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Olaparib Monotherapy and Olaparib + Pembrolizumab Combination Therapy for Ovarian Cancer (OLAPem)

Primary Purpose

Ovarian Cancer

Status
Completed
Phase
Phase 2
Locations
Japan
Study Type
Interventional
Intervention
Olaparib
Pembrolizumab
Sponsored by
National Cancer Center Hospital East
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Ovarian Cancer

Eligibility Criteria

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

Inclusion Criteria:

  1. Has given signed informed consent to participate in the clinical trial of her own will.
  2. Is aged 20 years or older on the day of signing the informed consent.
  3. Has been diagnosed with histologically confirmed, Stage III or IV epithelial ovarian, fallopian tube, or primary peritoneal cancer by the International Federation of Gynecology and Obstetrics (FIGO) staging system (2014), with a histological type of high-grade serous or Grade 3 endometrioid carcinoma.
  4. Have measurable disease based on RECIST 1.1.
  5. Is a candidate for debulking surgery.
  6. Has an HRD-positive tumor.
  7. Has an ECOG Performance Status of 0 or 1.
  8. Laboratory test results within 21 days prior to enrollment have met the following organ function criteria. However, measurements within 14 days of blood transfusion or administration of granulocyte-colony stimulating factor (G-CSF) are excluded.

    • Neutrophil count ≥ 1,500/mm3
    • Platelet count ≥ 100,000/mm3
    • Hemoglobin ≥ 9.0 g/dL
    • Serum creatinine ≤ 1.5 × ULN, or creatinine clearance ≥ 50 mL/min
    • T-Bil ≤ 2.0 mg/dL
    • ALT and AST ≤ 100 U/L (≤ 200 U/L if liver metastasis is present)
  9. A woman of childbearing potential must agree to use contraception after signing the informed consent, throughout the study period, and until at least 120 days following the last dose of the study drug

Exclusion Criteria:

  1. Has received previous allogeneic bone-marrow transplantation.
  2. Has concurrent interstitial lung disease/pneumonitis, or a history of (noninfectious) interstitial lung disease/pneumonitis that required treatment with steroids. Interstitial lung disease/pneumonitis includes radiation pneumonitis.
  3. Has received prior antitumor therapy (e.g., chemotherapy, molecular-targeted therapy, therapeutic antibody, endocrine therapy, immunotherapy, and investigational therapy).
  4. Has received surgery under general anesthesia within 28 days prior to enrollment. However, surgery to diagnose ovarian/fallopian tube/peritoneal cancer performed under general anesthesia is allowed.
  5. Has received radiation or radioactive isotope therapy within 28 days prior to enrollment.
  6. Has uncontrolled pericardial effusion, pleural effusion, or peritoneal effusion.
  7. Has a history of cerebral infarction, cerebral hemorrhage, or transient cerebral ischemia within 180 days prior to enrollment.
  8. Has a history of deep vein thrombosis or pulmonary embolism.
  9. Is receiving systemic glucocorticoid therapy or systemic immunosuppressive therapy.
  10. Has a history of autoimmune disease.
  11. Is infected with human immunodeficiency virus (HIV).
  12. Is infected with active* hepatitis B or hepatitis C.

    *: Active hepatitis B is defined as HBs antigen positive.

  13. Has a symptomatic infection within 14 days prior to enrollment.
  14. Has received a live vaccine within 28 days prior to enrollment.
  15. Has clinically critical cardiac disease (has a history of myocardial infarction or angina pectoris within 180 days prior to enrollment or has New York Heart Association [NYHA] class II or higher cardiac failure, uncontrolled arrhythmia, or QTc prolongation defined as QTc > 470 msec).
  16. Has active brain metastasis or a tumor causing spinal cord compression.
  17. Is pregnant or breastfeeding.
  18. Has a history of severe allergy, anaphylaxis, or hypersensitivity induced by humanized chimeric antibodies.
  19. Is allergic to biologics produced from Chinese hamster ovary (CHO) cells, carboplatin, or paclitaxel.
  20. Has a known or suspected active malignancy that is different from the disease of interest in the clinical trial or has a history of other malignancy within 3 years prior to enrollment. However, cutaneous basal cell carcinoma and cervical carcinoma in situ are not part of this exclusion criterion.
  21. Is unwilling to or unable to comply with the protocol.
  22. Is not eligible to enroll in the clinical trial based on the judgment by the Investigator or Sub-investigator.

Sites / Locations

  • National Cancer Center Hospital East
  • National Hospital Organization Shikoku Cancer Center
  • Kurume University Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Olaparib or Olaparib Plus Pembrolizumab

Arm Description

Cohort 1 : Olaparib will be administered for 6 weeks before surgery. Cohort 2 : Olaparib and Pembrolizumab will be administered simultaneously for 2 cycles(6 weeks) before surgery.

Outcomes

Primary Outcome Measures

Objective response rate (ORR)
Objective response rate (ORR) according to Response Evaluation Criteria in Solid Tumours (RECIST) version. 1.1.

Secondary Outcome Measures

The incidence of adverse events
The incidences and types of adverse events that occur during treatment will be evaluated according to the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.
Chemotherapy response score (CRS)
To evaluate the effect of histopathological treatment on patients with serous carcinoma and metastasis to the omentum. The histopathological treatment effect is determined according to the chemotherapy response score (CRS)
Progression-free survival (PFS)
PFS is defined as the time from the first dose to the earlier of progression assessed by the Investigator per RECIST v. 1.1 (PD) or clinical criteria, or death due to any cause.
Overall survival (OS)
OS is defined as the time from the first dose to death due to any cause.

Full Information

First Posted
June 2, 2020
Last Updated
July 4, 2023
Sponsor
National Cancer Center Hospital East
Collaborators
Merck Sharp & Dohme LLC
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1. Study Identification

Unique Protocol Identification Number
NCT04417192
Brief Title
Olaparib Monotherapy and Olaparib + Pembrolizumab Combination Therapy for Ovarian Cancer
Acronym
OLAPem
Official Title
A Pilot Study to Evaluate the Efficacy and Safety of Preoperative Olaparib Monotherapy and Preoperative Olaparib Plus Pembrolizumab Combination Therapy in Patients With HRD-Positive Stage III or IV Advanced Epithelial Ovarian/Fallopian Tube/Primary Peritoneal Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Completed
Study Start Date
December 1, 2020 (Actual)
Primary Completion Date
June 30, 2023 (Actual)
Study Completion Date
June 30, 2023 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
National Cancer Center Hospital East
Collaborators
Merck Sharp & Dohme LLC

4. Oversight

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

5. Study Description

Brief Summary
To evaluate the efficacy and safety of preoperative olaparib monotherapy and preoperative olaparib plus pembrolizumab combination therapy in patients with untreated stage III, IV high-grade serous or Grade 3 endometrioid ovarian cancer with Homologous Recombination Deficiency (HRD) positivity.
Detailed Description
To evaluate the efficacy and safety of preoperative olaparib monotherapy and preoperative olaparib plus pembrolizumab combination therapy in patients with untreated stage III, IV high-grade serous or Grade 3 endometrioid ovarian cancer with HRD positivity. The first cohort (Olaparib monotherapy : 10 cases) will be evaluated for the presence or absence of immune cell activation, and the tumor reduction effect will be evaluated in the second cohort (Olaparib plus pembrolizumab combination therapy : 20 cases).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Ovarian Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Model Description
This study has 2 cohorts. Cohort 1 is Olaparib monotherapy Cohort 2 is Olaparib plus Pembrolizumab combination therapy
Masking
None (Open Label)
Allocation
N/A
Enrollment
30 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Olaparib or Olaparib Plus Pembrolizumab
Arm Type
Experimental
Arm Description
Cohort 1 : Olaparib will be administered for 6 weeks before surgery. Cohort 2 : Olaparib and Pembrolizumab will be administered simultaneously for 2 cycles(6 weeks) before surgery.
Intervention Type
Drug
Intervention Name(s)
Olaparib
Intervention Description
Olaparib will be administered at a dose of 300mg as oral dose, twice a day.
Intervention Type
Drug
Intervention Name(s)
Pembrolizumab
Intervention Description
Pembrolizumab will be administered at a dose of 200mg as a 30-minutes IV infusion, Q3W (25 minutes to 40 minutes are acceptable).
Primary Outcome Measure Information:
Title
Objective response rate (ORR)
Description
Objective response rate (ORR) according to Response Evaluation Criteria in Solid Tumours (RECIST) version. 1.1.
Time Frame
6 weeks
Secondary Outcome Measure Information:
Title
The incidence of adverse events
Description
The incidences and types of adverse events that occur during treatment will be evaluated according to the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.
Time Frame
Up to 30 days after the last dose
Title
Chemotherapy response score (CRS)
Description
To evaluate the effect of histopathological treatment on patients with serous carcinoma and metastasis to the omentum. The histopathological treatment effect is determined according to the chemotherapy response score (CRS)
Time Frame
6 months from the end of registration
Title
Progression-free survival (PFS)
Description
PFS is defined as the time from the first dose to the earlier of progression assessed by the Investigator per RECIST v. 1.1 (PD) or clinical criteria, or death due to any cause.
Time Frame
6 months from the end of registration
Title
Overall survival (OS)
Description
OS is defined as the time from the first dose to death due to any cause.
Time Frame
6 months from the end of registration
Other Pre-specified Outcome Measures:
Title
Biomarkers
Description
Relationship between the germline mutation and therapeutic effect
Time Frame
2 years
Title
The change in tumor-infiltrating lymphocytes
Description
Relationship between the change in tumor-infiltrating lymphocytes in tumor tissue before and after therapy, and the therapeutic effect
Time Frame
2 years
Title
The therapeutic effect
Description
Relationship between the Tumor Mutation Burden (TMB) and the therapeutic effect
Time Frame
2 years

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
20 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Has given signed informed consent to participate in the clinical trial of her own will. Is aged 20 years or older on the day of signing the informed consent. Has been diagnosed with histologically confirmed, Stage III or IV epithelial ovarian, fallopian tube, or primary peritoneal cancer by the International Federation of Gynecology and Obstetrics (FIGO) staging system (2014), with a histological type of high-grade serous or Grade 3 endometrioid carcinoma. Have measurable disease based on RECIST 1.1. Is a candidate for debulking surgery. Has an HRD-positive tumor. Has an ECOG Performance Status of 0 or 1. Laboratory test results within 21 days prior to enrollment have met the following organ function criteria. However, measurements within 14 days of blood transfusion or administration of granulocyte-colony stimulating factor (G-CSF) are excluded. Neutrophil count ≥ 1,500/mm3 Platelet count ≥ 100,000/mm3 Hemoglobin ≥ 9.0 g/dL Serum creatinine ≤ 1.5 × ULN, or creatinine clearance ≥ 50 mL/min T-Bil ≤ 2.0 mg/dL ALT and AST ≤ 100 U/L (≤ 200 U/L if liver metastasis is present) A woman of childbearing potential must agree to use contraception after signing the informed consent, throughout the study period, and until at least 120 days following the last dose of the study drug Exclusion Criteria: Has received previous allogeneic bone-marrow transplantation. Has concurrent interstitial lung disease/pneumonitis, or a history of (noninfectious) interstitial lung disease/pneumonitis that required treatment with steroids. Interstitial lung disease/pneumonitis includes radiation pneumonitis. Has received prior antitumor therapy (e.g., chemotherapy, molecular-targeted therapy, therapeutic antibody, endocrine therapy, immunotherapy, and investigational therapy). Has received surgery under general anesthesia within 28 days prior to enrollment. However, surgery to diagnose ovarian/fallopian tube/peritoneal cancer performed under general anesthesia is allowed. Has received radiation or radioactive isotope therapy within 28 days prior to enrollment. Has uncontrolled pericardial effusion, pleural effusion, or peritoneal effusion. Has a history of cerebral infarction, cerebral hemorrhage, or transient cerebral ischemia within 180 days prior to enrollment. Has a history of deep vein thrombosis or pulmonary embolism. Is receiving systemic glucocorticoid therapy or systemic immunosuppressive therapy. Has a history of autoimmune disease. Is infected with human immunodeficiency virus (HIV). Is infected with active* hepatitis B or hepatitis C. *: Active hepatitis B is defined as HBs antigen positive. Has a symptomatic infection within 14 days prior to enrollment. Has received a live vaccine within 28 days prior to enrollment. Has clinically critical cardiac disease (has a history of myocardial infarction or angina pectoris within 180 days prior to enrollment or has New York Heart Association [NYHA] class II or higher cardiac failure, uncontrolled arrhythmia, or QTc prolongation defined as QTc > 470 msec). Has active brain metastasis or a tumor causing spinal cord compression. Is pregnant or breastfeeding. Has a history of severe allergy, anaphylaxis, or hypersensitivity induced by humanized chimeric antibodies. Is allergic to biologics produced from Chinese hamster ovary (CHO) cells, carboplatin, or paclitaxel. Has a known or suspected active malignancy that is different from the disease of interest in the clinical trial or has a history of other malignancy within 3 years prior to enrollment. However, cutaneous basal cell carcinoma and cervical carcinoma in situ are not part of this exclusion criterion. Is unwilling to or unable to comply with the protocol. Is not eligible to enroll in the clinical trial based on the judgment by the Investigator or Sub-investigator.
Facility Information:
Facility Name
National Cancer Center Hospital East
City
Kashiwa
State/Province
Chiba
Country
Japan
Facility Name
National Hospital Organization Shikoku Cancer Center
City
Matsuyama
State/Province
Ehime
Country
Japan
Facility Name
Kurume University Hospital
City
Kurume
State/Province
Fukuoka
Country
Japan

12. IPD Sharing Statement

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Olaparib Monotherapy and Olaparib + Pembrolizumab Combination Therapy for Ovarian Cancer

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