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Study for Women With Platinum Resistant Ovarian Cancer Evaluating EC145 in Combination With Doxil® (PROCEED) (PROCEED)

Primary Purpose

Ovarian Cancer

Status
Terminated
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
EC145
Pegylated Liposomal Doxorubicin (PLD/Doxil®/Caelyx®)
placebo
EC20
Sponsored by
Endocyte
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Ovarian Cancer focused on measuring cancer, ovarian, platinum-resistant, Phase III, EC145, EC20

Eligibility Criteria

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

Inclusion Criteria:

  • Participants must sign an approved informed consent form (ICF).
  • Participants must be ≥ 18 years of age.
  • Participants must have pathology-confirmed epithelial ovarian, fallopian tube, or primary peritoneal carcinoma.
  • Participants must have primary or secondary platinum-resistant ovarian cancer.
  • Participants must have at least a single (RECIST v1.1-defined) measurable lesion.
  • For the purpose of obtaining a RECIST v1.1 baseline scan, participants must have a radiological evaluation conducted no more than 28 days prior to beginning study therapy (PLD). NOTE: For participants with a history of CNS metastasis, baseline radiological imaging must include an evaluation of the head.
  • Participants must have had prior debulking surgery.
  • Participants must have received prior platinum-based chemotherapy for management of primary disease but must not have received more than 2 prior systemic cytotoxic regimens.
  • Participants are allowed to have received, but are not required to have received, one additional non-cytotoxic antitumor agent (eg, biologic or cytostatic) for the management of ovarian cancer.
  • Participants must have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1.
  • Participants must have recovered (to baseline/stabilization) from prior cytotoxic therapy-associated acute toxicities.
  • Participants must have adequate organ function including:

    1. Bone Marrow Reserve:

      1. Absolute neutrophil count (ANC) ≥ 1.5x10^9/L prior to treatment. Participants on maintenance doses of granulocyte colony stimulating factor (G-CSF) are eligible.
      2. Platelets ≥ 100x10^9/L
      3. Hemoglobin ≥ 9 g/dL
      4. Use of supportive care measures (eg, use of white blood cell [WBC] growth factors, antiemetics, epoetin) should follow the ASCO guidelines as listed at www.asco.org. Participants should receive full supportive care, including transfusion of blood as mandated by clinical need; however, transfusions administered for the sole purpose of meeting the study inclusion criteria between the time informed consent is signed and first dose of EC145/placebo/PLD is administered are not allowed.
    2. Hepatic: Total bilirubin level < 1.5 x ULN and ALT, AST, GGT, and alkaline phosphatase levels < 2.5 x ULN.
    3. Renal: Serum creatinine level ≤ 1.5 x ULN or for participants with serum creatinine levels above 1.5 x ULN, creatinine clearance ≥ 50 mL/min/1.73m^2
    4. Cardiac: Left ventricular ejection fraction (LVEF) equal to or greater than the institutional lower limit of normal.

Exclusion Criteria:

  • Patients refractory to primary platinum therapy where "refactory" is defined as disease progression within 6 months of first dose of initial platinum-based therapy.
  • Diagnosis of "tumor of low-malignant potential".
  • Prior exposure to PLD or anthracycline therapy.
  • Prior exposure to FR-targeted therapy (eg, EC145, EC0225, EC0489, farletuzumab).
  • Prior therapy with vinorelbine (Navelbine®) or vinca-containing compounds.
  • Prior abdominal or pelvic radiation therapy or radiation therapy to > 10% of the bone marrow at any time in the past or prior radiation therapy within the past 3 years to the breast/sternum, dermal lesions, head or neck.
  • Recent (i.e., ≤ 6 weeks) history of abdominal surgery or peritonitis
  • Serious comorbidities (as determined by the investigator) such as, but not limited to, active congestive heart failure or recent myocardial infarction. Patients who require antifolate therapy for the management of comorbid conditions (e.g., rheumatoid arthritis) will be excluded from the trial.
  • Pregnant or nursing.
  • Concurrent malignancy requiring therapy (excluding non-invasive carcinoma or carcinoma in situ).
  • Symptomatic central nervous system (CNS) metastasis.
  • Other concurrent chemotherapy, immunotherapy, radiotherapy, or any ancillary therapy that is considered to be investigational (i.e., used for non-approved indications(s) and in the context of a research investigation). Use of low dose corticosteroid therapy (e.g., for nausea prophylaxis) is acceptable; however, concomitant tamoxifen therapy is not. Supportive care measures are allowed.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Active Comparator

    Arm Label

    Arm A

    Arm B

    Arm Description

    EC145 + Pegylated Liposomal Doxorubicin (PLD)

    placebo + Pegylated Liposomal Doxorubicin (PLD)

    Outcomes

    Primary Outcome Measures

    Progression-free survival based on investigator assessment using RECIST v1.1.
    Progression is assessed at 6 week intervals through Week 24 and at 8 week intervals thereafter.

    Secondary Outcome Measures

    Compare overall survival of participants between treatment arms.
    OS analysis will occur when 384 deaths have occurred.
    Incidence of Adverse Events, Serious Adverse Events, and Deaths.
    Adverse events (as a measure of safety and tolerability) will be assessed at each study visit.

    Full Information

    First Posted
    July 7, 2010
    Last Updated
    September 24, 2021
    Sponsor
    Endocyte
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    1. Study Identification

    Unique Protocol Identification Number
    NCT01170650
    Brief Title
    Study for Women With Platinum Resistant Ovarian Cancer Evaluating EC145 in Combination With Doxil® (PROCEED)
    Acronym
    PROCEED
    Official Title
    A Randomized Double-Blind Phase 3 Trial Comparing EC145 and Pegylated Liposomal Doxorubicin (PLD/Doxil®/Caelyx®) in Combination Versus PLD in Participants With Platinum-Resistant Ovarian Cancer
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    September 2021
    Overall Recruitment Status
    Terminated
    Why Stopped
    DSMB decision
    Study Start Date
    April 22, 2011 (undefined)
    Primary Completion Date
    May 31, 2015 (Actual)
    Study Completion Date
    September 8, 2015 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Endocyte

    4. Oversight

    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    The purpose of this study is to compare progression-free survival (PFS) (based upon investigator assessment using RECIST v1.1) in participants with platinum-resistant ovarian cancer who receive combination therapy with EC145 and pegylated liposomal doxorubicin (EC145+PLD) with that in participants who receive PLD and placebo.
    Detailed Description
    This is a Phase 3 clinical trial to evaluate the efficacy and safety of the combination of EC145 and pegylated liposomal doxorubicin (PLD; available in the United States as Doxil® and outside the United States as Caelyx®) compared to PLD and placebo. Enrollment of 640 patients including approximately 500 that are folate receptor positive is planned. EC145 is a drug that is specifically designed to enter cancer cells via the folate vitamin receptor (FR) that is not generally found on normal cells. Experimental evidence shows that this target receptor is expressed on virtually all ovarian cancers. Early clinical evidence in a small number of Phase I participants, in a subset of participants in a completed single-arm Phase II study, and interim data from an ongoing randomized Phase 2 study (PRECEDENT) suggests that EC145 may have antitumor effect in women with platinum-resistant ovarian cancer and that EC145 alone and in combination with PLD is generally well-tolerated. This evidence suggests that EC145 may be useful as chemotherapy against platinum-resistant ovarian cancer. All participants will undergo imaging with the FR-targeting investigational diagnostic agent EC20 during the screening period to assess binding of the imaging agent EC20 to tumors. This non-invasive procedure will provide additional information on the utility of using EC20 imaging to identify subjects with the FR molecular "target" prior to treatment with EC145 therapy.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Ovarian Cancer
    Keywords
    cancer, ovarian, platinum-resistant, Phase III, EC145, EC20

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 3
    Interventional Study Model
    Parallel Assignment
    Masking
    ParticipantCare ProviderInvestigatorOutcomes Assessor
    Allocation
    Randomized
    Enrollment
    441 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Arm A
    Arm Type
    Experimental
    Arm Description
    EC145 + Pegylated Liposomal Doxorubicin (PLD)
    Arm Title
    Arm B
    Arm Type
    Active Comparator
    Arm Description
    placebo + Pegylated Liposomal Doxorubicin (PLD)
    Intervention Type
    Drug
    Intervention Name(s)
    EC145
    Intervention Description
    IV bolus on days 1,3,5 and 15,17,19 of a 4-week cycle
    Intervention Type
    Drug
    Intervention Name(s)
    Pegylated Liposomal Doxorubicin (PLD/Doxil®/Caelyx®)
    Other Intervention Name(s)
    Doxil, Caelyx
    Intervention Description
    50 mg/m2 (calculated on the basis of ideal body weight) every 4 weeks. Dose reductions permitted for toxicity.
    Intervention Type
    Drug
    Intervention Name(s)
    placebo
    Intervention Description
    IV bolus on days 1,3,5 and 15,17,19 of a 4-week cycle
    Intervention Type
    Drug
    Intervention Name(s)
    EC20
    Intervention Description
    During the screening period participants will receive a single intravenous administration of EC20 prior to SPECT imaging
    Primary Outcome Measure Information:
    Title
    Progression-free survival based on investigator assessment using RECIST v1.1.
    Description
    Progression is assessed at 6 week intervals through Week 24 and at 8 week intervals thereafter.
    Time Frame
    up to 26 months
    Secondary Outcome Measure Information:
    Title
    Compare overall survival of participants between treatment arms.
    Description
    OS analysis will occur when 384 deaths have occurred.
    Time Frame
    Approximately 20 months after last patient randomized
    Title
    Incidence of Adverse Events, Serious Adverse Events, and Deaths.
    Description
    Adverse events (as a measure of safety and tolerability) will be assessed at each study visit.
    Time Frame
    up to 26 months

    10. Eligibility

    Sex
    Female
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Participants must sign an approved informed consent form (ICF). Participants must be ≥ 18 years of age. Participants must have pathology-confirmed epithelial ovarian, fallopian tube, or primary peritoneal carcinoma. Participants must have primary or secondary platinum-resistant ovarian cancer. Participants must have at least a single (RECIST v1.1-defined) measurable lesion. For the purpose of obtaining a RECIST v1.1 baseline scan, participants must have a radiological evaluation conducted no more than 28 days prior to beginning study therapy (PLD). NOTE: For participants with a history of CNS metastasis, baseline radiological imaging must include an evaluation of the head. Participants must have had prior debulking surgery. Participants must have received prior platinum-based chemotherapy for management of primary disease but must not have received more than 2 prior systemic cytotoxic regimens. Participants are allowed to have received, but are not required to have received, one additional non-cytotoxic antitumor agent (eg, biologic or cytostatic) for the management of ovarian cancer. Participants must have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1. Participants must have recovered (to baseline/stabilization) from prior cytotoxic therapy-associated acute toxicities. Participants must have adequate organ function including: Bone Marrow Reserve: Absolute neutrophil count (ANC) ≥ 1.5x10^9/L prior to treatment. Participants on maintenance doses of granulocyte colony stimulating factor (G-CSF) are eligible. Platelets ≥ 100x10^9/L Hemoglobin ≥ 9 g/dL Use of supportive care measures (eg, use of white blood cell [WBC] growth factors, antiemetics, epoetin) should follow the ASCO guidelines as listed at www.asco.org. Participants should receive full supportive care, including transfusion of blood as mandated by clinical need; however, transfusions administered for the sole purpose of meeting the study inclusion criteria between the time informed consent is signed and first dose of EC145/placebo/PLD is administered are not allowed. Hepatic: Total bilirubin level < 1.5 x ULN and ALT, AST, GGT, and alkaline phosphatase levels < 2.5 x ULN. Renal: Serum creatinine level ≤ 1.5 x ULN or for participants with serum creatinine levels above 1.5 x ULN, creatinine clearance ≥ 50 mL/min/1.73m^2 Cardiac: Left ventricular ejection fraction (LVEF) equal to or greater than the institutional lower limit of normal. Exclusion Criteria: Patients refractory to primary platinum therapy where "refactory" is defined as disease progression within 6 months of first dose of initial platinum-based therapy. Diagnosis of "tumor of low-malignant potential". Prior exposure to PLD or anthracycline therapy. Prior exposure to FR-targeted therapy (eg, EC145, EC0225, EC0489, farletuzumab). Prior therapy with vinorelbine (Navelbine®) or vinca-containing compounds. Prior abdominal or pelvic radiation therapy or radiation therapy to > 10% of the bone marrow at any time in the past or prior radiation therapy within the past 3 years to the breast/sternum, dermal lesions, head or neck. Recent (i.e., ≤ 6 weeks) history of abdominal surgery or peritonitis Serious comorbidities (as determined by the investigator) such as, but not limited to, active congestive heart failure or recent myocardial infarction. Patients who require antifolate therapy for the management of comorbid conditions (e.g., rheumatoid arthritis) will be excluded from the trial. Pregnant or nursing. Concurrent malignancy requiring therapy (excluding non-invasive carcinoma or carcinoma in situ). Symptomatic central nervous system (CNS) metastasis. Other concurrent chemotherapy, immunotherapy, radiotherapy, or any ancillary therapy that is considered to be investigational (i.e., used for non-approved indications(s) and in the context of a research investigation). Use of low dose corticosteroid therapy (e.g., for nausea prophylaxis) is acceptable; however, concomitant tamoxifen therapy is not. Supportive care measures are allowed.
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Binh Nguyen, MD
    Organizational Affiliation
    Endocyte
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Links:
    URL
    http://www.endocyte.com
    Description
    Endocyte website

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    Study for Women With Platinum Resistant Ovarian Cancer Evaluating EC145 in Combination With Doxil® (PROCEED)

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