptomeningeal metastases Patient with immunocompromised status Patient with known active hepatic disease Prior treatment with a known PARP inhibitor Patient who has had major surgery ≤ 3 weeks prior to initiating protocol therapy and participant must have recovered from any surgical effects. Patient who has received investigational therapy ≤ 4 weeks, or within a time interval less than at least 5 half-lives of the investigational agent, whichever is shorter, prior initiating protocol therapy. Patient has had radiation therapy encompassing >20% of the bone marrow within 2 weeks prior to day 1 of protocol therapy Patient has had any radiation therapy within 1 week prior to day 1 of protocol therapy. Patient with known hypersensitivity to niraparib components or excipients. Patient has received a transfusion (platelets or red blood cells) ≤ 4 weeks prior to initiating protocol therapy. Patient has received colony stimulating factors (e.g., granulocyte colony-stimulating factor, granulocyte macrophage colony stimulating factor, or recombinant erythropoietin) within 4 weeks prior initiating protocol therapy. Patient has had any known Grade 3 or 4 anemia, neutropenia or thrombocytopenia due to prior chemotherapy that persisted > 4 weeks and was related to the most recent treatment. Patient with any known history of myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML) Patient with a serious, uncontrolled medical disorder. Examples include, but are not limited to, nonmalignant systemic disease, active, uncontrolled infection, uncontrolled ventricular arrhythmia, recent (within 90 days) myocardial infarction, uncontrolled major seizure disorder, unstable spinal cord compression, superior vena cava syndrome, or any psychiatric disorder that prohibits obtaining informed consent
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Elena Biagioli
Phone
+390239014650
Email
newton@marionegri.it
First Name & Middle Initial & Last Name or Official Title & Degree
Roldano Fossati
Email
newton@marionegri.it
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Nicoletta Colombo, MD
Organizational Affiliation
Istituto Europeo di Oncologia (IEO) - Milan
Official's Role
Principal Investigator
Facility Information:
Facility Name
Charité - Universitätsmedizin Berlin
City
Berlin
Country
Germany
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Elena Ioana Braicu
Facility Name
University Hospital Dresden
City
Dresde
Country
Germany
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Pauline Wimberger
Facility Name
Kliniken Essen Mitte
City
Essen
Country
Germany
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Florian Heitz
Facility Name
ASST degli Spedali Civili di Brescia
City
Brescia
Country
Italy
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Germana Tognon
Facility Name
ASST di Lecco
City
Lecco
Country
Italy
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Antonio Ardizzoia
Facility Name
Istituto Europeo di Oncologia
City
Milan
Country
Italy
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Nicoletta Colombo
Facility Name
Ospedale San Gerardo
City
Monza
Country
Italy
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Andrea Alberto Lissoni
Facility Name
Istituto Oncologico Veneto (IOV)
City
Padova
Country
Italy
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ornella Nicoletto
Facility Name
AO Arcispedale Santa Maria Nuova
City
Reggio Emilia
Country
Italy
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Alessandra Bologna
Facility Name
Policlinico Umberto I, Università di Roma "La Sapienza"
City
Roma
Country
Italy
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Pierluigi Benedetti Panici
Facility Name
AO Ordine Mauriziano
City
Torino
Country
Italy
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Annamaria Ferrero
Facility Name
AOU Città della Salute e della Scienza di Torino - Ospedale Sant'Anna
City
Torino
Country
Italy
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Dionyssios Katsaros

12. IPD Sharing Statement

Plan to Share IPD
No

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Newton Study (NEW Dosing mainTenance Therapy Ovarian caNcer)

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