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Niraparib Maintenance in Patients With Advanced Ovarian Cancer at Neoadjuvant Setting (NEOPRIMA)

Primary Purpose

Ovarian Cancer

Status
Active
Phase
Phase 2
Locations
Hong Kong
Study Type
Interventional
Intervention
Niraparib
Sponsored by
The University of Hong Kong
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Ovarian Cancer focused on measuring advanced, ovarian, cancer, neoadjuvant, niraparib

Eligibility Criteria

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

Inclusion Criteria:

  1. Patients must be at least 18 years old.
  2. Patients must have newly diagnosed, histologically confirmed high grade, serous or endometrioid, FIGO stage 3 or 4, ovarian, fallopian tube or primary peritoneal carcinoma before the start of NACT.
  3. Patients must have received 3 - 4 cycles of NACT containing either carboplatin or cisplatin, IDS with or without HIPEC, and 3 - 6 more cycles of adjuvant chemotherapy, prior to recruitment into the study.
  4. The patients should have only one cytoreductive surgery.
  5. The patients must show either complete (CR) or partial response (PR) to the platinum-based chemotherapy using RECIST 1.1 criteria.
  6. Patients should not be amenable to further surgery or radiotherapy except for the purpose of symptomatic relief.
  7. All surgery, chemotherapy and radiotherapy should finish more than 3 weeks prior to recruitment.
  8. Niraparib should be started within 8 weeks after the last dose of chemotherapy.
  9. Patients should have Eastern Cooperative Oncology Group (ECOG) performance score 0 to 2 within 28 days prior to recruitment.
  10. Patients must have adequate bone marrow, renal, hepatic and neurological function within 28 days prior to the start of treatment.
  11. Patients who have childbearing potential should practice highly effective contraception throughout the study until at least 30 days after completion of the treatment.

Exclusion Criteria:

  1. Patients who are diagnosed to have low-grade or borderline carcinoma, mucinous or clear cell cystadenocarcinoma, carcinosarcoma or undifferentiated carcinoma, are excluded.
  2. Patients who have stable disease or PD on the post-treatment scan or clinical evidence are excluded.
  3. Patients who have drainage of ascites within 4 weeks before recruitment are excluded.
  4. Patients who have with concurrent malignancy within five years (except for basal or squamous cell skin cancer or in-situ breast cancer) are excluded.
  5. Patients who have history of unresolved thrombocytopenia, myelodysplastic syndrome or acute myeloid leukaemia are excluded.
  6. Patients who have symptomatic brain or leptomeningeal metastases, or spinal cord compression are excluded unless these are treated and controlled within 28 days of recruitment.
  7. Patients with the significant past medical history, such as active hepatitis, myocardiac infarction, in the last six months are excluded.
  8. Patients with severe gastrointestinal conditions such as evidence of bowel obstruction in the last 4 weeks prior to enrolment, or history of inflammatory bowel disease, are not eligible.
  9. Patients having had severe infections within 4 weeks prior to the start of treatment are excluded.
  10. Patents with active tuberculosis, history of positive test for human immunodeficiency virus (HIV) or known acquired immunodeficiency syndrome (AIDS) are excluded.
  11. Patients with prior allogeneic stem cell or solid organ transplantation are excluded.
  12. Those patients who suffer from CTCAE grade 2 or more toxicity from previous treatment, except alopecia, are excluded.
  13. Patients who have used PARPi previously are excluded.
  14. Patients who are allergic to any component of niraparib are excluded.
  15. Patients who have used bevacizumab, or who are going to use bevacizumab as maintenance, are not eligible to join the study.
  16. Use of other investigational drugs within 28 days or at least 5 half-lives (whichever is longer) before study drug administration is not allowed.
  17. Patients who are pregnant or breastfeeding are excluded.
  18. Patients must not have either platelet or red blood cell transfusion, or granulocyte colony stimulating factor (G-CSF) within 2 weeks of the first dose of study treatment.
  19. Patients must not plan to donate blood during the study or for 90 days after the last dose of study treatment.
  20. Patients with major operation within 28 days or open biopsy within 7 days before enrolment are not eligible.
  21. Patients planned to have major surgery during the course of the study are excluded.

Sites / Locations

  • The University of Hong Kong

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Experimental arm

Arm Description

Niraparib 200 or 300mg daily orally for 18 cycles unless disease progression or intolerable side effects (whichever occurs first)

Outcomes

Primary Outcome Measures

PFS rate at 18 months
Proportion of patients who are progression-free at 18 months according to the RECIST 1.1

Secondary Outcome Measures

PFS by the RECIST 1.1
The time from first dose of trial medication to first documentation of objective tumor progression (PD) or to death due to any cause, whichever occurs first.
Overall survival
Overall survival is defined as the time from first dose of trial medication to date of death due to any cause.
OS rate at 18 months
Proportion of patients who are alive at 18 months
Change of biomarkers
Expression levels of markers like Ki-67 before and after chemotherapy
Treatment-related adverse events
Incidence of treatment-related adverse events classified by CTCAE version 5.0

Full Information

First Posted
February 17, 2020
Last Updated
October 2, 2023
Sponsor
The University of Hong Kong
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1. Study Identification

Unique Protocol Identification Number
NCT04284852
Brief Title
Niraparib Maintenance in Patients With Advanced Ovarian Cancer at Neoadjuvant Setting
Acronym
NEOPRIMA
Official Title
Niraparib Maintenance in Patients With Advanced Ovarian Cancer at Neoadjuvant Setting - a Phase 2, Single-arm Trial (NEOPRIMA Trial)
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
May 1, 2020 (Actual)
Primary Completion Date
October 1, 2023 (Anticipated)
Study Completion Date
October 1, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
The University of Hong Kong

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
This study aims to evaluate the effects of niraparib in those who have received neoadjuvant chemotherapy and subsequent interval debulking surgery, with or without hyperthermic intraperitoneal chemotherapy, and would also explore if there are any biomarkers, other than BRCA / HRD status and platinum sensitivity, that may help to identify those who may benefit from PARPi especially those who are HRD negative.
Detailed Description
Despite cytoreductive surgery and platinum-based chemotherapy, about 70% of patients with advanced ovarian cancer recur in the first 2 - 3 years. PARPi has been shown to be prolong survival in primary advanced ovarian cancer. However its role in neoadjuvant setting has not been fully evaluated.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Ovarian Cancer
Keywords
advanced, ovarian, cancer, neoadjuvant, niraparib

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Experimental arm
Arm Type
Experimental
Arm Description
Niraparib 200 or 300mg daily orally for 18 cycles unless disease progression or intolerable side effects (whichever occurs first)
Intervention Type
Drug
Intervention Name(s)
Niraparib
Other Intervention Name(s)
Zejula
Intervention Description
PARP inhibitor
Primary Outcome Measure Information:
Title
PFS rate at 18 months
Description
Proportion of patients who are progression-free at 18 months according to the RECIST 1.1
Time Frame
up to 18 months
Secondary Outcome Measure Information:
Title
PFS by the RECIST 1.1
Description
The time from first dose of trial medication to first documentation of objective tumor progression (PD) or to death due to any cause, whichever occurs first.
Time Frame
up to 5 years
Title
Overall survival
Description
Overall survival is defined as the time from first dose of trial medication to date of death due to any cause.
Time Frame
up to 5 years
Title
OS rate at 18 months
Description
Proportion of patients who are alive at 18 months
Time Frame
up to 18 months
Title
Change of biomarkers
Description
Expression levels of markers like Ki-67 before and after chemotherapy
Time Frame
up to 18 months
Title
Treatment-related adverse events
Description
Incidence of treatment-related adverse events classified by CTCAE version 5.0
Time Frame
up to 18 months

10. Eligibility

Sex
Female
Gender Based
Yes
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients must be at least 18 years old. Patients must have newly diagnosed, histologically confirmed high grade, serous or endometrioid, FIGO stage 3 or 4, ovarian, fallopian tube or primary peritoneal carcinoma before the start of NACT. Patients must have received 3 - 4 cycles of NACT containing either carboplatin or cisplatin, IDS with or without HIPEC, and 3 - 6 more cycles of adjuvant chemotherapy, prior to recruitment into the study. The patients should have only one cytoreductive surgery. The patients must show either complete (CR) or partial response (PR) to the platinum-based chemotherapy using RECIST 1.1 criteria. Patients should not be amenable to further surgery or radiotherapy except for the purpose of symptomatic relief. All surgery, chemotherapy and radiotherapy should finish more than 3 weeks prior to recruitment. Niraparib should be started within 8 weeks after the last dose of chemotherapy. Patients should have Eastern Cooperative Oncology Group (ECOG) performance score 0 to 2 within 28 days prior to recruitment. Patients must have adequate bone marrow, renal, hepatic and neurological function within 28 days prior to the start of treatment. Patients who have childbearing potential should practice highly effective contraception throughout the study until at least 30 days after completion of the treatment. Exclusion Criteria: Patients who are diagnosed to have low-grade or borderline carcinoma, mucinous or clear cell cystadenocarcinoma, carcinosarcoma or undifferentiated carcinoma, are excluded. Patients who have stable disease or PD on the post-treatment scan or clinical evidence are excluded. Patients who have drainage of ascites within 4 weeks before recruitment are excluded. Patients who have with concurrent malignancy within five years (except for basal or squamous cell skin cancer or in-situ breast cancer) are excluded. Patients who have history of unresolved thrombocytopenia, myelodysplastic syndrome or acute myeloid leukaemia are excluded. Patients who have symptomatic brain or leptomeningeal metastases, or spinal cord compression are excluded unless these are treated and controlled within 28 days of recruitment. Patients with the significant past medical history, such as active hepatitis, myocardiac infarction, in the last six months are excluded. Patients with severe gastrointestinal conditions such as evidence of bowel obstruction in the last 4 weeks prior to enrolment, or history of inflammatory bowel disease, are not eligible. Patients having had severe infections within 4 weeks prior to the start of treatment are excluded. Patents with active tuberculosis, history of positive test for human immunodeficiency virus (HIV) or known acquired immunodeficiency syndrome (AIDS) are excluded. Patients with prior allogeneic stem cell or solid organ transplantation are excluded. Those patients who suffer from CTCAE grade 2 or more toxicity from previous treatment, except alopecia, are excluded. Patients who have used PARPi previously are excluded. Patients who are allergic to any component of niraparib are excluded. Patients who have used bevacizumab, or who are going to use bevacizumab as maintenance, are not eligible to join the study. Use of other investigational drugs within 28 days or at least 5 half-lives (whichever is longer) before study drug administration is not allowed. Patients who are pregnant or breastfeeding are excluded. Patients must not have either platelet or red blood cell transfusion, or granulocyte colony stimulating factor (G-CSF) within 2 weeks of the first dose of study treatment. Patients must not plan to donate blood during the study or for 90 days after the last dose of study treatment. Patients with major operation within 28 days or open biopsy within 7 days before enrolment are not eligible. Patients planned to have major surgery during the course of the study are excluded.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ka Yu Tse, FRCOG
Organizational Affiliation
The University of Hong Kong
Official's Role
Principal Investigator
Facility Information:
Facility Name
The University of Hong Kong
City
Hong Kong
Country
Hong Kong

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Niraparib Maintenance in Patients With Advanced Ovarian Cancer at Neoadjuvant Setting

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