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Efficacy and Safety of Niraparib Combined With Oral Etoposide in Platinum Resistant/Refractory Recurrent Ovarian Cancer

Primary Purpose

Ovarian Cancer

Status
Unknown status
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Niraparib
Sponsored by
Peking Union Medical College Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Ovarian Cancer focused on measuring platinum resistent/refractory, ovarian cancer

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  • Signed informed consent before undertaking any study procedure.
  • Female, age 18-70.
  • Histologically confirmed FIGO stage III or IV non-mucinous epithelial ovarian cancer, fallopian tube cancer, or primary peritoneal cancer.
  • No limitation of the BRCA mutation and HRD status.
  • Platinum resistant or refractory recurrent disease.
  • Subjects must have received at least 1 prior line of platinum-based chemotherapy regimen and no more than twice.
  • Subjects must have measurable lesions with imaging evidence of disease progression (according to RECIST1.1 criteria); or without measurable/evaluable lesion (RECIST 1.1 criteria), but two consecutive cases of elevated CA125 > 2 times the upper limit of normal (> 70 U/ml) were detected.
  • Life expectancy of more than 6 months.
  • ECOG 0-1.
  • Good organ function, including:

    • Bone marrow function: neutrophil count ≥1,500/µL, platelets ≥100,000/µL, hemoglobin ≥10 g/dL;
    • Hepatic function: total bilirubin ≤ 1.5 x upper limit of normal (ULN) or direct bilirubin ≤1.0 x ULN, AST and ALT ≤2.5 x ULN unless liver metastases are present, in which case they must be ≤5 x ULN;
    • Renal function: serum creatinine ≤1.5 x upper limit of normal (ULN) or calculated creatinine clearance ≥60 mL/min using the Cockcroft-Gault equation.
  • Has a negative serum pregnancy test within 3 days prior to taking study treatment if of childbearing potential and agrees to abstain from activities that could result in pregnancy from screening through 3 months after the last dose of study treatment, or is of non-childbearing potential. Non-childbearing potential is defined as follows (by other than medical reasons):

    • ≥45 years and <60 years of age and has not had menses for >1 year
    • ≥60 years of age
    • Post-hysterectomy, post-bilateral oophorectomy, or post-tubal ligation.
  • Is able to adhere to the protocol.
  • Has recovered from previous chemotherapy induced toxic side effects to ≤ grade 1 CTCAE or basal level, apart from ≤ grade 2 CTCAE peripheral neuropathy or hair loss symptoms at steady state.

Exclusion Criteria:

  • Has a known hypersensitivity to the active or inactive ingredients of niraparib or compound which has similar chemical structure to niraparib.
  • Has a known hypersensitivity to the active or inactive ingredients of etoposide or compound which has similar chemical structure to etoposide.
  • prior PARP inhibitor therapy.
  • Has symptomatic uncontrolled brain or leptomeningeal metastasis.
  • Major surgery or chemotherapy within 3 weeks of starting the study or patient has not recovered from any effects of the surgery.
  • Receive palliative radiotherapy encompassing > 20% of the bone marrow within 1 week of entering the study.
  • Be diagnosed any invasive cancer other than ovarian cancer (apart from cured basal cell carcinoma and squamous cell carcinoma) within 2 years prior to study enrolment.
  • Previously or currently diagnosed of myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML).
  • Has other serious or uncontrolled disease.
  • Has any disease, treatment and laboratory abnormality that may interfere the study results and affect the fully attendance of study. Or the subject is considered to be not suitable for the study by the investigator. Cannot receive platelet or red blood cell transfusion within 4 weeks of study drug administration.
  • Pregnant, breastfeeding or expecting to conceive children during the study treatment period.
  • Adjusted for QT interval (QTc) >470 msec.

Sites / Locations

  • Peking Union Medical College HospitalRecruiting
  • Shandong Cancer HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Niparib combined with oral etoposide

Arm Description

Subjects will received niraparib 200mg or 100mg alternate once daily and oral etoposide 50mg on day 1-20 of a 30-day cycle. Oral etoposide was administered for a maximum of 6-8 cycles. Treatment was continued until disease progression, patient withdrawal or unacceptable toxic effects.

Outcomes

Primary Outcome Measures

Progression Free Survival (PFS)
PFS is defined as the time from randomization to first disease progression by investigator assessment using RECIST 1.1 or death, from any cause, whichever comes first.

Secondary Outcome Measures

Objective Response Rate (ORR)
ORR is defined as the proportion of subjects who have a partial response (PR) or complete response (CR) to therapy according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1.
Duration of Response (DOR)
DOR is defined as the time from the first date of response until the date of first documented progression.
Disease Control Rate (DCR)
DCR is defined as the proportion of subjects who have a complete response (CR), partial response (PR) and stable disease (SD) to therapy according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1.
CA125 Response Rate
The proportion of subjects with a minimum 50% reduction in CA-125 serum levels lasting for ≥28 days relative to baseline CA-125 serum levels.
The frequency and severity of adverse events
The frequency and severity of adverse events evaluated according to NCI CTCAE version 5.0 during subjects receiving the study treatment.

Full Information

First Posted
December 9, 2019
Last Updated
August 27, 2021
Sponsor
Peking Union Medical College Hospital
Collaborators
Zai Lab (Shanghai) Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT04217798
Brief Title
Efficacy and Safety of Niraparib Combined With Oral Etoposide in Platinum Resistant/Refractory Recurrent Ovarian Cancer
Official Title
A Single Arm, Prospective, Multicenter, Phase II Study to Evaluate the Efficacy and Safety of Niraparib Combined With Oral Etoposide in Platinum Resistant/ Refractory Recurrent Ovarian Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
December 2020
Overall Recruitment Status
Unknown status
Study Start Date
May 21, 2020 (Actual)
Primary Completion Date
March 1, 2022 (Anticipated)
Study Completion Date
June 1, 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Peking Union Medical College Hospital
Collaborators
Zai Lab (Shanghai) Co., Ltd.

4. Oversight

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

5. Study Description

Brief Summary
To evaluate the efficacy and safety of niraparib combined with oral etoposide in platinum resistant or platinum refractory recurrent ovarian cancer.
Detailed Description
This is a single arm, prospective, multicenter, phase II study to evaluate the efficacy and safety of PARP inhibitor niraparib combined with oral etoposide chemotherapy in women with platinum resistant or refractory recurrent ovarian cancer. Subjects will receive niraparib and oral etoposide in 30-day treatment cycles. After 6-8 cycles, oral etoposide will be discontinued. Subjects will receive niraparib alone until disease progression, intolerable toxicity or withdrawal of informed consent. The primary endpoint is progression free survival evaluated by Response Evaluation Criteria in Solid Tumors (RECIST v1.1). Secondary endpoints include overall response rate , duration of response, disease control rate, CA125 response rate and safety.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Ovarian Cancer
Keywords
platinum resistent/refractory, ovarian 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
36 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Niparib combined with oral etoposide
Arm Type
Experimental
Arm Description
Subjects will received niraparib 200mg or 100mg alternate once daily and oral etoposide 50mg on day 1-20 of a 30-day cycle. Oral etoposide was administered for a maximum of 6-8 cycles. Treatment was continued until disease progression, patient withdrawal or unacceptable toxic effects.
Intervention Type
Drug
Intervention Name(s)
Niraparib
Other Intervention Name(s)
oral etoposide
Intervention Description
Subjects will receive niraparib combined with oral etoposide (on day 1-20, every 30 days). After 6-8 cycles, oral etoposide will be terminated. Niraparib will be still given to subjects until disease progression, intolerable toxicity or withdrawal of informed consent.
Primary Outcome Measure Information:
Title
Progression Free Survival (PFS)
Description
PFS is defined as the time from randomization to first disease progression by investigator assessment using RECIST 1.1 or death, from any cause, whichever comes first.
Time Frame
Through study completion, an average of 1 year
Secondary Outcome Measure Information:
Title
Objective Response Rate (ORR)
Description
ORR is defined as the proportion of subjects who have a partial response (PR) or complete response (CR) to therapy according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1.
Time Frame
Through study completion, an average of 1 year
Title
Duration of Response (DOR)
Description
DOR is defined as the time from the first date of response until the date of first documented progression.
Time Frame
Through study completion, an average of 1 year
Title
Disease Control Rate (DCR)
Description
DCR is defined as the proportion of subjects who have a complete response (CR), partial response (PR) and stable disease (SD) to therapy according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1.
Time Frame
Through study completion, an average of 1 year
Title
CA125 Response Rate
Description
The proportion of subjects with a minimum 50% reduction in CA-125 serum levels lasting for ≥28 days relative to baseline CA-125 serum levels.
Time Frame
Through study completion, an average of 1 year
Title
The frequency and severity of adverse events
Description
The frequency and severity of adverse events evaluated according to NCI CTCAE version 5.0 during subjects receiving the study treatment.
Time Frame
Through study completion, an average of 1 year

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Signed informed consent before undertaking any study procedure. Female, age 18-70. Histologically confirmed FIGO stage III or IV non-mucinous epithelial ovarian cancer, fallopian tube cancer, or primary peritoneal cancer. No limitation of the BRCA mutation and HRD status. Platinum resistant or refractory recurrent disease. Subjects must have received at least 1 prior line of platinum-based chemotherapy regimen and no more than twice. Subjects must have measurable lesions with imaging evidence of disease progression (according to RECIST1.1 criteria); or without measurable/evaluable lesion (RECIST 1.1 criteria), but two consecutive cases of elevated CA125 > 2 times the upper limit of normal (> 70 U/ml) were detected. Life expectancy of more than 6 months. ECOG 0-1. Good organ function, including: Bone marrow function: neutrophil count ≥1,500/µL, platelets ≥100,000/µL, hemoglobin ≥10 g/dL; Hepatic function: total bilirubin ≤ 1.5 x upper limit of normal (ULN) or direct bilirubin ≤1.0 x ULN, AST and ALT ≤2.5 x ULN unless liver metastases are present, in which case they must be ≤5 x ULN; Renal function: serum creatinine ≤1.5 x upper limit of normal (ULN) or calculated creatinine clearance ≥60 mL/min using the Cockcroft-Gault equation. Has a negative serum pregnancy test within 3 days prior to taking study treatment if of childbearing potential and agrees to abstain from activities that could result in pregnancy from screening through 3 months after the last dose of study treatment, or is of non-childbearing potential. Non-childbearing potential is defined as follows (by other than medical reasons): ≥45 years and <60 years of age and has not had menses for >1 year ≥60 years of age Post-hysterectomy, post-bilateral oophorectomy, or post-tubal ligation. Is able to adhere to the protocol. Has recovered from previous chemotherapy induced toxic side effects to ≤ grade 1 CTCAE or basal level, apart from ≤ grade 2 CTCAE peripheral neuropathy or hair loss symptoms at steady state. Exclusion Criteria: Has a known hypersensitivity to the active or inactive ingredients of niraparib or compound which has similar chemical structure to niraparib. Has a known hypersensitivity to the active or inactive ingredients of etoposide or compound which has similar chemical structure to etoposide. prior PARP inhibitor therapy. Has symptomatic uncontrolled brain or leptomeningeal metastasis. Major surgery or chemotherapy within 3 weeks of starting the study or patient has not recovered from any effects of the surgery. Receive palliative radiotherapy encompassing > 20% of the bone marrow within 1 week of entering the study. Be diagnosed any invasive cancer other than ovarian cancer (apart from cured basal cell carcinoma and squamous cell carcinoma) within 2 years prior to study enrolment. Previously or currently diagnosed of myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML). Has other serious or uncontrolled disease. Has any disease, treatment and laboratory abnormality that may interfere the study results and affect the fully attendance of study. Or the subject is considered to be not suitable for the study by the investigator. Cannot receive platelet or red blood cell transfusion within 4 weeks of study drug administration. Pregnant, breastfeeding or expecting to conceive children during the study treatment period. Adjusted for QT interval (QTc) >470 msec.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Jiaxin Yang, MD
Phone
13661160998
Email
yangjiaxin@pumch.cn
First Name & Middle Initial & Last Name or Official Title & Degree
HuiMei Zhou, MD
Phone
18600012090
Email
mayflower0808@126.com
Facility Information:
Facility Name
Peking Union Medical College Hospital
City
Beijing
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
HuiMei Zhou
Phone
18600012090
Ext
18600012090
Email
mayflower0808@126.com
Facility Name
Shandong Cancer Hospital
City
Jinan
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Depu Zhang

12. IPD Sharing Statement

Plan to Share IPD
No

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Efficacy and Safety of Niraparib Combined With Oral Etoposide in Platinum Resistant/Refractory Recurrent Ovarian Cancer

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